Evaluation of clinical reflection and reasoning skills in undergraduate occupational therapy students

Abstract

Given the current focus on the importance of clinical reasoning in occupational therapy education, various ways to examine and evaluate clinical reflection and reasoning skills should be available. The main focus of this paper therefore is to examine and evaluate students’ clinical reflection and the process thereof as a fundamental dimension of clinical reasoning using the Self-Assessment of Clinical Reflection and Reasoning (SACRR) instrument (Royeen et al., 1994). This study adopted a longitudinal design method which followed a cohort of 80 undergraduate occupational therapy students over two years and performed repeated measurements to assess their development of clinical reasoning skills and reflective thinking ability based on their experiential learning during four blocks (CEII-pre, CEII-post, CEIII-post and CEIV-post) of clinical education placements, using the Single-factor Repeated Measures Analysis of Variance Design Method. From the factor analysis of SACRR results, four groupings; knowledge/Theory application, Decision making based on experience and evidence, Dealing with uncertainty and Self-reflection and reasoning were identified. The results of mean scores of items in the four groupings presented an increase trend, which was statistically significant (p<0.0005) from CE II-pre to CE IV-post for each subscale scores across four instances of clinical education placements. These findings clearly suggested that students’ level of reflection and reasoning abilities had improved gradually as the student’s progressed from lower level of clinical education experience to a next level of clinical education placement. The results also signify an important implication for theory and practice application within the undergraduate occupational therapy curriculum structure.

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