occupational therapist

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OT 321
Occupation: Theory and Analysis
Professional Reasoning in Practice
W & S CH 32
Instructor
Noor Ismael, MSc, PhD, OTR/L
29/9/2019
Learning Objectives
• Understand what is professional reasoning
• Learn about different aspects of professional reasoning
• Discuss the reasoning process, and how it is embedded in practice
situations

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Introduction
Professional Reasoning
• The process that practitioners use to plan, direct, perform, and
reflect on client care.
• The term reflects less of a medical perspective and more of education
and community practices.
Professional Reasoning
Requires meta-cognitive analysis, or
“thinking about thinking”

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Professional reasoning in occupational therapy is a whole-body
process; it involves knowledge gained from different senses during
practice situations.
Aspects of Professional Reasoning
• Scientific
• Narrative
• Pragmatic
• Ethical
• Interactive
• Conditional

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Scientific Reasoning
“Scientific reasoning is used to understand the condition that is
affecting an individual and to decide on interventions that are in the
client’s best interest.”
Forms of scientific reasoning
- Diagnostic reasoning
- Procedural reasoning
- Hypothetical deductive reasoning

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Examples of scientific reasoning questions
• What is the client’s medical, educational or social condition
prompting OT involvement?
• What are the performance skills, body functions, and daily living
limitations that typically result from this condition?
• What contextual factors typically affect performance?
• What theories and research are available to guide my assessment and
intervention decisions?
Narrative Reasoning
• What occupations are the most important for this person?

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Examples of Narrative Reasoning Questions
• What are the client’s life experiences, interests, previous life
habits/routines, and meaning associated with occupational activities.
• What are past/present perceived areas of success and competence
regarding his/her daily life occupations?
• What are the client’s priorities and desired target outcomes/goals?
• What occupational activities are both meaningful to the person and
useful in fulfilling therapy goals?
Pragmatic Reasoning
Scheduling
Insurance
Equipment

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Examples of Pragmatic Reasoning Questions
• Who is paying for these services and what are their expectations?
• What are the family, caregiver and community resources available to
support intervention and follow up recommendations?
• How much time is there to work with this person?
• What space, equipment and interdisciplinary support is available for
therapy/intervention?
• What are my professional competencies and development needs?
Ethical Reasoning
• Are the risks of therapy worth the benefits?

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Examples of Ethical Reasoning Questions
• What were the benefits and risks to the person? Did the benefits warrant
the risks?
• what were determining factors in prioritizing care for this client?
• How did you resolve conflicts when there were discrepancies between
team members’, caregivers’ and the client/families goals?
• How did you address issues of documentation when the requirements for
reimbursement conflicted with standard documentation procedures?
Interactive Reasoning
• Thinking directed toward building positive interpersonal relationships
with clients, permitting collaborative problem identification and
problem solving.

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Examples of Interactive Reasoning Questions
• How can I best relate to this person?
• How can I put this person at ease?
• What is the best way for me to encourage this person?
• What cultural factors do I need to consider as I engage with this
person?
Conditional Reasoning
• “flexibly responding to changing conditions or predicting possible
client futures”

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Schell’s Ecological Model of Reasoning
Schell’s Ecological Model of Reasoning

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Developing and Improving Professional
Reasoning
Professional reasoning Continuum
-Novice
- Advanced Beginner
-Competent
-Proficient
-Expert
Questions

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• Lab material includes completing the professional reasoning
assignment on case study groups.