Group B
Group B
October 8, 2021 4:40 PM CST
October 8, 2021 4:40 PM CST
Clues to the Neural Underpinnings of Embodied Reasoning
Susan H. Lin, ScD, OTR/L, FAOTA, FACRM
Rationale:
In neuroscience, the process of how emotions influence reasoning includes: (1) Emotions, (2) Feelings, (3) Decision-making, and (4) Reasoning. Since embodied reasoning involves somatic sensations/feelings, explication of the processes and neural underpinnings of how emotions, feelings, and consciousness related to our actions would further understanding of embodied reasoning.
Objectives:
1. Analyze the relationships between consciousness, cognitive functions, and affect/emotions in embodied reasoning
2. Identify neural underpinnings of emotions and consciousness
Methods:
Antonio Damasio, a neurologist, proposed a continuum of emotional processing with three stages: state of emotion, which can be triggered and executed nonconsciously; state of feeling, which can be represented nonconsciously; and a state of feeling made conscious, where one knows both the feeling and emotion. To test his hypothesis, emotion is not dependent on consciousness, Damasio devised experiments with “David”, a man with damaged bilateral temporal lobes (hippocampus, amygdala). Although David could not recall previous days or events, he showed a consistent pattern of socialization. Damasio’s “Good Guy/Bad Guy” experiments involved staged interactions with Good Guy, Neutral Guys, and Bad Guys (brusque, denied requests), all delivered in random order in equal time periods over five days. Then researchers showed David photographs of people.
Findings: When shown sets of 4 photographs and asked questions, David chose the Good Guy over 80% of the time, higher than the 25% expected by chance. Damasio described David’s embodied reasoning during the experiment. Since David’s emotions were induced nonconsciously (ventromedial prefrontal cortices, basal forebrain, and amygdalae were damaged), then these regions couldn’t be required for emotion or consciousness.
Discussion/Implications: Damasio concludes that for one to know that he/she has feelings, “it’s necessary to add the process of consciousness in the aftermath of the processes of emotion and feeling.”
Using the Model of Evidence-Informed Professional Thinking to Support Ethical Practice
Professional expertise depends on ‘the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values and reflection in daily practice’ (Epstein & Hundert, 2002, p. 266 ). The development and maintenance of expertise is dependent on the integration and performance of clinical reasoning, evidence-based practices, and measuring outcomes (Duncan & Murray, 2012; Higgs, 2020). Importantly, one’s rate of engagement in (or “doing”) these activities provide an underlying indicator of competency. The measure of EIPT, a new assessment tool, uses the self-report habits of doing essential activities of clinical reasoning, EBP, and outcome measurement in one tool to accurately assess and interpret four levels of competent performance. The measure of EIPT (Benfield & Johnston, 2020), including its theoretical underpinnings, psychometric properties, and clinical uses, will be presented. Participants will be able to explain how this framework and assessment provides insight into the habits of practice of clinicians in daily practice. Implications: Improving our understanding and ability to measure practice habits can improve our understanding of the activities which lead to the development of expertise and measure the effects of interventions which target clinical reasoning, EBP, and outcome measurement.
Guidance for Fieldwork Educators in Promoting Professional Reasoning: Development of the PLUS Framework
Karina Dancza, PhD, MA (SEN), BAppSc(OT), Assistant Professor, Health and Social Sciences, Singapore Institute of Technology
Jodie Copley, PhD, BOccThy (Hons); Associate Professor, Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland
Monica Moran, DSocSc, MPhil (OT), DipCOT, Associate Professor of Rural Health, Western Australian Centre for Rural Health-WACRH, The University of Western Australia
Rationale: Fieldwork is a valuable strategy to enable students’ development of professional reasoning. Guidance for supervisors on how to facilitate this learning is less well understood.
Objectives: To present the Professional Learning through Useful Support (PLUS) Framework.
Methods: Action Research was used to investigate fieldwork experiences of fourteen students and eleven supervisors across four cycles. Semi-structured interviews were analysed using template analysis. Themes related to supervisory support were consolidated and compared with educational theory to form the PLUS Framework.
Findings: The PLUS Framework describes guidance strategies used by skilled supervisors to promote students’ professional reasoning. The framework has three focal points: 1. ‘Guide’, where supervisors discuss and share their practice approaches in a timely way; 2. ‘Link’, when supervisors unpack their theoretical and professional reasoning in practice environment; and 3. ‘Challenge’, when supervisors support students to embrace feelings of discomfort and uncertainty associated with new learning and encourage them to take time and practice to build their skills.
Implications: The PLUS framework is an educational tool that was developed to focus supervisors’ limited supervision time with students on areas that have significant impact on the development of professional reasoning. Further research will focus on its applicability in different contexts.