clinical reasoning

Professional/Clinical reasoning

- application of professional knowledge and skills to plan, direct, perform, and reflect on client care

- complex and dynamic process connected directly to therapy action

- ability to provide reason in any given session

when does professional/clinical reasoning occur

when practitioner is thinking about or doing OT for identified individual or group

what does professional/clinical reasoning reflect

occupational therapist's range of practice settings and thinking at various levels of care (e.g. care routines, practice standard

when is the process of professional/clinical reasoning used by practitioners

to develop and provide OT services for individuals, groups, or populations

reasoning in practice

= constant problem solving

- to identify and define occupational performance concerns

- to determine the fit between client and occupational requirements

- to develop interventions that improve participation and function with targeted occupations

application of heuristic reasoning (type of clinical reasoning)

clinician's integration of:

` professional knowledge (theories, frameworks)

` personal theories

` values

` beliefs

` lived experiences

Types of professional reasoning

- Ethical reasoning (Eh)

- Narrative reasoning (No

- Procedural/scientific (Point)

- Interactive reasoning (In)

- Conditional (Crying)

- Pragmatic (Pussy)

scientific reasoning

- reasoning involving use of applied logical and scientific methods (hypothesis testing, pattern recognition, theory based decisions)

- assists therapist in understanding condition affecting individual and intervention that are client centered

- used to identify problems and develop solutions

scientific reasoning: diagnostic reasoning

- explains the why of client's challenges based on science and client based information

- understanding typical symptoms and areas of concern related to certain diagnosis

scientific reasoning: procedural reasoning

- when practitioners are thinking about disease of disability

- decide which intervention activities to use to address a person's functional performance problems

narrative reasoning

- used to make sense of people circumstances and understanding how the client's disease, illness, or disability is impacting the person

- goes beyond scientific understanding of the disease

- understanding client's experience from their perspective

pragmatic reasoning

- practical reasoning that's used to fit therapy possibilities into current realities of service delivery

- focus on logistics related to occupational therapy services

- includes limited to scheduling, equipment, payment/costs, therapists skills

ethical reasoning

- helps analyze an ethical dilemma

- generating alternate solutions, and determining actions to be taken

interactive reasoning

- focuses on building positive interpersonal relationships with clients with the use of collaboration to identify problems and solutions

- application of therapeutic use of self to relate to person anxieties, non verbal body language, support client participation and motivation

- strategies include advocating, collaboration, empathizing, encouraging, instructing, and problem solving

conditional process

practitioners ability to be flexible and modify intervention in response to changing conditions and to context where therapy is occurring

reflect in action

- practitioner's ability to think on the spot and adapt to meet the demands of situation

- usually occurs when usual approaches aren't working

reflect on action

- Critical thinking that occurs after the fact

- the reflection about practice, what worked and what did not work

- the consideration and application of alternate approaches (which may require collaboration with your team members or learning activities such as reading through literature)

how does clinical reasoning guide practitioners

- planning, directing, performing, and reflecting on client care with consideration of practical realities of service delivery

how is clinical reasoning multifaceted and enables practitioners

- to understand client challenges, impairments, disabilities, and performance contexts

- predicts impact these have on occupational performance as well as appreciate the meaning of occupational performance limitations

what does clinical reasoning develop

experience and active engagement in evidence based practice