The use of an online video library in the development of case-based clinical reasoning skills in occupational therapy education

Abstract

Clinical reasoning, the cognitive process of a skilled occupational therapist, is a complex and necessary component of evaluating clients and implementing interventions that facilitate each client’s achievement of relevant and meaningful participation in daily occupations. Clinical reasoning encompasses a set of skills that must be integrated into college curricula for the preparation of occupational therapists, but it is not easily taught in a classroom setting. This complementary, mixed methods study explored how specific instructional techniques, constructed on the tenants of case-based reasoning, influenced the development of clinical reasoning in occupational therapy students, and sought to understand the student experience regarding use of these instructional techniques. Students participated in either a text based case activity or a video-based case activity with an associated clinical reasoning component. When the effects of GPA, age and experience were partialled out, the video group demonstrated statistically significantly higher scores in inductive reasoning (p<.05), but the text group demonstrated higher scores in self-perceived reasoning, although not statistically significant (p=.06). Students utilizing both case based methods reported satisfaction with the case-based learning activities groups, and identified authenticity of videos and more explicit information gained from the text cases as strengths of the particular case-based methods. Students in the video group described their use of clinical reasoning in more explicit and defined ways than the text group. It was concluded that case-based reasoning using either method promotes clinical reasoning and student satisfaction; however, video cases and the associated learning activity facilitate inductive reasoning and explicit understanding of the reasoning process in occupational therapy.