151. Exploring Clinical Reasoning in Doctor of Physical Therapy (DPT) Students through Computer-Based Simulation
- Author
-
Denise Romano
- Abstract
This purpose of this multiple article dissertation was to explore clinical reasoning in Doctor of Physical Therapy (DPT) students using a computer-based simulation. The first article, is a systematic literature review, examining the use of technology-enhanced simulation in physical therapy (PT) education. Sixteen articles met the inclusion criteria and demonstrated how various forms of technology-enhanced simulation affected PT students' knowledge, skills, and/or attitudes. Although not superior to other methods of instruction, the use of technology-enhanced simulation resulted in positive learning outcomes including improved clinical reasoning, knowledge acquisition, self-efficacy, communication and teamwork skills, and empathy. The process of developing and validating a computer-based simulation using evidence-based guidelines was documented in the second article. The simulation was developed using the International Nursing Association for Simulation Learning (INACSL) Healthcare Simulation Standards of Best Practice (HSSOBP) as a guide. The simulation was then subjected to a measure of content validity using a content validity index (CVI). This article also includes a discussion of DPT students' perceptions of the computer-based simulation. The students expressed satisfaction with the learning activity and found value in the learning experience. The third article is a mixed methods study in which the use of clinical reasoning strategies and the relationship between quality of reflection and clinical reasoning strategy use were explored. Written responses collected from the validated computer-based simulation were analyzed using qualitative, quantitative, and mixed methods techniques. Results were consistent with the findings of other studies, including an observed progression toward more sophisticated reasoning strategies and an increased focus on factors that contribute to patient impairments. However, inconsistent with prior studies of clinical reasoning with DPT students was the incorporation of patient impact into the reasoning processes observed across all class years. Overall, the results of this dissertation support technology-enhanced simulation as a viable method of instruction in a PT curriculum and confirm the findings of other studies outlining a developmental progression of clinical reasoning. The implications of this research support the development of effective instructional strategies to facilitate clinical reasoning and the creation of developmental milestones to help to determine competency levels. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]
- Published
- 2022