Coaching questions to facilitate clinical decision-making and clinical reasoning with students

To facilitate clinical decision-making and clinical reasoning skills, student supervisors should consider the questions that they ask themselves.  These questions have value as a teaching and scaffolding tool as they can provide concrete examples of the thinking steps that underpin clinical reasoning.  This can assist students to make the 'jump' from data gathering to making clinical decisions on diagnosis and treatment.

'Delaney, Golding and Bialocerkowski (2013) in 'Teaching for thinking in clinical education: Making explicit the thinking involved in allied health clinical reasoning' developed a series of questions that can be used by student supervisors to enable students to think and reason like expert health professionals.  Students can also use these questions as a self-reflection activity to increase clinical reasoning skills.

Clinical role - Questions students can address to determine their clinical role

  • Why am I here?
  • What is the purpose of my role for this person?
  • What can I provide?
  • What are the limitations of my role?
  • What is the purpose of the referral?
  • What do doctors think the prognosis will be?
  • After my intervention, will there still be ongoing issues for the patient? • Who do I need to refer to?

Knowledge: Questions students can address to isolate relevant clinical knowledge

  • What is the profile of the patient?
  • What do I need to know for this patient?
  • What information do I need before I start?
  • How does this relate to what I already know?
  • What is the priority?
  • What things about this patient problem will impact on my assessment?

Teaching for thinking in clinical education

  • What information should I gather through my subjective and objective examination?
  • What are the problems that need to be assessed?
  • What has been done prior?
  • What has been effective?
  • Do I have enough social information?
  • What have other members of the health team found?
  • What tools do I have available to me?
  • Which assessment or diagnostic tool is going to provide me with the best information?
  • What anatomic structures are involved?
  • What are the connections between the presenting problem, history and patterns?

Patient perspective: Questions students can address to integrate the patient narrative and context with their clinical knowledge

  • Who is the patient? What are their concerns, medical conditions, social situations, culture and home environment?
  • Why did the patient present at the hospital?
  • Are there any other issues with vision/hearing/strength/balance/ co-ordination/cognition/pain that impact the patient’s safety/ability to manage at home? What level of function did they have? Where are they now? Where do they want or need to get to?
  • Is the patient/carer aware of my intervention?
  • What would be the best outcome from the patient’s perspective? What actions do I need to take to achieve this outcome?
  • Do I feel I have a full picture of the patient’s lifestyle?
  • What level of questioning can this patient tolerate?

Other resources to support student clinical reasoning


  • Delany, C., Golding, C., & Bialocerkowski, A. (2013). Teaching for thinking in clinical education: Making explicit the thinking involved in allied health clinical reasoning. Focus on Health Professional Education, 14(2), 44–56., C., & Baum, C. (1997). Enabling function and well-being (2nd ed.).  Thorofare: Slack


Was the information on this page helpful?