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| the process used by practitioners to plan, direct, perform and reflect on client care. |
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| using the term professional resoning broadens the discussion to include the reasoning that occurs in non-medical environments, such as schools and community settings, as well as resoning done by supervisors, fieldwork educators, and occupational therapy managers as they conceptualize occupational therapy practice. |
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| -systematic approach to creating, testing and using knowledge to make decisions. |
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| -a process of methodical thinking by which problems or needs are detected or inferred. ex. seeing person can't breath well so decrease physical level of activity. |
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the thinking steps involved in working through the intervention reoutines for identified conditions.
-guides therapist in thinking about the patients; physical performance problems. Using identified conditions and then predicting the value. |
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| resoning process used to make sense of people's particular circumstances, prospectively imagine the effect of illness, disability, or occupational performance problems on their daily lives, and create a collaborative, story that is enacted with clients and families through intervention. |
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practical reasoning used to fit therapy possibilities into the current realities of service delivery, such as scheduling options, payment for services, equipment availability, therapists' skills, management directives, and the personal situation of the therapist.
-generally not focused on client or client's condition, but rather on all the physical and social "stuff" that surrounds the therapy encounter as well as the therapists' internal sense of what he or she is capable of and has the time and energy to complete. |
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reasoning directed to analyzing an ethical dilemma, generating alternative solutions, and determining actions to be taken; systematic approach to moral conflict.
-tension often evident as therapist attempts to deterine what is the "right" thing to do, particularly when faced with dilemmas in therapy, competing principles, and risks and benefits. |
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used when the therapist want to understand the patient as a person.
thinking directed toward building positive interpersonal relationships with clients, permitting collaborative problem identification and problem solving.
-therapist concerned with what client likes or doesn't like; use of praise, empathetic comments, and nonverbal behaviors to encourage and support client's cooperation. |
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-conditional reasoning used to project an imagined future condition or situation for the person.
a blending of all forms of reasoning for the purposes of flexibly responding to changing conditions or predicting possible client futures.
-typically found with more experienced therapists who can "see" multiple futures, based on therapists' past experiences and current information. |
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-ADLs
-IADLs
-rest and sleep
-education
-work
-play
-leisure
-social participation |
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Values, beliefs and spirituality
-body functions
-body structures |
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-Sensory perceptual skills
-motor and praxis skills
-emotional regulation skills
-cognitive skills
-communication and social skills |
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habits
-routines
-roles
-rituals |
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cultural
-personal
-physical
-social
-temporal
-virtual |
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| context and environment (6) |
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objects used and their properties
-space demands
-social demands
-sequencing and timing
-required actions
-required body functions
-required body structures |
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| novice, advanced beginners, competant, proficient workers, experts. |
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| 5 succeding stages of expertise |
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| apply basic rules but do not particularly pay attention to the surroundings. |
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| learn thru experience in a variety of situations but still rely on the rules when making decisions |
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| -adopt a plan for making a decision based on a limited number of factors to ascertain a conclusion. |
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| more engaged in their task of paying attention to the present situation in light of past encounters with similar circumstances. |
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| -more intuitive and take reflexive actions based on past practice/experiences and greater understanding of the situation. |
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| that which is taken for granted as the basis for argument or action. Shape what therapists see, affect the interpretation they make and guide what course of action they select. |
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| Therapists reasoning is influenced by at least 4 sources |
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Definition
-client
-practice setting
-profession
-internal valuses, beliefs, and assumptions of therapists. |
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| - act to selectively determine the scope of our attention by filtering infor and guiding perceptions toward what to notice, what to ignor, what is relevant and what is irrelevant. |
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| assumptions form the screen through which therapists view and understand therapeutic experiences. |
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| -a personal philosophy of meaning with which we interpret our lives... that informs life choices and life satisfaction (spirituality) |
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| organization of our memories and processes used to learn and use information in those memories, use past memories to learn and recall to think quick on our feet. Like if we need to modify or change an activity we can recall past memories. |
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| memories are organied in these and they include what works and what doesn't work. |
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| aka short term memory. mediates our perceptions of the world with our memory or knowledge of the world. Purpose to process but not store info enables us to make sense of incoming information and reflect on what we experience. |
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| storage system for both declaritive knowledge and procedural knowledge |
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| -what we know and declare |
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| avility to do something such as perform various intervention or assessment techniques. |
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Long term memory comprises frames that include semantic concepts, their attribute-values, structural invariants, and constraints.
