Semin Speech Lang 2019; 40(03): 151-161
DOI: 10.1055/s-0039-1688814
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Supporting the Development of Clinical Reasoning of Preprofessional Novices in Dysphagia Management

Sebastian Doeltgen
1  Speech Pathology, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
2  Swallowing Neurorehabilitation Research Laboratory, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
,
Stacie Attrill
1  Speech Pathology, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
,
Joanne Murray
1  Speech Pathology, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
03 June 2019 (online)

Abstract

Proficient clinical reasoning is a critical skill in high-quality, evidence-based management of swallowing impairment (dysphagia). Clinical reasoning in this area of practice is a cognitively complex process, as it requires synthesis of multiple sources of information that are generated during a thorough, evidence-based assessment process and which are moderated by the patient's individual situations, including their social and demographic circumstances, comorbidities, or other health concerns. A growing body of health and medical literature demonstrates that clinical reasoning skills develop with increasing exposure to clinical cases and that the approaches to clinical reasoning differ between novices and experts. It appears that it is not the amount of knowledge held, but the way it is used, that distinguishes a novice from an experienced clinician. In this article, we review the roles of explicit and implicit processing as well as illness scripts in clinical decision making across the continuum of medical expertise and discuss how they relate to the clinical management of swallowing impairment. We also reflect on how this literature may inform educational curricula that support SLP students in developing preclinical reasoning skills that facilitate their transition to early clinical practice. Specifically, we discuss the role of case-based curricula to assist students to develop a meta-cognitive awareness of the different approaches to clinical reasoning, their own capabilities and preferences, and how and when to apply these in dysphagia management practice.

Financial Disclosure

All of the authors receive a salary from Flinders University. None of the authors have any other disclosures.