Assessment Process Research Articles

A Multidimensional, Person-Centered Framework for Functional Assessment in Dementia: Insights from the 'What', 'How', 'To Whom', and 'How Much' Questions.

Dementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers.

Assessment of learning levels of students using ‘Dennis Congo study skill inventory’ & evaluation of protocol for slow, average & advanced learners in medical education

: Students starting their medical education congregate from diverse educational environments and varied learning experiences. Hence, they would have developed individual preferences in learning styles for obtaining and refining information. Some students need accelerated approach so that they can learn things in the syllabus at their own speed. While some lack focus and understand topics at a slower pace compared to their peers. The process of assessment of the learning levels of students and conduction of activities for them can open up a new window for the teachers in adopting different teaching learning methods and result in more dynamic classroom interaction. This also paves way for adoption of appropriate strategies to address the concerns of all learners. The study was done with the aim to explore the study skills and determine any correlation between study skills of the students and their academic performance. This is a cross-sectional observational, questionnaire - based descriptive study involving undergraduate students enrolled in medical college. A predesigned, pretested structured and validated questionnaire, the Denis Congo Study Skills Inventory was administered on the sample. Study Skills Efficacy Scores were determined using the same. Learners were categorized as slow, average and advanced based on their scores in the first internal examination. These scores were aligned with the study skills used by the learner and the data was analysed using Microsoft Excel 2010 & IBM SPSS Statistics 28.0.1.1 Windows software to find out any correlation.: It was found that all the six skills included in the Dennis Congo study skill inventory may need to be developed in slow learners with equal emphasis so as to facilitate them in becoming average learners. All the six skills also require improvement in average learners to become advanced learners, however our study shows that more emphasis needs to be laid on the development of skills of note-taking, memory enhancement, test preparation and concentration. Out of these, note-taking and test preparation are skills which might be easier to work on as compared to memory and concentration, as a part of these skills are inherent to the individual. Teachers can play a significant role in helping the students in acquiring the skills. : Factors affecting student academic performances is a multidimensional issue which has to be identified at individual level. Deficient study skills appear to be a statistically significant cause for poor academic performance. With the objective to change the learner’s behaviour, it can be conveyed to learners what exactly is to be accomplished by providing a direction in the planning of a learning activity.This study assesses student learning levels in medical education using the 'Dennis Congo Study Skill Inventory'. It further evaluates a tailored protocol designed for slow, average, and advanced learners, aiming to enhance learning outcomes across diverse proficiency levels."

Perspectivism and Health Professions Assessment.

This article aims to outline perspectivism and perspectival thinking by drawing on established scholarship from the philosophy of science and to demonstrate its relevance to health professions education. Perspectivism embraces the notion that knowledge always inherently arises from particular perspectives. "Truth" always depends on an evaluative background. Perspectivism is a form of epistemic humility that sees epistemic claims (relating to knowledge) as fundamentally historically and contextually situated. This article contends that perspectivism is a fruitful and relevant lens to apply to health professions assessment. It is a way of thinking that is all around us, even if we do not realize it. It extends discourse around the value of subjectivity in assessment and may cut through many prevailing debates on assessment practice. Perspectivism is a sort of middle-ground that is not meant to be another idea or "-ism" to add to a list of ideas, but constitutes a shift in how philosophy can be applied by adopting a broader, more holistic perspective. Applying a perspectival lens to health professions education embraces the imperative to make interpretive processes in assessment philosophically explicit. This opens the possibility of adopting multiple philosophical stances concurrently and allows actors to appreciate different methodological viewpoints with more charity. This scholarly perspective encourages the assessment community to continue to innovate through an appreciation of the importance of a wide range of assessment perspectives by uncovering the drivers of specific commitments to philosophical positions. Although the focus is on assessment in the health professions, perspectival thinking has the potential to advance medical education discourse and practice more generally beyond assessment. The hope with this essay is that by encouraging more critical reflection, this description of perspectival thinking will further aid researchers and practitioners in health professions education to better understand what is happening philosophically with more frequency.

