Clinical competence among physiotherapists

The proposal should follow the below structures ,reference numbers will be as appropriate
as for a merit writing and double spaced require in paragraph .A research proposal
generally addresses the following:
Title Page – this must include the title of your research proposal, your student number and
date
Abstract
Table of Contents (with relevant page numbers)
Section 1: Introduction – This section includes
Introduction to the section (overview and background information)
Statement of the problem proposed to be investigated
General statement of the aim(s) of the proposed research
Relevance, significance or need for the study
Section 2: Literature Review – This section includes
Introduction to the section
Process of literature identification
Critical analysis of the literature relative to the proposed study
Combination, comparison and contrasting of the literature:
Conclusion: summary of the literature findings linked to the study aims and a research
question(s) or hypothesis(s)
Research question(s) or hypothesis(es) to be investigated in the proposed study
Section 3: Methodology – This section includes
Selection and justification of research approach or design
Section
Specific methods of data collection to be used in the research and their justification
Sampling strategy
Description of how subjects/participants will be recruited

2

Indication and justification of required number of subjects/participants
Indication and justification of inclusion/exclusion criteria
Materials or equipment needed and accessibility (if appropriate)
Comprehensive description of procedures
Description of pilot test of data collection method that will be carried out prior to initiation
of the full study Description of outcome measure(s) or standardized tool or questionnaire
including levels of measurement Justification of chosen method(s) of data analysis
Consideration of possible sources of bias (in quantitative or survey approaches) or role of
researcher (in qualitative approaches)
Indication of safety issues, if relevant to the proposed study
Indication of any risks to subjects / researcher- no risk is not acceptable, all studies have
some risk, even if minor
Indication of ethical issues relevant to the proposal including explanation of how informed
consent is achieved, issues of confidentiality, anonymity and data security
4 Conclusion – This section includes:
Discussion of possible limitations of the study as proposed. ? Overall conclusion for the
proposal
Reference List -Reference list for entire proposal in Harvard reference format
Appendices – The following should be included:
Participant information sheet and consent form for the proposed study
Proposed data collection sheets
A copy of the questionnaire (if relevant)
Any other relevant documentation for your proposal
Time frame

3
Clinical Reasoning in Physiotherapy: Perceptions of Postgraduate Student

Physiotherapists Doing Msc. in UK   

Abstract

Clinical reasoning is an extremely fundamental aspect of clinical competence among
physiotherapists. However, there is limited research regarding how postgraduate students doing
their Masters degree understand and develop this cardinal component. This research aims at
exploring the current perceptions held by Masters postgraduate students in the UK. A qualitative
research approach will be used and there will be 10 participants from Queen M. University. The
study will use purposive sampling and focus groups will be used to gather data.

4

Table of contents

Introduction…………………………………………………………………4
Overview and background…………………………………………………..4
Problem statement…………………………………………………………..4
General statement of the aims……………………………………………….4
Significance of the study…………………………………………………….4
Literature review……………………………………………………………..4
Summary of the literature…………………………………………………….6
Methodology…………………………………………………………………6
Research approach……………………………………………………………6
Data collection methods………………………………………………………6
Sampling strategy……………………………………………………………..7
Recruiting the participants…………………………………………………….7
Required number………………………………………………………………7
Inclusion and exclusion criteria………………………………………………..7
Materials……………………………………………………………………….7
Data analysis methods…………………………………………………………7
Sources of bias………………………………………………………………….8
Role of researcher………………………………………………………………8
Safety issues and Risks…………………………………………………………9
Ethical issues……………………………………………………………………9
Possible limitations………………………………………………………………9
Conclusion………………………………………………………………………9
Reference list……………………………………………………………………10
Appendices……………………………………………………………………..11

  1. Interview Schedule……………………………………………………..11
  2. Informed consent letter…………………………………………………12
  3. Study timetable …………………………………………………………14

