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Clinical Reasoning Curricula & Assessment

This consortium will serve as a resource and forum for educators both clinical and academic interested in best practice for teaching and assessing clinical reasoning skills. Additionally, the group will work to develop a research plan relative to clinical reasoning and will conduct multi-institutional research projects to increase our understanding of clinical reasoning.


  • To develop a research plan to further the understanding of all aspects of clinical reasoning
  • To conduct multi-site research studies relative to clinical reasoning
  • To provide continuing education relative to teaching and assessing of clinical reasoning
  • To develop best practice standards for clinical reasoning curricula and assessment
  • To be a resource for educators seeking advanced knowledge relative to understanding, teaching and assessing clinical reasoning skills

The CRCAC Consortium will meet at CSM and ELC

    Journal Club:

    Thank you to all of you who joined our virtual journal club, it was a great discussion! For those of you how could not make it here is a link to the recording: http://apta.adobeconnect.com/pgdykf9303jw/


    • Chair: Karen Huhn PT, PhD huhnk@husson.edu
    • Vice Chair: Chris Sebelski PT DPT PhD OCS chris.sebelski@health.slu.edu
    • Secretary: Nicole Christiansen PT PhD MAappSc  nchristensen@samuelmerritt.edu
    • Nominating Committee: Terri Miller Teresa.Miller@downstate.edu and Brent Harper PT DPT DSc PhD, OCS bharper2@RADFORD.EDU

    Bibliography of Select Clinical Reasoning Articles:


    1. Leighton R, S. Model for teaching clinical decision making in a physical therapy professional curriculum. Journal of Physical Therapy Education. 1997;11:23-30.

    2. Tichenor CJ, Davidson J, Jensen G. Cases as shared inquiry: Model for clinical reasoning. Journal of Physical Therapy Education. 1995;9:57-62.

    3. Koharchik L, Caputi L, Rob M, Culleiton AL. Fostering clinical reasoning in nursing students. Am J Nurs. 2015;115:58-61.

    4. Higgs J. Developing clinical reasoning competencies. Physiotherapy. 1993;78:575-582.

    5. Artino, AR, Cleary, T, Dong, T, Hemmer, PA, Durning, SJ. Exploring clinical reasoning in novices: A self-regulated learning microanalytic assessment approach. Medical Education. 2014;48:280-291.

    6. Epstein RM. Mindful practice in action: Technikcal competenece, evidence-based medicien, and relationship-cenered care. Families, Systems & Health. 2003;21:1-9.

    7. Fleming A, Cutrer W, Reimschisel T, Gigante J. You too cna teach clinical reasoning. Pediatric Perspectives. 2012;130.

    8. Durning SJ, Ratcliffe T, Artino AR, et al. How is clinical reasoning developedm maintained, and objectively assessed? views from expert internists and interanal medicine interns. J Contin Educ Health Prof. 2013;33:215-223.

    9. Saucier B, S. Critical thinking outcomes of computer-assisted instruction versus written nursing process. Nurs Health Care Perspect. ;21:240-246.

    10. Durning S, Artino AR, J., Pangaro L, van dV, Schuwirth L. Context and clinical reasoning: Understanding the perspective of the expert's voice. Med Educ. 2011;45:927-938.

    11. Rochmawati R, Wiechula R. Education strategies to foster health professional students' clinical reasoning skills.Nursing and Health Sciences. 2010;12:244-250.

    12. Embrey DG, Guthrie MR, White OR, Dietez J. Clinical decision making by experienced and inexperienced pediatric physical therapists for children with diplegic cerebral palsy. Phys Ther. 2006;76:220-214.

    13. Tanner CA. Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education [H.W. Wilson - EDUC]. 2006;45(6):204. http://search.proquest.com/docview/198113959.

    14. Koharchik L, Caputi L, Robb M, Culleiton A. Fostering clinical reasoning in nursing students. AJN, American Journal of Nursing. 2015;115(1):58-61. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00000446-201501000-00031. doi: 10.1097/01.NAJ.0000459638.68657.9b.

    15. Kumta S, Tsang PL, Cheng J. Fostering critical thinking skills through a web-based tutorial programe for final year medical students- A randominzed control study. Journal of Educational Multimedia and Hypermedia. 2003;12:267-273.

    16. Bowen JL. Educational strategies to promote clinical diagnostic reasoning. N Engl J Med. 2006;355:2217-2225.

    17. Mitchell R, Unsworth C. Clinical reasoning during community health home visit: Expert and novice differences. British Journal of Occupational Therapy. 2005;68.