Midterm conversations as co-creation of equitable and inclusive formative assessment

Although assessment of student learning remains a thorny area for co-creation in education, a growing number of researchers and practitioners advocate and enact partnership in formative and summative assessment as part of equity work. In this case study, we join these efforts in reflecting on students’ and our own experiences of the midterm conversation that we use as a key formative assessment structure and process across three co-facilitated courses. The midterm conversation—a partnership among students and instructors as co-teachers—is embedded in course design and curriculum with the goal of advancing, informing, and sustaining our pedagogical commitments. This case illustrates how we practice assessment as dialogue and as emergent understanding. This practice is based on an expectation of diverse learning goals and outcomes and on trust in students’ capacities to direct their learning with reference to their own interests and standards for their work.

Augmenting Academic Efficiency: The Integration of Assessments Within the Addie Model for Pedagogical Development

This paper explores the integration of assessments within the ADDIE model for pedagogical development, emphasizing its crucial role in enhancing learning experiences. Through a meticulous literature review, theoretical frameworks, practical implementations, and outcomes of assessment integration are examined. Assessments, spanning formative, summative, and authentic types, are shown to be integral to each phase of the ADDIE model, promoting customized interventions, continuous improvement, and data-driven decision-making. While challenges such as resource constraints and expertise gaps exist, strategies including professional development and technology integration offer pathways to overcome them. Furthermore, actively involving learners in the assessment process, providing timely feedback, and aligning assessments with learner interests can enhance motivation and engagement, fostering intrinsic motivation and self-directed learning. This study underscores the importance of integrating assessments into the ADDIE Model, advocating for learner-centered approaches and instructional design practices.

Web-Based Education Personnel Management: An Innovation in the Development of Education Management in the 21st Century

In the 21st century, technology-based institutions require clear parameters for evaluating employee performance. Manual performance assessment processes necessitate the development of a technology-driven information system to streamline leadership's evaluation of employees. This study is dedicated to analyzing the prerequisites for designing an information technology-based performance monitoring system tailored for educational staffs, organized into four stages: defining, designing, developing, and disseminating. By involving 71 educational staffs, this study resulted in the creation of the SI-IKAH (Sistem Input Kinerja Harian Tenaga Kependidikan) or the Daily Performance Input System for Education Personnel, specifically designed for the Universitas Pendidikan Indonesia Sumedang Campus. The system comprises modules for collecting personal information, work unit details, types of tasks, work hours, work outcomes, and generating reports for educational staff. This study concludes that the implementation of this system has the potential to boost employees performance motivation, ensure the currency of institutional data, and enhance the efficiency of employee work assessments.

Rice Quality Analysis Using Image Processing

In many Asian countries, rice is a popular food that lots of people eat. It is easy to find worldwide. When people use rice for food, they often make different products from it. In farming and food science, checking the quality of rice is really important to make sure people like it and to farm it well. This study wants to change how we usually check rice quality. Instead of doing it by hand, we want to use computers to look at pictures of rice and figure out if it's good or not. We'll use fancy math and technology to do this quickly and accurately. This new way will make it easier to make sure rice is good quality, which is important as farming keeps changing. By employing advanced algorithms and image pre-processing techniques, this research aims to automate the evaluation process. The focus is on identifying key quality parameters such as grain size and shape swiftly and accurately. This innovative approach not only enhances precision but also streamlines the assessment process, offering a promising avenue for optimizing rice quality control in agriculture and food science

A Methodological Framework for Assessing the Agroecological Performance of Farms in Portugal: Integrating TAPE and ACT Approaches

Agroecology integrates science, social movements, and agricultural practices, playing a central role in the sustainability of food systems. It addresses agroecosystems and food systems holistically; however, defining whether a farm is agroecological remains a challenge. This article proposes a methodology to measure farms’ agroecological performance, adapted to the family farming context in Portugal. The aim of the developed methodology is to compare the agroecological performance of family farms (conventional and non-conventional), providing information about anchors for agroecological transition and supporting public policies. A literature review identified existing farm evaluation methodologies, with Tool for Agroecological Performance Evaluation (TAPE) and Agroecology Criteria Tool (ACT) scoring highest in an assessment process. Questions from both were integrated into a questionnaire for family farmers. This field work provided critical insights towards the methodologies: (1) territorial adaptability; (2) transition constraints’ origin; and (3) use of non-academic language. The results were incorporated into the developed methodology, which combines the TAPE indicator matrix and Gliessman’s five levels of food system change, the latter of which provides the framework for the ACT. This study made it possible to identify the most relevant aspects for characterizing family farmers/farms and the importance of how the evaluation criteria/indicators are ordered by element/theme, as it alters the values of each farm’s agroecological performance.

