The two papers presented in this session truly complimented each other, stimulated interesting questions, and resulted in a positive energy amongst delegates for future improvements.
87.1 What students think is best practice when teaching them clinical reasoning in practice education, by Caroline Hills. A study of 3rdand 4thyear Australian students using a qualitative descriptive method.
Caroline, who moved from Australia to Ireland has completed this for her PhD study. She gave a definition of clinical reasoning, then expressed that there is no consensus about the best way to teach it to OT students. The overarching aim was to do a mixed methodology study to investigate learning preferences of OT students whilst on their clinical placements, what was the best thing about being on placement ?. Out of this came an important subtheme of teaching clinical reasoning. Caroline suggested that clinicians are often in a rush to get to the end-point when explaining to students, and that this can result in a lack of deep learning. The semi-structured face to face, Skype and telephone interviews were analysed thematically.
Three main themes resulted.
- Talk it through: students wanted the educator to take the time to explain the point, break it down to their level and explain possible alternatives.
- How to develop my reasoning; encourage me to think and apply theory, ask me a question to check I have understood.
- Preferred teaching and learning approaches for clinical reasoning; make it two way, don’t put me on the spot and give me time to reflect.
The conclusions drawn were that clinical reasoning must be a two way process that this should be graded to aid learning, and that there is a need for a clinical reasoning template. Instead of concentrating on being process led, we will do an initial assessment, then functional assessment, instead it is arguably better to discuss the reasons why each step happens. Another key theme that was discovered, was that concept of belongingness; students value feeling that they belong whilst on placement. There is a lot of evidence within medicine and nursing about this, more is needed within OT.
87.2. Using Q-methodology to identify the factors influencing occupational therapy practice educators offering placements to undergraduate OT students, by Jenny Devers from University of Northampton
Jenny introduces this by saying that practice placements are essential within OT training programs. However, there are rising concerns about placement shortages so there is needs to be a call to find strategies and solutions. Jenny looked at the number of qualified OT’s in practice (38000) and considered the number of OT students (5,500 per year) so felt that really there shouldn’t be a problem, but yet there is, so she was keen to find out why.
A comprehensive literature search gave a range of positive rationale, including that students are energising and a positive influence, but yet there are many negative influences also. Ethics was gained and a range of sites deemed suitable, 16 eligible sites were secured and sent the pack to complete. Participants answered all the questions according to the scale, and they were asked to give comments for the questions that were answered at each end of the scale (most agreed / most disagreed). The data was then transferred back into the matrix. Analysis revealed 3 main themes; strong professional value, student impact and placement support. The recommendations were
There was an interesting debate in the room with considerations for future improvements, with a key theme of universities and placement providers collaborating closely to build the future workforce.
Written by @imms_eh_OT