    18. Noll E, Jensen G. Clinical reasoning of an experienced physiotherapist: Insight into clinician decision-making regarding low back pain. Physiotherapy Research International. 2001;6:40-51.

    19. Eva KW. What every teacher needs to know about clinical reasoning. Med Educ. 2005;39:98-106.

    20. Cappelletti A, Engel JK, Prentice D. Systematic review of clinical judgement and reasoning in nursing. J Nurs Educ. 2014;53:453-458.

    21. New resource for patient safety and quality. Advances in Neonatal Care. 2008;8(4):193. doi: 10.1097/01.ANC.0000333700.86195.e5.

    22. Shellenbarger T, Robb M. Technology-based strategies for promoting clinical reasoning skills in nursing education. Nurse Educator. 2015;40(2):79-82. http://www.ncbi.nlm.nih.gov/pubmed/25402714. doi: 10.1097/NNE.0000000000000111.

    23. Woods NN. Science is fundamental: The role of biomedical knowledge in clinical reasoning. Med Educ. 2007;41:1173-1177.

    24. Watson F, Rebair A. The art of noticing: Essential to nursing practice. British Journal of Nursing. 2014;23.

    25. Vendrely A. An investigation of the relationships among academic performance, clinical performance, critical thinking and success on the physical therapy licensure examination. J Allied Health. 2007;36:108.

    26. Case K, Harrison K, Roskell C. Differences in the clinical reasoning process of expert and novice cardiorespiratory physiotherpistsPhysiotherapy. 2000;86:14-21.

    27. Kuiper RA, Pesut DJ. Promoting cognitive and metacognitive reflective reasoining skills in nursing practice: Self-regulated learning theory. J Adv Nurs. 2004;45:381-391.

    28. Schuwirth L. Is assessment of clinical reasoning still the holy grail? Med Educ. 2009;43:298-299.

    29. Scaffa M, W. Brief report-effects of problem-based learning on clinical reasoning in occupational therapy. The American Journal of Occupational Therapy. 2004;58.

    30. Robertson LJ. Clinical reasoning part 2: Novice/expert differences. British Journal of Occupational Therapy. 1996;59:212-216.

    31. Ramani S, Leinster S. AMEE guide no. 34: Teaching in the clinical environment. Med Teach. 2008;30:347-364.

    32. Norman G, Young M, Brooks L. Non-analytical models of clinical reasoning: The role of experience. Med Educ. 2007;41:1140-1145.

    33. Dowding D. Commentary on banning M (2008) A review of clinical decision making: Models and current research. journal of clinical nursing 17, 187-195. Journal of clinical nursing. 2009;18(2):309. http://www.ncbi.nlm.nih.gov/pubmed/19120761. doi: 10.1111/j.1365-2702.2008.02471.x.

    34. Audetat MC, Dory V, Nendaz M, et al. What is so difficult about managing clinical reasoning difficulties? Med Educ. 2012;46:216-227.

    35. Petit dit Dariel O, Ravaut F, Rothan-Tondeur M. Developing serious game potential in nursing education. Nurse education today.

    36. Jensen G, Shepard KF, Hack LM. The novice versus the experienced clincian: Insights into the work of the physical therapist. Phys Ther. 1990;70:314.

    37. Jensen G, Gwyer J, Shepard KF, Hack L. Expert practice in physical therapy. Phys Ther. 2000;80:28-43.

    38. Unsworth CA. The clinical reasoning of novice and expert occupational therapists. Scandinavian Journal of Ocuppational Therapy. 2001;8:163-173.

    39. Simmons B. Clinical reasoning concept analysis. Journal of Advanced Nursing. 2010;66(5).

    40. Groves M, A. Assessing clinical reasoning: A method to monitor its development in a PBL curriculum. Med Teach. 2002;24:507-515.

    41. Eva KW, Hatala RM, LeBlanc VR, Brooks LR. Teaching from the clinical reasoning literature: Combined reasoning strategies help novice diagnosticians overcome misleading information. Med Educ. 2007;41:1152-1158.

    42. Doody C, McAteer M. Clinical reasoning of expert and novice physiotherpists in an outpatient orthopaedic setting.Physiotherapy. 1992;88:258-268.

    43. Kreiter CD, B. The validity of performance-based measures of clinical reasoning and alternative approaches. Med Educ. 2009;43:320-325.

