Exploration of Factors Perceived to Influence Development of Diagnostic Reasoning in Athletic Trainers and Athletic Training Students

Context: Diagnostic reasoning is acknowledged as a vital skill for medical practice, but research regarding this core aspect of medical cognition as it pertains to athletic training contexts is scarce. To compare athletic training--specific clinical reasoning skills with those of other health care practitioners, educators need to better understand how athletic trainers (ATs) think, what helps them think better, and what may hinder their thinking skills as related to diagnostic reasoning challenges in the clinical context. Objective: To conduct a preliminary investigation into ATs' and undergraduate athletic training students' perceptions about their diagnostic reasoning processes. Secondarily, to identify and compare activities or practices that may influence individual diagnostic reasoning abilities. Design: Qualitative research. Setting: Online interviews. Patients or Other Participants: Twenty-three participants (11 ATs, 12 senior-level athletic training students) were convenience sampled from a pool of participants used in a separate, multifaceted diagnostic reasoning study. Main Outcome Measure(s): Participants were interviewed in an online format to determine their diagnostic processing ability and perceived factors that enhance and hinder diagnostic reasoning. Data were analyzed using a general inductive approach. Results: Analysis determined ATs and athletic training students used similar reasoning processes to previously reported expert- and novice-level reasoning abilities, respectively. Professional socialization and metacognitive activities were found to enhance individual diagnostic reasoning abilities in both groups. Lack of professional socialization and time in ATs and limited experiences and educational settings in athletic training students were thought to detract from diagnostic reasoning development. Conclusions: Use of diagnostic reasoning and factors perceived to influence ATs' and athletic training students' ability found within our study correspond with previously reported theories and mimic the current understanding of expert and novice abilities respectively. Understanding factors that influence diagnostic reasoning ability is crucial for developing effective pedagogical and curricular strategies in athletic training education.