frames make it easy to describe the rich complex knowledge involved in therapy and many options OTs have for therapy |
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| describes how we store semantic, conceptual knowledge as well as how we store information necessary for carrying out actions. Information from procedural and declaritive knowledge interacts, and can only be acted on, only when it is activated and brought into working memory. work together in working memory. All problem solving occurs in working memory. |
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| assumes knowledge is represented in memory using sensory-based codes of sight, hearing, smell, touch, and taste rather then semantic representation |
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| anything in the environment that prompt the therapist to consider a specific diagnosis. |
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| cognition about cognition, and is a contributer to expert problem solving. (ex. taking notes because we are aware of our limitations)this emerges with experience. |
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| occurs as we dolidify our knowledge an skills so they become both fast and efficient at problem solving. Happens with practice. |
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| expertise is having experience and knowledge to work at a high level in a given domain. Novice is just beginning to learn a new domain and may be slow and inefficient in problem solving. More experience = expert knowledge. |
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| seeks to establish structured rules for reaching conclusions that are irrefutable. |
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| scientific reasoning overlaps partly with this in that both are concerned with the evaluation and application of research evidence to clinical practice. evidence based practice includes clinical experience and expert opinion, and takes into account the wishes, goals, and values of the clinet. |
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-a disciplined investigation of an empirical question.
The act of creating and testing knowledge.
Analysis of principles and scientific method in actual practice
uses many of the same cognitive techniques that scientific reasoning uses, but scientific inquiry is directly focused on the generation of generalizabile knowledge, whereas scientific reasoning concerns itself with decision making in practice. |
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-A scheme of a formal deductive argument with a major and minor premise and a conclusion.
example: all OTRs are registered with NBCOT
gayle is an OTR
therefore gayle is registered with NBCOT. |
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| using rules of logic with premises to reach irrefutable conclusions. always uncertainty |
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| use of empirical data and confirming or disconfirming hypotheses to draw conclusions. uncertainty |
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| Evidence based practice includes (3things) |
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| 1. published evidence of an interventions effectiveness. 2. clinical experience and expertise of the practionar and the experience of others. 3. values, goals, preferences, and wishes of client. |
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| When does reasoning begin? |
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Definition
| moment referal is recieved and read reasoning may begin |
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| If problimatic referral.... |
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Definition
| questions arise....is it appropriate for OT service? Is it appropriate for me? Do I have the qualification? then the practioner and collegues would need to consider their qualification to provide effective therapy for this individual. |
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| Frame of reference selection can come from..... (4 things) |
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| 1. attendence at work shop 2. past sussessful experience 3. preliminary published evidence 4. studies proven that it worked. |
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| -logical thing to do and includes...who, what occupations are important and why, relevant contexts for the client and carefivers, history, interests/values/motivations; goals and priorities amoung goals; and desired and feasible outcomes. |
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| analysis of OT performance |
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| assessment is in early stages of OT process, usually involves decision making to identigy unknowns. observations what a client can and can't do. |
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| formulation involves collaborative prioritization of goals b/n therapist and client/family/caregiver. in accordance with evidence based practice. |
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| -things can best be understood by taking it apart and studying the individual pieces. |
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| how an individual experiences phenomena. the way I tell a stoy tells you a great deal about me and my life, even when i tell a story about some one or something else. |
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| deals in subjective, personalized paticulars and specifics of lived experiences, human intention, and action that connects events across time and defines possibilities. |
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| creating stories about future |
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| telling stories about past/present. |
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| specific aspects of the life story deal with health and deviations from it. |
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| type of occupational narritive that expresses the persons volition as a set of ideas, percaptions and values that are assembled into a meaningful account by an investigator through a process of elicting parts of a person's life story and selectively retelling those aspects which are exemplory of volition. |
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| 4 common errors of scientific reasoning |
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| 1. too few cues observed or too many leading to confusion. 2. inaccurate interpretation of cues. 3. not generating multiple hypotheses, premature closing of reasoning. 4. favoring the search for confirming evidence, instead of seeking disconfirming evidence of hypothesis. |
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| empirically discoveredmistakes made by professionals in practice. |
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| the use of decuctive and inductive reasoning to confirm or disconfirm possible explanations of a phenomenon. |
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