The time to prepare for and dominate the October NPTE is now! There are many factors to consider when comparing those who passed and those who failed the July NPTE. However, the biggest factor that separates those who succeeded was, clinical reasoning. When you hear the term, “clinical reasoning” what does it make you think of? You may think it means to recall the modalities or exercises you performed in the clinic with one patient, and that you can use those same techniques with a different patient you’re currently treating. Also, you may have a more direct idea, that you can apply the knowledge you learned in school and try to apply that knowledge to a clinical situation. While these ideas and approaches aren’t entirely false, they don’t allow you to implement true clinical reasoning. I’ll explain further below.
During your clinical internships, you are assigned a C.I. or, Clinical Instructor. In working with your C.I., you’re supposed to gain experience through working with and treating a variety of patient conditions. However, here is the secret. While your internship is meant to expose you to a variety of settings, with various patient disorders and functionalities, your internship is also meant for your C.I. to challenge you. A great Clinical Instructor will challenge you every step of the way. In every thing you do with your patients, you need to be challenged and asked, “why?” When learning how to perform a specific mobilization, or when instructing a patient to do a PNF pattern, have your C.I. ask you why you are choosing to do that specific intervention? This is when you can apply the knowledge you learned in school about how adhesive capsulitis occurs, or when it is necessary to use a Grade 4 instead of a Grade 2 or 3 mobilization. In understanding the “why” for each of these circumstances, you can accurately apply reason to those clinical situations. No matter if you are working with a patient with a stroke or a patient that lacks range of motion; you must seek out the reason for their limitation and then apply your knowledge of interventions to that specific clinical situation.
On the flip side of the student that correctly implements clinical reasoning is the student that just knows lists. They know a list of symptoms and a list of interventions, and they try to throw these items at a specific pathology. However, if you use this method on the NPTE, you will easily be confused when a question tries to deceive you, by describing the pathology in an obscure way. Now you are frantically running through your list of symptoms to throw at a pathology you may not have studied enough for, such as a posterior cerebral artery stroke. In addition to this, now you’ve mistakenly used your list for a medial cerebral artery stroke and answered the question incorrectly. While this student possesses the knowledge, their approach lacks all clinical reasoning. Therefore, they lack the ability to reason and select the correct intervention that fits that specific clinical picture. The ability to reason through the problem is the essence of clinical reasoning.
So, what do you do if you weren’t fortunate enough to have a Clinical Instructor that challenged you to practice critical thinking and clinical reasoning? You join the winning team at the NPTE Prep Success Course! Instead of teaching one on one, for the first time in the history of NPTE Prep Success, Dr. Kyle Rice will be teaching to a group of students! There are only a few spots left, so be sure to sign up today.
However, if you decide not to join the winning team or the spots have already filled up, the way you can gain clinical reasoning for yourself is to get an accountability partner. This partner must be strong in the area that you’re weak in and vice versa. Your partner must be strong in musculoskeletal systems or non-systems, if you are weak in either of those areas. Be sure that you aren’t just spitting facts back and forth at each other. This is basic knowledge that you can read from your school books. Don’t be basic. Challenge one another, the same way that your C.I. should have challenged you. Do more than just explain what adhesive capsulitis is, explain why it happens. Be specific in your explanation of why you would use a Grade 3 mobilization instead of a Grade 2 or 4. Describe the sequence of events that occur with a medial artery stroke and a posterior artery stroke and the differences between the two. If this sounds like a lot of work, that’s because it is. However, this is the effort that is required if you want to dominate the NPTE in October.
On the contrary, these actions will not help you if your accountability partner isn’t also trying to dominate the NPTE. Like you, your partner needs to be willing to put forth 150% effort to master their clinical reasoning skills. This partnership must be mutually beneficial and requires the same amount of work and effort from both parties. If only one person is willing to challenge the other, then the partnership quickly dissolves into a wagon. So now one of you is pulling and the other is being dragged along. Therefore, make sure your accountability partner fully understands what you are trying to accomplish and the effort you are expecting of them. Search high and low, near and far for this extraordinary student. In this age of technology, distance should not be a factor. Skype and video messaging are your friends. With that, go forth and build up your clinical reasoning skills. Hope to see you on the winning team, with the NPTE Prep Success Course!
Dawnette Waters, Lead Blog Writer