scholarly journals Problem Representation in Occupational Therapy

2021 ◽  
Author(s):  
◽  
Linda J Robertson
Keyword(s):  
Occupational Therapy ◽  
Treatment Planning ◽  
Clinical Reasoning ◽  
Environmental Context ◽  
Problem Representation ◽  
Academic Knowledge ◽  
Domain Specific Knowledge ◽  
Reasoning Skills ◽  
Novices And Experts ◽  
Clinical Reasoning Skills

<p>Clinical reasoning is a fundamental component of occupational therapy practice. Educators, researchers and clinicians are faced with the challenge of understanding and fostering the acquisition of clinical reasoning skills. The aim of this study was to examine the internal problem representations held by students and clinicians in respect of clients they had been treating for a period of time. Such representations form the basis on which treatment is formulated so are highly influential in the clinical reasoning process. The ultimate purpose of the study was to identify educational strategies that could be used to assist students to develop clinical reasoning skills. Understandings gained from the literature and from observation, indicated that there would be differences between novices and experts and that the work setting would affect problem representation. Thus the influence of experience and location was the primary focus of the study. To place the study within the context of the occupational therapy literature, the beliefs underlying problem representation were also explored to determine whether or not these were consistent with the philosophical assumptions identified in the literature. The method of investigation was an interview with pre-determined questions. The interview was consistent with the theory base of the study (ie. information processing), but the analysis also included the investigation of qualitative aspects. To ensure a developmental perspective was gained, respondents included students on two different levels of an occupational therapy course and clinicians who were currently practicing. The total number of respondents was 67 ie. 14 stage II students, 31 stage III students (ie. in their final year) and 22 clinicians. The study illustrated that the environmental context affects problem representation in respect of both the amount of data to be considered and the nature of that data. Differences between students' and clinicians' representation of the problem were related to qualitative aspects rather than identification of the elements relevant to treatment planning. In particular, clinicians were more able to elaborate on the data, justify their responses and provide a humanistic perspective beyond the more technical aspects of knowing the clients concerns. The beliefs governing thinking about treatment, demonstrated consistency with the occupational therapy literature (apart from one assumption). A major finding of this study is that the development of schemata related to practice areas is the basis of sound reasoning and justification of treatment planning decisions. Both domain specific knowledge and an understanding of the environmental context are important to the forming of these schemata. The implication for teaching is that the wealth of experiential knowledge that is gained by students while on clinical practice should be tapped to enable them to make links with academic knowledge and thus develop a comprehensive problem representation.</p>

scholarly journals Problem Representation in Occupational Therapy

2021 ◽  
Author(s):  
◽  
Linda J Robertson
Keyword(s):  
Occupational Therapy ◽  
Treatment Planning ◽  
Clinical Reasoning ◽  
Environmental Context ◽  
Problem Representation ◽  
Academic Knowledge ◽  
Domain Specific Knowledge ◽  
Reasoning Skills ◽  
Novices And Experts ◽  
Clinical Reasoning Skills

<p>Clinical reasoning is a fundamental component of occupational therapy practice. Educators, researchers and clinicians are faced with the challenge of understanding and fostering the acquisition of clinical reasoning skills. The aim of this study was to examine the internal problem representations held by students and clinicians in respect of clients they had been treating for a period of time. Such representations form the basis on which treatment is formulated so are highly influential in the clinical reasoning process. The ultimate purpose of the study was to identify educational strategies that could be used to assist students to develop clinical reasoning skills. Understandings gained from the literature and from observation, indicated that there would be differences between novices and experts and that the work setting would affect problem representation. Thus the influence of experience and location was the primary focus of the study. To place the study within the context of the occupational therapy literature, the beliefs underlying problem representation were also explored to determine whether or not these were consistent with the philosophical assumptions identified in the literature. The method of investigation was an interview with pre-determined questions. The interview was consistent with the theory base of the study (ie. information processing), but the analysis also included the investigation of qualitative aspects. To ensure a developmental perspective was gained, respondents included students on two different levels of an occupational therapy course and clinicians who were currently practicing. The total number of respondents was 67 ie. 14 stage II students, 31 stage III students (ie. in their final year) and 22 clinicians. The study illustrated that the environmental context affects problem representation in respect of both the amount of data to be considered and the nature of that data. Differences between students' and clinicians' representation of the problem were related to qualitative aspects rather than identification of the elements relevant to treatment planning. In particular, clinicians were more able to elaborate on the data, justify their responses and provide a humanistic perspective beyond the more technical aspects of knowing the clients concerns. The beliefs governing thinking about treatment, demonstrated consistency with the occupational therapy literature (apart from one assumption). A major finding of this study is that the development of schemata related to practice areas is the basis of sound reasoning and justification of treatment planning decisions. Both domain specific knowledge and an understanding of the environmental context are important to the forming of these schemata. The implication for teaching is that the wealth of experiential knowledge that is gained by students while on clinical practice should be tapped to enable them to make links with academic knowledge and thus develop a comprehensive problem representation.</p>

scholarly journals Comparison of clinical reasoning skills in occupational therapy students in the USA and Scotland

