Service-learning and case-based learning’s impact on student’s clinical reasoning : A repeated measures design study

Clinical reasoning is crucial for the occupational therapy profession to thrive in an ever-changing healthcare environment but is seldom isolated for explicit instruction and outcome measurement in course curricula. A single-factor repeated measures design study was conducted to compare the impact of didactic case-based learning and experiential service-learning on the development of the clinical reasoning of students at a midwestern public university’s entry-level master of occupational therapy program. The participants were sixteen graduate occupational therapy students who had completed their foundation-level courses. Participants explored modes of clinical reasoning in occupational therapy for eight weeks (the first half of the semester), using didactic case-based learning, and then participated in an eight-week (the second half of the semester), experiential service-learning practicum engaging uninsured and underinsured adult clients in occupational therapy evaluation and intervention. The dependent variable of clinical reasoning was measured using the Self-Assessment of Clinical Reflection and Reasoning (SACRR) survey which was administered at the start and end of both phases of the study. SACCR scores increased generally but were only significant during the experiential phase (mean difference =7.384, p=0.018). The change was also significant overall from pre-test to post-test 2 (mean difference =13.621, p \u3c0.001). The explicit integration and evaluation of clinical reasoning instruction in course curricula, preferably using experiential service-learning pedagogy, appears to facilitate the development of the clinical reasoning of graduate students in an entry-level master occupational therapy program