week 2 Flashcards
define reasoning
a cause, explanation or justification of do something. What is right, practical or possible. The ability of the mind to think, understand and form judgements logically.
define thinking
a person’s ideas or options. Have a particular opinion, belief or idea about something or someone.
what did professional reasoning used to be called
Clinical reasoning: traditional terminology/implies medical practice. (PAST)
whats professional reasoning
- How therapists actually think when engaged in practice (sometimes hard to explain why)
- A metacognitive process (thinking about thinking)
- Process used to plan, direct, preform and reflect on client care
- Usually performed quickly so therapists can act on their reasoning right away (after practice)
scientific reasoning
- Involved the use of applied logical and scientific methods such as hypothesis testing, pattern recognition and statistical evidence.
Used to: - Understand the condition affecting the individual
- Select interventions in the clients best interest
Recognised in discussions as: - Impersonal, focus on diagnosis, condition, evidence from research or what typically occurs when alike clients.
EXAMPLES:
What is the nature of the illness, injury or development problem?
What are the common impairments or disabilities resulting from this condition?
diagnostic reasoning
- Involves the investigation and analysis of cause or nature of conditions requiring occupational intervention.
Used to: - Recognise and explain the condition affecting an individual
- Select interventions in the clients best interest
Recognised in discussions as: - Both personal and impersonal information
- Therapists attempts to explain why client is experiencing problems using scientific and client based information.
EXAMPLES:
What are the occupational performance problems this client has or may have in the future?
What are the factors contributing to this problem?
narrative reasoning
- Involving the understanding of the meaning that a disease, illness or disability has to an individual
- Focuses on cleints occupational strries
Used to: - Understand clients perspective of their current situations
- Understand roles, occupational functioning, impacts on occupational performance
Recognised in discussions as: - Personal, focused on the client, including past, present and anticipated future
- Involved appreciation of clients culture as basis for understanding
- Relates to the so what of the condition for the persons life.
EXAMPLES: what is this persons life story?
What is the nature of this person as an occupational being?
How has the health condition affected the persons life story or ability to continue his or her life story?
interactive reasoning
- Involves the understanding of current supports, engagement and attitude towards service systems. Relies on communicative process to enter the clients life world to better understand how to help.
Used to: - Build positive interpersonal relationships with clients
- Permit collaborative problem identification and problem solving
- Understand environmental influences of client practitioner relationships
Recognise in discussions as: - Concern with what the client likes or does not life
- Use of praise, empathetic comments, and nonverbal behaviours to encourage and support clients cooperation.
EXAMPLES:
How can I best relate to this person?
procedural reasoning
- Involving the understanding of clients conditions, likely prognoses and evidence based interventions that are likely to support optimal outcomes.
Used to: - Guide evidence based interventions to achieve clients desired outcomes in the context of the specific conditions
- Consider advantages/disadvantages of various interventions
Recognised in discussions as: - Using therapy regimes or routines thought to be effective with problems identified that are typically used with clients in the given setting.
EXAMPLE:
How are clinets like this usually handled in my setting?
conditional reasoning
- Involves the understanding of a clients condition and how change is conditional upon participation in the therapeutic process.
- Considers what is the best intervention for the specific cleint
Used to: - Anticipate situations in treatments
- Imaging future possibilities for clients
Recognised in discussions as: - Typically seen with more experienced therapists who can see multiple futures based on the therapists past experiences and current information.
EXAMPLES:
where is this person going?
pragmatic reasoning
- Involves implementing of therapy possibilities into the current realities of service delivery.
Used to: - Consider how therapy can operate given resources and reimbursement issues
Recognise in discussions as: - Generally not focused on client or the clients condition but rather on all the physical and social aspects that surrounds the therapy encounter
- Therapists sense of what they are capable of and his time and energy to complete
- Discussing the treatments that a realistic within the treatment setting.
EXAMPLES:
Who is paying for services and what are their rules?
What family or caregiver resources are there to support intervention?
ethical reasoning
- Involves a moral conflict where on moral stand or action conflicts with another (systematic approach to moral conflict)
Used to: - Analyse an ethical dilemma
- Generate alternative solutions and determining actions to be taken
Recognised in discussions as: - Tension is often evident as therapist attempts to determine what is the right thing to do, practically when faced with dilemmas in therapy competing principles, risks and benefits.
