Table 2 Summary of findings presented for each programme and cohort

Identification of the problem

Y1 students identified the main problem but focused on details related to medical issues and motor function. Y2 students identified a range of problems related to the individual and the main carer. Y3 students were able to recognize the added importance of contextual factors.

Y1 students identify the problem quickly and informally, relating the information to personal experience. Y2 use a problem-based approach, trying out hypotheses on each other. Y3 and Y4 students evaluate explanations by alternating between roles (SLT, caregiver, school personnel).

Y1 students had difficulties in identifying the main problem whereas Y2 students identified relevant problems in a structured way

Use of data in the case

Y1 students needed support from the facilitator to identify the relevance of some key information. Y2 students used profession-specific models to identify and discuss relevant information. Y3 students identified relevant information in the case without the need for structured tools.

All information is considered in the discussions by Y1 to Y4.

Some Y1 students missed some information given and wanted more.

Y2 students identified and used relevant information in the case.

Analysis

Y1 students described and analysed primary motor and psychological factors that influenced performance. Y2 students demonstrated a deeper understanding by including basic environmental factors. Y3 students showed understanding of key components of occupational performance and participation in the community. They moved beyond home environment and began to consider participation, identity and societal pressures.

Y1 to Y4 students use course content and experiences from clinical training to guide their analyses. Y1 also include personal experiences in the analysis, relating to friends and family members in a situation similar to the one described in the case. Y3 and Y4 make multifaceted analyses, relating to intrapersonal and organizational domains.

The analysis made by Y1 students was superficial and some groups identified lack of knowledge. Y2 students systematically made a deep analysis.

Synthesis and decision

Y1 students used occupational therapy theories but a lack of knowledge to support intervention. Y2 students identified a need for additional information and teamwork. Y3 students based their decisions on relevant theories and frames of references to support evidence-based intervention.

Y1 suggest many approaches to address the issue, based on interviews with clinical SLTs and common knowledge of the SLT role. Y2 show clear signs of their future role, with descriptions of suggested assessments and intervention. Y3 and Y4 present individualized interventions for parents and school personnel.

Y1 students had difficulties; they needed more knowledge and advice from a facilitator and focused more on caring than midwifery.

Y2 students arrived at decisions based on professional competence.

Professional language

Y1 students used informal language but made an effort to keep an occupation-focused approach. Y2 students used correct concepts connected to theories, whereas Y3 students used various frames of references and ethical dilemmas in their discussions

Y1 students mainly use colloquial language, but show basic understanding of advanced scientific and clinical concepts. Y2 students replace lay definitions with scientific equivalents to guarantee mutual understanding. Y3 and Y4 students have acquired professional concepts and vocabulary.

Students in both cohorts used correct terms and concepts; Y1 students sometimes used informal language whereas Y2 students used the language of the maternity ward.

Prior knowledge

Y1 students used their knowledge in how constraints in motor skills may affect occupational performance. Y2 and Y3 expanded this and also used their understanding of the Person-Environment-Occupational Performance model in their clinical reasoning. Y3 students used ethical principles, social justice and laws related to OT.

Y1 is baseline, with previous course content in related subjects only and no SLT courses. Y2 and Y3 have completed courses in atypical child language development and clinical training, relevant to the case, with Y3 also having additional research methodology. Y4 also had completed a course in reading disability, and clinical training, relevant to the case.

Y1 students had deep knowledge in caring but superficial in midwifery. Y2 students had relevant experience-based professional knowledge.

Theory based

Y1 students shared/compared their theoretical knowledge. Y2 students showed adequate knowledge and discussed consequences whereas Y3 students showed theoretical understanding and supported evidence-based practice.

Y1 mainly retold the case, explaining with basic theoretical constructs. Y2 and Y3 showed evolved theoretical understanding and ability to interpret and explain. Y4 could identify gaps in their knowledge, and demarcations to related professions.

Y1 students had theoretical knowledge, but insufficient. Y2 students had adequate knowledge and referred to experience, not to literature

Polemical

Y1 students discussed, came to consensus and agreed, Y2 students discussed and challenged one another. Y3 students were able to deal with challenges, resolve them and reached agreement on resources needed to solve the case.

Y1 showed great consensus, with students filling in the comments of others. Y2 corrected each other, and asked for additional information and references to arguments and standpoints. An argumentative tone in Y4, with provocative questions, stimulated further discussions.

Y1 students largely agreed. Y2 students sometimes disagreed, in a kind manner.

Supportive

Y1 students supported each other well. Y2 and Y3 students both supported and challenged learning in the group.

All students, Y1 to Y4, had a supporting discussion climate, with questions aimed to reach a common goal rather than exposing gaps in the knowledge of others.

Students were supportive in both groups an in Y2 even reinforcing.

Perspective-shifting/metaphoric

Y1 students went back to the case and found important dilemmas they first missed. Y2 and Y3 students added perspectives and discussed “outside the box”. Including an interprofessional teamwork focus.

Y1 advanced the discussion by taking the perspective of the patient, parents and school personnel, but not the SLT. Y2, in contrast, showed few examples of looking beyond the SLT role. Y3 and Y4 included all perspectives in their discussions, and those of other professionals, with a focus on the SLT role.

In both cohorts by returning to the case and finding new perspectives.

Communication within the group

Y1 students discussed and listened well, Y2 students talked and questioned each other and Y3 students communicated in a more creative manner, generating new ideas and professional thinking.

The discussions were conducted increasingly independent of the facilitator from Y1 to Y4.

In both cohorts students communicated well: talked, listened and asked questions. Y2 students exchanged experiences and could teach each other in a kind manner.

Trust within the group

Friendly, trustfully and open in Y 1 and 2. Some Y3 students were first eager to use and show their knowledge but after a while all students had the opportunity to raise their ideas and comments.

In all groups, Y1 to Y4, students appear comfortable with each other, although a few students remain quiet in the full-group discussions. A relaxed atmosphere in Y4 allowed playful comments without losing a professional tone.

There was trust and openness in both cohorts. The attitude was professional but more friendly and careful in the Y1 group.

Interaction with the teacher

Y1 students needed the facilitator more than Y2 students who asked some questions. Y3 students discussed with each other and were in charge of the process and decisions taken.

Y1 and Y3 had much to say but needed questions from the facilitator to start the discussions while Y2 and, in particular, Y4 worked more independently.

The small groups worked independently. Y1 students needed a lot of help from the teacher when all groups gathered to exchange experiences, whereas the Y2 students took care of most of the discussion themselves also during the gathering.