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This site is a McMaster University workbook that outlines each type of reasoning,. It breaks down what you should do and ask your self in the clinical reasoning process. It may not be totally practically with practice as a clinical but i think as students in our fieldwork sites could make this part of their "homework" each night to develop these clinical reasoning skils.

This document was created as a workbook in order to introduce students to the various concepts/types of clinical reasoning and to facilitate students to make comprehensive clinical decisions regarding patient care. This workbook defines each type of clinical reasoning occupational therapy practitioners may utilize in order to deliver patient-centered care including narrative reasoning, procedural reasoning, interactive reasoning, pragmatic reasoning, and conditional reasoning. Under each type of clinical reasoning various strategies are listed in order to help an occupational therapy practitioner utilize the particular type of clinical reasoning to better understand and relate to the patient and deliver more effective treatment.

It is important to understand and apply throughout evaluation and intervention, clinical reasoning concepts such as narrative, procedural, interactive, pragmatic, and conditional. This article outlines and discusses the clinical reasoning concepts in further detail.

This 1991 AJOT article discussed clinical reasoning. The article stressed the importance of not allowing our clinical reasoning to biomechanical and biomedical focused. Rather, as occupational therapists, our clinical reasoning should focus on human world of motives, values, and beliefs.

This document provides a broader definition of clinical reasoning that is associated and expected from occupational therapists. Due to the nature of our profession as being client-centered and a mix of artistic and scientific rationale, OT's are expected to provide clinical reasoning that expands beyond the medical model into a meaning-centered, interpretive model. The reason for this expanded clinical reasoning for OT's is that we are not just looking at an individual in terms of their disability, rather we look at an individual in a holistic manner.

This document provides a broader definition of clinical reasoning that is associated and expected from occupational therapists. Due to the nature of our profession as being client-centered and a mix of artistic and scientific rationale, OT's are expected to provide clinical reasoning that expands beyond the medical model into a meaning-centered, interpretive model. The reason for this expanded clinical reasoning for OT's is that we are not just looking at an individual in terms of their disability, rather we look at an individual in a holistic manner.

This article discusses three types of clinical reasoning often used with occupational therapy practitioners. These types include scientific, narrative, and pragmatic. The main questions brought up by the authors were what is clinical reasoning and how does it influence practice?, what can we do to increase clinical reasoning skills?, and do views of clinical reasoning work in the reality of practice?. Aspects that influence use of clinical reasoning included the therapists views of OT, therapists life knowledge, ability to carry out treatments, and interest in patients and profession. It is important to understand what types of clinical reasoning are being utilized in particular practice contexts in order to help with the creation of staff and self development models.

This website outlines the various types of clinical reasoning in occupational therapy practice. It also provides flashcards and quizzes on clinical reasoning.

This web resource provides flashcards to help occupational therapy practitioners/students better understand clinical reasoning. This resource provides information concerning the process of clinical reasoning, development of clinical reasoning skills, as well as outlines the various types of clinical reasoning occupational therapy practitioners may utilize in order to provide more effective patient-centered care.

This website provides quiz material in regards to clinical reasoning. The following concepts found on the website may also be found on the NBCOT, who knows?!? The quiz material includes: Process of Clinical Reasoning, Types of Clinical Reasoning, Scientific Reasoning, Process of Scientific Reasoning, Diagnostic Reasoning, Procedural Reasoning, Narrative Reasoning, Pragmatic Reasoning, Practice context, Personal context, Ethical Reasoning, Interactive & Conditional Reasoning, Development of Clinical Reasoning Skills.

This article discusses the importance of clinical reasoning in a time when evidence-based practice is becoming more prevalent. It is stressed that clinical reasoning is so important because randomized clinical trials can still be incomplete and hard to generalize. Clinical reasoning is vital to incorporate with randomized clinical trials to meet the responsibilities that the patients have entrusted in their health care professionals.

