Teaching and Assessment of Clinical Reasoning of Health Science Students on Clinical Placement: A Systematic Literature Review

Mrs Kathryn Fitzgerald1

1WA Centre For Rural Health, Geraldton, Australia


The aim of this study was to examine how health science students develop clinical reasoning skills whilst on clinical placements, and how this learning is assessed.

A systematic literature review was undertaken centred on teaching and assessing clinical reasoning for health science students while undertaking a clinical placement. After a preliminary screen, 137 articles were critically appraised and 23 articles were included for further detailed analysis.

Key results will be presented describing models of clinical reasoning, and how these can be used as a foundation for teaching and assessment. Several themes were identified focusing on teaching, including experiential learning, narrative approaches, prompts and questions, and visual systems. An integrated model of clinical reasoning will be discussed. There was limited evidence linking assessment of clinical reasoning to clinical placement outcomes.

The results will be discussed in relation to teaching and assessment of clinical reasoning when students are on rural clinical placements.  Having a shared understanding of clinical reasoning models and access to quality teaching of clinical reasoning, will enhance students’ ability to become effective and competent rural clinicians. Best practice methods for teaching clinical reasoning in rural placements may be through multidisciplinary approaches reflecting current models of interprofessional practice and assessment of clinical reasoning should be linked to students’ overall assessment of clinical performance when on clinical placement.


Kathryn Fitzgerald has worked in rural and remote areas as an  Allied Health professional in clinical practice,  in policy and program development and in health professions’ education for over 30 years, and has been involved with SARRAH since the organisation’s early days. She currently works as the Clinical Education Manager for the WA Centre for Rural Health based in the Midwest of Western Australia.

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