Multi-modal recommender system for predicting project manager performance within a competency-based framework

The evaluation of performance using competencies within a structured framework holds significant importance across various professional domains, particularly in roles like project manager. Typically, this assessment process, overseen by senior evaluators, involves scoring competencies based on data gathered from interviews, completed forms, and evaluation programs. However, this task is tedious and time-consuming, and requires the expertise of qualified professionals. Moreover, it is compounded by the inconsistent scoring biases introduced by different evaluators. In this paper, we propose a novel approach to automatically predict competency scores, thereby facilitating the assessment of project managers' performance. Initially, we performed data fusion to compile a comprehensive dataset from various sources and modalities, including demographic data, profile-related data, and historical competency assessments. Subsequently, NLP techniques were used to pre-process text data. Finally, recommender systems were explored to predict competency scores. We compared four different recommender system approaches: content-based filtering, demographic filtering, collaborative filtering, and hybrid filtering. Using assessment data collected from 38 project managers, encompassing scores across 67 different competencies, we evaluated the performance of each approach. Notably, the content-based approach yielded promising results, achieving a precision rate of 81.03%. Furthermore, we addressed the challenge of cold-starting, which in our context involves predicting scores for either a new project manager lacking competency data or a newly introduced competency without historical records. Our analysis revealed that demographic filtering achieved an average precision of 54.05% when dealing with new project managers. In contrast, content-based filtering exhibited remarkable performance, achieving a precision of 85.79% in predicting scores for new competencies. These findings underscore the potential of recommender systems in competency assessment, thereby facilitating more effective performance evaluation process.

Risk assessment of high-speed railway CTC system based on improved game theory and cloud model

PurposeIn order to solve the problem of inaccurate calculation of index weights, subjectivity and uncertainty of index assessment in the risk assessment process, this study aims to propose a scientific and reasonable centralized traffic control (CTC) system risk assessment method.Design/methodology/approachFirst, system-theoretic process analysis (STPA) is used to conduct risk analysis on the CTC system and constructs risk assessment indexes based on this analysis. Then, to enhance the accuracy of weight calculation, the fuzzy analytical hierarchy process (FAHP), fuzzy decision-making trial and evaluation laboratory (FDEMATEL) and entropy weight method are employed to calculate the subjective weight, relative weight and objective weight of each index. These three types of weights are combined using game theory to obtain the combined weight for each index. To reduce subjectivity and uncertainty in the assessment process, the backward cloud generator method is utilized to obtain the numerical character (NC) of the cloud model for each index. The NCs of the indexes are then weighted to derive the comprehensive cloud for risk assessment of the CTC system. This cloud model is used to obtain the CTC system's comprehensive risk assessment. The model's similarity measurement method gauges the likeness between the comprehensive risk assessment cloud and the risk standard cloud. Finally, this process yields the risk assessment results for the CTC system.FindingsThe cloud model can handle the subjectivity and fuzziness in the risk assessment process well. The cloud model-based risk assessment method was applied to the CTC system risk assessment of a railway group and achieved good results.Originality/valueThis study provides a cloud model-based method for risk assessment of CTC systems, which accurately calculates the weight of risk indexes and uses cloud models to reduce uncertainty and subjectivity in the assessment, achieving effective risk assessment of CTC systems. It can provide a reference and theoretical basis for risk management of the CTC system.

Puzzling parrotfishes: Radiocarbon age validation and updated longevity estimates for western Atlantic species in support of sustainable fisheries management

