Using the Case Method to Develop Clinical Reasoning Skills in Problem-Based Learning

Abstract

Clinical reasoning is increasingly recognized as a crucial component of the occupational therapy process. Different types of clinical reasoning used by occupational therapists have been identified, including scientific, procedural, interactive, narrative, conditional, and pragmatic reasoning. This article describes the use of the case method in the University of New Mexico undergraduate occupational therapy curriculum to facilitate development of occupational therapy students' problem-solving and reasoning abilities. The case method is a component of problem-based learning that emphasizes small group work to solve clinical problems that are presented as case studies. Students are presented with a variety of case formulas including paper or written cases, videotape cases, simulated client cases, and real client cases to promote the development of specific types of clinical reasoning. Problem-based learning may also hold promise as an educational strategy for fieldwork students and clinicians.

The Impact of Online Video Cases on Clinical Reasoning in Occupational Therapy Education: A Quantitative Analysis

“…The design of cases has included textbased cases, actors portraying clients, live interviews of clients, and videotapes of therapists and patients. These have been presented in classrooms as well as over internet platforms (Bazyk & Jeziorowski, 1989;Liu et al, 1997;Lysaght & Bent, 2005;Neistadt & Smith, 1997;Neistadt, Wight, & Mulligan, 1998;VanLeit, 1995). Consistent with literature in related disciplines, occupational therapy student satisfaction has been reported with instructional methods that use case-based reasoning and with learning outcomes that included knowledge acquisition, skill development, and readiness for fieldwork (Cook & Triola, 2009;Lysaght & Bent, 2005;Tomlin, 2005).…”

“…Case-based learning has been a staple of graduate and undergraduate education in a variety of health disciplines (Curran et al, 2008;Jonassen & Hernandoz-Serrano, 2002;Kaddoura, 2011;Kolodner, 1997;Thistlethwaite et al, 2012;Williams, 2009) and in occupational therapy (Bazyk & Jeziorowski, 1989;Liu et al, 1997;Lysaght & Bent, 2005;Neistadt & Smith, 1997;VanLeit, 1995). And although there is evidence for the use of this educational model, this evidence has not linked casebased learning specifically to clinical reasoning in occupational therapy in the past (Boyt Schell & Schell, 2008;Falk-Kessler & Ciaravino, 2006;Lederer, 2007;Mattingly, 1991;Rogers, 1983;Unsworth & Baker, 2016;Vogel et al, 2009).…”

“…This allows for consideration of the individual client in occupational therapy evaluation and interventions. The format of these cases have historically included written or text-based cases, videotaped patients, simulated or standardized patients, and stories elicited from former occupational therapy clients (Bazyk & Jeziorowski, 1989;Liu, Schneider & Miyazaki, 1997;Lysaght & Bent, 2005;Neistadt & Smith, 1997;VanLeit, 1995). All of these methods have theoretical foundations in case-based reasoning, a model that may be useful for understanding the cognitive process that occupational therapists use in performing clinical reasoning.…”

Comparison of Final Exam Test Scores of Neuroscience Students Who Experienced Traditional Methodologies versus Problem-Based Learning Methodologies

“…VanLeit (1995) has reported that students engaged in problem-based learning "move beyond being passive data collectors and begin, albeit slowly, to apply information and use a variety of reasoning skills critical to solving real clinical problems" (p. 352).…”

A Community Based Experience to Enhance Occupational Therapy Student Clinical Skills with Clients with Mental Illness

“…Beltran, Scanlan, Hancock, and Luckett (2007) found that structured experiences with a strong mentor and formal reflection were beneficial in altering student perceptions of individuals experiencing mental illness. Through these experiences, students are able to enhance their procedural, scientific and pragmatic reasoning, as well as experience deeper empathy and the ability to develop clinical reasoning skills (VanLeit, 1995). Beltran et al (2007) identified several factors that can positively or negatively impact a student's ability to work with individuals experiencing mental illness.…”