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Introduction

Overview and background
Clinical reasoning is the decision making and thinking process that is used in clinical
practice. Physiotherapists are required to link theory and practice since past experiences and
present knowledge are necessary in making any decision. It is imperative for any physiotherapist
to have advanced skills in clinical reasoning. These decisions involve the care, management, and
treatment of patients (Anderson, 2005: 105). In this regard, a physiotherapist can be able to
explain and justify to patients why he used particular treatment plans (Larin, Wessel & Al-
Shamlan, 2009: 39). This ensures that the best decisions are made, which is vital for the
provision of quality patient care. Clinical reasoning is also considered to be a cardinal
component for all physiotherapists’ clinical competence. Usually, clinical decisions are made
after considerations of a patient’s physical and clinical conditions (Zayas & Lietz, 2010: 197).
This study was considered necessary following the concerns of musculoskeletal clinical teachers
regarding the level of variability of clinical reasoning skills among postgraduate students across
the curriculum. The variability was most evident during the second year of the students’ masters
program.
Problem statement
Clinical reasoning is a process that takes place during every interaction a physiotherapist
has with patients as well as significant others including health team members and carers (Larin,
Wessel & Al-Shamlan, 2009: 56). In addition, clinical reasoning is cardinal when devising
management strategies and treatment plans and this is based on professional judgment, patient
choice, knowledge, experience, and clinical data. During the process, a certain treatment
intervention is selected over other possible options and it continues throughout unending patient
management. This points out how vital clinical reasoning is among physiotherapists. Using a
phenomenographic perspective, a wide array of research indicates that learning conceptions
among students influences their learning manner. Students who perceive learning to be repetitive
memorization have a higher likelihood of using simple strategies and, therefore, conceptualize
the topic in a limited way. On the other hand, students who learn with an intention of
understanding of understanding the topic have higher tendencies of engaging in activities that
achieve more sophisticated conceptualization and promote understanding (Larin, Wessel & Al-
Shamlan, 2009: 47). This gives the implication that how physiotherapy postgraduate students
conceptualize clinical reasoning is likely to impact on their manner of reasoning in clinical
settings. Research examining the manner in which clinical reasoning is comprehended and
perceived among physiotherapy postgraduate students is limited (Zayas & Lietz, 2010: 201).
Purpose of the study
The aim of this study will be to explore the perceptions of clinical reasoning among
physiotherapy masters students in the UK.
Aims and objectives:

  1. To explore the present knowledge and understanding of clinical reasoning amongst
    postgraduate students physiotherapists in UK.
  2. To determine the experiences of clinical reasoning in various field of physiotherapy
    practice amongst postgraduate student.
  3. To describe the perspectives of clinical reasoning among postgraduate students
    physiotherapists.
    General Research question

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What are the perceptions of clinical reasoning in physiotherapy amongst student physiotherapists
undertaking masters’ degree in UK?
Research Questions

  1. What is the present knowledge and understanding of clinical reasoning amongst
    postgraduate students physiotherapists in UK? (Anderson, 2005: 105).
  2. What are the clinical reasoning experiences in various fields of practice among
    postgraduate students?
  3. What are the clinical reasoning perspectives among the postgraduate students
    physiotherapists?
    Significance of the study
    Knowledge of the understanding, perceptions, and experiences of clinical reasoning
    among postgraduate physiotherapy students is vital in designing useful teaching curriculums.
    Teaching can only become a rational activity when the instructor comprehends how and what
    students conceptualize or discern the phenomenon being imparted on them (Ramklass, 2013: 8).

