Occupational Therapy Clinical Reasoning: Supervision for the Transition from Student to Clinician
Date of Award
Dissertation - Restricted
Doctor of Philosophy (PhD)
Students in every profession travel through a transition from the academic world to the world or practice. Inherent in that transition is the development of judgment and reasoning that guide daily professional decisions. Through the application of knowledge to experience, the novice's judgment and reasoning develop new dimensions. The nature of the process by which knowledge and experience become judgment continues to be a mystery and an ongoing challenge for educators. My motivation to pursue this project was the desire to understand the developmental processes which transform academic knowledge and practical experience into professional judgment. As an occupational therapy educator the development of clinical reasoning was a major focus of cu.curriculum planning and classroom efforts. The transfer of problem solving skills from the classroom to the clinic was the most difficult curricular challenge. Students who could reason effectively in the classroom environment often reported being unsure of what to do in the clinical setting. With five years of study about critical thinking and clinical reasoning, the answers seemed more complex rather than simpler. The disciplines of education and curriculum development became my tools for organizing and interpreting the complexities of critical thinking. Key elements in the development of occupational therapy clinical reasoning were identified, and resulted in changes in the academic preparation of students. These changes led to the development of a training curriculum for supervisors who guided the students' transition from the classroom to the clinic. This research study evaluated the effectiveness of a curriculum for training supervisors to guide the development of occupational therapy students' clinical reasoning The scope of the study was Limited to one academic setting in order to maintain consistency in academic preparation. Clinical supervisors bad virtually no previous training in how to help the student develop clinical reasoning skills. The curriculum included content on specific cognitive strategies to be used in discussing clinical decisions, and stages of development for clinical reasoning. The research study evaluated the effectiveness of the curriculum for changing the supervisors' behaviors and students' clinical reasoning skills. The purpose of this paper was to describe how to enhance the transfer of clinical reasoning from classroom to clinic. The nature of clinical reasoning and the nature of supervision are explicitly presented. Beliefs about the nature of the learner and learning were implicit in the curriculum. This paper will hopefully serve as a beginning point for other persons who are seeking to understand bow professional judgment develops, and the means to influence that development.