Online discussions develop students' clinical reasoning skills during fieldwork.

AIM

Pilot study to examine if the addition of a structured framework improved the quality of clinical reasoning demonstrated within clinically based online discussions by occupational therapy students undertaking fieldwork.

METHODS

Cognitive elements of the clinical reasoning process present within students' discussions were compared before (2005 cohort) and after (2007 cohort) the introduction of a structured framework to guide discussions. Students' self reports (2007 cohort) of clinical reasoning skills were also analysed before and after two consecutive fieldwork placements.

RESULTS

The structured framework increased the proportion of postings containing the advanced 'evaluate' element of clinical reasoning and decreased the proportion of postings containing only the basic 'understand' elements. Self-reported clinical reasoning skills improved following the first fieldwork placement and this improvement was sustained following the second placement.

CONCLUSIONS

The structured framework appears useful in enhancing students' depth of clinical reasoning during fieldwork, although further investigation is required.