Literature review

Novice practitioners as well as postgraduate students mostly use the hypothetical-
deductive strategy of clinical reasoning. This approach is considered to be weak since the
practitioner usually focuses on the superficial issues. Novice practitioners as well as postgraduate
students use this strategy as they consider it to be the best considering their limited non-
propositional knowledge (Larin, Wessel & Al-Shamlan, 2009: 62).
For physiotherapists to be able to deliver safe and effective care, there is a need for
additional categories (Crawford, Fazey & Singer, 2010: 59). Therapists with varying training are
likely to ask questions that differ. In addition, they will conduct different tests depending on the
significance accorded to physical and subjective information availed by the patients. However,
regardless of these variations, the questions asked by physiotherapists aim at reaching a common
goal; understanding and managing the patient’s problem. Physiotherapists acquire this
information based on the symptom’s source or dysfunction, contributing factors,
contraindications and precautions to treatment and physical examination, management, and
prognosis. It is worth noting that the mentioned categories are not specific to any approach or
physiotherapy philosophy (Hendrick et al., 2009: 438). Any physiotherapist using the
hypothetical-deductive clinical reasoning cannot underrate these categories.
Regardless of the fact that epidemiological studies offer insight into the possible cause of
various injuries and diseases, physiotherapists have a role of informing patients the level to
which their disorder in agreeable to physical therapy as well as the estimated timeframe for
which recovery is possible (Jensen et al., 2000: 29). Therefore, the prognosis category can be
made based solely on every patient’s individual presentation. So as to be able to receive
information that leads to various hypothesis categories, there is a need to use both physical and
subjective examination (Ramklass, 2013: 5).
Conducting routine treatment plans that are not linked to previous patient examination
requires physiotherapists to have clinical reasoning skills. It is extremely important to use data
generated from patient interviews in generating problem statements and establishing measurable
goals. Treatments should be made based on the generated hypothesis. Physiotherapists should
also be able to reassess the impacts of the implemented treatment (Hendrick et al., 2009: 440).
This algorithm helps is teaching the hypothetical- deductive clinical reasoning method as well as
helping clinicians to identify instances where their actions are not formulated logically.

7
Physiotherapists recommend a model that emphasizes on hypothesis modification,
testing, and generation, and this should be incorporated throughout the entire encounter with a
patient. This also includes physical examination, interview, and ongoing management (Jensen et
al., 2000: 35). It is worth pointing out that the clinical reasoning process depicts a cyclical
character and the process also has phases that are influenced by numerous key factors. The first
step in the clinical reasoning process requires the therapist to observe and interpret the patient’s
initial cues. These steps should also encompass the opening moments where the therapist greets
the patient (Ramklass, 2013: 7).There should be observation of particular cues including the
resting posture, movement patterns, facial expressions, appearance, age, and all spontaneous
comments. These cues enable the therapist to come up with an initial concept regarding the
problem. This also should involve preliminary working hypotheses that will be considered
throughout the entire examination as well as during the ongoing treatment (Jensen et al., 2000:
40). A majority of the curriculum frameworks recommend that there should be a reciprocal link
between postgraduate and clinical settings (Sole et al., 2013: 63). An addition, the frameworks
assert that strong links are necessary between practice and theory. Rarely do postgraduates use
pattern recognition due to limited experience and knowledge and this may lead to disregard of
contextual information. A majority of the physiotherapists hold the notion that the physiotherapy
setting determines the decisions that are made (Ramklass, 2013: 4). For instance,
physiotherapists working in the musculoskeletal setting are more oriented towards functional or
movement problems and, therefore, there may be difficulties identifying other vital problems. On
the same note, physiotherapists working in the pediatric, geriatric, or neurology environment
tend to emphasize more on the client’s psychomotor, social, and psychological status (Crawford,
Fazey & Singer, 2010: 64).
The reflections and perceptions of more experienced practitioners and students vary from
novice students who are beginning their clinical experience. Mostly, novices and students who
are unable to modify treatment sessions during their practice use reflect-for-action and reflect-
on-action (Hendrick et al., 2009: 441). A majority of the physiotherapists hope to improve their
clinical reasoning skills with continued practice. Errors made during a session can be a tool for
cultivating better clinical reasoning skills and reflecting on modifications that are likely to better
future sessions (Zayas & Lietz, 2010: 189). On the contrary, experts possess the ability of
adapting treatment procedures in a session to fit the patient.
Summary of the literature
Clinical reasoning is a very vital strategy in physiotherapy since it guides practitioners in
the decisions they make, offering the most relevant treatment plan, and putting all individual
aspects into consideration. There is a need for practitioners to possess in-depth non-propositional
and propositional knowledge, sociocultural and psychological knowledge, and immense
experience. These are the ingredients for sound clinical reasoning. Clinical reasoning is a
thinking that is essential for guiding practice. Narrative reasoning is acknowledged to be very
crucial in informing practitioners about patient attitudes, emotions, beliefs, and feelings, and
these have an impact on patient outcomes and treatment interventions (Hendrick et al., 2009:
435). Continuous reflection is important in that it leads to initiation of alternative treatments that
can suit the patient and maximize his outcomes.
There are several clinical reasoning models that are basically founded on the analysis of
patient and clinician interactions (Anderson, 2005: 105). These are extremely important and
relevant to physiotherapy. They include narrative reasoning, diagnostic or hypothetico-deductive
reasoning, and pattern recognition.