For management efforts to succeed in Caribbean fisheries, local fishers must support and be willing to comply with fishing regulations. This is more likely when fishers are included in a stock assessment process that utilizes robust scientific evidence, collected in collaboration with fishers, to evaluate the health of fish stocks. Caribbean parrotfishes are important contributors to coral reef ecosystem health while also contributing to local fisheries. Scientifically robust stock assessments require regional species-specific information on age-based key life history parameters, derived from fish age estimates. Evaluation of the accuracy of age estimation methods for fish species is a critical initial step in managing species for long-term sustainable harvest. The current study resulted from a collaborative research program between fish biologists and local fishers investigating age, growth, and reproductive biology of the seven parrotfish species landed in U.S. Caribbean fisheries; specifically, we validated age estimation for stoplight parrotfish Sparisoma viride and queen parrotfish Scarus vetula. This is the first study to directly validate age estimation for any parrotfish species through analysis of Δ14C from eye lens cores. Our age estimation validation results show that enumeration of opaque zones from thin sections of sagittal otoliths for a Sparisoma and a Scarus species provides accurate age estimates. The oldest stoplight parrotfish and queen parrotfish in the Δ14C age estimation validation series were 14 y and 16 y; while the oldest stoplight parrotfish and queen parrotfish we aged to-date using the Δ14C validated age estimation method were 20 y and 21 y, respectively. Fish longevity (maximum age attained/life span) is a key life history parameter used for estimation of natural mortality, survivorship, and lifetime reproductive output. Past reviews on parrotfishes from the Pacific and Atlantic concluded that most Caribbean/western Atlantic parrotfish species are relatively short-lived with estimated maximum ages ranging from 3–9 y. However, information from our collaborative research in the U.S. Caribbean combined with recently published age estimates for Brazilian parrotfish species indicate that many western Atlantic parrotfishes are relatively long-lived with several species attaining maximum ages in excess of 20 y.

Platform policy and online abuse: Understanding differential protections for public figures

Public figures are subject to high rates of online abuse than everyday users. This article presents findings from a study on digital platforms’ higher threshold for protecting public figures in contrast to everyday users. Presenting a summary of extant literature on the experience, impact and harms of online abuse of public figures, we analyse 31 platform terms of service and related policies to understand the extent to which platforms openly differentiate between public figures and other users. We focus on platforms’ use of ‘newsworthiness’ and ‘public interest’ to justify the differential threshold. Using a cultural-informed approach, we analyse platforms’ reliance on ‘newsworthiness’ and ‘public interest’ justifications to argue that these justifications are utilised without regard for the histories, risk assessment, ethics and labour-intensive processes in which the concepts of newsworthiness and public interest became familiar among more traditional media forms such as news organisations.

Design, Rationale and Initial Findings From HERA-FIB on 10 222 Patients With Atrial Fibrillation Presenting to an Emergency Department Over An 11-Year Period.

For the majority of patients with atrial fibrillation (AF), disease management has improved in recent years. However, there are still populations underrepresented or excluded in current registries and randomized controlled trials. HERA-FIB (Heidelberg Registry of Atrial Fibrillation) was planned to assess real-world evidence for the prevalence, demographic characteristics and management of patients with the diagnosis of AF presenting consecutively to a chest pain unit. HERA-FIB is a retrospective, observational, single-center study on patients with a diagnosis of AF presenting to a chest pain unit from June 2009 until March 2020. This article describes the structure, governance, outcome assessment, quality and data collection processes of the registry. Additionally, characteristics of populations of special interest are described. The study consecutively enrolled 10 222 patients presenting with AF to the chest pain unit of the University Hospital of Heidelberg. Clinical parameters and patient characteristics were assessed retrospectively. Outcome parameters included rates for all-cause death, stroke, myocardial infarction and major bleedings. We were able to investigate patient cohorts of special interest such as advanced chronic kidney disease, octogenarians, and those with acute coronary syndrome who are often underrepresented in current studies and randomized controlled trials. HERA-FIB is one of the largest real-world single-center retrospective registries on patients with AF, which captures the era of transition from vitamin K antagonists to non-vitamin K oral anticoagulation regimens in clinical practice and offers the possibility to investigate patient populations usually underrepresented or excluded in current available randomized controlled trials and registries. URL: https://www.clinicaltrials.gov; unique identifier: NCT05995561.

