Expert Clinicians' and Students' Views on Clinical Reasoning in Occupational Therapy

1995 ◽  
Vol 58 (3) ◽  
pp. 119-123 ◽  
Author(s):  
Jenny Strong ◽  
Jillian Gilbert ◽  
Susan Cassidy ◽  
Sally Bennett
Keyword(s):  
Occupational Therapy ◽  
Clinical Reasoning ◽  
Nominal Group Technique ◽  
Occupational Therapists ◽  
Nominal Group ◽  
Time Constraints ◽  
Relative Importance ◽  
Good Communication ◽  
Occupational Therapy Students ◽  
The Individual

In this study, an examination was made of the clinical reasoning processes used by expert occupational therapists and post-clinical fourth-year occupational therapy students. Using nominal group technique, the factors involved in clinical reasoning were derived and their relative importance determined. The most highly valued skill for the experts was good communication, while the most highly valued skill for the students was a knowledge of and understanding of disability. The experts considered a wider range of factors when making clinical decisions than did the students, and rated their level of clinical reasoning at a higher level than did the students. For the experts, the factors identified as important in clinical reasoning were concerned more with gaining an understanding of the patients both by using general principles of diagnosis and illness and by gaining an understanding of the illness as it affected the individual patient. Meanwhile, for the students, greater emphasis was placed upon the influence of pragmatic factors on treatment, such as resources, time constraints and other environmental factors.

Research Priorities in Forensic Occupational Therapy

2003 ◽  
Vol 66 (2) ◽  
pp. 55-64 ◽  
Author(s):  
Edward A S Duncan ◽  
Karen Munro ◽  
Margaret M Nicol
Keyword(s):  
Occupational Therapy ◽  
Outcome Measures ◽  
Group Work ◽  
Nominal Group Technique ◽  
Research Priorities ◽  
Occupational Therapists ◽  
Assessment Tools ◽  
Nominal Group ◽  
Specific Research ◽  
Effective Group

National research priorities have been developed and published by the College of Occupational Therapists (Ilott and White 2001). Such an exercise, however, cannot provide the specific research priorities of a particular area of practice. A questionnaire survey was undertaken to ascertain the specific research priorities of forensic occupational therapists. The survey had three parts: determining research priorities, examining outcome measures and exploring the use of protocol-driven group work. Three specific research priorities were clearly defined by part one of the survey: the development of appropriate outcome measures, the development of rigorous and effective group-work programmes and the development of effective risk assessment tools. The nominal group technique was used in order to triangulate the data. The survey also examined the participants' use of outcome measures: a high number of the participants (62%, 44/71) stated that they used outcome measures in practice. The participants' responses to the third aspect of the survey, regarding the use of protocol-driven groups, were more varied. The majority of the groups reported by the participants were ‘home grown’, with little research base underpinning their implementation. The methodological weaknesses of undertaking such a survey are examined. The paper concludes that having identified clinicians' priorities in forensic occupational therapy research, the challenge is how best to gather robust evidence for practice.

Limitations on Participation and Their Relation to Social Determinants of Health Among Occupational Therapists and Occupational Therapy Students During Coronavirus Lockdown

2021 ◽  
Vol 75 (6) ◽  
Author(s):  
Nuria Menéndez Álvarez ◽  
Emiliano Diez Villoria ◽  
Estíbaliz Jimenez Arberas ◽  
Ana María Castaño Pérez ◽  
Antonio León García Izquierdo
Keyword(s):  
Occupational Therapy ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Occupational Therapists ◽  
Determinants Of Health ◽  
World Health ◽  
International Classification Of Functioning ◽  
Occupational Therapy Students ◽  
The Impact ◽  
The Relationship

