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

Abstract

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.