The application of the international classification of functioning, disability and health as a framework in clinical reasoning; educators’ and graduates’ perspectives: a qualitative study

Abstract

Background

The use of the International Classification of Functioning, Disability and Health (ICF) as a framework to scaffold students' clinical reasoning is recommended to address the multifactorial context of service delivery and complexities of health issues. However the application of the ICF in clinical reasoning is still not optimal due to personal and institutional factors. To train students to use the ICF in clinical reasoning, we need to understand both the students’ and the educators' perspectives on its use as a framework.

Objective

The purpose was to explore and compare perspectives of physiotherapy educators and graduates toward applying clinical reasoning using the ICF as a framework.

Methods

a qualitative approach adopting interpretive research paradigms was employed to understand how educators and graduates perceive the use of ICF in clinical reasoning. Two focus groups were used for data collection. Six graduates and five educators participated in the study.

Major findings

We identified five common themes between educators and graduates that described how the application of the ICF shaped clinical reasoning during students’ final year of study. These themes represent different approaches toward practicing clinical reasoning using the ICF, namely; critical thinking, workplace environment, holistic, activity and participation, and patient-centered.

Conclusion

results revealed that the use of the ICF in clinical reasoning helped students develop contextual awareness and adopt a holistic and patient-centered approach. Some challenges like unsupportive workplaces were reported by both educators and graduates which hindered the use of the ICF in clinical reasoning. Another challenge reported by graduates and having a negative impact on their learning was different expectations from educators.

Keywords:

• Clinical reasoning
• education
• International Classification of Functioning Disability and Health
• learning
• physiotherapy

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Dania Qutishat

Dania Qutishat is an assistant professor at the School of Rehabilitation Sciences, The University of Jordan. She holds a PhD in Physiotherapy from Sheffield Hallam University/UK. She is the course leader for Therapeutic Exercise at the Department of Physiotherapy. She has initiated "Moving for Health" campaign to promote physical activity among university staff and students. Her research interest is mainly in physiotherapy education and physical activity.

Emad Al-Yahya

Emad Al-Yahya is an associate professor of neuroscience and neurorehabilitation at the School of Rehabilitation Sciences. He is also an associate Research Fellow, Movement Science Group, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK. His area of research is motor control. He is interested in the neurophysiological basis of normal and abnormal movements, - in particular gait-, and their implications in rehabilitation.

Maha T. Mohammad

Maha T. Mohammad is an associate professor at the School of rehabilitation Sciences, The University of Jordan. She teaches physiotherapy for patients with neurological conditions and research methodology courses. Her research interests focus on gait changes in patients with diabetes, physical activity measurement, and physiotherapy education.

Jennifer Muhaidat

Jennifer Muhaidat is an assistant professor at the School of Rehabilitation Sciences, The University of Jordan. She is a physiotherapist by training and has completed her graduate studies in the area of falls’ prevention for older adults in the United Kingdom. Her research interests are in physical activity measurement and promotion with a special focus on older adults and in cognitive-motor interference in various populations.

Lara Al-Khlaifat

Lara Al-Khlaifat is an Assistant Professor at the School of Rehabilitation Sciences, The University of Jordan. She holds a PhD in Rehabilitation from University of Salford/United Kingdom. She is currently the head of the Physiotherapy Department since 2018. Her research interests are in musculoskeletal physiotherapy focusing on knee osteoarthritis, exercises, physical fitness, physical activity, patients' perception, and service delivery.

Rasha Okasheh

Rasha Okasheh, is a research fellow in realist evaluation at the centre of Health and clinical Research at the university of the West of England. She holds a PhD in the measurement of functional outcomes following pulmonary rehabilitation from Sheffield Hallam University-UK. Her work implements mixed methods research, realist evaluation and theory driven evaluation focusing on health service evaluation and development. Rasha is a cardiorespiratory physiotherapist by background. She is a member of the European respiratory society, and a certified trainer in the TELER method of patient reported outcome measures. Her favourite place to do research is in the clinical sites and the community addressing people with chronic cardiac and respiratory conditions. Her vision is to enable everybody to reach their maximum potential getting up and around!