How can clinical reasoning teaching change from a ‘black-box phenomenon’ to a structured clinical reasoning curriculum? Insights from a scoping review.

• IntroductionClinical reasoning (CR) is scarcely explicitly taught in health profes- sions education. Barriers to teach CR include lack of awareness of teaching methods and a change-resistant teaching culture. Thus, CR often becomes a ‘black-box phenomenon’ that students need to develop informally. To advance our understanding of structured CR curriculum design in health professions education a scoping review was conducted. MethodologyArksey and O’Malley’s six-stage framework (1) was applied. Peer- reviewed articles were searched in PubMed, Web of Science, CINAHL, and manual searches, resulting in the identification of 2932 studies, which were screened by the team.ResultsTwenty-six articles were selected from medical, nursing, physical ther- apy, occupational therapy, midwifery, dentistry, and speech language therapy education. The analysis identified three themes: Features of CR curriculum design; CR theories informing curricula; and CR teaching content and methods.DiscussionNo all-encompassing CR curriculum design was identified. However, several theories and specific methods were described supporting CR development. Dual-process theory was the most prevalent theory and active learning approaches were emphasized. Patient centeredness in CR teaching was scarcely described. The diversity of methods stresses that educators need to make the intended meaning of CR explicit in their curricular work.ConclusionSpecific theories and teaching methods can support curriculum devel- opment. Lack of overall CR curriculum strategy in the literature stresses further guidance on a longitudinal CR curriculum that support stu- dents’ CR progression throughout study programs.

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Physiotherapy

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