2025 Articles

Exploring the relationship of diagnostic reasoning, self-efficacy, and clinical reasoning of physical therapy students

Cunningham, Shala; Kessinger, Matthew; Mott, Alejandra; Carter, Megan; Plassman, Christine; Downs, Madison; South, Catherine

Purpose: One of the primary objectives of entry-level physical therapy education is to develop students’ clinical reasoning (CR) skills to provide optimal, patient-centered care. However, CR is a highly contextualized concept, and the assessment of CR development to ensure students have the requisite skills for safe patient care prior to clinical experiences is challenging within an education program. Self-assessment tools may provide a time-efficient opportunity to assess students’ CR development across their education. Both diagnostic reasoning and self-efficacy have been correlated with CR performance in physical therapy. This study aimed to explore the relationship between diagnostic reasoning, self-efficacy, and CR development among physical therapy students.
Methods: Diagnostic reasoning was assessed through the Diagnostic Thinking Inventory (DTI). Self-efficacy was measured by the New General Self-Efficacy (NGSE) scale and Physical Therapist Self-Efficacy (PTSE) scale. CR ability was evaluated through the Think Aloud Standardized Patient Examination (TASPE) performed during a standardized patient simulation, and scores for the CR performance criteria as assessed by clinical instructors on the Physical Therapist Clinical Performance Instrument Version 2006 (CPI).
Results: There was no correlation between self-assessment scores on the DTI, NGSE, PTSE, and CR performance assessed by faculty during a standardized patient simulation (TASPE) or clinical instructors using the midterm and final CPI during a 12-week full-time clinical experience.
Conclusion: This study was unable to identify a self-assessment tool or a student performance indicator that could accurately predict CR performance during upcoming full-time clinical experiences.