Date Approved

3-14-2018

Embargo Period

3-19-2019

Document Type

Dissertation

Degree Name

EdD (Doctor of Education)

Department

Educational Services and Leadership

College

College of Education

Advisor

Thompson, Carol C.

Committee Member 1

Basehore, Pamela

Committee Member 2

Walpole, Mary Beth

Keywords

Clinical Reasoning, Garrison's Community of Inquiry, Graduate Health Science, Social Constructivism, Vygotsky

Subject(s)

Medical education; Clinical competence

Disciplines

Higher Education | Medicine and Health Sciences

Abstract

Employment in health science professions requires technical skills and the ability to engage in high-level reasoning skills in order to make appropriate recommendations about the care of a patient. Developing clinical reasoning skills, then, is a central component of graduate health science training programs. The purpose of this phenomenological study is to understand how learning is structured in graduate health science courses at a comprehensive state university and how graduate health science students develop clinical reasoning skills. Situated in Vygotsky's social constructivism theory and applying Garrison's CoI framework, the aim was a discussion of themes and patterns that emerged from a qualitative analysis of student clinical reasoning in graduate health science programs. Two graduate health science instructors and 62 graduate health science students participated. Data collection included transcripts from instructor-student and student-student discourse during active learning opportunities in the classroom, transcripts from instructor semi-structured interviews, transcripts from student focus groups, and detailed field notes. Several key findings emerged. First, instructors and students viewed significant factors in developing clinical reasoning differently. Second, graduate health science students' clinical reasoning skills did not develop in gradual progression and were impacted by the classroom format, instructor expectations, and social dynamics within the classroom. Third, instructional pedagogies were significant factors in the clinical reasoning skills graduate health science exhibited in the classroom.

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