8

Methodology

Research approach
An interpretive and qualitative approach founded on phenomenography principles
(internal relationship, 2 nd -order perspective, and experience structure) will be used in the
research. As far as 2 nd -order perspective is concerned, category meanings will be defined based
on students’ explanations of clinical reasoning conceptualizations as opposed to definitions
obtained from previous researches. The structure and meaning of students’ conceptualizations
will be accessed through questions regarding what they comprehend in regard to every aspect
and how this is understood (Zayas & Lietz, 2010: 193).
Data collection methods
Data will be collected from the postgraduate students through focus groups interviews at
the middle of their second year after all practical sessions and lectures involving clinical
reasoning are over. Through the focus groups interviews, it will be possible to collect data from a
number of participants in one session. Participants will have an opportunity of hearing what
others have to say and this will ensure that they rethink their views. The focus group will be
scheduled to occur within three weeks following completion of the MS clinical placement. The
exercise of data collection will take one month. The study will be conducted by a PhD student
who has a science background.
Basically, the focus group will concentrate on what the students comprehend and the
manner in which they carry out their practice. Participants will be requested to elaborate their
practice examples and describe how they understand clinical reasoning, clinical information or
knowledge as well as learning, including how that understanding is achieved. The audiotapes
will be transcribed verbatim and the transcripts will be checked against the audiotapes before
beginning data analysis.
Sampling strategy
Purposive sampling will be used in the study. The study will comprise of 10
physiotherapy postgraduate students from Queen M. University in the UK. The student
participants will be selected based on their availability. The students will be in their second year
of Masters study and with a minimum of 2 years physiotherapy experience. The experience
should either be in card or neuro respiratory or musculoskeletal physiotherapy, which will form
the basis for grouping. These three practice fields will be chosen since they represent cardinal
physiotherapy areas of practice as acknowledged by the United Kingdom Physiotherapy Council.
In addition, the participants will be grouped based on their sex (Sole et al., 2013: 60). Purposive
sampling will ensure that knowledgeable and experienced participants are used in the study.
Recruiting the participants
Students will be given adequate information regarding the research during lectures at the
start of their second year in master’s degree. The students will also be guaranteed that failing to
participate in the research will not bear any effects on their assessment results or grades. They
will, therefore, be asked to volunteer (Jones, 1992: 881).
Required number
10 participants from Queen M. University will be adequate to provide sufficient data in
the research.
Inclusion and exclusion criteria
During the selection of participants, those who have English as their second language will
be excluded. In addition, postgraduate students who are not through with their MS clinical
placement by the year of the study will also be excluded. The participants shall be aged 22 years

