TEACHING DIAGNOSTIC REASONING - USING A CLASSROOM-AS-CLINIC METHODOLOGY WITH VIDEOTAPES

Objectives. The purpose of this study was to examine the effects of a ''classroom-as-clinic'' format, using videotaped occupational therapy evaluations, on students' diagnostic reasoning skills. In the classroo m-as-clinic format, students write a problem list on the basis of prel iminary client information before viewing the videotape. Method. A pos t-hoc experimental design was used to compare the accuracy of treatmen t plan problem lists for two groups of senior occupational therapy stu dents-one group viewed two videotapes of client-therapist interactions without a classroom-as-clinic format (n = 82), and one group viewed t he same videotapes within the context of a classroom-as clinic format (n = 45). Both groups viewed the same two videotapes. Videotape 1 was of a client with a brain stem infarct, and Videotape 2 was of a client with traumatic brain injury. Results. Subjects experiencing a classro om-as-clinic format identified significantly more occupational therapy problems for Videotape 1 than those who did not have preevaluation in formation. There was no significant difference between the two subject groups in the accuracy of their problem lists for Videotape 2. Only s ubjects in the non-classroom-as-clinic group showed a significant impr ovement from Videotape 1 to Videotape 2 in occupational therapy proble m identification. Conclusion. This study suggests that to be truly eff ective when used with videotapes, the classroom-as-clinic methodology needs to be combined with explicit coaching in problem sensing and pro blem definition.