Effects of Level II Fieldwork on Clinical Reasoning in Occupational Therapy

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.

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Values Influencing Clinical Reasoning in Occupational Therapy: An Exploratory Study

The Occupational Therapy Journal of Research ◽

10.1177/153944929001000105 ◽

1990 ◽

Vol 10 (1) ◽

pp. 41-55 ◽

Cited By ~ 28

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.

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Applying Clinical Reasoning: A Caseload Management System for Community Occupational Therapists

British Journal of Occupational Therapy ◽

10.1177/030802269605900505 ◽

1996 ◽

Vol 59 (5) ◽

pp. 207-211 ◽

Cited By ~ 13

Author(s):

Tracy Fortune ◽

Susan Ryan

Keyword(s):

Occupational Therapy ◽

Clinical Reasoning ◽

Occupational Therapists ◽

Occupational Therapist ◽

Therapy Assessment ◽

Therapy Services ◽

Subjective Phenomenon ◽

Experienced Therapist ◽

Perceived Complexity ◽

Complex Cases

This article presents a system of caseload management for community occupational therapists. Using the clinical reasoning work of Mattingly and Fleming as a framework, the perceived complexity of each case for a community occupational therapist was analysed and then paralleled with the type and amount of clinical reasoning required. Following an initial occupational therapy assessment, each case is given a numerical weighting, graded at 3 for complex cases and from 1 for non-complex or simple cases. The degree of complexity or weighting is recognised to be a subjective phenomenon dependent on the experience, knowledge and skills of the therapist. The cases held by an occupational therapist are able to be mixed so that the experienced therapist holds a varied caseload of complex and simple work. Beginning therapists can follow the same measured approach thus augmenting their background experience. This method promotes continuing education, assists experiential learning and provides variety. Using this system, it is proposed that occupational therapy services are enhanced by reducing unnecessary casework from therapists' active caseloads, allowing increased time to work on complex cases and using expertise more efficiently.

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