Background/context.
Effective Clinical Reasoning (CR) skills are central to health professionals’ clinical competence. Consequently, CR skills are a key graduate outcome of many health degrees and teaching of these skills is often embedded in the curricula of these programs. However, expert clinical academics, while teaching novices, often find it difficult to explain their tacit process of clinical decision-making (Delany & Golding, 2014). Differences in novices’ and experts’ CR processes specific to medicine and other allied health care practitioners have been identified and frameworks for teaching CR skills in these disciplines have been proposed (Angus et al., 2018; Benner, 2000; Sole et al., 2019). However, such research in complementary medicine is lacking where CR education is often limited.
The initiative/practice.
A qualitative descriptive study was conducted to capture the cognitive, intuitive, and analytical aspects of the CR process of Naturopathic Medicine (NM) practitioners and to subsequently develop a novel CR framework for NM learners.
Methods of evaluative data collection and analysis.
Semi-structured interviews of 15 Novice and 16 expert NM practitioners were conducted and transcribed verbatim to obtain a full recount of their CR processes within real-life clinical settings. Interview data were analysed using content analysis. Categories were then compared between novice and expert NM practitioners to reveal components of CR that were similar and different between the two groups. The categories, and relationships between these categories, were translated to identify key facets of NM clinical reasoning.
Evidence of outcomes and effectiveness.
A novel CR framework was designed to facilitate teaching of CR skills to novice NM learners that will potentially influence the curriculum of naturopathy programs. The framework also aims to support novice NM graduates in making timely and safe clinical decisions to facilitate improvements in patient outcomes. An important next step of this work will be to evaluate the effectiveness of the framework in improving novice NM practitioners’ CR skills prior to implementing in NM curriculum.
References.
Angus, L., Chur-Hansen, A., & Duggan, P. (2018). A qualitative study of experienced clinical teachers’ conceptualisation of clinical reasoning in medicine: Implications for medical education. Focus on Health Professional Education A Multi-Professional Journal, 19(1), 52. https://doi.org/10.11157/fohpe.v19i1.197
Benner, P. (2000). From novice to expert: Excellence and power in clinical nursing practice, commemorative edition.
Pearson. Delany, C., & Golding, C. (2014). Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators. BMC Medical Education, 14(1), 20. https://doi.org/10.1186/1472-6920-14-20
Sole, G., Skinner, M., Hale, L., & Golding, C. (2019). Developing a framework for teaching clinical reasoning skills to under-graduate physiotherapy students: A Delphi study. New Zealand Journal of Physiotherapy, 47(1), 49–58. https://doi.org/10.15619/nzjp/47.1.06