1st Edition

Clinical Reasoning and Decision Making in Physical Therapy Facilitation, Assessment, and Implementation

By Gina Musolino, Gail Jensen Copyright 2019

    Clinical reasoning is an essential non-negotiable element for all health professionals. The ability of the health professional to demonstrate professional competence, compassion, and accountability depend on a foundation of sound clinical reasoning. The clinical reasoning process needs to bring together knowledge, experience, and understanding of people, the environment, and organizations along with a strong moral compass in making sound decisions and taking necessary actions.
    While clinical reasoning and the role of mentors has been a focus of the continued growth and development of residency programs in physical therapy, there is a critical need to have a broader, in-depth look at how educators across academic and clinical settings intentionally facilitate the development of clinical reasoning skills across one’s career. Clinical Reasoning and Decision Making in Physical Therapy: Facilitation, Assessment, and Implementation fills this need by providing a comprehensive and in-depth focus on development of the patient-client management skills of clinical reasoning and clinical decision-making. It takes into account teaching and learning strategies, assessment, and technological applications across the continuum from novice to residents/fellows-in-training, along with academic and clinical faculty for both entry-level and specialist practice.
    Drs. Gina Maria Musolino and Gail Jensen have designed this comprehensive resource with contributions from professional colleagues. The text centers on life-long learning by encouraging the development of clinical reasoning abilities from professional education through residency education. The aim and scope of the text is directed for physical therapy education, to enhance clinical reasoning and clinical decision-making for developing professionals and post-professionals in both clinical and academic realms, and for the development of clinical and academic faculty.
    Clinical Reasoning and Decision Making in Physical Therapy uniquely offers both evidence-based approaches and pragmatic consultation from award-winning authors with direct practice experiences developing and implementing clinical reasoning/clinical decision-making in practice applications for teaching students, residents, patients, and clinical/academic faculty in classrooms, clinics, and through simulation and telehealth.
    Clinical Reasoning and Decision Making in Physical Therapy is the first of its kind to address this foundational element for practice that is key for real-world practice and continuing competence as a health care professional. Physical therapy and physical therapist assistant students, faculty, and clinicians will find this to be an invaluable resource to enhance their clinical reasoning and decision making abilities.



    About the Editors

    Contributing Authors

    Foreword by Edelle [Edee] Field-Fote, PT, PhD, FAPTA

    Section I Theoretical Foundations: Guiding Practice for the Profession

    Chapter 1 Clinical Reasoning: Why It Matters

    Chapter 2 Teaching Clinical Reasoning: Lessons Learned in Medical Education

    Chapter 3 Self-Assessment and Reflective Practice: Evolutions for Clinical Reasoning

    Chapter 4 Expertise in Clinical Reasoning: Uncovering the Role of Context

    Chapter 5 From Ethical Reasoning to Ethical Action

    Chapter 6 Clinical Reasoning and Decision-Making: An Abridged Literature Review

    Chapter 7 Andragogy: Health Professions Clinical Reasoning Transitioning From Novice to Expert

    Section II Clinical Reasoning: Teaching, Learning, and Assessment

    Chapter 8 A Curricular Perspective on Teaching Clinical Reasoning in Entry-Level Education

    Chapter 9 Patterns of Clinical Reasoning Development in Entry-Level Physical Therapist Students

    Chapter 10 The Clinical Reasoning and Reflection Tool: Clinical Application for Clinical Decision-Making

    Chapter 11 Using a Comprehensive Framework to Assess Clinical Reasoning

    Chapter 12 Using a Structured and Evidence-Based Approach to Remediate Clinical Reasoning: A Case Report Summary

    Chapter 13 Clinical Reasoning Using System 1 and System 2 Modeling

    Chapter 14 The Relevance of Metacognition for Clinical Reasoning

    Chapter 15 Facilitation of Clinical Reasoning: Teaching and Learning Strategies Across the Continuum of Learners

    Chapter 16 Assessment of Clinical Reasoning: Strategies Across the Continuum of Professional and Post-Professional Physical Therapy Education

    Chapter 17 The Role of Standardized Tests in Assessing Clinical Reasoning and Critical Thinking

    Chapter 18 Developing Clinical Reasoning and Decision-Making Skills: Simulations and Debriefing

    Chapter 19 Capturing Teachable Moments: Developing Clinical Problem-Solving of the Physical Therapist Assistant

    Section III Clinical Reasoning: Research, Innovation, and Best Practice Exemplars

