Clinical reasoning in musculoskeletal practice: students' conceptualizations

Area of Science:

• Medical Education
• Physical Therapy
• Qualitative Research

Background:

• Limited qualitative research exists on physical therapist students' conceptualizations of clinical reasoning (CR).
• Understanding student perspectives on CR is crucial for effective pedagogy.

Purpose of the Study:

• To explore physical therapist students' perspectives on clinical reasoning (CR).
• To identify how students conceptualize and utilize CR in practice.

Main Methods:

• Qualitative, cross-sectional study involving 31 undergraduate physical therapist students in New Zealand.
• Semi-structured interviews were conducted to gather data on CR understanding and application.
• A three-stage analysis categorized student conceptualizations and identified cross-category themes.

Main Results:

• Five distinct categories of CR conceptualization were identified, ranging from knowledge application to problem-solving and pattern building.
• Five general themes emerged: forms of CR, spatiotemporal aspects, patient focus, confidence attributions, and the role of clinical experience.
• Categories represented a continuum of CR sophistication, with higher levels observed in later-year students.

Conclusions:

• Student conceptualizations of CR form a developmental continuum, offering insights into learning progression.
• Identified themes provide a novel framework for analyzing and understanding CR development.
• Findings have significant implications for refining physical therapy education and curricula.