The Application Of The International Classification Of Functioning, Disability And Health As A Framework In Clinical Reasoning; Educators' And Graduates' Perspectives: A Qualitative Study

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.