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Abstract

Purpose: Clinical reasoning is an essential skill for Physical Therapists to develop for making sound decisions regarding patient care. Case-method teaching is an instructional strategy commonly implemented in physical therapy professional education programs for facilitating clinical reasoning skill acquisition. One advantage of case-method teaching is the various ways cases can be portrayed. The purpose of this study was to identify how a case is portrayed effects student thinking and their subsequent clinical decision making. Method: Third-year student physical therapists (n = 14) working in dyads clinically reasoned through a hypothetical musculoskeletal case presented via written case study or simulated patient experience. Talk aloud methodology via concurrent reports was implemented for data collection. Mann-Whitney U-tests followed by manual calculations of effect sizes were conducted for comparing hypothesis category generation between groups. Results: A total of 14 hypothesis categories were generated by the student dyads during the problem-solving sessions. Specifically, students generated more ideas regarding health condition, and contextual factors when thinking through a written case study whereas significantly more thoughts regarding symptom characteristics, client perspectives, and minimizing reasoning errors were generated during simulated patient experiences. Conclusion: When implementing case-method teaching, physical therapy academic educators need to be aware that the manner a case is portrayed affects the clinical judgements students generate and their learning of clinical reasoning. Future research should continue to investigate these effects and how they ultimately impact clinical practice.

Author Bio(s)

Nicholas LaRosa, EdD, DPT, is an Assistant Professor in the Department of Clinical and Applied Movement Sciences at the University of North Florida in Jacksonville, FL. He is also a licensed physical therapist in the state of Florida.

Daniel L. Dinsmore, PhD, is an Associate Professor in the Department of Teaching, Learning and Curriculum at the University of North Florida in Jacksonville, FL. He is also the Research Director of the Northeast Florida Center for STEM Education.

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