Effectiveness of a Clinical Reasoning Course on Willingness to Think Critically and Skills of Self-Reflection

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Background and Purpose.

One may possess the skills of good critical thinking but may be unwilling to use them in certain situations, and conversely one may have the habits of the mind of good critical thinking but may fail to possess the requisite skills to use them effectively. Students entering a Doctor of Physical Therapy (DPT) program are most likely already quite good at conceptualizing, analyzing, and synthesizing information. However, during a curriculum review, the faculty of a DPT program agreed that students failed to exhibit sufficient higher-order thinking required for clinical reasoning, one of the primary intended outcomes of the curriculum. The faculty members hypothesized that making the skills and attributes of clinical reasoning more explicit early in the program would help set the stage for improving students' clinical reasoning skills throughout the rest of the DPT curriculum.

Case Description.

A course entitled “Critical Reasoning” was created as an introduction to the habits of the mind and traits required for good critical thinking and reflective skills. The intentions of the course were to provide a framework for the development of clinical reasoning skills and to make these skills, attributes, and habits of good clinical thinking explicit. The purpose of this study was to explore the effectiveness of this Critical Reasoning course on increasing students' awareness of and willingness to think and reflect critically.


There was a statistically significant increase from pre- to post-intervention in students' willingness to think critically as measured by the California Critical Thinking Disposition Inventory. The Self Reflection and Insight Scale also indicated improvement in students' insight into their thinking and their reflective skills.

Discussion and Conclusion.

It would seem that, given the statistically significant improvement in both outcome measures, the course may have had a positive effect on improving students' willingness and ability to think about their thinking. Making the habits of the mind and the skills of critical reflection explicit early in a curriculum can lead to improvements in students' willingness to think and reflect critically. However, the course's effect on students' overall clinical reasoning skills cannot be assumed without further investigation.

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