Importance: For the first time in recent history, people worldwide have faced severe restrictions in occupations because of the measures adopted by governments to contain the coronavirus disease 2019 (COVID-19) crisis. Objective: To determine the limitations on participation of occupational therapists and occupational therapy students during “lockdown” and their impact on social determinants of health. Design: A cross-sectional, descriptive study conducted via an online survey. Participants: A total of 488 occupational therapists and occupational therapy students in North America, South America, and Europe. Outcomes and Measures: A questionnaire consisting of the World Health Organization Disability Assessment Schedule 2.0 of the International Classification of Functioning, Disability and Health and items developed to assess the impact of lockdown on daily life was emailed to occupational therapy professional associations, organizations, and universities between April and June 2020. It was available in English, Spanish, and Portuguese and met all the parameters listed in the Declaration of Helsinki. Results: The roles and routines of people across the developed world have been affected by lockdown measures. The study shows marked differences between participants in the domains of getting along and life activities, as well as influence on the environment. Moreover, South American participants experienced these difficulties to a greater extent than European participants. Conclusions and Relevance: This study quantifies the limitations in the participation of occupational therapists and occupational therapy students and the relationship of occupation to social determinants of health. What This Article Adds: The results of this research corroborate the relationship between health and occupation and highlight elements, such as the environment and context, that are important in occupational therapy. Therapists’ ability to analyze occupation in relation to contextual and cultural factors will benefit clients.

‘Positive Preparation’: Educational Input on HIV/AIDS in British Occupational Therapy Schools

1994 ◽  
Vol 57 (3) ◽  
pp. 76-78
Author(s):  
Sue Rugg
Keyword(s):  
Occupational Therapy ◽  
Small Group ◽  
Occupational Therapists ◽  
Postal Survey ◽  
Occupational Therapy Students ◽  
Group Settings ◽  
Hiv Aids

This article presents the results of a national postal survey to determine the type and amount of educational input on HIV/AIDS received by British occupational therapy students. All respondents (18/25 courses, 72%) indicated that they currently provided such input, with an average of 11.9 hours of course time being devoted to it. The majority of presenters were occupational therapists, although colleagues from many other backgrounds were also involved. Much of the material was considered in small group settings, with the content being balanced among a range of aspects. The article concludes that most British occupational therapy students are ‘positively prepared’ to work with clients with HIV/AIDS.

scholarly journals Barriers to antigen detection and avoidance in chronic hypersensitivity pneumonitis in the United States

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kerri I. Aronson ◽  
Ronan O’Beirne ◽  
Fernando J. Martinez ◽  
Monika M. Safford
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Nominal Group Technique ◽  
The United States ◽  
Antigen Detection ◽  
Nominal Group ◽  
Clinical Knowledge ◽  
Financial Barriers ◽  
Chronic Hypersensitivity Pneumonitis ◽  
The Individual ◽  
Development And Validation

Abstract Background Chronic hypersensitivity pneumonitis (CHP) is an interstitial lung disease (ILD) caused by long term exposure to an offending antigen. Antigen avoidance is associated with improved outcomes. We are unable to identify the antigen source in approximately half of patients. When an antigen is successfully identified, patients have difficulty with avoidance. Methods We conducted three structured group discussions with US based ILD specialists utilizing the nominal group technique (NGT). Participants listed barriers to antigen detection and avoidance in CHP. Each participant ranked what they perceived to be the top three barriers in the list in terms of importance. The master list of barriers was consolidated across the three groups into themes that were prioritized based on receiving the highest rankings by participants. Results Twenty-five physicians participated; 56% had experience caring for CHP patients for ≥ 16 years. Sixty barriers to antigen detection were categorized into seven themes of which the top three were: 1. unclear significance of identified exposures; 2. gaps in clinical knowledge and testing capabilities; 3. there are many unknown and undiscovered antigens. Twenty-eight barriers to antigen avoidance were categorized into five themes of which the top three were: 1. patient limitations, financial barriers and lack of resources; 2. individual patient beliefs, emotions and attachments to the antigen source; and 3. gaps in clinical knowledge and testing capabilities. Conclusions This study uncovered challenges at the individual patient, organizational, and societal levels and ranked them in terms of level of importance. These findings provide information to guide development and validation of multidisciplinary support and interventions geared towards antigen identification and avoidance in CHP.

scholarly journals The meaning that undergraduate Occupational Therapy students at the University of KwaZulu-Natal attach to the Occupation of dance

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Thanalutchmy Lingah ◽  
Juwairiyya Paruk
Keyword(s):  
Occupational Therapy ◽  
Personal Growth ◽  
Occupational Engagement ◽  
Structured Interviews ◽  
Beneficial Effects ◽  
Occupational Therapy Students ◽  
Qualitative Research Design ◽  
Kwazulu Natal ◽  
The Individual ◽  
The University

