Clinical Reasoning Framework
INTRODUCTION
Clinical reasoning is an essential component to effective evaluation, the establishment of relevant hypothesis’ linked to the patient condition, and implementation of a safe and evidence informed management plan of care.
PURPOSE
Develop an evidence based clinical reasoning framework to facilitate faculty instruction, minimize ambiguity, and enhance student clinical reasoning competence across the curriculum of The 海角社区 DPT Program.
METHODS
In November 2017, the 海角社区 DPT faculty met to develop a program definition of clinical reasoning, refine our assessment of student clinical reasoning competence, develop a clinical reasoning framework, and discuss approaches to integrate this framework across the curriculum. Faculty discussed where and how clinical reasoning was currently implemented and assessed. An iterative process was utilized with faculty discussions and concept mapping to develop a consensus based clinical reasoning definition and framework. Key concepts and terms were discussed to standardize comprehension. From this initial meeting, 3 working groups were formed for development, integration, and assessment.
RESULTS
The process led to a final, faculty approved, consensus based clinical reasoning definition and framework that synthesizes current clinical reasoning models combined with concepts from the American Physical Therapy Association’s Guide to Physical Therapist Practice and the World Health Organization’s International Classification of Function model. The process of developing and formalizing the framework enhanced faculty’s knowledge regarding clinical reasoning complexity. Our framework has been integrated into the curriculum using standardized terminology and active learning methods easily modifiable to curricular specific objectives.
CONCLUSION
Implementation of a standardized framework may enhance student clinical reasoning competence. Clinical reasoning is an essential component of entrustable professional activities in physical therapy education which has the potential to contribute to safe, autonomous, and effective clinical practice.
FUTURE GOALS
Integration of clinical reasoning framework with our clinical instructors. Assess the incorporation of our CR framework impact on enhancing clinical reasoning learning outcomes.
ACKNOWLEDGMENTS
Faculty of The University of Texas at El Paso Doctor of Physical Therapy Program, all of whom provided intellectual capital in the development, refinement, and implementation of our clinical reasoning model.