Fieldwork educators have expressed concerns about the readiness of occupational therapy students for clinical reasoning in the practice setting. Experiential learning involving face-to-face personal interactions with clients facilitates the application of theoretical knowledge, and the development of professional skills, competence, and self-confidence. Having the opportunity for extensive hands-on time working with clients, such as is offered in a pro bono clinic structure, may positively impact student clinical reasoning development of occupational therapy students.

Purpose: The purpose of this study was to explore the impact of participation in a student-run occupational therapy pro bono clinic on student perceptions of clinical reasoning ability.

Method: The Self-Assessment of Clinical Reflection and Reasoning (SACRR) was administered in this quasi-experimental, one-group, pre-posttest study to a convenience sampling of 20 students enrolled in a 3-year occupational therapy doctorate program in the upper Midwest.

Results: Results of a Wilcoxon signed-ranks test for nonparametric data indicated statistically significant improvements in SACRR results of 17 of the 26 questions with a statistical significance of p < 0.05. The students' total score for the pretest and posttest (composite for all 26 items) also indicated statistically significant improvements after participation in the pro bono clinic.

Conclusion: These findings add to the existing literature by describing the impact of specific experiential learning structures on clinical reasoning skill development. Comparisons are made to other health professions and implications for practice are explored. Further study of specific factors contributing to student clinical reasoning development within the learning structure of a pro bono clinic is recommended.

Keywords: experiential learning, occupational therapy, student-run clinic

Author Bio(s)

Julie Sandvig, OTD, OTR/L is an assistant professor at the University of Mary Occupational Therapy Program in Bismarck, ND. She is a licensed occupational therapist at a pediatric outpatient clinic in Bismarck, ND. Julie serves as the co-coordinator of the student lead pro bono clinic on campus that provides free Occupational Therapy students to community members in need.


Katherine M. Achbach, statistician