Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators.
BACKGROUND
Clinical reasoning is fundamental to all forms of professional health practice, however it is also difficult to teach and learn because it is complex, tacit, and effectively invisible for students. In this paper we present an approach for teaching clinical reasoning based on making expert thinking visible and accessible to students.


METHODS
Twenty-one experienced allied health clinical educators from three tertiary Australian hospitals attended up to seven action research discussion sessions, where they developed a tentative heuristic of their own clinical reasoning, trialled it with students, evaluated if it helped their students to reason clinically, and then refined it so the heuristic was targeted to developing each student's reasoning skills. Data included participants' written descriptions of the thinking routines they developed and trialed with their students and the transcribed action research discussion sessions. Content analysis was used to summarise this data and categorise themes about teaching and learning clinical reasoning.


RESULTS
Two overriding themes emerged from participants' reports about using the 'making thinking visible approach'. The first was a specific focus by participating educators on students' understanding of the reasoning process and the second was heightened awareness of personal teaching styles and approaches to teaching clinical reasoning.


CONCLUSIONS
We suggest that the making thinking visible approach has potential to assist educators to become more reflective about their clinical reasoning teaching and acts as a scaffold to assist them to articulate their own expert reasoning and for students to access and use.
School of Health Sciences, The University of Melbourne, Melbourne, Australia. C.delany@unimelb.edu.au.
Clare
C
Delany
Clinton
C
Golding
D000488:Allied Health Personnel; D001315:Australia; D002983:Clinical Competence; D015510:Clinical Medicine / Q000193:education*; D006801:Humans; D012106:Research; D013663:Teaching; D062606:Tertiary Care Centers; D013850:Thinking