Clinical reasoning (CR) is a key learning domain for physical therapy educators and core skill for entry level practitioners. Integrated clinical experiences (ICE) and problem-based learning (PBL) are each reported to improve interpersonal and social domains, while promoting knowledge acquisition and clinical reasoning. Unfortunately, studies monitoring CR during ICE with concurrent PBL in physical therapy education are sparse. We hypothesize that an ICE with concurrent PBL is associated with increased self-reported CR in third year student physical therapists (PTs) in the United States. The Self-Assessment of Clinical Reflection and Reasoning (SACRR) survey was administered to 42 student PTs at the beginning, and end of their third and final year of didactic training. Between pretest and posttest analyses, participants completed a faculty-led ICE and PBL coursework for 16 weeks. The SACRR overall and 26 individual item scores were examined. Wilcoxon ranked-signed test and paired t-test were used with statistical significance accepted at P< 0.05. Significant improvements observed in SACRR overall score (P< 0.001), including six of the 26 survey items centered around decision-making based on experience and evidence as well as self-reflection and reasoning. An ICE with PBL is associated with increased self-assessed CR and reflection in third year student PTs in the United States. Monitoring the impact of curricular design on CR may improve educators' ability to improve cognitive and psychomotor skills, with a call for increased explicit use of theoretical frameworks and teaching techniques for coping with uncertainty to enhance entry level training.
Keywords: Clinical reasoning; Integrated clinical experience; Physical therapy; Problem-based learning.