    44. Wessel J, W. Critical thinking and learning styles of students in a problem-based, master's entry-level physical therapy program. Physiotherapy Theory and Practice. 2004;20:79.

    45. McLeod-Sordjan R. Evaluating moral reasoning in nursing education. Nursing Ethics. 2014;21(4):473-483. http://search.proquest.com/docview/1547884116. doi: 10.1177/0969733013505309.

    46. Vendrely A. Critical thinking skills during a physical therapist professional education program. Journal of Physical Therapy Education. 2005;19:55-59.

    47. McCannon R, Robertson D, Caldwell J, Juwah C, Elfessi A. Comparison of clinical reasoning skill in occupational therapy students in the USA and scotlandOccupational Therapy International. 2004;11:160-176.

    48. Seldomridge L, W. Measuring critical thinking in graduate education: What do we know? Nurse Education. 2006;31:132-137.

    49. Newble D, Norman G, Vleuten vd. Assessing clinical reasoning. In: Higgs, J, Jones,M., ed. 2nd ed. Boston: Butterworth Heineman; 2002.

    50. Zettergren KK, Beckett R. Changes in critical thinking scores: An examination of one group of physical therapist students. Journal of Physical Therapy Education. 2004;18:73-79.

    51. Wilson RW. Evaluative properties of critical thinking tests: Change scores from students in physical therapy and other health care professions. Journal of Physical Therapy Education. 2000;14:27-31.

    52. Scott JN, Mrkert RJ, MM D. Critical thinking: Change during medical school and relationship to performance in clinical clerkships. Med Educ. 1998;32:14-18.

    53. May BJ, Dennis JK. Expert decision making in physical therapy-a survey of practitioners. Phys Ther. 1991;71:190.

    54. King C, B. Expertise in diagnostic reasoning: A comparitive study. British Journal of Therapy and Rehabilitation. 1998;5:78-87.

    55. Garrett BM, Callear D. The value of intelligent multimedia simulation for teaching clinical decision-making skills. Nurse Educ Today. 2001;21:382-390.

    56. Bartlett DJ, Cox PD. Measuring the change in students' critical thinking ability: Implications for health care education. J Allied Health. 2002;31:64-69.

    57. Jensen G, Gwyer J, Shepard KF, Hack L. Attribute dimensions that distiguish master and novice therapy clinicians in orthopedic settings. Phys Ther. 1992;72:711.

    58. May B, D. Expert decision making in physical therapy-a survey of practitioners. Phys Ther. 1991;71:190.

    59. Young JQ, Van Merrienboer J, Durning S, Ten Cate O. Cognitive load theory: Implications for medical education: AMEE guide no. 86. Meidcal Teacher. 2014;36:371-384.

    60. Kabanza F, Bisson G, Charneau A, Jang T. Implementing tutoring strategies into a patient simulator for clinical reasoning learning. Artif Intell Med. 2006;38:79-96.

    CSM 2017

    We met at CSM in San Antonio for another great discussion. Select our "Documents" tab to the right to be taken to a Glossary of Terms related to clinical reasoning that was developed at our meeting.


    JOIN US for the Clinical Reasoning Symposium in beautiful Omaha, NE on July 20-23, 2017! The symposium will be hosted by Creighton University and is is designed for all educators across academic and clinical environments (DCEs, CCCEs, CIs, Residency/Fellowship Directors/Mentors, Academic Faculty) working to facilitate learners' development of clinical reasoning abilities.

    Register here: https://aptaeducation.org/events/clinical-reasoning-symposium/2017/index.cfm

    Deadline for registration is May 15th!