9
or more and have not less than 2 years physiotherapy experience. Students who practice in the
card or neuro respiratory or musculoskeletal physiotherapy fields will be selected to participate
in the study and their inclusion will ensure diverse clinical practice setups and, therefore, it will
be easier to explore clinical reasoning skills and perceptions.
Materials
The research will be funded by the Research into University Teaching grant. Adequate
time will be dedicated so as to ensure quality research (Crawford, Fazey & Singer, 2010: 59).
Data analysis methods
During every analysis stage, the data will be explored separately while searching for
evidence that does not confirm to evolving categories and themes (Adams, 1981: 32). The
research analysis will assess and address assumptions in regard to evolving categories and
themes regularly. This will be a strategy for ensuring trustworthy data representation. The base
analysis unit will comprise of the entire student’s transcript. The analysis will involve three
stages;
First, there will be a crude initial sorting and reading where individual transcripts will be
read and grouped based on similarities and differences (Bialocerkowski, Golding & Delany,
2013: 47). This will ensure that there is easier access to the complex and huge amount of data.
Second, there will be a refined categorization where transcripts in every group will be subjected
to a more detailed analysis. There will be a keen analysis of various aspects regarding students’
conceptual fields and these will be compared to other aspects so as to come up with the meanings
that students link to knowledge, learning, patient care, practice, and clinical reasoning (Jensen et
al., 2000: 39). This analysis will be aimed at revealing what students understand regarding
clinical reasoning (meanings ascribed to the whole and parts), each aspect’s structure (how
experiences will be described), and the potent logic or rationale for the link between aspects (the
reason why students comprehended experiences in the manner they will describe them).
Transcategory and intracategory differences and similarities will be identified and compared.
There will be a continuous revisitation of the emerging categories and these will be adjusted so
that they are considered in the data using the above described disconfirmation process. Detailed
descriptions of every category will be prepared (Bialocerkowski, Golding & Delany, 2013: 47).
The criteria used for allocating categories will be identified, and the experiences of every
individual will be checked against the criteria and category description. Finally, completed
category descriptions will be subjected to meta-analysis with the aim of identifying general
themes that were evidenced in various forms across categories (Sole et al., 2013: 59).
Validity and reliability
So as to ensure that procedural reliability and validity are maintained during the study,
the interview questions will be reviewed regularly to ensure that their answers relate to the
purpose of the study. In addition, there will be continuous checks during analysis (Crawford,
Fazey & Singer, 2010: 52). Focus group interviews will provide quality controls as participants
will provide balances and checks on each other. This will be useful in curbing extreme and false
views.
Pilot study
Before the main study, a pilot study will be conducted using another group of 10
participants with the same qualifications as those in the main study but who will not participate
in the main study. This will be aimed at assessing the appropriateness and testing the adequacy
of the research instruments. The pilot study will help in determining if the sampling technique is

10
effective, collecting preliminary data, determining the important resources, and it will also be
used to convince the funding body.
Preventing bias
The research will consider measures that would inhibit bias (Sran & Murphy, 2009: 236).
It will audit the evolving categories and themes. This will be achieved this through checking
them regularly against the raw data as a strategy of promoting validity. Several strategies such as
disconfirmation and audit trails are some of the means through which robustness and credibility
of the data analysis and research process will be promoted. Category descriptions will be
subjected to audit as well as peer review in two seminars. Each of the seminars will have twenty
five physiotherapy faculty staff members and academic staff members, and this will be
conducted at the proposed location of the research. The audience will be required to give their
feedbacks and these will be noted and included in the research. The research will verify clinical
reasoning conceptualizations as well as cross-category themes based on his clinical reasoning
experiences in physiotherapy curriculum (Sran & Murphy, 2009: 241). It will review audit trails
and ensure a step-by-step cross-examination of the associated documents and research process.
Role of researcher
Data will be mediated through the researcher; human instrument. The research will be
required to elaborate relevant self aspects, as well as assumptions and biases, experiences that
qualify the ability in conducting research, and any expectations. Research journals that explicit
personal reflections and reactions and insights into the past and self will be kept. The study will
ask probing questions, then listen, think, and later ask more probing questions so as to engage a
deeper conversation. A picture will be built through the use of theories and ideas from numerous
sources. The research will ensure that validity and reliability are maintained (Bialocerkowski,
Golding & Delany, 2013: 47).
Safety issues and Risks
The research will adhere to the protocols of ethical research practice so as to ensure the
well-being and safety of the participants (Sran & Murphy, 2009: 237). Regardless of the fact that
this is a qualitative research and only minimal risks can occur to the participants, any risks that
are likely to occur will not be disregarded. The research is a bit sensitive and will touch on
taboos and personal issues, which might pose threats to the participants. The research will also
be keen on maintaining safety. Measures will be put in place to avoid wider risks to the
researcher’s discipline, institution, and field of study (Adams, 1981: 39).
The participants will have the benefits and risks of participating elaborated to them as a
component of the consent procedure. This will ensure that they put this into consideration when
deciding if to participate or not. Risks will be assessed during the entire research. During the
dissemination and publication of the research, risk considerations will be addressed. When
conducting the interviews, the research will be sensitive to the feelings of participants and any
discomfort or distress they experience will be solved appropriately. In this research, it is
expected that there will be more emotional than physical risks. The research will also be keen on
noting physical signs so as to identify where participants need to elaborate more or when the
interview should be stopped (Jones, 1992: 877).
Ethical issues
Before the study is conducted, a copy of the proposal will be presented to the Human
Ethics Committee so that they grant their approval. Participants will take part in the research
voluntarily and confidentiality will be guaranteed (Jones, 1992: 882). No real names of the
participants will be used.

