Clinical reasoning Flashcards
List the types of clinical reasoning
Think P.I.C.N
Procedural
Interactive
Conditional
Narrative
What is “the thought process that guides practice”?
Or “A thinking process that happens over time, as the therapists interacts with the client”?
Clinical reasoning
Fill in the blanks:
____ reasoning guides treatment.
____ reasoning guides therapy
Procedural reasoning guides treatment.
Interactive reasoning guides therapy.
Which type of reasoning is the ‘how to’ of the therapeutic process?
Procedural reasoning
Which type of reasoning focuses on the client as a person?
Interactive
By using interactive reasoning we can begin to understand the person better, and can appreciate the disability or illness experience for the client. This type of reasoning “humanizes” the conditions that you identified through your procedural reasoning.
Which type of reasoning is usually seen in therapists at the expert level and can be described as a multidimensional process that involves complicated forms of reasoning?
Conditional
What are the three types of knowledge?
- Propositional knowledge
- Professional craft knowledge
- Personal knowledge
Which two types of thinking did the philosopher Bruner identify?
Narrative – thinking through story telling, trying to understand a person’s experience and unique life story.
Paradigmatic – thinking through a propositional argument, taking a particular and seeing it in general terms, as an instance of a general type (e.g. diagnosis
or problem) or a particular theoretical perspective
Clinical reasoning involved the skilful combination of what three things?
- Scientific knowledge
- The art of therapy
- Ethical considerations
How is therapeutic reasoning different to clinical reasoning?
The term “therapeutic reasoning” is used to avoid the medical model connotations of the term “clinical” and to highlight the client-focused collaborative nature of the proposed reasoning process.
What is therapeutic reasoning?
How therapist uses the theory to understand a client and to develop, implement and monitor a plan of therapy with a client.
Therapeutic reasoning using MOHO should be client- centred, theory driven, and evidence-based.
What is professional reasoning?
The process that practitioners use to plan, direct, perform, and reflect on client care.
What is the process that practitioners use to plan, direct, perform, and reflect on client care?
Professional reasoning
____ reasoning is typically performed quickly because the practitioner has to act on that reasoning right away.
Professional reasoning
- the process that practitioners use to plan, direct, perform and reflect on client care.
What is the process that practitioners use to plan, direct, perform and reflect on client care?
Professional reasoning
____ reasoning is included as one of the curriculum threshold concepts, identified as troublesome knowledge for students to grasp.
Clinical reasoning
What are the five threshold concepts identified as troublesome knowledge for students to grasp?
1) purposeful and meaningful occupation,
2) client-centred practice,
3) integral nature of occupational therapy theory and practice,
4) identity as an occupational therapist, and
5) thinking critically, reasoning and reflecting.
What are the two forms of narrative reasoning
- Story making or therapeutic emplotment.
2. Story telling (by the therapist)
Name the type of reasoning used when a therapist thinks about a client’s ailments and possible procedures?
Procedural
In ____ reasoning the focus is on problem definition intervention selection
Procedural
____ _____ is used to help the therapist _____ with and better understand the client as a person, his/her experience of the illness or disability and intervention in order to tailor therapy to the client’s needs
Interactive reasoning
Interactive reasoning
Used to help the therapist interact with and better understand the client as a person, his/her experience of the illness or disability and intervention in order to tailor therapy to the client’s needs
Which type of therapy helps the therapists better under the client as a person?
Interactive
_____ reasoning moves beyond the person and the clinical problems and places them in a broader social and temporal context.
Conditional
A complex form of social reasoning used by experienced therapists to help the client in the process of reconstructing a life that is now impacted by injury or disease. Considered to be the most elusive of the 4 forms.
Conditional reasoning
Remember P.I.C.N
Which form of reasoning is considered to be the most unique to OT?
Conditional reasoning
Why is conditional reasoning called ‘conditional’?
Because the therapist thinks about the whole condition including the person, the illness or disability, the meanings of the illness/disability for the person, the family, and the social and physical contexts in which the person lives.
What’s the difference between inductive and deductive reasoning?
Deductive reasoning starts with a general theory, statement, or hypothesis and then works its way down to a conclusion based on evidence.
Inductive reasoning starts with a small observation or question and works it’s way to a theory by examining the related issues.
What kind of reasoning starts with a general theory, statement, or hypothesis and then works its way down to a conclusion based on evidence?
Deductive
dominant quantitative research paradigm thinking
What kind of reasoning starts with a small observation or question and works it’s way to a theory by examining the related issues?
Inductive
dominant qualitative research paradigm thinking
List three types of clinical reasoning identified outside the field of OT
- Content/knowledge
- Diagnostic
- Ethical reasoning
- Inductive reasoning
- Deductive
- Teaching as reasoning
- Pragmatic
- Interpretive
The most highly valued skill by ‘expert clinicians’ was what?
Good communication and gaining an understanding of the illness as it affected the individual client.
The development of clinical reasoning skills is broken into how many stages?
Five
What are the stages of development of clinical reasoning skills?
- Novice
- Advanced beginner
- Competent
- Proficient
- Expert
Which stage of development of clinical reasoning skills recognises and understands rules of practice, uses intuition to know what to do next, uses
conditional reasoning?
Expert
Which stage in the development of clinical reasoning skills views situations as whole instead of in
isolated parts, able to develop a vision of where the client should go, able to modify easily?
Proficient
Define the ‘competent’ stage of development of clinical reasoning skills.
Sees more facts, understands client’s problems, individualises treatment, but may lack creativity and flexibility.
Community OT’s clinical reasoning was found to be influenced by ___ and ___ factors.
Internal and external
List some of the internal factors which were found to influence OT’s clinical reasoning.
Internal factors included past experiences, expertise and perceived complexity of a problem. Plus personal habits, personality and conception of teaching.
List some of the external factors which were found to influence OT’s clinical reasoning.
The practice context (e.g. organisational or cultural imperatives, physical location of intervention), particularly shapes community OTs’ clinical reasoning.
