Evaluating the Clinical Reasoning of Student Health Professionals in Placement and Simulation Settings: A Systematic Review
Abstract
:1. Introduction
- What tools have been developed or investigated for evaluating students’ clinical reasoning as applied in clinical education placement and simulation settings of health professional education?
- What constructs or aspects of clinical reasoning are those tools designed to assess?
2. Materials and Methods
3. Results
3.1. Overview of Included Studies
3.2. Conceptual Foundations of the Clinical Reasoning Evaluation Tools
4. Discussion
4.1. There Remains Inconsistent Use of Terminology around Clinical Reasoning
4.2. Each Evaluation Tool Has Limited Evidence
4.3. There Is Minimal Evidence for Allied Health or Multi-Disciplinary Crossover
4.4. Evaluation Tools Reported in the Literature Represent Two Contrasting Objectives
4.4.1. Tools to Assess the Development of Diagnostic Reasoning
4.4.2. Tools to Judge the Quality of Performance as a Reflection of Reasoning Processes
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Inclusion Criteria | Exclusion Criteria |
---|---|
Studies meeting ALL the following:
|
|
Construct | Theoretical Underpinning | Evaluation Tool or Measure (Discipline of Student) |
---|---|---|
Clinical Decision Making | None stated (an adaptation of the Physical Therapist Clinical Performance Instrument) [28] | Clinical Decision Making Survey Tool (Physical Therapy) [29] |
Not stated | Surgical Decision Making Rating Scale (Medicine) [59] | |
Clinical Judgement | Clinical Judgement Model [49] | Lasater Clinical Judgement Rubric (Nursing) [17,70,71,72,73,74,75,76] |
Lasater Clinical Judgement Rubric—Korean version (Nursing) [52] | ||
Lasater Clinical Judgement Rubric—Dutch version (Nursing) [53] | ||
Virtual Patient Lasater Clinical Judgement Rubric (Nursing) [54] | ||
Scenario-specific Assessment Tool for Febrile Infant Care Simulation (adaptation of the Lasater Clinical Judgement Rubric; Nursing) [55] | ||
Simulation Evaluation Tool (an adaptation of the Lasater Clinical Judgement Rubric) (Nursing) [56] | ||
Clinical Reasoning | “A SECRET” reasoning approach [33] | A SECRET Assessment (Occupational Therapy) [32] |
Clinical Reasoning Process model [51] | Clinical Reasoning Evaluation Simulation Tool (CREST) (Nursing) [57] | |
Nurses Clinical Reasoning Scale (Nursing) [58] | ||
IDEA Framework, structural semantics, and RIME [35] | IDEAs Assessment Tool (Medicine) [34] | |
Novice Clinical Reasoning Model [45] and Social cognitive theory [46,47] | Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM; Nursing) [48] | |
Outcome Present State Test Model [50] | Outcome Present State Test (OPT; Nursing) [77] | |
Revised Bloom’s Taxonomy [44] and Dreyfus Model [13] | Clinical Reasoning Grading Rubric (Physical Therapy) [43] | |
Script Theories [11,12] | Multiple Choice Question Exam (Medicine) [36] * | |
Script Concordance Test (Medicine) [36] *, [78,79,80,81,82,83,84,85,86,87,88,89], [90] *, [91] * (Nursing) [92], [91] * (Pharmacy) [93] | ||
Script Concordance Test with Think Aloud (Medicine) [37], [90] * | ||
Not stated | Clinical Reasoning Problems Test (Medicine) [60], [90] * | |
Critical Thinking | Benner’s [41] levels of nursing experience, and Bloom’s [42] cognitive domains | Clark Simulation Evaluation Rubric (Nursing) [40] |
Consensus dimensions of critical thinking in nursing [18] | Carter Assessment of Critical Thinking in Midwifery (Preceptor / Mentor Version) (Midwifery) [21], [23] * | |
Carter Assessment of Critical Thinking in Midwifery (Student Self-Rating Version) (Midwifery) [22], [23] * | ||
Carter Assessment of Critical Thinking in Midwifery (Reflective Writing) (Midwifery) [23] * | ||
Rubric for assessing critical thinking dimensions (Nursing) [20] | ||
Expert Consensus on Critical Thinking [19] | Critical Thinking Self-Reflection Tool (Nursing) [24] | |
Yoon’s Critical Thinking Tool (Nursing) [25] | ||
IDEAS five-step critical thinking problem-solving process [31] | Critical Thinking Skills Rating Instrument (CTSRI; Medicine) [30] | |
Structured Observation of and Assessment of Practice [27] | Clinical Viva (Nursing) [26] | |
Situation Awareness | Situation Awareness [38] | Situation Awareness Global Assessment Technique (SAGAT; Nursing) [39] |
Not Specified | Not stated | Clinical Performance Examination (CPX; Medicine) [61] |
Computer-based Case Simulation (CCS; DxR Clinician Software; Medicine) [63] | ||
Exam formats: Context-rich single best answer versus key feature problems (Medicine) [62] | ||
Exam formats: Extended matching questions, with think aloud (Medicine) [64] | ||
Interactive Simulation of Patients Objective Structured Clinical Examination (OSCE) Station (Medicine) [65] | ||
Objective Structured Clinical Examination (OSCE) Note Writing Station (Medicine) [66] | ||
Reflective Thinking Instrument (Nursing) [67] | ||
Virtual Patient Case Patient Summary Statement Rubric (Medicine) [68] | ||
Virtual Patient Case Procedural Rubric and Semantic Rubric (Medicine) [69] |
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Brentnall, J.; Thackray, D.; Judd, B. Evaluating the Clinical Reasoning of Student Health Professionals in Placement and Simulation Settings: A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 936. https://doi.org/10.3390/ijerph19020936
Brentnall J, Thackray D, Judd B. Evaluating the Clinical Reasoning of Student Health Professionals in Placement and Simulation Settings: A Systematic Review. International Journal of Environmental Research and Public Health. 2022; 19(2):936. https://doi.org/10.3390/ijerph19020936
Chicago/Turabian StyleBrentnall, Jennie, Debbie Thackray, and Belinda Judd. 2022. "Evaluating the Clinical Reasoning of Student Health Professionals in Placement and Simulation Settings: A Systematic Review" International Journal of Environmental Research and Public Health 19, no. 2: 936. https://doi.org/10.3390/ijerph19020936