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首页> 外文期刊>The Internet journal of allied health sciences practice >Creating Significant Learning Experiences for Clinical Reasoning by Physical Therapist Students
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Creating Significant Learning Experiences for Clinical Reasoning by Physical Therapist Students

机译：为理疗师学生提供重要的临床推理学习经验

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Background: Clinical reasoning skills are embedded in all aspects of practice. There is a lack of consensus and standards for curriculum design and teaching methods of clinical reasoning in entry-level education of health professionals. Purpose: The purpose was to describe a process of designing one comprehensive, planned sequence of four courses to create significant learning experiences for clinical reasoning for Doctor of Physical Therapy students. Method: Fink’s design process was used to develop four clinical decision-making courses to ensure a close alignment of learning goals, feedback and assessment, and learning activities to engage students in practicing components of clinical reasoning. Student outcomes were measured by self-efficacy ratings for clinical reasoning in a practical exam for first-year students and by ratings of performance by clinical instructors for third-year students. Results: 41 first-year students ranked their confidence in making clinical decisions both before and after a midterm practical. A paired t-test found a significant difference (.05t40 = -6.66, ρ=0.00) in the mean ratings of students from the pre-practical assessment to the post-practical assessment about confidence in making clinical decisions. Third-year students received ratings that met or exceeded expectations on five audited skills from the Physical Therapist manual for the Assessment of Clinical Skills (PT MACS), both at midterm and at the final assessment. No significant differences between midterm and final ratings on any of the selected skills were found using a Chi-Square Test of Independence (α=.05). Conclusion: The four-course sequence was designed using four themes: patient-centered care, models of practice, and evidence-based practice, and ethics/legal issues. This paper offers specific details about how one method of teaching clinical reasoning meets the current trends in education and health care for accountability and meaningful outcomes. Students gained practical knowledge and skills in the components of clinical reasoning and decision-making by participating in active and engaging significant learning experiences.
机译：背景：临床推理技能已植入实践的各个方面。在卫生专业人员的入门级教育中，缺乏针对临床推理的课程设计和教学方法的共识和标准。目的：目的是描述设计一门综合性，计划中的四门课程的过程，以为物理治疗医生的学生提供重要的临床推理学习经验。方法：芬克（Fink）的设计过程用于开发四项临床决策课程，以确保学习目标，反馈和评估以及学习活动的紧密结合，以使学生参与实践临床推理的各个环节。对于一年级学生，通过临床实践中的自我推理能力进行临床推理评估，而对于三年级学生，则通过临床指导人员的绩效评估来衡量学生的结局。结果：41名一年级学生对他们在中期实践之前和之后做出临床决定的信心排名。配对t检验发现，从练习前评估到练习后评估对学生做出临床决策的信心方面，学生的平均评分存在显着差异（.05t40 = -6.66，ρ= 0.00）。三年级学生在期中和期末评估中均获得了《物理治疗师临床技能评估手册》（PT MACS）对五项审核技能的评估，达到或超过预期。使用卡方独立性检验（α= .05），发现所选技能的中期和最终评分之间没有显着差异。结论：这四个过程的顺序设计有四个主题：以患者为中心的护理，实践模型和循证实践以及道德/法律问题。本文提供了有关如何教授临床推理的一种方法如何满足教育和卫生保健当前趋势的问责制和有意义的结果的具体细节。通过参与积极而有趣的学习经历，学生在临床推理和决策过程中获得了实践知识和技能。

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