Treatment trajectories of gender incongruent Austrian youth seeking gender-affirming hormone therapy

ObjectiveThe aim of this study was to describe the treatment trajectories of Austrian children and adolescents with gender incongruence seeking gender-affirming medical care.MethodsPatients who presented with gender incongruence at the pediatric outpatient clinic for differences in sex development at a large university hospital in Austria from January 2008 to December 2022 were included in a retrospective chart review, and analyzed regarding referral numbers, patient characteristics, treatment trajectories, fertility preservation, and legal gender marker changes.ResultsOf 310 eligible patients, 230 (74.2%) were assigned female at birth (AFAB), and 80 (25.8%) were assigned male at birth (AMAB). The number of referrals increased steeply from 2008 to 2018, whereafter it stabilized at around 50 per year. At the time of initial presentation, the median age of patients was 15.6 years (IQR 14.3-16.8). AMAB individuals tended to be younger (median 14.9 years, IQR 13.9-16.8) than AFAB individuals (median 15.8 years, IQR 14.4-16.8; p= 0.012). 207 (66,8%) completed the assessment process and were eligible for gender affirming medical treatment (GAMT). Of those, 89% (186/207) commenced gender affirming hormone therapy in the pediatric outpatient clinic (79/186 received GnRHa monotherapy, 91/186 GnRHa and sex steroids, and 16/186 sex steroid monotherapy). Of the 54 AMAB individuals receiving GAMT, 6 (11.1%) completed fertility preservation prior to therapy initiation. Only 1/132 AFAB adolescents receiving GAMT completed fertility preservation. Chest masculinization surgery was performed in 22 cases (16.7%), and breast augmentation in two cases (3.7%) between the ages of 16 and 18. Changes in legal gender marker were common, with 205 individuals (66.1%) having changed their legal gender marker.ConclusionThis is the first time that treatment trajectories, fertility preservation rates, and changes of legal gender marker have been described in Austrian adolescents with gender incongruence seeking GAMT. The majority received GAMT and changed their legal gender marker, while gender affirming surgery rates were low, and utilization of fertility preservation treatment options was rare.

Psychosocial and Educational Vulnerability of Overweight Children from Urban Schools

Childhood obesity is a pervasive health issue, with multifaceted implications for developmental trajectory. Participants included 5,573 K-5 students enrolled in a high-poverty urban public-school setting. Through an informal yet holistic assessment process, students identified as exhibiting overweight issues were compared to peers not designated as overweight across several relevant categories. Overweight students were more likely to be from lower socioeconomic backgrounds; have a high association with special education service needs; represent a more intensive overall risk level as perceived by student support staff; and mostly exhibit decreased performance in report card grades, standardized test scores, and academic engagement. Results confirm previously documented disparities in school functioning and consideration for at-risk status; this is especially relevant in an underserved context, in which regular access to services may be limited. Therefore, reliance on initial screening measures becomes necessary as a preventative mechanism to better assist children in need and to facilitate intervention planning.

Beyond the Bell curve

One of the most important, and neglected, aspects of the school assessment process is the feedback phase. The purpose of this exploratory study was to examine the extent to which feedback is being conducted, training in feedback, and the types of feedback practices used in school settings. One hundred thirty-two school assessment professionals were surveyed, and results suggest that most believe in the importance of test feedback and are utilizing it. Results of this study also indicate that test feedback practices are lacking with most practitioners simply plotting scores on a bell curve. Recommendations for more culturally responsive, meaningful, and ethical feedback practices are discussed, including how to incorporate therapeutic assessment values and techniques in school settings.

Change-making in Environmental Impact Assessment (EIA): piloting changeology approach using England as a case study

ABSTRACT Piecemeal changes to the Environmental Impact Assessment (EIA) process have to date not fully delivered EIA’s normative goals and met today’s environmental challenges. By regarding the to date approaches to change-making as a problem requiring a solution, this paper applies critical analysis to reflect upon current change-making based on England’s EIA system as a case study. The analysis identifies a lack of innovative ideas and sound evidence-based approaches to inform and support the change-making process. Consequently, we argue for an epistemology of change-making (changeology) so that the entire approach can be based on an empirically informed framework, to inform the journey (process) and destination (fit-for-purpose EIA) and make the EIA process fit-for-purpose and aligned to future expectations. Changeology should be viewed as more than informing one-time change-making but as a framework of well-studied practice for changing (or improving) EIA in the long term.

