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The aim of this study was to evaluate the construct validity of the Health Science Reasoning Test (HSRT) by determining if the test could discriminate between expert and novice physical therapists' critical-thinking skills. Methods: Experts identified from a random list of certified clinical specialists and students in the first year of their physical therapy education from two physical therapy programs completed the HSRT. Results: Experts (n = 73) had a higher total HSRT score (mean 24.06, SD 3.92) than the novices (n = 79) (mean 22.49, SD 3.2), with the difference being statistically significant t (148) = 2.67, p = 0.008. Conclusion: The HSRT total score discriminated between expert and novice critical-thinking skills, therefore establishing construct validity. To our knowledge, this is the first study to compare expert and novice performance on a standardized test. The opportunity to have a tool that provides evidence of students' critical thinking skills could be helpful for educators and students. The test results could aid in identifying areas of students' strengths and weaknesses, thereby enabling targeted remediation to improve critical thinking skills, which are key factors in clinical reasoning, a necessary skill for effective physical therapy practice. J Allied Health 2011; 40(4):181-186.
EXCELLENCE in physical therapy requires effective and efficient clinical reasoning. Clinical reasoning is a complex phenomenon comprised of an ensemble of contextual and cognitive factors. Contextual factors include health and life circumstances as well as emotional and social factors of both the patient and the therapist.1 Therapists clinical skill or experience is also a contextual factor. Cognitive factors are skills of wise judgment, reflection, and critical thinking. Critical thinking includes the skills of induction, deduction, evaluation, analysis, and inference. The intended outcome of clinical reasoning of physical therapists is to make a judgment about how to best provide interventions in light of patients signs, symptoms, goals, and life circumstances.2 Clinical reasoning, a metacognitive skill, requires therapists to think critically about patient signs and symptoms and, perhaps even more importantly, about their own thinking. Figure 1 provides a simplified representation of some of the cognitive and contextual factors involved in clinical reasoning.
The Commission on Accreditation of Physical Therapy Education (CAPTE) mandates physical therapy educators develop student's clinical-reasoning skills as well as assess students' ability to demonstrate...