Identifying Instructional Methods for Development of Clinical Reasoning in Entry-Level Occupational Therapy Education: A Mixed Methods Design

Abstract

Occupational therapy education must teach using contemporary and evidence-based practices that yield graduates with clinical reasoning skills to successfully practice in dynamic and challenging environments. Researchers used a mixed-methods research design to identify the most frequently used and valued instructional methods for developing clinical reasoning with entry-level occupational therapy students. Researchers recruited full-time educators teaching in entry-level occupational therapy programs throughout the United States. Ninety-two occupational therapy educators completed the survey for the quantitative portion of the study. Subsequently, six occupational therapy educators participated in an interview for the qualitative portion of the study. Participants most frequently used laboratory experiences and least frequently used rotating chair discussion for developing clinical reasoning. Participants perceived experiential learning as the most valuable and rotating chair discussion as the least valuable instructional method for developing clinical reasoning. The three themes of the educator, the student, and the environment emerged from the qualitative data. Outcomes suggest occupational therapy educators must embrace the role of facilitator and continue to explore a variety of effective instructional methods. In order to achieve this role, occupational therapy educators need to engage in personal and professional development. Researchers provide additional strategies for developing the clinical reasoning skills required for successful occupational therapy practice.

Use of Case Studies to Promote Critical Thinking in Occupational Therapy Students

“…Although experiential learning has been identified as one of the most valuable instructional methods for critical thinking that is also well-received by the students (Henderson, Coppard, & Qi, 2017;Goldbach & Stella, 2017), it is not always practical. An important aspect of experiential learning is the interaction with real clients.…”

Self-Determination Theory and Professional Reasoning in Occupational Therapy Students: A Mixed Methods Study

“…These reflections demonstrated a level of professional reasoning expected of students preparing for longer-term clinical experiences (e.g. level II fieldwork) (Henderson et al, 2017).…”

“…There are a variety of definitions present in the literature and used interchangeably for both professional reasoning and clinical reasoning. Henderson et al (2017) define clinical, or professional, reasoning as "a high level, cognitive thought process that integrates professional and acquired knowledge to deliver OT services in various contexts with clients with complex concerns" (p. 2). Professional and clinical reasoning also employ factual knowledge, practical working knowledge, and instinctual reactions to clients and situations (Unsworth & Baker, 2016).…”

“…Self-determination theory informs us that competence is an individual's need to feel capable (Orsini et al, 2015) and to engage in a "just-right" challenge as OTs often state. Educators can focus on assignments and experiences that provide opportunities for students to feel competent, which might involve group work, guided learning, opportunities for frequent feedback, and discussion (Henderson et al, 2017). Educators should also be hesitant to harshly judge a student's efforts when they are clearly functioning in a competency-seeking phase, and could instead recognize they are at the beginning phases of this continuum and seek solutions to help them move toward relatedness.…”

“…Occupational therapists (OTs) use professional reasoning to make decisions when working with clients. The workforce expects new graduates to enter the field with this vital skill set in place in order to meet a variety of needs in a complex healthcare environment (Furze et al, 2015;Henderson, Coppard, & Qi, 2017;McCannon, Robertson, Caldwell, Juwah, & Elfessi, 2004;Scaffa & Wooster, 2004). Therefore, developing student competence in professional reasoning is a critical role of OT educational programs.…”