This paper describes the research process and methodology used in the American Occupational Therapy Association/American Occupational Therapy Foundation Clinical Reasoning Study. This study examined the clinical reasoning of occupational therapists through a 2-year ethnography of therapists at one hospital site. The research was innovative in several important respects. One important innovation was a combined ethnographic and action research design that involved collaboration between the research team and those therapists being studied. Therapists who were research subjects became actively involved in examining and reflecting on their own practice through group analysis of videotaped sessions with clients. One outcome of this action research component was that the study served as both a research and a staff development project.

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The expectations for accountability are very real in today’s health arena. The Association has many resources to assist the member in addressing this most important aspect of our practice. Nedra Gillette, M. Ed., OTR, FAOTA, Research Coordinator, AOTF, has developed this issue for presentation to you.

We have suggested that certain research challenges now face the profession. In summary, these challenges may be seen as part of the dual mission of research in a practice profession. Research must contribute to the development of a body of knowledge: some research is academic and theoretical in nature and other research helps to sustain and improve clinical practice. In either case, theory in a practice profession differs significantly from that in more traditional sciences. It is, in fact, more sophisticated and complex than the theory utilized by nonpractice professions, because it must provide the means to state intended outcomes and identify the methods required to achieve the prescribed results (5). This is known as "prescriptive theory" and represents the ultimate research challenge to the practice profession. Prescriptive theory cannot rest on studying what is and what has been; it must anticipate what might be--indeed, what must be--if patients are to achieve their greatest potential as functional members of society.

irecrions for the Future is a process esrablished by rhe American Occupational Therapy Associarion for rhe exploration of issues concerning practice, educarion, and research. The aniviries carried our rhrough rhe Direnions for the FUlure program yielded lhe following challenge to rhe profession: The verification of praclice rhrough research is critical LO the survival of occupalional lherapy. McClain (1987) anticipaled lhis challenge when she proposed "lhe lhesis lhar rhe primary concern of lhe 1980s is lhe profession's epislemology" (p. 607), ilS search for lrulh. Allhough lrurh may and usually does emerge lhrough praclice, it cannOl be claimed as such in the absence of scholarly efforts to test the assumptions that may masquerade as rruth. Wesr (as cired by McClain, 1987) described rhe profession's values, "which are characrerized by rhe belief in the worth of the individual and the value of meaningful doing" (p. 607). Other values srrongly held by occupational rherapis[s emerged rhrough recenr studies of pracrice that focused on the clinical reasoning of the therapisl: