Clinical reasoning is considered a core skill in healthcare and this is a skill that is difficult to teach using traditional teaching methods. Amy Lawton, Academic in Victoria University’s College of Health and Biomedicine explains that there is no ‘cookie-cutter’ approach when it comes to teaching clinical reasoning. It it is a combination of areas students need to learn in order to be successful like clinical experience, clinical context and evidence based practice.

At VU’s recent Learning and Teaching Symposium, Amy and colleague Breanna Wright explained some of the challenges they face teaching clinical reasoning to Osteopathy students.

The challenges:

• How do we develop truly authentic content?
• How do we get students to think about thinking?
• How do we engage students in the reflective process? (which is essential for advancement of the clinical reasoning skill).

The solution:

The answer is self-efficacy! Self efficacy (SSE) is the belief in one’s capacity to execute a plan to successfully achieve a goal. Increases in SSE leads to higher level of task performance. The pair teamed up with Learning Designer Rosy Borland to develop H5P branching scenarios, where students’ clinical reasoning could be challenged through a long term clinical scenario. Some of the benefits are that it can offer authentic and diverse scenarios, reinforce key prior knowledge, integrate new theory, provide timely, meaningful feedback and reflection. Last but not least, students can attempt the scenario multiple times without posing any risks to others.

The branching scenario was set up so that students can choose their own adventure, depending on their skill level and what they need to practice further. As students work their way through the branching scenario, they also receive ongoing feedback within the tool. Embedding strong structured opportunities for constructive feedback is a key principle of the VU Block Model.

Watch Amy, Breanna and Rosy’s full presentation.

See the following H5p Branching Scenario example created:
References:

Botezatu, M., Hult, H., Tessma, M. K., & Fors, U. G. (2010). Virtual patient simulation for learning and assessment: superior results in comparison with regular course exams. Medical teacher, 32(10), 845-850.​

Forbes, R. (2017). Patient education best practice; enhancing physiotherapy students’ self-efficacy and skills​

Higgs, J., Jones, M. A., Loftus, S., & Christensen, N. (Eds.). (2008). Clinical reasoning in the health professions E-book. Elsevier Health Sciences.​

Torres, G., Villagrán, I., Fuentes, J., Araya, J. P., Jouannet, C., & Fuentes-López, E. (2020). Interactive virtual scenarios as a technological resource to improve musculoskeletal clinical reasoning skills of undergraduate physiotherapy students. Physiotherapy Theory and Practice, 1-11.​

Venskus, D. G., & Craig, J. A. (2017). Development and validation of a self-efficacy scale for clinical reasoning in physical therapists. Journal of Physical Therapy Education, 31(1), 14-20.