Fostering clinical reasoning in physiotherapy: comparing the effects of concept map study and concept map completion after example study in novice and advanced learners

Katherine Montpetit-Tourangeau, Joseph-Omer Dyer, Anne Hudon, Monica Windsor, Bernard Charlin, Sílvia Mamede, Tamara van Gog, Katherine Montpetit-Tourangeau, Joseph-Omer Dyer, Anne Hudon, Monica Windsor, Bernard Charlin, Sílvia Mamede, Tamara van Gog

Abstract

Background: Health profession learners can foster clinical reasoning by studying worked examples presenting fully worked out solutions to a clinical problem. It is possible to improve the learning effect of these worked examples by combining them with other learning activities based on concept maps. This study investigated which combinaison of activities, worked examples study with concept map completion or worked examples study with concept map study, fosters more meaningful learning of intervention knowledge in physiotherapy students. Moreover, this study compared the learning effects of these learning activity combinations between novice and advanced learners.

Methods: Sixty-one second-year physiotherapy students participated in the study which included a pre-test phase, a 130-min guided-learning phase and a four-week self-study phase. During the guided and self-study learning sessions, participants had to study three written worked examples presenting the clinical reasoning for selecting electrotherapeutic currents to treat patients with motor deficits. After each example, participants engaged in either concept map completion or concept map study depending on which learning condition they were randomly allocated to. Students participated in an immediate post-test at the end of the guided-learning phase and a delayed post-test at the end of the self-study phase. Post-tests assessed the understanding of principles governing the domain of knowledge to be learned (conceptual knowledge) and the ability to solve new problems that have similar (i.e., near transfer) or different (i.e., far transfer) solution rationales as problems previously studied in the examples.

Results: Learners engaged in concept map completion outperformed those engaged in concept map study on near transfer (p = .010) and far transfer (p < .001) performance. There was a significant interaction effect of learners' prior ability and learning condition on conceptual knowledge but not on near and far transfer performance.

Conclusions: Worked examples study combined with concept map completion led to greater transfer performance than worked examples study combined with concept map study for both novice and advanced learners. Concept map completion might give learners better insight into what they have and have not yet learned, allowing them to focus on those aspects during subsequent example study.

Keywords: Clinical reasoning; Cognitive load; Concept map; Far transfer; Near transfer; Physiotherapy; Worked example.

Conflict of interest statement

Ethics approval and consent to participate

The ethics committee of Université de Montréal’s Faculty of Medicine approved the study (12-029-CERES-D). Participants gave their informed consent to participate in the study.S5

Consent for publication

Not applicable. This manuscript contains no individual person’s data in any form (including individual details, images or videos). Consent forms should not be attached.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of study activities
Fig. 2
Fig. 2
Flowchart of guided-learning phase activities

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