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Validated Tools to Evaluate Clinical Reasoning in Simulation-Based Learning: A Systematic Review for Physical
Journal, Physical Therapy Education
|May 22, 2026
Summary
This review identified tools for assessing clinical reasoning (CR) in physical therapy students but found methodological limitations. More research is needed to improve CR skill development in Doctor of Physical Therapy (DPT) programs.
Area of Science:
- Medical Education
- Physical Therapy Education
Background:
- Clinical reasoning (CR) is crucial for Doctor of Physical Therapy (DPT) students.
- Simulation-based learning experiences (SBLEs) are increasingly used to develop CR skills.
- Validated assessment tools for CR in SBLEs within DPT programs are limited.
Purpose of the Study:
- To systematically review and assess tools measuring CR, clinical decision making (CDM), and critical thinking (CT) in SBLEs for DPT programs.
- To identify the psychometric properties and quality of existing assessment tools.
Main Methods:
- Systematic review following the PRISMA framework.
- Searched PubMed, CINAHL, ERIC, and Web of Science for peer-reviewed articles post-2017.
- Assessed tool quality using the Modified Medical Education Research Study Quality Instrument (MMERSQI).
Main Results:
- 23 studies were included, with a mean MMERSQI score of 61.7.
- Most tools showed internal consistency and content validity, but concurrent validity and reliability were less reported.
- Tools primarily assessed diagnostic and procedural reasoning, with limited assessment of other reasoning types.
Conclusions:
- Several reliable and valid tools for CR/CDM/CT assessment exist.
- Methodological limitations include limited reasoning strategy diversity and multi-institutional validation.
- Further research is needed to develop comprehensive assessment tools and compare simulation-based with traditional teaching methods for CR development.
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