The use of clinical case studies to develop clinical reasoning in sports therapy students: the students’ perspective

Abstract

Relevance: The study is relevant to the theme of research, education and practice. It is a pedagogical study and involves innovative practice via the use of clinical case studies (CCS) in developing clinical reasoning skills in undergraduate students. Purpose: The aim of this study was to examine a cohort of undergraduate 2nd year undergraduate sports therapy students’ perceptions regarding the effectiveness of CCS in the development of clinical reasoning skills and how CCS may influence performance in a Sports Injury Clinic. Methods/analysis: The study involved 55 students (n=23 male, 32 female) and used a mixed methods approach involving a questionnaire with open ended questions, Likert scale questionnaire and interviews which aimed to determine students’ perceptions of their performance. The entire second year undergraduate cohort participated in the study as they were deemed to have the appropriate knowledge level. The questions and statements were constructed by the researcher following a review of similar approaches via a pilot study involving 15 undergraduate 3rd year sports therapy students to determine that the questions were appropriate and to ensure face validity. The CCS were reviewed by lecturers on the programme to ensure face validity. Five main areas were investigated via open ended questions: defining clinical reasoning; advantages of CCS; disadvantages of CCS; the effectiveness of CCS in comparison to real patients; and whether CCS helped students working in a Sports Injury Clinic. Students completed a 5 point Likert scale which asked three statements regarding the clinical environment. Questionnaire responses were assessed via inductive category building which involved the identification of common themes across the responses which were then grouped according to similarity and then discussed and explored further via individual interviews with 15 randomly selected students. Themes had to be present in at least 10 separate questionnaire responses to be considered and theme analysis was reviewed by one other lecturer on the programme to confirm that identified themes were appropriate. Data collected from the Likert scale was used to provide descriptive statistics. Analysis was divided into males and females and the total cohort. Results: Students’ perceptions of whether CCS improve their patient communication skills demonstrates that the majority of students (n = 51) either strongly agreed or agreed with this statement and only one student disagreed. Students’ perceptions of whether CCS improve confidence levels when working in the Sports Injury Clinic demonstrated that the majority of students (n = 51) either strongly agreed or agreed with the statement and only one student disagreed. Students’ perceptions of whether CCS improved clinical reasoning demonstrated that the majority of students (n = 53) either strongly agreed or agreed and two students neither agreed nor disagreed. Discussion and conclusions: The students’ responses were generally in favour of the use of CCS to aid the development of confidence, communication and clinical reasoning. CCS may assist the journey to clinical competence and create ‘thinking therapists’ and bridge the gap to treating actual patients. Future research may investigate gender differences. Impact and implications: CCS may develop clinical reasoning and may aid the development of core clinical skills. Funding acknowledgement: No funding was required.