Chapter 16: Working Together—Clinical Reasoning and Collaboration

Flashcards covering key concepts from the lecture notes on clinical reasoning, OT/OTA collaboration, and related topics.

What governs supervision requirements between OT and OTA and how does it vary?

Supervision is required in occupational therapy; the amount and frequency vary by state licensure/certification laws.

Which organization’s documents describe the OT-OTA collaborative relationship?

AOTA (American Occupational Therapy Association).

What three primary forms of thinking are identified in Mattingly and Fleming’s clinical reasoning model?

Narrative reasoning, Procedural reasoning, Interactive reasoning.

What is the underlying form of reasoning in Mattingly and Fleming’s model?

Narrative reasoning.

Name the additional form of reasoning that deals with setting-related factors like length of stay and insurance.

Pragmatic reasoning.

What does interactive reasoning focus on?

Understanding the client as an individual, the disability from the client’s perspective, and the client within their cultural context.

What does procedural reasoning involve?

Problem identification/definition, goal setting, and intervention selection and planning.

What does conditional reasoning entail?

Understanding the whole condition (family, social, physical contexts), imagining how it could change, and engaging the client in constructing a new conditional image (often via narrative).

What does ethical reasoning involve in OT practice?

Considering ethical principles, identifying conflicts, assessing their value/significance, and understanding stakeholder dynamics.

What is intuitive reasoning?

OTs' sensitivity to their own emotions and to clients’ emotions during care.

What is culturally responsive care?

Understanding and appreciating cultural differences; awareness of how culture is part of the client’s life and how it affects care; practitioner awareness of their own culture’s impact.

What are activity analysis and occupational performance analysis?

Activity analysis analyzes activities used in therapy; occupational performance analysis analyzes the person and their contexts and the context of therapy.

What is evidence-based practice?

Using theory and research to substantiate chosen approaches in practice.

What is tacit knowledge in clinical reasoning?

Knowledge gained from experience that informs practice.

Why is reflection important in clinical reasoning?

It enables meaning-making of the intervention and development of tacit knowledge.

How has OT practice evolved over time?

From a focus on doing and being to explicit theory applied to practice and, currently, evidence-based practice.

What is the process described by Mattingly and Fleming for paying attention to cues in the intervention environment?

Use tacit and habituated thought, then unconsciously shift interventions in response to cues.

What does narrative reasoning involve?

Storytelling and story creation.

What did the Lyons and Crepeau (2001) study contribute?

An example of promoting efficacious clinical reasoning within the supervisory relationship between a seasoned OTA and supervising OTs.

Name three factors that can interfere with the tandem OT/OTA supervision.

Blind trust in the OTA's skills, limited information on the client, and time constraints (apathetic OT or inexperienced staff).

What is essential to promote clinical reasoning within supervision?

Effective communication skills.

What is the importance of evidence-based practice in OT?

It uses theory and research to guide practice, ensuring approaches are supported by evidence.

What change does the chapter describe about the collaboration and team model?

Supervision considerations and continuing education are emphasized, with variation by state.

What is activity analysis focused on?

Analyzing the various activities used in therapy sessions.

What is occupational performance analysis focused on?

Analyzing the person and their contexts, and the context in which therapy is provided.

What does Mattingly and Fleming say about the nature of clinical reasoning as a process?

It is dynamic and fluid; values, norms, and symbolic meaning are used to guide, gauge, and frame thought.

What are the key elements of the supervisory dialogue between OT and OTA?

OTs and OTAs take responsibility for their contributions and demonstrate mutual trust and respect for each other’s skills and judgments.