The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) describes Orthopedic Manual Therapy (OMT) as a specialist field in physiotherapy for the treatment of neuromusculoskeletal conditions based on clinical reasoning. The aim of this study was to explore how students in a OMT physiotherapy master programme describe their clinical reasoning. Nine participants were included in the study. Data was collected using a semi-structured interview guide and were analyzed with qualitative content analysis. The analysis resulted in one main category: “A multidimensional picture of clinical reasoning” and three categories: 1) Confidence in the role as physiotherapist; 2) Decision making, a cognitive analytical process 3) Creating alliance and involving the patient in the clinical reasoning. The participants described a multidimensional picture of clinical reasoning which gradually developed and eventually encompassed several aspects in the subcategories. The conclusion of the study is that all the parts above are needed in the clinical reasoning and it takes years to develop effective clinical reasoning. For future studies, it would be of interest to explore how recently graduated physiotherapists with a bachelor degree describe their clinical reasoning.

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