Developing clinical reasoning: The role of deliberate practice, reflection, and analogical mapping

Current health care reforms changed the focus of how respiratory care professionals evaluate and reason through patient care decisions. As a result, educational institutions must format instructional programs in a way that develops clinical reasoning ability among students. Research indicated that practice, reflection, and cognitive processes are necessary for effective clinical reasoning ability but do not adequately answer the question of how they are related. As a first step in addressing this issue and to develop a clinical reasoning model to guide instructors\u27 educational programs, this study explored the ways in which deliberate practice, reflection, and analogical mapping assisted in the development of develop clinical reasoning ability. ^ Data were collected from senior Cardio-Respiratory Care students ( N = 34) attending three Universities. Both descriptive and inferential statistics were used to explain the variance related to the development of clinical reasoning ability. Qualitative data were collected and analyzed using thematic coding to explore students\u27 perceptions of how deliberate practice, reflection, and analogical mapping assisted in their development of clinical reasoning ability. ^ Results of this study suggest that students develop clinical reasoning ability through a cyclical process of engaging in deliberate practice that is supported by an instructor who provides support and feedback and a clinical environment where goals and expectations are clearly defined. Further, results suggest that deliberate practice engages students in an implicit learning process that is linked to a recursive analogical reflection process through which students draw upon both tacit and explicit knowledge and integrate them into a complex knowledge system that enhances clinical reasoning ability. ^ Finally, results suggest that when practiced successfully, clinical reasoning enhances students\u27 self-regulation and self-efficacy in decision-making in a way that allows for further engagement in deliberate practice and further development of clinical reasoning ability. The results of this study support the use of deliberate practice, reflection, and analogical mapping as a way to develop clinical reasoning ability and thereby help students to become competent health care providers.