What methods are being used to teach clinical reasoning in physical therapy education and are they effective? A systematic review of literature

Introduction
Development of clinical reasoning (CR) is a critical skill for physical therapy (PT) students. A consensus of the most effective way to teach CR is lacking. The purpose of this study was to identify educational methods that PT education programs in the United States and abroad are utilising to develop CR skills and compare the effectiveness of those methods.

Methods
Preferred Reporting Items for Systematic Review (PRISMA) guidelines were followed. A literature search was conducted in September 2021 and March 2022 in the following databases: PubMed, CINAHL, Health Source: Nursing/Academic Edition, and Academic Search Ultimate (EBSCO). Articles that investigated instructional methods used to teach and measure CR in PT students were included. Data extracted included instructional method details and results of outcome measures used to assess CR.

Results
Of 324 articles, 12 met eligibility. Instructional methods included simulated patients (n = 3), case activities (n = 6), patient care activities (n = 2), and curriculum design considerations (n = 2). Results suggested that CR performance improved with all but was better when students worked in dyads or groups (n = 3). A variety of outcome measures were used to assess CR, the majority relying on student self-assessment of CR skills.

Conclusions
This systematic review illustrates great variety in the methods used to teach and measure CR in PT education, all of which resulted in improved CR. Further research comparing the effectiveness of teaching methods and the reliability and validity of outcome measures of CR is needed.