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Clinical Reasoning as a student

Blog // Clinical Reasoning as a Student

As a 3rd year physiotherapy student, I understand how much content and knowledge students in our course are confronted with. It is a known fact that with all this content comes exams, where there is a “correct” answer to each question. Many students know what to say/write when they come across these questions, due to route learning and sleepless nights cramming. Through this process of study, many students are able to remember the correct answer and place that down on the “paper” or “screen” (Covid-19 appropriated) to get the marks they were after. Although, many students in this situation don’t completely understand why and how they got the answer and this is due to a lack of clinical reasoning. This became apparent to me after discussing with other students in my cohort that we understood the answer, but not always how to get there.

Firstly, clinical reasoning can be understood best as the process by which a therapist interacts with a patient, gathering and testing hypothesis, to then determine diagnosis and form a treatment/management plan accordingly. This process is undoubtedly one of the most important aspects of the physiotherapy profession, as it adapts and takes in each individual patient’s circumstance, which in turn creates the environment for an individualised assessment, treatment and management plan.

So, knowing this, my 3 biggest tips around clinical reasoning as a student are:

  1. Understand that all patients are different and therefore every assessment should be as well. For example, you have two patients both with anterior knee pain; one comes in with a resting PVAS of 7/10 with pain on all movements and one comes in with no resting pain saying “it only comes on with jumping.” Although these patients both have anterior knee pain, they should both be assessed differently, factoring in the information gathered in the subjective assessment.
  2. If it doesn’t make sense to you…question it, don’t just blindly proceed. This will further your knowledge from both wider reading and learning new information on how to treat and manage patients.
  3. Assess what is in front of you! There is another human being right in front of you with many answers to the questions you have. These answers may not be what they tell you specifically but how they present on the day, for example how they walk in, their body language and facial expressions. How the patient presents should determine how your assessment/treatment/management should be navigated. This can be learned through getting out and talking to people in everyday life and understanding how to manoeuvre through social situations.

I hope this helps students who are struggling or want to extend themselves, as it took me a little while to understand clinical reasoning and its importance to not only the physiotherapy profession but the patient.

Written by Riley O'Connell

3rd Year Student, ACU, Australia

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