The Clinical Reasoning of Novice and Expert Occupational Therapists

Abstract

Over the past 15 years, research in health sciences has consistently shown that differences in the performance of novice and expert clinicians are predominantly due to their clinical reasoning abilities. Furthering our knowledge of the ways expert and novice occupational therapists reason can help us to explicate the complexities of practice and ultimately assist novices to think like experts. This paper presents the findings of a study which investigated qualitatively and quantitatively the clinical reasoning of novice and expert occupational therapists. Three expert and two novice occupational therapists working in rehabilitation settings wore head-mounted video cameras while completing three therapy sessions (assessment, treatment, discharge planning). Therapists then viewed the videos and reported back on their reasoning. These verbal reports were transcribed and analysed. While the quantitative results indicated several differences in both the amounts and types of clinical reasoning used by novices and experts, the qualitative analyses were more useful in revealing differences in the ways these two groups presented their clinical reasoning. The findings suggest that novice therapists could benefit from spending more time reflecting on the therapy process, and discussing their therapy with expert colleagues.