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Possible limitations
Regardless of the fact that the results of the study may inform Masters postgraduate
students in the United Kingdom, their application to PhD postgraduate students should be made
with extra caution. The research design used is inappropriate in identifying a developmental
trend. The development of clinical reasoning as well as its influences can only be investigated
through the use of longitudinal studies that track how individual students progress in different
physiotherapy disciplines including neurorehabilitation. The research will be conducted on a
volunteer basis and this gives the implication that many students will disagree to participate.
According to Adams (1981: 76), student recall bias and volunteer basis might influence the
responses students will give regarding patient-related questions. Therefore, these might influence
the distribution of clinical reasoning conceptualizations (Jones, 1992: 876). The study will also
be limited in that there will group dynamics including reluctance to air opinions publicly and
power struggles.

Conclusion

In the past, clinical reasoning perceptions were not explored qualitatively through the use
of direct experience from students as the data. There is a need for further research of this nature
and in particular, longitudinal studies. These will offer a novel way through which perceptions
on clinical reasoning can be explored as well as insight into its assessment, teaching, and
development. There is a need for constant assessments regarding students’ understanding at a
specific period during their study. This knowledge is extremely important to students and
teachers in student learning advancement.

12

Reference list

Adams, P 1981, Effective teaching of tertiary learners: strategies and faculty development
implications, University of Lethbridge, New York.
Anderson, LW 2005, ‘Objectives, Evaluation, and the Improvement of Education,’ Studies in
Educational Evaluation, vol. 31, pp. 102- 113.
Bialocerkowski, A, Golding, C & Delany, C 2013, ‘Teaching for thinking in clinical education:
Making explicit the thinking involved in allied health clinical reasoning,’ Focus on
Health Professional Education: A Multi-disciplinary Journal, vol. 14 iss. 2, pp. 44- 56.
Crawford, RJ, Fazey, PJ & Singer, KP 2010, Teaching and learning in postgraduate manual
therapy education: Perspectives on clinical supervision. In Educating for sustainability.
Proceedings of the 19th Annual Teaching Learning Forum, 28-29 January 2010. Perth:
Edith Cowan University.
Hendrick, P, Bond, C, Duncan, E, & Hale, L 2009, ‘Clinical Reasoning in Musculoskeletal
Practice: Students’ Conceptualizations,’ Physical Therapy, vol. 89 iss. 5, pp. 430-442.
Jensen, GM, Gwyer, J, Shepard, KF & Hack, LM 2000, ‘Expert practice in physical therapy,’
Physical Therapy, vol. 80 iss. 1, pp. 28-43.
Jones, MA 1992, Clinical Reasoning in Manual Therapy, PHYS THER. Vol. 72, pp. 875- 884.
Larin, H, Wessel, J & Al-Shamlan, A (2009), ‘Reflections of physiotherapy students in the
United Arab Emirates during their clinical placements: a qualitative study,’ BMC Med
Educ., vol. 20: iss. 3, pp. 34- 67.
Ramklass, S 2013, ‘The clinical Education Experience of Student- Physiotherapists within a
Transformed Model of Healthcare,’ The Internet Journal of Allied Health Sciences and
Practice, vol. 11, iss. 2, 1-9.
Sole, G, Schneiders, A, Hebert-Losier, K & Perry, M 2013, ‘Perceptions by physiotherapy
students and faculty staff of a multimedia learning resource for musculoskeletal practical
skills teaching,’ New Zealand of Physiotherapy, vol. 41 iss. 2, pp. 58- 64.
Sran, MM & Murphy, S 2009, ‘Postgraduate Physiotherapy Training: Interest and Perceived
Barriers to Participation in a Clinical Master’s Degree Programme,’ Physiother Can., vol.
61 iss. 4, pp. 234–243.
Zayas, LE & Lietz, CA 2010, ‘Evaluating qualitative research for social work practitioners,’
Advances in Social Work, vol. 11 iss. 2, pp. 188- 202.

