Learning and Development of Diagnostic Reasoning in Occupational Therapy Undergraduate Students.
Pedro Moruno-Miralles, Adriana Reyes-Torres, Miguel-Ángel Talavera-Valverde and 2 others
PMID 32934612WHAT IT FOUND
Occupational therapy students get better at spotting performance problems as they progress, but struggle to link symptoms to causes.
Few can build a full diagnosis, relying on single variables instead of complex interactions, which risks misdirected treatment.
Key findings
01Students showed significant improvement in identifying and categorizing performance problems and components across academic years, particularly between first and fourth year.
02None of the students produced a complete occupational therapy diagnosis, and only a small minority could associate multiple symptoms or signs as probable causes of performance problems.
03Students predominantly used reductive explanations, focusing on single variables rather than the complex interaction of factors needed for effective diagnostic reasoning.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The cross-sectional design compares different students at different stages rather than tracking the same students over time, so individual learning trajectories are not clear. The study could not control for potential confounding variables such as prior clinical experience or individual differences in reasoning style. The case study was validated for reliability but the specific cultural context of the three universities may limit generalizability to other educational systems. Second-year students were excluded, so the progression between the first two years is not represented.
Declared interests
No specific funding sources or conflicts of interest are declared in the provided text.
The easy way to misread this
Do not assume that students' ability to diagnose improves automatically with clinical exposure or academic progression. The study shows that while students get better at spotting problems, their ability to synthesize a complex diagnosis remains poor even in the final year, requiring targeted educational intervention.