The process of decision making

1. ASSIGNMENT No. 1
Ambreen Sadaf
Bsot02153003
Semester 6
Bachelors of Occupational Therapy
[EVIDENCE BASED PRACTICE]
THE PROCESS OF CLINICAL DECISION MAKING
AND
CRITICAL APPRAISAL OF RESEARCH ARTICLE
Submitted to:
Ms. Atia Ur Rehman
24-04-2018

2. THE PROCESS OF CLINICAL DECISION MAKING
The Clinical Decision Making Process is the process of establishing an appropriate
intervention for a client.
Key to this process is the utilization of:
1. Evidence based practice.
2. A client centred practice approach.
3. The International Classification of Functioning, Disability and Health (ICF).
4. The development of goals those are Specific, Measurable, Achievable, Realistic, and
Timed.
This Clinical Decision Making Process was designed to be used at the individual or
community/group level and to be applicable in preventative and treatment based approaches.
A. Examination
History
Client interview, chart review and/or community health assessment
Assessment
Selection of and timing of evaluation including outcome measures.
B. Identification of Issues
Individual (occupational therapy diagnosis) and/or community issues.
Point of referral for further investigation.
C. Goals
Development of SMART goals based upon client goals, expected outcomes and prognosis.
Point of referral for further intervention
D. Strategy for Intervention
Also known as “Plan of Care”
Point of referral for further intervention. – may include prioritization of issues which will be
addressed
E. Intervention
F. Re-examination
Maximized client autonomy from OT.
Establish follow-up, maintenance, and client sustainable programs.

3. Autonomous from OT
SMART Goals:
S-Specific
M-Measurable
A-Achievable
R-Realistic
T-Timed
These goals are a reflection of the occupational therapy diagnosis and prognosis.
The occupational therapist diagnosis culminates from the occupational therapy examination
and evaluation, where the examination is the process of obtaining data from the client, and
the evaluation requires the therapist to make judgements based on the data.
Whereas the medical diagnosis may be based on pathological origins, the occupational
therapist diagnosis is based on impairments and functional limitations as assessed by the
occupational therapist. 1
Examination
Identification
Intervention
Re-Examination
Goals
Strategy

4. CRITICAL APPRAISAL OF RESEARCH ARTICLE
Critical appraisal is a systematic process used to identify the strengths and weaknesses of a
research article in order to assess the usefulness and validity of research findings.
The most important components of a critical appraisal are an evaluation of the
appropriateness of the study design for the research question and a careful assessment of the
key methodological features of this design.
Other factors that also should be considered include the suitability of the statistical methods
used and their subsequent interpretation, potential conflicts of interest and the relevance of
the research to one's own practice.
This Review presents a 10-step guide to critical appraisal that aims to assist clinicians to
identify the most relevant high-quality studies available to guide their clinical practice. 2

5. REFERENCES:
1. http://umanitoba.ca/rehabsciences/media/2015-16_Clinical_Decision_Making_Process.pdf
2. https://www.medscape.com/viewarticle/706399