Overview
This lecture presents the eight main types of clinical reasoning used in occupational therapy, explaining their definitions, applications, and distinctions, using a case example throughout.
Introduction to Clinical Reasoning
- Clinical reasoning is the mental process used to assess information and make decisions in occupational therapy (OT).
- Different types of reasoning are used at various points in the OT process, often blending together.
Types of Clinical Reasoning
Scientific Reasoning
- Focuses on understanding the client's medical condition using scientific, theoretical, and evidence-based information.
- Involves recalling knowledge of anatomy, physiology, and research relevant to the client’s diagnosis.
Diagnostic Reasoning
- Applies scientific information to analyze the client’s specific functional deficits.
- Hypothesizes how the condition impacts the client’s occupations and roles.
Procedural Reasoning
- Concerns the steps, interventions, protocols, and policies within a setting.
- Guides choices based on standard procedures, documentation, and expected routines.
Interactive Reasoning
- Focuses on building rapport and fostering a therapeutic relationship through communication and empathy.
- Considers the client’s comfort, preferences, and motivation.
Narrative Reasoning
- Considers the client’s occupational story, including past, present, and future roles and experiences.
- Helps understand how life changes affect their sense of meaning and participation.
Pragmatic Reasoning
- Takes into account practical constraints like time, resources, context, clinician skills, and insurance.
- Decides what is realistic and achievable in given circumstances.
Ethical Reasoning
- Weighs ethical principles (e.g., beneficence, autonomy) to determine the right course of action.
- Ensures decisions respect client rights and professional standards.
Conditional Reasoning
- Integrates all previous reasoning types to adapt responses to complex, changing situations.
- Experienced clinicians use this to anticipate outcomes and tailor interventions dynamically.
Key Terms & Definitions
- Clinical Reasoning — The process OTs use to analyze, decide, and act in client care.
- Scientific Reasoning — Using evidence and theory to understand conditions.
- Diagnostic Reasoning — Linking scientific information to occupational impact.
- Procedural Reasoning — Following intervention protocols and routines.
- Interactive Reasoning — Building therapeutic rapport for collaboration.
- Narrative Reasoning — Understanding the client’s life story and meaning.
- Pragmatic Reasoning — Considering practicalities and real-world limitations.
- Ethical Reasoning — Applying moral principles to practice decisions.
- Conditional Reasoning — Synthesizing all reasoning types for flexible, holistic care.
Action Items / Next Steps
- Review the AOTA Code of Ethics.
- Reflect on which type of clinical reasoning is your strength and how it applies in your coursework or practice.
- Prepare examples of each reasoning type for future reference or exams.