    Chapter 20 Developing a Successful Clinical Approach: The Collaborative

    Partnership of the Physical Therapist–Physical Therapist Assistant Team

    Chapter 21 A Three-Dimensional Model for Developing Clinical Reasoning Across the Continuum of Physical Therapist Education

    Chapter 22 Responding to the Call: Measuring Critical Thinking in Physical Therapist Education

    Chapter 23 Telehealth: An Innovative Educational and Instructional Strategy to Develop Clinical Decision-Making in Physical Therapist Practice

    Chapter 24 Mobile-Based Instructional Scaffolding: A Developmental Tool for Facilitating Physical Therapist Student Clinical Reasoning

    Chapter 25 Promoting Clinical Reasoning Within Clinical Teaching in Post-Professional Residency and Fellowship Programs

    Chapter 26 Evolving Expertise in Evidence-Based Practice With Contemporary Clinical Reasoning

    Chapter 27 Early Career Faculty Development: Maximizing Social Capital for Meaningful Clinical Reasoning

    Chapter 28 The Director of Clinical Education Leading the Way: Facilitating Clinical Reasoning and Clinical Problem-Solving With the Clinical Education Team With Case Exemplars

    Chapter 29 Reflection as a Clinical Decision-Making Tool: Navigating a Challenging Mentoring Situation—A Case Report Analysis Acronyms Financial Disclosures



    Gina Maria Musolino, PT, DPT, MSEd, EdD, is Founding Program Director and Clinical Professor, Doctor of Physical Therapy Program with the Department of Kinesiology & Community Health, College of Applied Health Sciences, The University of Illinois at Urbana–Champaign, Champaign, Illinois. She received her BS in Physical Therapy from Washington University School of Medicine (WUMS PT) Program in Physical Therapy (St. Louis, Missouri); her MSEd from Southwest Baptist University (Bolivar, Missouri); her EdD with specialization in Curriculum Design, Development and Evaluation from Nova Southeastern University (NSU), Fischler College of Education (Ft. Lauderdale, Florida); and her post-professional Doctor of Physical Therapy (DPT) degree from Utica College (Utica, New York). Dr. Musolino has over 25 years as a physical therapy educator, director of clinical education, expert, and educational consultant.

    Dr. Musolino was honored with the prestigious American Physical Therapy Association (APTA) Lucy Blair National Service Award (2012) for service of Exceptional Value to the Association. Dr. Musolino’s published works focus on the scholarship of teaching and learning with focused explorations of professionalism, service learning, cultural competence, clinical reasoning, health policy leadership, and clinical education. Dr. Musolino has served on several voluntary boards in support of the health professions. She was elected for 12 years of Board leadership with the APTA APTE (formerly Education Section), two 4-year terms each as President, Vice-President, and Director-at-Large for Promotion.

    Gail M. Jensen, PT, PhD, FAPTA, FNAP, is Dean, Graduate School and College of Professional Studies and Vice Provost for Learning and Assessment, Professor of Physical Therapy, and Faculty Associate for Center of Health Policy and Ethics at Creighton University in Omaha, Nebraska. She holds a BS in Education from the University of Minnesota, MA in physical therapy, and a PhD in educational evaluation both from Stanford University. Dr. Jensen served as principal investigator for the research on Physical Therapist Education for the Twenty First Century (PTE-21): Innovation and Excellence in Physical Therapist Academic and Clinical Education, that is the focus a 2019 SLACK Incorporated publication, Educating Physical Therapists. Dr. Jensen is a qualitative researcher well known for her scholarly publications related to expert practice, clinical reasoning, professional ethics, educational theory, and interprofessional education and practice. During her career she has held faculty appointments at Stanford University, Temple University, The University of Alabama at Birmingham, and Samuel Merritt University, and she was a part of the founding faculty of the first clinical doctoral program in physical therapy at Creighton University. She has coauthored/edited several books, including the Third Edition of Handbook of Teaching for Physical Therapists; Leadership in Interprofessional Health Education and Practice; Realising Exemplary Practice-Based Education; Expertise in Physical Therapy Practice, Second Edition; Educating for Moral Action: A Sourcebook in Health and Rehabilitation Ethics; and most recently, Clinical Reasoning in the Health Professions, Fourth Edition.

    " I recommend this text as an educational resource in both clinical and academic settings . . . This text has provided me a new complement of concepts and tools to employ."
    —Jennifer Miller, PT, DPT, CLT, WCS, Journal of Women's Health Physical Therapy