Effects of Educational Interventions Designed to Develop Physical Therapist Learners' Clinical Reasoning: A Systematic Review

Abstract

Objective: The objective of this systematic review was to investigate the effects of educational interventions designed to develop physical therapist learners' clinical reasoning (CR) across the full continuum of professional development.

Data sources: A systematic search was conducted of 6 databases, the entire Journal of Physical Therapy Education collection, and the reference lists of included articles through March 2022.

Study selection: English-language primary relevant research studies of all research designs were included while grey literature was excluded.

Data extraction and synthesis: Two reviewers independently extracted data from and determined risk of bias of each of the 40 included studies. Disagreements were resolved by consensus or use of a third reviewer. A narrative synthesis summarized and explained the quantitative data. Meta-analysis was not possible due to data heterogeneity. Qualitative data were synthesized using thematic analysis.

Main outcome(s) and measure(s): Main outcomes were effects of the educational interventions per the Kirkpatrick model.

Results: Forty articles met the inclusion criteria. Twenty-two of the 33 studies with quantitative data involving student or practicing physical therapists reported statistically significant positive outcomes. Three major themes emerged from thematic analysis of 23 studies: perceived educational gain, valued elements of educational interventions, and identified challenges to learning.

Conclusions and relevance: Educational interventions that appeared to have a positive impact on learning outcomes were identified. However, the available research lacks rigor for the authors to develop evidence-based guidelines to support the development of CR in physical therapist learners. Given the importance of CR, high quality studies are warranted. This comprehensive systematic review appeared to be the first one in the profession to have investigated the effects of educational interventions designed to develop learners' CR across the entire professional development. Educators and researchers may benefit from the findings to develop educational interventions and future studies.

Keywords: Clinical Decision Making; Clinical Reasoning; Educational Interventions; Physical Therapists; Student Physical Therapists.