For clinical education workshop November 6, 2015. Images are royalty free or my own except for; 6,7,8 https://maarjakolberg.files.wordpress.com/2015/02/image.jpg

1. faci l i tat ing t he development of
CLINICAL REASONING

2. Matthew Molineux
professor of occupational therapy
head, discipline of occupational therapy
program director, bachelor of occupational therapy
practice educator

3. Matthew Molineux
professor of occupational therapy
head, discipline of occupational therapy
program director, bachelor of occupational therapy
practice educator

4. I. What is clinical reasoning?
II. Why is it important?
III. Reflective exercise
IV. Strategies to develop reasoning

5. clinical reasoning
What is

6. Step 1
Step 2
Step 3
Step 4
Step 5
Step 6

9. clinical reasoning
diagnostic
professional

10. the cognitive process that underlies
diagnosis and management of a patient’s
presenting problem
Linn, A., Khaw, C., Kildea, H., & Tonkin, A. (2012). Clinical reasoning - A guide to improving
teaching and practice. Australian Family Physician, 41(1-2), 18-20.

11. ability to integrate and apply different types
of knowledge, to weigh evidence, critically
think about arguments and to reflect upon
the process used to arrive at a diagnosis
Linn, A., Khaw, C., Kildea, H., & Tonkin, A. (2012). Clinical reasoning - A guide to improving
teaching and practice. Australian Family Physician, 41(1-2), 18-20.

12. cognitive process
diagnosis management
patients
problem
integrate and apply
different types of knowledge
weigh evidence
think critically
reflect

13. cognitive process
diagnosis management
patients
problem
integrate and apply
different types of knowledge
weigh evidence
think critically
reflect
com
plex
m
ultiple
sources

14. ?

15. …practice skills and knowledge
…reasoning

16. technical rational
professional artistry
Fish, D. (1995). Quality Mentoring for Student Teachers: A
Principled Approach to Practice. London: David Fulton

17. follows rules and laws
aims for efficient systems
knowledge is permanent
theory is applied to practice
technical expertise is all
quality = quantity
training

18. starts where rules fade
wants creativity
knowledge is dynamic
theory from practice
professional judgements
embraces uncertainty
education

19. technical rational
professional artistry
Fish, D. (1995). Quality Mentoring for Student Teachers: A
Principled Approach to Practice. London: David Fulton

20. use past experience
perceive patterns
selective attention
perceive problems at a deep level
understand client perspective
Expert
Novice

21. strands of reflection
Fish, D. (1991). Developing a theoretical framework. In D. Fish, S. Twinn & B. Purr (Eds.), Promoting Reflection:
Improving the Supervision of Practice in Health Visiting and Initial Teacher Training (pp. 17-31). London: West
London Institute of Higher Education.

22. factual
retrospective
sub-stratum
connective

23. factual
reconstructing the experience, drawing mainly
on procedural knowledge of it

24. retrospective
developing a wholist theory about, and a
critique of, the entire experience, drawing
mainly on procedural knowledge of it

25. sub-stratum
uncovering and exploring critically the
personal theory which underlies the
experience, and considering how it relates to
and might be helped by formal theory

26. personal
theory
formal
theory

27. connective
considering how the experience might relate
to future experiences

28. factual
retrospective
sub-stratum
connective

29. strategies to develop reasoning

30. shared language

31. dedicated time

32. model

33. model
BEWARE: tacit knowledge

34. vary expectations

35. 35
= learning
experience

36. 36
= learning
experience
+ reflection

37. 37
reflection
prospective … spective … retrospective

38. 38
reflection
articulation

39. 39
reflection
articulation
written verbal role play

40. 40
reflection
articulation
problem list prioritisation
provide feedback
read widely

41. Strategies to develop clinical reasoning
shared language
dedicated time
model
techniques
…reflection
…articulation
…problem list prioritisation
…provide feedback
…read widely

42. what did you see me do?
why do you think I did that?
why did you do that?
what sort of reasoning were you using?
why was it X and not Y?
give me an example of Z from that session
”

43. interrupt them
insist on use of theory
drill down

44. I. What is clinical reasoning?
II. Why is it important?
III. Reflective exercise
IV. Strategies to develop
reasoning

45. I. What is clinical reasoning?
II. Why is it important?
III. Reflective exercise
IV. Strategies to develop
reasoning
?