EXAMPLES:
Are the risks of the therapy worth the benefits?
whats the three stages of professional reasoning
ormuakting impressions
information gathered planning
monitoring
whats formulating an impression stage
- The initial stage where the OT try to develop an understanding based on typically fairly limited information available to them.
whats information gathered planning stage
- More detailed assessment driven by gaps identified in earlier stages
- Collaborative engagement with clients to make plans for service provision
whats monitoring stage
- Continual evaluation and improvement
- If, on balance outcomes are less than expected, further consideration should be given to:
- Clients current difficulties or their desired occupational futures (narrative reasoning)
- Clients understanding of their conditions and their relationships with support networks (interactive reasoning)
- The most effective interventions for clients specific situations (procedural and conditional reasoning)
whats professional reasoning in summary
interactions amount practitioner and client and practice context
whats the five stage of professional reasoning continum
Novice advanced beginner competent proficent expert
whats the thing to remember the professional reasoning continum
no adult can pay everyhting
novice
Novice (no experience in practice area):
- Use rule based procedural reasoning to guide actions but does not recognise contextual cues.
- Not skilful in adapting rules to fit situations
- Uses procedural/ scientific reasoning
- Want to find an instruction manual.
advanced beginner
Advanced beginner (<1 year):
- Begins to incorporate contextual information into rule based thinking
- Recognises differneces between therotical epectations and presenting problems
- Relies on external guides as a form of reasoning
- Recognises additional cues and begins to see client as an individual
competent
Competent (1-3 years):
- Sees more facts
- Understand clients problems
- Individualises treatment
- May lack creativity and flexibility
proficient
Proficient (3-5 years):
- View situations as a while instead of in isolated parts
- Able to develop a vision of where the client should go
- Able to modify easily
expert
Expert (5-10 years):
- Recognises and understands rules of practice
- Uses intuition to know what to do next
- Uses conditional reasoning
- Able to flow conversation and action smoothly
whats the three stages of the development of ot
- Pre paradigm stage – the formation of the field
- Paradigm stage – members of the discipline articulate, subscribe & abide to a common set of ideas
- Crisis – inability of the paradigm to deal with new problems in the field
define paradigm
members of profession are bound together by a shared vision- a set of perspectives, ideas, concepts, approaches, theories and values
define conceptual perspective
fundamentals that are found in the body of knowledge of the profession and discussed by those seeking to define the nature and purpose of the field.
whats the ancient chinse proverb
- I hear and I forget.
- I see and I remember.
- I do and I understand.
- Confucius; Chinese philosopher
the age of enlightenment (reason)
questioned old ways of viewing the world and provided new ways of knowing.
whats moral treatment
All people, even the most challenged are entitled too consideration and human compassion.
Focus on the patient’s environment and life situation
Physical, temporal and social environment was engineered so as to correct faulty habits of living and regenerate new ones
Engagement of patients in normal activities within a cheerful and supportive environment
Goal of arranging healthy living
Use of moral remedies such as education, work, routine, and play as therapeutic process to normalise disorganised behaviour
whats idleness
-led to demoralisation, the degeneration of attention, preoccupation with morbid thoughts and assumption of an invalid identity.
whats habit dysfunction
could accompany both mental and physical illness and threatened competent performance.
breakdown of the balance in daily life occupations
emanated primarily from a loss or failure of playfulness.
what year was oT founded
USA in 1917
what year was National Society for the Promotion of Occupational Therapy was formed in 1917
1917
what year was American occupation therapy association was formed
1921
who’s the father of occupational therapy
Willian duton
who’s the mother of occupational therapy
Eleanor slagle
whats the occupational therapy self assessment
- Client centred
- Paper and pencil instrument
- Self report (done by client)
- Initial assessment (when they first come to the facility)
- Outcome measure (afterwards) (allows a comparison)
- Looks at level of competence (how well) in values about occupational performance and participation (involvement in the occupation).
whats the purpose of th e OSA
- Clients viewpoint
- Clients priorities
- Identifies strategies
- Enhances communication
- Enhances collaboration
define volition
: the desire/goal/will/motivation/confident in abilities to do what you want to do
define habituation
: turning things into a habit/ things you do regularly/having a satisfying routine/ habits make up the role you play