ABSTRACT INTRODUCTION: Occupational Engagement is an inextricable component of life and is considered essential to human survival. Doing an occupation that is positively perceived (such as dance) can lead to the experience and expression of meaning which then enhances quality of life. This study aimed to explore the meaning that undergraduate Occupational Therapy students studying at the University of KwaZulu-Natal attach to dance as an occupation METHOD: The study followed an exploratory qualitative research design with purposive sampling. Focus groups and semi-structured interviews were utilized to collect data which were analysed thematically RESULTS: Five themes emerged: Centre stage (an exploration of factors motivating engagement); On Pointe (beneficial effects of dance); My Solo Dance Experience (the individual's journey whilst engaging); It Takes 2 to Tango (exploring the role of relationships) & Dancing to the Beat (exploring time available for engagement). The hidden complexities of 'meanings' attached to the occupation of dance emerged which were experienced as subjective and multi-dimensional CONCLUSION: The study revealed that the meanings attached to dance were based on individual experiences with the occupation, others and the environment. Engagement in the occupation of dance (doing) enhances personal growth (becoming) and becomes a part of the individual (being Keywords: doing; being; becoming; belonging; occupational engagement; occupational balance; occupation; dance; meaning

The Relationship between Engagement in Occupations and Pressure Sore Development in Saudi Men with Paraplegia

2005 ◽  
Vol 68 (7) ◽  
pp. 307-314 ◽  
Author(s):  
Ruth Cutajar ◽  
Anne Roberts
Keyword(s):  
Occupational Therapy ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Spinal Cord Injuries ◽  
Occupational Therapists ◽  
Pressure Sore ◽  
Pressure Sores ◽  
Level Of Activity ◽  
Occupational Activities ◽  
The Individual

Various research studies have explored the factors that predispose people with spinal cord injuries to pressure sore development. Two hundred risk factors have been associated with pressure sore occurrence. One of the variables commonly reported to affect pressure sore occurrence is a decreased level of activity (Vidal and Sarrias 1991, Fuhrer et al 1993). This concurs with the philosophy of occupational therapy that a reduction in activity can generate pathology (Miller et al 1988). This research study investigated whether decreased participation in occupational activities (work, leisure and activities of daily living) was related to pressure sore occurrence in paraplegic men. The sample was selected randomly from the occupational therapy discharge files of a rehabilitation facility in Saudi Arabia. The data were collected by means of a telephone questionnaire from a total of 58 men, over a 3-month period. The study showed that there was a large increase in unemployment in paraplegic men following injury (from 10% to 59%) and, as might be expected, manual workers were more vulnerable than office workers. The study found no significant association between pressure sore occurrence and whether or not the individual was employed. However, it showed a statistically significant association between unemployment and pressure sores severe enough to lead to hospitalisation. The study also found a statistically significant association between individuals' independence in activities of daily living and the number of pressure sores that they had reported in the last 2 years. These findings indicate the potential importance of clients remaining occupationally active for their wellbeing and the significant contribution that occupational therapists can make by enabling rehabilitation of occupational activities.

On Clinical Reasoning: Patterns of Reflection on Practice

1996 ◽  
Vol 16 (2) ◽  
pp. 98-110 ◽  
Author(s):  
Anitha Alnervik ◽  
Gunilla Svidén
Keyword(s):  
Occupational Therapy ◽  
Qualitative Analysis ◽  
Clinical Reasoning ◽  
Preliminary Investigation ◽  
Occupational Therapists ◽  
Treatment Session ◽  
Conditional Reasoning ◽  
Narrative Form ◽  
Reasoning Patterns ◽  
Reflection On Practice

Five qualified occupational therapists and their patients were videotaped during a treatment session. The occupational therapists first were asked to describe the session in a narrative form, i.e., “tell the story,” and then they were asked to describe the thoughts and considerations on which they had conducted the treatment session, i.e., “reflection on practice.” A qualitative analysis was performed in accordance with the model for clinical reasoning developed by Fleming (1991). Both quantitative and qualitative analysis showed that procedural reasoning was predominant both in storytelling and reflection on practice, and a very small number of comments was classified as interactive or conditional reasoning. The results of this preliminary investigation suggested that we should examine the role that reflection on practice plays in examining, developing, and teaching the art of occupational therapy.