Sniderman, A., LaChapelle, K., & Rachon, N. (2013). The necessity for clinical reasoning in the era of evidence-based medicine. Mayo Clinic Proceedings, 88(10), 1108-1114. The authors of this article claim that evidence is often contradictory, insufficient, and may not apply to all individuals. Therefore, clinical reasoning is a necessary skill for practitioners to possess in order to make the best choices for our clients. Clinical reasoning is defined as the pragmatic process of expert clinical problem solving. The authors note that clinical reasoning is not the same as intuitive decision-making. Clinical reasoning requires is a disciplined, analytical, scientific approach to clinical problems. Research limitations discussed in this article include lack of evidence, incomplete evidence, conflicting evidence, low generalizability of RCTs, and limited transferability of group results to individuals. Although clinicians need to utilize available evidence to guide clinical decisions, it is important for clinicians to be aware of limitations in research to make sound clinical decisions.

This PDF document serves as an instructor's resource to clinical reasoning, why it is important, as well as the process to implement clinical reasoning into practice. The resource was written for nurses but can apply to occupational therapists as well. According to the authors, clinical reasoning describes the process by which occupational therapy practitioners collect cues, process information, come to an understanding concerning a patient's problem/situation, develop a plan and implement interventions, evaluate the outcomes, and lastly reflect and learn from the experience. Within healthcare, clinical reasoning is vital because those with effective clinical reasoning skills are better able to detect impending deterioration in patients and are also able to pinpoint what is impacting their ability to function at their prior level. This two skills enable therapists to provide more effective treatment and often they receive better functional outcomes from their patients. The clinical reasoning cycle outlined in this resource begins by considering the patient and their situation. The occupational therapist must then collect cues/information from the patient, their family, and the environment itself. The therapist must then process the information, identify the problems, establish therapy goals, take action through treatment intervention, and evaluate treatment outcomes. The final step includes reflecting on the process and learning from any mistakes or misconceptions in order to grow and mold into a more experienced clinician.

This is an instructional pdf file that discusses clinical reasoning in general terms, why clinical reasoning skills are important for health care personnel, examples and practical applications of clinical reasoning, and critical thinking habits to apply to one's everyday practice.

This article highlights the increased pressure placed on occupational therapists to utilize evidence-based practice when working with patients. The main purpose of this article is to provide occupational therapy practitioners with the knowledge and skill sets to utilize evidence to support their treatment and provide the best possible care to their patients. According to the authors, evidence-based practice requires occupational therapy practitioners to synthesize their clinical expertise, with the best evidence available to them through systematic review, as well as considering their patients' values and preferences. This article presents a framework that occupational therapy practitioners can utilize in order to create a more evidence-based practice. The first step includes asking clinical questions and then searching the literature in order to discover answers to the question. When gathering research information the occupational therapists must then place the research in hierarchies, deciphering what studies are more reliable and valid and what studies will provide better support to answer your clinical questions. This part of the process includes critically appraising the research to decide which studies are strongest and have the most sound evidence to support the clinical question. Throughout the entire process it is important for the therapist to utilize their clinical judgment in order to make the best decisions, as evidence-based practice requires a collaboration between research, clinical expertise, and patient preferences.

Bennett, S., & Bennett, J. (2000). The process of evidence-based practice in occupational therapy: informing clinical decisions. Australian Therapy Journal. 47, 171-180 This is a very helpful article from the Australian Therapy Journal that describes the process of evidence-based practice in occupational therapy. It emphasizes the importance that our profession now has placed on building our foundation in evidence-based practice and how we must have "sound evidence" to back up our treatments and interventions. The article discusses the framework to use with evidence-based practice, clinical questions to ask in research and the types of evidence to focus on at this point in time for our profession. This is a very valuable resource for newcomers to the profession as well as individuals who graduated in the past without the research component who may be interested in research at this point in time. Bennett and Bennett (2000) walk the reader through how to search for evidence based practice articles and then how to critically appraise them. It addresses the clinical importance and validity and how to know when you have a good study. Finally, it helps you to gauge how to know when you can use the evidence for individual clinical decisions.

