An Assessment of Clinical Decision Making Skills Across a Physical Therapy Curriculum

Abstract

The problem: Physical therapy faculty state as an objective that graduates will be competent in clinical decision making. As students progress through the curriculum, and out into the profession, clinical decision making skills should increase. The problem is assessing these skills. The purpose of this research was to assess the clinical decision making of students across a curriculum. Procedures: The participants were four physical therapy classes (162 students). For the study, the Class of 1994 was one year post-graduation, the Class of 1995 had just graduated, the Class of 1996 had completed half of the curriculum, and the Class of 1997 had just enrolled in the program. The Class of 1997 was retested after two semesters. The Clinical Decision Making Scale(CDMS)(Jenkins, 1985)was administered to the students. The CDMS consisted of 40 items designed to measure the decision-making process. The scale yielded a total score and four subscale scores. Findings: No significant differences were found between CDMS total scores for the four classes. The Class of 1995 scored significantly higher on Subscale A (Searching for Alternatives and Options) than the Class of 1997. The Class of 1996 scored significantly higher than the Classes of 1994 and 1997 on Subscale D (Searching for Information and Unbiased Assimilation of New Information). The Class of 1997 exhibited a near significant increase (p = -051) in total CDMS scores between enrollment and retesting. There were no significant relationships between CDMS scores and grade point averages (GPA) or clinical instructors' ratings. Conclusions: (1) Students at different levels of the curriculum did not exhibit differences in overall clinical decision making. (2) Students at different levels of the curriculum did exhibit differences in subsets of clinical decision making. (3) Students exhibited growth in clinical decision making across the first year of the curriculum. (4) Students' clinical decision making could not be predicted from GPA or clinical instructors' perceptions of students' clinical decision making. Recommendations: Research should be undertaken to gather longitudinal and normative CDMS data on physical therapy students and graduates to track development over their education and career.