    Campbell University

    Frank Tudini, PT, DSc, OCS, FAAOMPT

    Chapman University

    Susan Mais Requejo,

    Chapman University

    Jacklyn Brechter , PhD, PT

    Clarkson University

    Vicki Lafay,

    Columbia University

    Wing Fu, PT, PhD, MA

    Creighton University

    Lisa Black, PT, DPT

    Creighton University

    Jennifer Furze, PT, DPT, PCS

    Elon University

    Wendy Herbert, PT, PhD

    Emory University

    Tami Phillips, PT, DPT, MBA

    Emory University

    Tambre Phillips, PT, DPT, MBA

    Gannon University

    stephanie adams, DHSc, OTR/L

    Husson University

    Karen Huhn, PT PhD

    Husson University

    Kelly Macauley, PT, EdD, DPT, CCS, GCS

    Husson University

    Laura Sage, PT, DPT, MEd, GCS, WCC

    Long Island University - Brooklyn Campus

    Rosa Torres-Panchame, PT, DPT, OCS

    Mercer University

    Nora Bethany Collier,

    MGH Institute of Health Professions

    Tracy Brudvig, PT, DPT, PhD, OCS

    Mount St Joseph University

    Michael Obert,

    Nazareth College of Rochester

    JJ Mowder-Tinney, PT, PhD, NCS

    New York University

    Teresa Miller, PT, PhD

    New York University

    Sue O'Brien, PhD

    Northern Arizona University

    Petra Williams,

    Northwestern University

    Bill Healey, PT, EdD, GCS

    Nova Southeastern University - Fort Lauderdale

    Jennifer Canbek, PT, PhD, NCS

    Quinnipiac University

    Tracy Wall, PT, PhD

    Quinnipiac University

    Ken Kosior, PT, EdD, PTM, ATC

    Radford University

    Brent Harper, PT, DPT, DSc, OCS, FAAOMPT

    Rockhurst University

    Linda D'Silva, PT, PhD

    Rosalind Franklin University of Medicine and Science

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    Saint Francis University

    Kara L Kobal,

    Saint Louis University

    Chris Sebelski, PT, DPT, PhD, OCS

    Samuel Merritt University

    Nicole Christensen, PT, PhD, MAppSc

    Seton Hall University

    michael giuliano , MD, MEd, MHPE, MA

    Shenandoah University

    Aaron Hartstein,

    State University of New York Downstate Medical Center

    Teresa Miller, PT, PhD, GCFP

    Texas Womans University

    Jennifer Barbee Ellison,

    Texas Womans University

    Jennifer Ellison, PT, PhD

    The Ohio State University

    Amelia Siles, PT, DPT, NCS

    The Ohio State University

    Amelia Siles, PT, DPT, NCS

    The University of North Carolina at Chapel Hill

    Jennifer Martin, PT, DPT, GCS

    The University of North Carolina at Chapel Hill

    Rebecca Bliss, PT, DPT

    Thomas Jefferson University

    Susan Wainwright, PT PhD

    Touro University of Nevada

    Steve Liaos, DPT, DSC(c), OCS, SCS, FAAOMPT

    University at Buffalo, State University of New York

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    University of Cincinnati

    Ben Just, PT, MPT

    University of Colorado

    Michael Bade, PT, DPT, PhD, OCS, FAAOMPT

    University of Florida

    stephanie adams, DHSc, OTR/L

    University of Michigan - Flint

    Karen Berg,

    University of Minnesota

    Becky Olson-Kellogg,

    University of Minnesota

    Jacquelyn Ruen,

    University of Minnesota

    Jacquelyn Ruen,

    University of Missouri

    Anita Campbell,

    University of North Florida

    Nicholas LaRosa, DPT

    University of South Alabama

    Heidi McDermott, PT, DPT, OCS

    University of Southern California

    Sarah Gilliland, PT, DPT, PhD, CSCS

    University of Southern California

    Michael Andersen, PT, DPT, OCS

    University of Southern California

    Jonna Schengel, PT, MA, Ed.D.

    University of Southern California

    Deborah Walker, PT, DPT, OCS, GCS, CEEAA

    University of St. Augustine for Health Sciences - Florida

    Tobi Baldwin, PT

    University of Texas at El Paso

    Bryan Boyea, PT, DPT, OCS

    University of Texas at El Paso

    Bryan Boyea, PT, DPT, OCS

    University of the Incarnate Word

    Jaime Gonzalez, PT, DPT, OCS, SCS

    University of Utah

    Elizabeth Lane, PT, DPT, PhD(c), OCS, FAAOMPT

    University of Utah

    Kevin Helgeson, DHSc, PT

    University of Vermont

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    University of Wisconsin- Milwaukee

    Kathryn Zalewski,

    Virginia Commonwealth University

    Shawne Soper, PT, DPT, MBA

    Washington University in St. Louis

    Carey L Holleran,

    West Virginia University

    Julia Castleberry, DPT, NCS, GCS

    Winston-Salem State University

    Nancy Smith,

    Strategic Plan (docx)
    Download (80 KB)


    We held our first virtual journal club in December. The article discussed was: 

    Oberg K, Normann B, Gallaher S. Embodied-enactive clinical reasoning in physical therapy. Physiotherapy Theory and Practice. 2015;31(4):244-52.

    Here is a link to the recorded discussion: 


    We will host another journal club in March, more info to come.

    Join the Conversation. Contribute and Share in the ACAPT Discussions

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