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Appendixes

Focus Group Interview Schedule

  1. This first question addressed all about you. Give me a little information about yourself.
    How old are you? Where are you from? Why did you decide to do physiotherapy?
  2. Which is you field of practice?
  3. You have just completed you MS clinical placement. I would request you to reflect about
    the placement. Then select a certain patient you dealt with and are comfortable
    discussing.
    Depending on the response given, some of the probable probes include the following;
    i. Tell me about the patient.
    ii. What problem did the patient have?
    iii. Why have you preferred discussing this particular patient?
    iv. What were you thought on interacting with the patient for the first time?
    v. How did you respond to the situation?
    vi. What was the reason behind this reaction?
    vii. What were your conclusions?
    viii. What drove you to those conclusions?
    ix. Can you elaborate on the process through which the conclusions were reached?
  4. What do you understand by the term clinical reasoning?
    a. Can you elaborate more?
    b. Can you give an example where clinical reasoning is essential in physiotherapy practice?
    c. Why do you think it is necessary?
  5. Can you provide an example where you were required to use you clinical reasoning skills
    during practice?
    i. Elaborate more about the situation; what took place?
    ii. Were you skills productive?
  6. Why is clinical reasoning necessary during practice?
  7. What did you acquire and develop your clinical reasoning skills?
    a. Can you elaborate more about that?
    b. What factors affected the development?
    c. Has the development changed? How?
    d. Has physiotherapy curriculum impacted on these skills in you?
  8. What do you think clinical knowledge means?
  9. How is learning achieved in the clinical area?
  10. What does learning mean to you?
  11. What questions, suggestions, comments, or concerns do you have?

14

Informed consent letter

Title of the study: Clinical Reasoning in Physiotherapy: Perceptions of Postgraduate Student
Physiotherapists Doing Msc in UK     
Researcher:
Name
Department
Address
Phone number
Email
Background:
This is an invitation for you to participate in a research. Before making the decision to
participate, it is crucial that you comprehend the reason as to why the research is being
conducted and all that it involves. Therefore, I request that you read this information keenly.
Kindly ask any questions or clarifications that may arise. If you need more information, contact
the researcher.
The study is aimed at exploring the present understanding on clinical reasoning among
postgraduate students, the perceptions they hold, and how these are acquired.
Study Procedure
You will be expected to dedicate some of your time to answer the interview questions. The study
will be elaborated more during lectures and the participation is voluntary.
Risks
There are minimal risks related to this research. The risks are the same as those experienced
when revealing work-related concerns to others. Some of the questions in the study may make
some participants emotional particularly those connected to their experiences. You can decline
answering some the questions and if there are pressing concerns, you are also free to terminate
participation.
Benefits
There shall be no direct benefit for volunteering to participate in the study. However, it is hoped
that the questions and responses given will enable the participants to reflect more about their
practice. No monetary compensation will be given to the participants.
Confidentiality
Kindly note that no identifying information should be released during the interview. The
responses should be anonymous.
Consent
My signature on this consent form confirms that I have read and comprehended the information
and will, therefore, take part in the study. I understand I can withdraw in case I have any pressing
concerns and the participation is voluntary. I also understand that a copy of this consent form
will be given to me. I will participate in the study voluntarily.

15

Signature………………………….. Date ……………………..

16

Study timetable
Activity Estimated Timeframe
Pilot study 1 st January- 15 th March
Develop research objectives 16 th March- 22 nd March
Design research protocol 23 rd – 31 st March
Designing the instrument 1 st – 12 th April
Recruit participants 13 th – 30 th April
Pretesting and revising the instrument 1 st – 14 th May
Collect data 15 th May- 15 th June
Transcribe recordings 16th – 22 nd June
Data analysis 23 rd June- 23 rd July
Prepare the presentation 24 th – 5 th August
Present the preliminary results to the
committee

6 th – 9 th August
Prepare the report 10 th – 23 rd August
Present the report 24 th – 26 th August