TEACHING CLINICAL REASONING AS A THINKING FRAME

Objective. Clinical reasoning concepts can be viewed as descriptions o f mental operations or as a thinking frame-a structure to organize and support clinical thinking. This study examined an approach for teachi ng clinical reasoning as a thinking frame to occupational therapy stud ents. Method. A quasi-experimental pretest-posttest design was used wi th a convenience sample of 10 undergraduate occupational therapy senio rs. All participants (a) acquired the thinking frame of clinical reaso ning concepts through explicit instruction and (b) practiced that thin king frame with an external aid-the Clinical Reasoning Care Study Form at. The accuracy of participants' definitions of clinical reasoning co ncepts before and after this learning experience were examined to asse ss their acquisition of the thinking frame. The content of clinical re asoning case studies were examined to assess students' application of the thinking frame to clinical situations. Results. Wilcoxon signed ra nk tests done on presemester and postsemester definitions ratings indi cated that the latter were rated significantly higher than the former for (a) narrative reasoning(p = .008), (b) procedural reasoning(p = .0 05), (c) interactive reasoning(p = .006), (d) pragmatic reasoning(p = .008), and (e) conditional reasoning(p = .01). The content of particip ants' clinical reasoning case studies indicated that they were able to apply clinical reasoning concepts. Conclusion. The results suggest th at using a clinical reasoning thinking frame to organize clinical obse rvations is an effective way to help entry-level occupational therapy students learn and apply clinical reasoning concepts.