Abstract:
Objectives: Clinical reasoning is at the heart of clinical work; it is affected by different field
factors. A clear understanding of the reasoning process could solve practitioners' problems
on how to make their underlying theories, assumptions and values more explicit. The aim
of this research is to understand how clinical reasoning process is formed in the context of
occupational therapists working in different clinical settings in Iran.
Methods: A purposeful and theoretical sampling of 15 occupational therapists working in
clinical settings was performed through semi-structured interviews. All the data were recorded,
transcribed, and analyzed using Strauss and Corbin’s (2008) grounded theory approach and
constant comparative analyses.
Results: Conceptual model was developed to explain the relationships among the main
categories extracted through the grounded theory. Achieve an observable change emerged as
the core category. Other important categories linked to the core category were, performing the
continuum of clinical reasoning, context of clinical reasoning, and effective factors in clinical
reasoning.
Discussion: Findings showed that achieving an observable change in the client was the
main consequence of the action/interaction strategies. Some facilitating factors related to
the therapist, helped to process reasoning with a holistic and client-centered view, while also
helping to develop the self-belief and professional identity. The dominance of medical views
and a lack of health insurance were two intervening factors that constrained the dynamics of
clinical reasoning within the context of practice.
Machine summary:
Research Paper: Occupational Therapists' Clinical Reasoning: A Qualitative Study Narges Shafaroodi1, Mohammad Kamali2*, Soroor Parvizi3, Afsoon Hassani Mehraban1 1.
Article info: Received: 16 May 2017 Accepted: 23 Jul. 2017 Keywords: Context, Observable change, Social identity, Medical view, Holistic view, Professional identity, Grounded theory, Occupational therapist A B S T R A C T Objectives: Clinical reasoning is at the heart of clinical work; it is affected by different field factors.
The aim of this research is to understand how clinical reasoning process is formed in the context of occupational therapists working in different clinical settings in Iran.
Moreover, clinical reasoning is a context-dependent process that guides occupational therapists to plan, direct, perform and reflect upon client care [8].
Therefore, this qualitative research method can be used to explore the understand- ing and experiences of occupational therapists as part of the clinical reasoning process.
Conceptual model of clinical reasoning process of occupational therapy ‘… WRe ehsaevaertcrhainliimngitcaotniosunltations, for instance for the clients who come from far away, … He comes to the clin- ‘What affects the intervention is that insurance depart- ment [health cover] does not recognize our treatment.
4. Discussion The study used grounded theory to explore the process of clinical reasoning among occupational therapists in Iranian context.
In these circumstances, reviewing the curriculum of occupational therapy, updating knowledge by participat- ing in re-educating course or workshops, and sharing experiences, understandings and negotiating outcomes in international, national or other health sciences confer- ences and congresses, might facilitate clinical reasoning process and develop a professional identity in this social context.