This article discusses the process of clinical reasoning and the difficulties of teaching and/or learning this crucial skill. This document also presents a model for students to follow when attempting to develop solid clinical reasoning skills.

This article outlines the process of clinical reasoning and provides a framework for clinicians to utilize when attempting to teach clinical reasoning to students. This article was written with a focus on teaching junior doctors how to develop stronger clinical reasoning skills, but the same is applicable to occupational therapy students. Clinicians often know clinical reasoning when they see it but have a difficult time articulating and teaching it to their students. Clinical reasoning requires an individual to integrate and apply a variety of knowledge, weigh the presented evidence, critically think about all facets of the evidence, and finally to reflect upon the process utilized to arrive at the decision. Clinical reasoning encourages personal reflection and experience, which is why it is so difficult to teach to new grads/students that have little to no experience.

This study examined the contents of supervision needed by novice therapists to develop clinical abilities, focusing on their clinical experience and using an original evaluation table. An evaluation of clinical abilities basic attitudes, therapeutic skills, and clinical practice-related thoughts was conducted in 29, 21, and 9 therapists with clinical experience of 0-1 (1 year group), 1-2 (2 years group), and 2-3 (3 years group) years, respectively. On comparison of scores for the 55 evaluation items focusing on clinical experience, there were no significant differences in those for basic attitudes-related items among the 3 groups, while those for therapeutic skills-related items markedly varied between the 1 and 3 years groups. In scores for clinical practice-related thoughts-related items, significant differences were observed between the 1 and 3 years groups and between the 2 and 3 years groups. On comparison of scores among the items in each group, there were marked differences between those related to basic attitudes and clinical practice-related thoughts in the 1 and 2 years groups.

This article is from the American Journal of Occupational Therapy. I felt that it went along with our discussion about becoming fieldwork educators in the future. This study researches the effectiveness of case studies that influence clinical reasoning vs, typical educational case studies. This study goes into depth about clinical reasoning and how it influences educational experiences of students. The research participants, OT students, were asked to complete intervention plans based on client needs and in response to both the medical model of clinical reasoning and paper case study educational methods of learning. Information was qualitatively reviewed to analyze the intervention plans and videotaped discussions were used to guide clinical reasoning process/learning experience. The results showed that clinical reasoning case studies, compared to traditional case studies, promoted three main themes including increased quality of intervention plans, participant confidence levels in treatment plans, and enhanced understanding of the clinical reasoning process. This study is important for FEs and educators to increase clinical reasoning process of students as well as interventions for clients.

This article is a great read and discusses a multitude of strategies to teach technical skills while providing a foundation for clinical reasoning for students on fieldwork.

This study investigated the validated a clinical reasoning tool to describe OT perspectives in the home modification process. This included the development of a personal factors guideline to aid OT practitioners' clinical reasoning in home modification interventions. Factors to consider range from course of diagnosis and patient's preference to compliance and resources. This article showed how holistic OT is because it looked at home modification based on all client factors/environment to guide clinical reasoning for interventions.

This posting discusses clinical reasoning within occupational therapy by summarizing a chapter out of a book written by Willard and Spackman entitled Professional Reasoning in Practice. The writer of the blog explains that clinical reasoning within occupational therapy includes the entire process of planning, directing, performing, and reflecting on the various aspects of patient care. It was interesting to see how the writer goes explained clinical reasoning; stating that clinical reasoning is broken down into various cognitive processes. These various cognitive processes enable therapists to store information into categories and within a certain order so that when they come across similar situations later in their practice they can anticipate what to expect and how to handle the situation. The writer then defines the eight types of clinical reasoning (scientific, diagnostic, procedural, narrative, pragmatic, ethical, interactive, and conditional) and how they are utilized within the field of occupational therapy. Clinical reasoning is something that is very valuable within the field; however, it is something that takes time and experience to develop. Those who have experience working within the field of occupational therapy tend to utilize more of a conditional reasoning approach, as this approach is more of a blend of the various types of clinical reasoning and requires a higher skill set. Ultimately we should strive to develop conditional reasoning as practitioners in the field.