The purpose of this descriptive study was to analyze physical therapists ' clinical problem solving and compare the results with physicians ' clinical problem solving. Ten skilled physical therapy clinicians were observed as they performed an initial interview with a patient. Their performance was audiotaped and later analyzed. The therapists defined their problem lists and developed treatment plans early in the interview, as they gathered data. This clinical problem-solving sequence is comparable to a method reported in the literature that is used by physicians. This model of clinical problem solving based on actual performance of clinicians can be used to train physical therapy students and, perhaps, to refine clinical evaluation skills. Key Words: Education, Physical therapy. The question of how physicians solve patient problems has been intensively studied in recent years. Barrows and Tamblyn called medical problem solv-ing the clinical reasoning process and described it as the scientific method of clinical medicine.1 The basic purpose of the studies of both Barrows and Tamblyn1 and Elstein and associates2 was to describe the clinical reasoning process physicians use to make diagnos-tic and therapeutic decisions. In addi-tion, Barrows and Tamblyn described a model for teaching this clinical reason-ing process to medical students. The purpose of this study was to ex-amine how a selected group of clinical physical therapists evaluated patients and made decisions about clinical prob-lems and treatment plans. The results of this descriptive study were then com-pared with the descriptive studies of Bar-rows and Tamblyn1 and Elstein and as-sociates.2 The research question was asked, Do clinical physical therapists use a clinical reasoning process comparable to the clinical reasoning process de-scribed for physicians? If the answer was yes, then physical therapy educators have a teaching model in the Barrows and Tamblyn book that can be useful in physical therapy education with mini-mal translation. Physical therapy edu-

The purpose of this study was to investigate the approaches to studying of first-and second-year students in a problem-based physical therapy program. The Short Inventory of Approaches to Studying was administered to 112 first-year students (66 female, 46 male) and 100 second-year students (62 female, 38 male). Ninety-nine first-year students and 88 second-year students responded to the inventory, representing a return rate of 88%. The results of both groups were compared. Further comparisons were made with reported normative inventory scores and with inventory results reported of first-year students in a medical problem-based school. All comparisons were made using two-tailed t tests. The inventory scores proved similar in both year groups of physical therapy students and were more desirable than the normative values. The first-year physical therapy students ' scores were similar to those of the first-year medical students reported to be desirable. It was concluded that the physical therapy students possess desirable approaches to studying.

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This paper discusses two methods used in training allied health students to clarify patients ' problems and develop treatment plans to resolve them. The traditional problem solving approach is presented as a means to Introduce students to patient evaluation and treatment planning, while clinical reasoning is seen as a more expert way to approach this process. The incorporation of problem solving early in allied health curricula, followed by instruction and practice in clinical reasoning, is recommended. An instructional model for facilitating students ' acquisition of clinical reasoning skill is presented. Flowcharts of the problem solving and clinical reasoning processes and a model for instruction in clinical reasoning are included. (9 references) (Author/GL) *************$******x*************************************k************ * Reproductions supplied by EDRS are the best that can be made * from the original document. U S DEPARTMENT OF EDUCATION Office of Education & ReSearch and imPfovement