The impact of an Italian student led physiotherapy clinic on student clinical reasoning
Autori
Sabot Raffaele Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Buoite Stella Alex Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Galmonte Alessandra Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Turolla Andrea Department of Biomedical and Neuromotor Sciences – DIBINEM, Alma Mater Studiorum Università di Bologna, Bologna, Italy; Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Canton Gianluca University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Murena Luigi University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Deodato Manuela University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Background and aims
Student-led clinics represent innovative academic-service models that enhance clinical reasoning (1) and practice through collaborative interactions among physiotherapy students, patients, and academic supervisors within dedicated clinical environments. Clinical reasoning constitutes a fundamental competency in physiotherapy education, enabling students to transition from theoretical knowledge to effective clinical decision-making (2,3). For bachelor-level students, developing robust clinical reasoning skills supports the delivery of safe, individualized, and evidence-based care. Previous research has demonstrated that clinical reasoning among physiotherapy students was significantly improved in student-led clinics compared to traditional educational models (4, 5). Consequently, the primary aim of this study was to evaluate and compare the impact of a student-led clinic model versus conventional clinical placement settings on clinical reasoning development in physiotherapy students.
Methods
A quantitative cross-sectional survey following STROBE guidelines was conducted among second- and third-year BSc physiotherapy students from University of Trieste who completed internships in both the Professional Development (PD) student-led clinic and traditional clinical settings. The study utilized a newly developed “Evaluation of Clinical reasoning during internship” questionnaire assessing eight domains of clinical reasoning, with responses scored from 1 (definitely not) to 5 (definitely). Data collection occurred between May-December 2024. Statistical analysis employed chi-square tests comparing “Good outcomes” (scores 4-5) versus “Bad outcomes” (scores 1-3), with significance set at p<0.05. The questionnaire demonstrated excellent internal consistency (α=0.921) and good test-retest reliability.
Results
A total of 102 students completed the questionnaire anonymously. The sample consisted of 38 women (37.25%) and 64 men (62.75%), with a mean age of 22.8 years (SD ± 2.1). The PD model demonstrated statistically significant superior student-perceived effectiveness compared to traditional models (territorial rehabilitation systems, hospitals, private centers, sports facilities, and elderly residences) across nearly all assessed domains. Specifically, the PD model showed substantial advantages in medical history taking, physiotherapy assessment and goal setting (25-30% higher positive responses), treatment progression and patient education (87% vs. 57-60% positive scores), discussion with peers (91.8% vs. 41.4%) and student-perceived autonomy in clinical reasoning (89% vs. 56.5%).
Conclusion
This study provides the first investigation of an Italian student-led physiotherapy clinic’s impact on clinical reasoning development. The PD model significantly enhanced clinical
reasoning across seven of eight evaluated domains compared to traditional placement models. These findings support previous research recognizing student-led clinics as sustainable, innovative models benefiting both regional healthcare systems and universities, while demonstrating their superior effectiveness in developing critical clinical reasoning skills among physiotherapy students.
REFERENCES
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