Clinical reasoning and reflective practice: implications of fieldwork activities

Objectives. Theories and research suggest that learning clinical reasoning skills requires students to be reflective in their practice. To explain this proposition, five research questions were developed to examine the effect of: (a) the fieldwork experience on clinical reasoning skills, (b) degree of participation in different clinical reasoning activities on clinical reasoning skills, and (c) the total number of clinical reasoning activities in which students participated related to clinical reasoning. Method. Data (n = 70) were collected using a researcher-developed case analysis test, the Adaptive Style Inventory, and a questionnaire. Paired t tests, ANCOVA, and multiple regressions were used to analyze the data from the research questions. Results. Fieldwork does improve clinical reasoning skills (large effect size). Participation in activities thought to develop clinical reasoning skills was mixed. Conclusion. The results support the improvement of fieldwork as a mode of developing clinical reasoning skills in occupational therapy students.