Which Clinical Reasoning Models Are Used by Physiotherapists, Occupational Therapists and Selected Allied Health Professionals? A Scoping Review.

BACKGROUND AND AIMS: Clinical reasoning is a critical skill for Allied Health professionals, enabling informed decision-making in patient care. While a wide variety of clinical reasoning models are taught across disciplines, it remains unclear which models are frequently applied in practice. The scoping review aimed to map the literature on clinical reasoning models used by allied health professionals.

METHODS

This review was informed by Joanna Briggs Institute's framework for scoping review. Searches were conducted across Medline, Embase, Emcare, SCOPUS, CINAHL, the Cochrane Library and gray literature sources in January 2024. Results were screened in duplicate and data were descriptive synthesized and summarized the clinical reasoning approaches reported in the included studies.

RESULTS

Forty studies were included, spanning clinical reasoning literature from physiotherapy, occupational therapy, psychology, podiatry, speech pathology, and dietetics; no studies were identified for social work or exercise physiology. Hypothetico-deductive reasoning and pattern recognition were the most commonly reported models of clinical reasoning across the included studies, while three track reasoning and dual-process theory also featured across some professions. Seven additional models were also reported, though these were documented as isolated instances.

CONCLUSION

While several clinical reasoning models are used by Allied Health professionals in practice, only a handful are commonly reported in the literature, particularly within physiotherapy and occupational therapy. This is despite Allied Health curricula and training programs drawing on a much broader range of models. Evidence for other Allied Health professions remain limited, highlighting a need for further research to determine whether these patterns hold more broadly. These findings suggest a need to reassess the teaching and application of clinical reasoning models within the professions studied. Further research, particularly with underrepresented Allied Health professions, can help identify preferences and drivers influencing model use in practice.