Values Influencing Clinical Reasoning in Occupational Therapy: An Exploratory Study

1990 ◽  
Vol 10 (1) ◽  
pp. 41-55 ◽  
Author(s):  
Elaine D. Fondiller ◽  
Lois J. Rosage ◽  
Barbara E. Neuhaus
Keyword(s):  
Qualitative Research ◽  
Content Analysis ◽  
Occupational Therapy ◽  
Clinical Reasoning ◽  
Research Methodology ◽  
Exploratory Study ◽  
Occupational Therapists ◽  
Qualitative Research Methodology ◽  
Interview Format

This exploratory study used qualitative research methods to identify values that influence clinical reasoning in occupational therapy. Through an interview format, selected occupational therapists were asked to respond to a predetermined list of questions about a general case study. The interviews were tape-recorded and a content analysis of the tapes yielded 18 distinct value statements. Implications of the findings and recommendations for further studies are presented. Qualitative research methodology is examined for its utility in occupational therapy.

scholarly journals Apprehension and interest

2017 ◽  
Vol 45 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Esther Linnane ◽  
Alison Warren
Keyword(s):  
Occupational Therapy ◽  
Learning Experience ◽  
Occupational Therapists ◽  
Occupational Therapy Education ◽  
Content Type ◽  
Republic Of Ireland ◽  
Occupational Therapy Students ◽  
The Republic ◽  
Time Basis ◽  
Therapy Education

Purpose Role-emerging placements have been used internationally within occupational therapy education but are relatively new to Ireland. At times, there has been a debate in the profession regarding the use of this placement model. This paper aims to generate views from both occupational therapists and occupational therapy students on the use of role-emerging placements in the Republic of Ireland. Design/methodology/approach Electronic surveys were administered to occupational therapy students and occupational therapists in Ireland. Quantitative data were analysed using the SPSS Statistics software package and the content of the open question responses were analysed into themes. Findings Occupational therapists (n = 60) and occupational therapy students (n = 45) indicated that there were inconsistent views surrounding role-emerging placements. It is deemed as an effective method for student learning, but apprehension exists around inclusion within occupational therapy programmes in the Republic of Ireland. Preference was indicated towards inclusion of role-emerging placements on a part-time basis within formal occupational therapy education. Originality/value Both respondent groups viewed that role-emerging placements can positively influence new areas of occupational therapy practice and concern over the use of the placement model requires further exploration and debate. This study is from an Irish context, although there are similarities with other countries’ use of the placement model. There is a need for research through an in-depth exploration of the learning experience of undertaking role-emerging placements from the students’ perspective and identification of supports required to promote an optimal learning experience.

scholarly journals Student Perceptions of Growth-Facilitating and Growth-Constraining Factors of Practice Placements: A Comparison between Japanese and United Kingdom Occupational Therapy Students

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Reiko Miyamoto ◽  
Dido Green ◽  
Peter Bontje ◽  
Natsuka Suyama ◽  
Nobuo Ohshima ◽  
...  
Keyword(s):  
United Kingdom ◽  
Occupational Therapy ◽  
Student Perceptions ◽  
Time Management ◽  
Nominal Group ◽  
Clinical Knowledge ◽  
Knowledge And Skills ◽  
Self Reflection ◽  
Occupational Therapy Students ◽  
The Uk

This study compared growth-facilitating and growth-constraining experiences of practice placements as perceived by occupational therapy students from Japan and the United Kingdom (UK). Fifteen students from Japan and 14 from the UK used a nominal group technique (NGT) to rank, individually and in groups, their subjective learning experiences during practice placements. Qualitative analysis and simple tabulation based on ranking of items obtained in the NGT were performed. Five item categories were identified from both Japanese and UK students: self-reflection, the role of supervisor, sense of responsibility, clinical knowledge and skills, and time management. Results showed that all students perceived opportunities for self-reflection and feedback from supervisors as growth facilitating and students’ passive attitudes towards requirements of practice placements as growth constraining. Country-specific differences between students were observed in clinical knowledge and skills, sense of responsibility, and time management. Japanese students perceived that preparatory study led to successfully treating clients during placement, and they tended to commit to placement assignments at the expense of time outside. UK students valued working independently with a sense of responsibility but considered time-management problems within their placement hours as growth constraining. These differences can be explained by different social norms and expectations of students from Japan and the UK.

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