Background: Clinical reasoning skills are embedded in all aspects of practice. There is a lack of consensus and standards for curriculum design and teaching methods of clinical reasoning in entry-level education of health professionals. Purpose: The purpose was to describe a process of designing one comprehensive, planned sequence of four courses to create significant learning experiences for clinical reasoning for Doctor of Physical Therapy students. Method: Fink’s design process was used to develop four clinical decision-making courses to ensure a close alignment of learning goals, feedback and assessment, and learning activities to engage students in practicing components of clinical reasoning. Student outcomes were measured by self-efficacy ratings for clinical reasoning in a practical exam for first-year students and by ratings of performance by clinical instructors for third-year students. Results: 41 first-year students ranked their confidence in making clinical decisions both before and after a midterm practical. A paired t-test found a significant difference (.05t40 = -6.66, ρ=0.00) in the mean ratings of students from the pre-practical assessment to the post-practical assessment about confidence in making clinical decisions. Third-year students received ratings that met or exceeded expectations on five audited skills from the Physical Therapist manual for the Assessment of Clinical Skills (PT MACS), both at midterm and at the final assessment. No significant differences between midterm and final ratings on any of the selected skills were found using a Chi-Square Test of Independence (α=.05). Conclusion: The four-course sequence was designed using four themes: patient-centered care, models of practice, and evidence-based practice, and ethics/legal issues. This paper offers specific details about how one method of teaching clinical reasoning meets the current trends in education and health care for accountability and meaningful outcomes. Students gained practical knowledge and skills in the components of clinical reasoning and decision-making by participating in active and engaging significant learning experiences.

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Introduction. Self-efficacy is believed to be a link between knowledge and the application of knowledge and skills to specific situations. No previously published survey comprehensively measures the self-efficacy of student physical therapists for the outcomes expected of entry-level physical therapists. Methods. The Self-Efficacy of Physical Therapist Student Outcomes (SEPTSO) survey was designed according to the recommended guidelines for tools measuring self-efficacy. Each of the 25 items was linked to published outcomes expected of entry-level physical therapists. Students in 3 cohorts of a 3-year Doctor of Physical Therapy (DPT) program completed the online SEPTSO 3 times over the course of 1 academic year. Results. There was a statistically significant difference among the 3 cohorts in self-efficacy. 05 F 74 = 51.93, ρ < .0001, with significant differences between self-efficacy scores in the classes of DPT 3 and DPT 1 (ρ < .001) and DPT 2 and DPT 3 (ρ < .001). A 2 × 4 Analysis of Variance (ANOVA) examining the effect of age or sex found no significant main effects for age (ρ = .059) or sex (ρ = .113) and no significant interactions (ρ = .843). Cronbach's alpha was .983 for the 25 items, demonstrating excellent and significant internal validity, and the item-to-total correlation was high for each item, ranging from .981 to .983. A factor analysis resulted in a model in which 2 factors explained 71% of the variance within the factors of patient management and professionalism. Discussion. The SEPTSO survey possesses excellent content validity without bias for age or sex. The potential uses of the SEPTSO survey include program evaluation, curriculum evaluation to identify program weaknesses, accreditation, and self-reflection in students.

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