Assembly process analysis and system design for deep in-situ fidelity corer

The deep in-situ corer is an essential tool for exploring the physical and mechanical behaviours of rocks at varying depths. Corers are multi-part products, encompassing extensive redundant assembly information stemming from the intricate assembly processes and numerous components. Thus, designing assembly systems for corers poses complexity challenges. This paper proposes an automated assembly system design framework, comprising assembly process analysis and system development. The proposed framework offers comprehensive design processes for multi-part product assembly systems, emphasizing managing information amount and complexity during the design phase. Specially, design principles and methods for minimizing information amount are analysed. And the directed graph is utilized to express the assembly information. Building upon this foundation, automated assemblability assessment and assembly process modular clustering is proposed to amalgamate and streamline assembly information, thus reducing design complexity. Leveraging pre-processed assembly information, the sub-functional solutions for assembly system are solved and optimized with AD (Axiomatic Design) and TRIZ (the Theory of Inventive Problem Solving). A case study of the deep-sea gas hydrate corer validated the effectiveness of the proposed methods in reducing information amount and yielding sub-functional solutions, thereby facilitating overall system design realization. Assembly experiments verified the designed system accomplished functional requirements. This study serves as a valuable reference for automated assembly analysis and system development for multi-part products, offering technical insights into developing deep in-situ cores from an assembly perspective.

The Role of Intermediaries in Connecting Community-Dwelling Adults to Local Physical Activity and Exercise: A Scoping Review.

Connecting inactive individuals to local physical activity (PA) and exercise, via intermediaries (professionals who can facilitate and support connections to non-medical services) may be an effective method to tackle physical inactivity. Evidence regarding the processes of intermediaries, the profile of people referred, how connections to local PA and exercise are made and outcomes of these connections is lacking. This scoping review followed guidelines from the Joanna Briggs Institute. Searches of four electronic databases (Embase, Medline, Web of Science, CINAHL) and an extensive grey literature search were conducted from inception to June 2022. Full-text studies which reported on community-dwelling adults (population), and the processes of intermediaries (concept) when connecting to local PA and exercise (context) were considered for inclusion. A logic model was created to map processes to outcomes. Evidence advances and gaps were identified. N = 28 studies were identified. Participants referred to an intermediary were older, female, and with poorer health. Where possible, the processes of referral, assessment, follow-up and discharge by intermediaries were described, as well as the local PA and exercise services used. Short-term PA outcomes appeared positive after working with intermediaries, but many studies were poorly described, and the review was not designed to examine effectiveness of this intervention. Many aspects of the processes were poorly described. More robust studies evaluating the processes of intermediaries are needed, as well as further exploration of the optimum processes in improving PA outcomes.

Use of the International IFOMPT Cervical Framework to inform clinical reasoning in postgraduate level physiotherapy students: a qualitative study using think aloud methodology

BackgroundVascular pathologies of the head and neck are rare but can present as musculoskeletal problems. The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) Cervical Framework (Framework) aims to assist evidence-based clinical reasoning for safe assessment and management of the cervical spine considering potential for vascular pathology. Clinical reasoning is critical to physiotherapy, and developing high-level clinical reasoning is a priority for postgraduate (post-licensure) educational programs.ObjectiveTo explore the influence of the Framework on clinical reasoning processes in postgraduate physiotherapy students.MethodsQualitative case study design using think aloud methodology and interpretive description, informed by COnsolidated criteria for REporting Qualitative research. Participants were postgraduate musculoskeletal physiotherapy students who learned about the Framework through standardized delivery. Two cervical spine cases explored clinical reasoning processes. Coding and analysis of transcripts were guided by Elstein’s diagnostic reasoning components and the Postgraduate Musculoskeletal Physiotherapy Practice model. Data were analyzed using thematic analysis (inductive and deductive) for individuals and then across participants, enabling analysis of key steps in clinical reasoning processes and use of the Framework. Trustworthiness was enhanced with multiple strategies (e.g., second researcher challenged codes).ResultsFor all participants (n = 8), the Framework supported clinical reasoning using primarily hypothetico-deductive processes. It informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests, to inform clarity and support for diagnosis and management. Most participant’s clinical reasoning processes were characterized by high-level features (e.g., prioritization), however there was a continuum of proficiency. Clinical reasoning processes were informed by deep knowledge of the Framework integrated with a breadth of wider knowledge and supported by a range of personal characteristics (e.g., reflection).ConclusionsFindings support use of the Framework as an educational resource in postgraduate physiotherapy programs to inform clinical reasoning processes for safe and effective assessment and management of cervical spine presentations considering potential for vascular pathology. Individualized approaches may be required to support students, owing to a continuum of clinical reasoning proficiency. Future research is required to explore use of the Framework to inform clinical reasoning processes in learners at different levels.