Investigating speech therapists' clinical reasoning: analysing think-aloud protocols and integrating multiple-source data.

We report results from pilot studies of speech and language therapists who used a web-based case-based teaching resource (www.patsy.ac.uk) to diagnose previously unseen patient cases. The aim was to identify sources of impasse in their clinical reasoning. Pairs of therapists collaborated - they were encouraged to `think aloud' and were videotaped. Other data were derived from the PATSy system logs. The time course and sequence in which students administered standardised language tests to the (virtual) patient were determined from the log data. The think aloud discourses and the PATSy log data were triangulated. A coding scheme for the think aloud protocols was also developed. This required, inter alia, making decisions about the grain size of analysis. Together, the two sources of rich data provided useful insights into students' clinical reasoning. The results will inform subsequent stages of the project, specifically: 1. by elucidating the extent to which domainspecific knowledge versus more general reasoning heuristics are involved, and 2. by identifying topics around which structured task-directed discussion (TDD) exercises can be developed. The TDDs will be used in the next project phases as a principled method for eliciting educational dialogues for re-use as vicarious learning resources.