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Background and Purpose. Clinical reasoning is a complex, nonlinear problem–solving process that is influenced by models of practice. The development of physical therapists’ clinical reasoning abilities is a crucial yet underresearched aspect of entry-level (professional) physical therapist education.

Objectives. The purpose of this qualitative study was to examine the types of clinical reasoning strategies physical therapist students engage in during a patient encounter.

Methods. A qualitative descriptive case study design involving within and across case analysis was used. Eight second-year, professional physical therapist students from 2 different programs completed an evaluation and initial intervention for a standardized patient followed by a retrospective think-aloud interview to explicate their reasoning processes. Participants’ clinical reasoning strategies were examined using a 2-stage qualitative method of thematic analysis.

Results. Participants demonstrated consistent signs of development of physical therapy–specific reasoning processes, yet varied in their approach to the case and use of reflection. Participants who gave greater attention to patient education and empowerment also demonstrated greater use of reflection-in-action during the patient encounter. One negative case illustrates the variability in the rate at which students may develop these abilities.

Conclusions. Participants demonstrated development toward physical therapist–-specific clinical reasoning, yet demonstrated qualitatively different approaches to the patient encounter. Multiple factors, including the use of reflection-in-action, may enable students to develop greater flexibility in their reasoning processes.


This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Physical Therapy, volume 97, issue 5, in 2017 following peer review. The definitive publisher-authenticated version is available online at DOI:10.1093/ptj/pzx028

pzx028_Supp.pdf (64 kB)
Supplementary Data

Peer Reviewed



American Physical Therapy Association



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