Group F
Group F
October 9, 2021 2:10 PM CST
October 9, 2021 2:10 PM CST
Occupational Therapy Assistant Students’ Perspectives of Clinical and Professional Reasoning Development During Level II Fieldwork
Marie-Christine Potvin, PhD, OTR/L; Jeanne Coviello, OTD, OTR/L
Occupational therapy academic programs are preparing occupational therapy assistant (OTA) students to develop and use clinical and professional reasoning in practice. A component of this academic education, Level II fieldwork (FW), develops clinical and professional reasoning by allowing students to practice these skills. Although numerous studies have investigated this topic in occupational therapy students, only one small study has previously investigated this in OTA students. Thus, we designed a mixed methods study of OTA students during Level II FW (n = 58) to expand our knowledge of learning experiences that develop clinical and professional reasoning skills. Six themes emerged from the qualitative analysis: “hands-on experience,” “thinking on your feet,” “the value of community-based placements,” “the supervision approach of the FW educator,” “application of evidence-based practice,” and “interprofessional interactions.” According to most participants, their clinical and professional reasoning development was positively impacted when their FW educator chunked information (88.5%), modeled best practice (84.6%), asked questions (84.6%), or engaged in story-telling (84.6%), with the latter two being perceived as most impactful. The study results suggest that the development of clinical and professional reasoning may be highly individualized and driven by what students experience.
Professional Reasoning of Expert Occupational Therapists Using the Dynamic Occupational Therapy Method
Angelica da Silva Araujo, PhD Student, BSc (OT), MSc (Sciences)
Tais Quevedo Marcolino, BSc (OT), MSc (Education), PhD (Education)
Rationale: There are gaps in how practice models shape occupational therapists' professional reasoning. The Dynamic Occupational Therapy Method (DOTM) is a Brazilian framework developed over the past 50 years, which offers a theoretical and a methodological structure for occupational therapy practice.
Objective: To investigate the professional reasoning of expert occupational therapists who ground their practice in the DOTM.
Methods: Following a constructivist grounded theory approach, interviews were conducted with ten Brazilian expert occupational therapists; interviews were analyzed through constant comparative analysis.
Findings: The experts’ professional reasoning followed three major processes: situational diagnostic construction; triadic relationship's dynamic movements management (target-person, activities, and practitioner); and evaluation of the practice/associative path. The clients’ uniqueness and situation, and an ethical-aesthetic dimension, underpinned therapists’ reasoning. Reasoning was organized through: thoughtful observation, information collection, memorization, associative thinking, construction of situated questions/hypotheses, and construction of narratives.
Discussion: The study identifies another three-track mind that through situated cognitive processes moves to: a) know the target-person in his/her situation, b) manage the triadic relationship for new experiences, and c) analyze the practice collaboratively, enabling the construction of new meanings. This research contributes to thinking about client-centered practice and the practitioner's responsibility to dynamically guide this process.
Theoretical Knowledge as Foundation to Professional Reasoning: What is Happening Now and What More Can be Done to Support Student Learning During Fieldwork
Alis Moores, MSc, BHSc(Hons), GCert Academic Practice
Karina Dancza, PhD, MA (SEN), PGCLT (HE), GCert Health Sciences, BAppSc (OT)
Merrill Turpin, PhD, Grad Dip Counsel, BOccThy, Associate Professor
Jodie Copley, PhD, BOccThy(Hons)
Intro
Theory is foundational to professional reasoning and can be derived within the profession (discipline specific knowledge), outside the profession (related knowledge) and relate to learning and teaching (educational knowledge). Fieldwork is an important teaching strategy for students to use theory and develop their professional reasoning. Little is known about how theory is described and used in practice education literature.
Objective
A scoping review aimed to identify what is known about theory use in occupational therapy practice education.
Method
A search of four electronic data bases (Cinahl, Embase, Pubmed and Scopus), identified 19 publications focusing on occupational therapy practice education and theory use. Deductive codes of discipline specific, related and educational theoretical knowledge were used for analysis.
Results
Terms used to describe theoretical and related knowledge were not clearly defined and were sometimes presented as incongruent. Few articles offered clear examples where occupation was the primary focus and related knowledge was also considered. Educational knowledge was used to interpret research findings but rarely applied to the conscious design of educational methods.
Conclusions
Practice education literature needs clearer definitions and examples of theory use. Explanations of educational methods to support students’ theory use and professional reasoning during fieldwork are also needed.
Development of Moral Reasoning in Graduate OT and PT Students
Brenda S. Howard, DHSc, OTR, FAOTA
Background: Development of moral reasoning in OT and PT students has been under-researched. Existing research has compared moral reasoning of OT and PT students, examined practitioners’ experiences of moral distress, and explored practitioners’ moral distress. Investigators found no studies examining the relationship between ethics educational content and its effectiveness in moral reasoning development in the US.
Purpose: The purpose of this study was to analyze the differences in moral reasoning between first year and second year OT and PT graduate students at one Midwestern mid-size teaching university and between students and OT and PT practitioners.
Method: Investigators used the Defining Issues Test – II to examine moral reasoning in 154 participants, which included first- and second-year OT and PT students, and OT and PT practitioners.
Results: While no significant differences were found between groups in moral reasoning schema, the pattern of moral reasoning was consolidated in practitioners and transitional in students, suggesting a mature ability to discriminate between moral reasoning schema when making moral decisions. Greatest significance was between second year students and practitioners.
Conclusion: Clinical educational experiences are pivotal during development of moral reasoning patterns. Greater support for moral decision making during clinical educational experiences may facilitate moral reasoning development.
Research Snapshot
Applying a Decision-Making Aid for Upper Limb Neurorehabilitation in Practice: A Cross Cultural Clinical Utility Study
Amelia Tan, PhD Candidate, BOccThy (Hons); Associate Professor Jodie Copley, PhD, BOccThy; Professor Jennifer Fleming, PhD, BOccThy (Hons), School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Rationale: Clinical reasoning in upper limb (UL) neurorehabilitation is complex. The Hypertonicity Intervention Planning Model (HIPM) is a decision-making aid which guides therapists to individualise UL management. Research supports its conceptual meaningfulness, but evidence of clinical utility is required.
Objectives: To examine the HIPM’s cross-cultural utility through gathering therapists’ perceptions of its usefulness and challenges of applying it in clinical practice.
Methods: Participants were 44 occupational therapists working in UL neurorehabilitation in Australia or Singapore who had received HIPM training. Three focus groups were conducted utilising a modified nominal group technique. Qualitative data were analysed using interpretive description.
Findings: Participants in both countries found the HIPM useful for guiding clinical reasoning for assessment, goal-setting, and interventions. Utility was influenced by: 1) systemic or organisational supports and barriers such as inter-disciplinary collaboration or availability of resources, time, and funding; 2) therapist factors such as confidence and skills to apply the HIPM, openness to changing practice, and exposure to suitable clients; and 3) client factors such as acceptance or compliance with HIPM interventions.
Implications: Organisational support is key to optimising clinical utility of the HIPM. Supplementary resources, progressive tiers of training to suit therapist experience levels, and refresher training may enhance utility.