Final- Clinical Reasoning Flashcards
For an OT and OTA to enhance participation in meaningful life roles and occupations what must they do effectively?
Discover the clients story
Understand his or her diagnosis or condition
Synthesize all the info into a coherent, evidence based practice and client centered treatment plan
Use clinical reasoning strategies for intervention
What are the 5 processes used by practitioners to plan, direct, perform and reflect on client care?
1) narrative
2) scientific
3) pragmatic
4) ethical
5) conditional (interactive)
What is clinical reasoning?
Helps students analyze evaluation, treatment and discharge scenarios to help pinpoint instances of each type of reasoning being used
Multifaceted cognitive process
Involves several different layers of thought, evidence and experience
Difficulty to pinpoint which type of reasoning is being used
OTs used knowledge, experience, EBP, client info to develop CR skills
What is professional reasoning?
Encompasses a broader scope than clinical reasoning
Includes non medical settings (homes, schools, communities, etc)
PR and CR both require to synthesize info to reflect on practice
What is the narrative reasoning?
Allows client to tell a story Involving his/ her life, culture, illness
Shapes meaningful interventions
Helps create occupational profile
Important when developing intervention plan
What is the occupational profile?
Info that describes the clients occupational history and experience, patterns of daily living, interests, values and needs
What is therapeutic listening in narrative reasoning?
OT is listening to client
Helps shape continuing course of intervention
Forms bond between OT and client
Makes client feel accepted and comfortable
Builds trust and therapeutic relationships
Trust is reinforced when OT shares a story about themself
What is scientific/ procedural reasoning?
Occurs when OT uses foundational knowledge (anatomy, physiology etc) to understand the condition the client presents
Begins upon referral
“A systemic approach to creating, testing, using knowledge to make decisions”
Systemic approach that’s starts with occupational profile (client factors) and then intervention plan and implementation
Generates hypothesis and tests them frequently (hypothesis shifting)
What is pragmatic reasoning?
Used to determine practical issues affecting service delivery
Attempts to understand everyday issues (outdated equipment etc) affects services to clients and family members
Enables OT to identify practical strategies for intervention to ensure highest quality of care
Required looking beyond client factors and consider CONTEXT
What is ethical reasoning?
Used to drive intervention process that ensures that all the choices that are made are morally justified
What “should” be done in the best interest of the person and family
Fairness to all clients with who they interact
OTs must never ignore safety
Grounded by 7 core values
What are the 7 core values ethical reasoning is grounded by?
1) altruism
2) equality
3) freedom
4) justice
5) dignity
6) truth
7) prudence
What is conditional (interactive) reasoning?
Combines reading about client (narrative and procedural) with those about the world in which treatment is delivered (ethics and pragmatic)
Ability to really know the client
Communicate, trust and hope to the client
Individualize treatment
Constant need for adapt treatment in response to success and failure
How does the use of reasoning affect clinical practice?
Improves outcomes through the effective use of research, reflection and self direction
Student must reflect on experiences in classroom and fieldwork
Case studies improve CR
Self directs learning improves CR
OTs must understand the type and application of each type of reasoning
OTs must use research to evaluate the effectiveness of reasoning and intervention methods
How do case studies improve CR?
Recall case details
Critically analyze info
Synthesize new knowledge with previous knowledge
Evaluate the effectiveness of all this knowledge
What CR is used for choice of frame of reference?
Ethical
