Occupational therapy clinical reasoning: Supervision for the transition from student to clinician

Jane Ellen Olson Affeldt, Marquette University


The problem addressed in this study was teaching occupational therapy students to transfer clinical reasoning skills from the classroom to the clinical setting. The purpose was to assess the effectiveness of a curriculum for training clinical supervisors to verbalize cognitive strategies during supervisory interaction in order to enhance transfer of the students' clinical reasoning. An experimental methodology was used to assess the effectiveness of a training curriculum for occupational therapy clinical supervisors. Thirty supervisors were randomly assigned to either a treatment or control group. The treatment group participated in six hours of training to verbalize cognitive strategies during supervisory interactions between the student and supervisor. A ten minute tape recording of interaction between the supervisor and student was completed during fieldwork experience. Students' and supervisors' statements were coded for use of cognitive strategies. The students' clinical judgment was measured using the American Occupational Therapy Association Fieldwork Evaluation. The findings of the study showed no significant differences between the treatment and control groups. Supervisors who were trained to verbalize cognitive strategies in supervisory interaction demonstrated no significant differences in the number of cognitive strategies verbalized from those supervisors who were not trained. Students whose supervisors were trained demonstrated no significant differences in verbalization of cognitive strategies or in judgment scores from students whose supervisors were not trained. A significant knowledge increase from pre-test to post-test was noted for supervisors completing the training experience. Students as a group used significantly more verbalizations of cognitive strategies than supervisors. Based on the findings, the training curriculum was not effective in changing the supervisors' use of cognitive strategies during supervisory interaction. The significant increase of scores from pre-test to post-test supported that supervisors comprehended the training material, but did not apply concepts during supervision. The finding that students used significantly more cognitive strategies supported that students used cognitive strategies to link knowledge and experience. Conclusions included recommendations for increasing the supervisors' ability to guide the students' use of cognitive strategies and enhancing the students' development of clinical reasoning.

Recommended Citation

Affeldt, Jane Ellen Olson, "Occupational therapy clinical reasoning: Supervision for the transition from student to clinician" (1993). Dissertations (1962 - 2010) Access via Proquest Digital Dissertations. AAI9411515.