Assessment of Diagnostic clinical reasoning skills among undergraduate Physiotherapy students

Ho, Jason Yi Zeng (2024) Assessment of Diagnostic clinical reasoning skills among undergraduate Physiotherapy students. Final Year Project, UTAR.

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Abstract

Background: Clinical reasoning is a vital cognitive process in physiotherapy, directly influencing patient outcomes. However, its assessment among Malaysian physiotherapy students has been under-explored. Understanding the diagnostic clinical reasoning skills of these students can provide insights into the effectiveness of current educational strategies and highlight areas for improvement. This study aims to bridge the gap by evaluating the diagnostic clinical reasoning abilities of undergraduate physiotherapy students in a private university, focusing on the integration of theoretical models with practical applications to enhance patient care. Objective: To assess and analyze the diagnostic clinical reasoning skills of undergraduate physiotherapy students at Universiti Tunku Abdul Rahman, Malaysia, using the Diagnostic Thinking Inventory (DTI). Methods: A cross-sectional study design was carried out among the physiotherapy students who had completed a clinical reasoning course or clinical posting experience. Participants were consented and they were required to complete the DTI, comprising sections on flexibility in thinking and structural memory. Data were analyzed using descriptive and inferential statistics, including normality tests (Kolmogorov-Smirnov), correlation tests (Pearson’s and Spearman’s), and reliability tests (Cronbach's alpha). Results: Statistical analysis revealed that 41.7% of participants exhibited poor diagnostic clinical reasoning skills. Among the cohort, fourth-year students achieved the highest mean scores in both flexibility in thinking and structural memory, suggesting that clinical exposure positively influences these abilities. Overall, flexibility in thinking scores exceeded those for structure in memory, indicating an imbalance in skill development. Conclusion: Based on the present study, it is concluded that the students lacks in clinical reasoning capabilities especially the diagnostic reasoning skills as it was assessed using the diagnostic thinking inventory. This study emphasizes the need for targeted educational reforms to address gaps in clinical reasoning education and refine strategies to produce skilled, patient-centered physiotherapists capable of delivering superior healthcare outcomes. Keywords: Diagnostic Thinking Inventory, clinical reasoning, physiotherapy students, assessment of diagnostic reasoning skills.

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