2004 ◽  
Vol 11 (3) ◽  
pp. 160-176 ◽  
Author(s):  
Robin McCannon ◽  
David Robertson ◽  
Jennifer Caldwell ◽  
Charles Juwah ◽  
Abdulaziz Elfessi
Keyword(s):  
Occupational Therapy ◽  
Clinical Reasoning ◽  
Occupational Therapy Students ◽  
The Usa ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills

Clinical Reasoning, Part 2: Novice/Expert Differences

1996 ◽  
Vol 59 (5) ◽  
pp. 212-216 ◽  
Author(s):  
Linda J Robertson
Keyword(s):  
Problem Solving ◽  
Occupational Therapy ◽  
Treatment Planning ◽  
Clinical Reasoning ◽  
Problem Representation ◽  
Educational Strategies ◽  
New Model ◽  
Concrete Experience ◽  
Further Development ◽  
Problem Representations

In part 1, a model of problem solving in occupational therapy was presented; the problem-representation component of this has now been developed to depict the differences between student and clinician in problem representation. This new model illustrates that both students and clinicians have access to the same information but that this is more clearly defined and organised in the clinician. The abstract, unlinked data of the student are ultimately transformed by concrete experience to a rich supply of schemata, which then become the basis for further development of problem representations in a particular area of practice. Clinicians frequently weave a human perspective into their understanding of the client whereas students, although able to note the client's concerns, are more likely to treat this information as another piece of data than to integrate it into treatment planning. A number of educational strategies are discussed.

The Model of Human Occupation: A Developing Conceptual Tool for Clinicians

1989 ◽  
Vol 52 (6) ◽  
pp. 210-214 ◽  
Author(s):  
Gary Kielhofner ◽  
Margaret Nicol
Keyword(s):  
Occupational Therapy ◽  
Clinical Reasoning ◽  
Occupational Therapists ◽  
Clinical Use ◽  
Current Development ◽  
Human Occupation ◽  
Conceptual Tool ◽  
Model Of Human Occupation ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills

This article discusses the evolution and current development of the model of human occupation, a conceptual tool designed to enhance the clinical reasoning skills of occupational therapists. A brief overview is provided of a number of conceptual forces in American occupational therapy which preceded and led up to the development of the model; this is followed by a description of the model, its intended clinical use and its implications for British occupational therapy.

Analisis Capaian Kompetensi Mahasiswa dalam Objective Structured Clinical Examination (OSCE) Semester Ganjil Tahun Ajaran 2017/2018 Fakultas Kedokteran Universitas HKBP Nommensen Medan

2020 ◽  
Vol 5 (2) ◽  
pp. 28-35
Author(s):  
Jenny Novina Sitepu
Keyword(s):  
Clinical Examination ◽  
Clinical Reasoning ◽  
Clinical Skills ◽  
Objective Structured Clinical Examination ◽  
Treatment Practice ◽  
Standard Patient ◽  
The Mean ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills ◽  
Academic Year

Backgroud: Clinical skills is one of competency as a doctor. Objective Structured Clinical Examination (OSCE) is an ideal way to assess clinical skills for undergraduated, graduated, and postdraduated clinical students. The low score in some OSCE station can be an input for teaching and curriculum improvement. This study aim to analyzed student competency achievement in first term in 2017/2018 academic year in  Fakultas Kedokteran Universitas HKBP Nommensen. Methods: This study was qualitative study with descriptive design. The sample was OSCE score in first term in 2017/2018 academic year. Student achievement was the mean score of every student in all station in OSCE. Competency achievement was the mean of students score for every competency in OSCE. Next, the stations was categorized in practice/ procedure skills station and clinical reasoning skills station. Skills achievement was got form the mean of score (in percent) of procedure skills and clinical reasoning station. Indept interview with students and lectures was held to knowed their perception about OSCE. Results: Students’ achievement in OSCE of first term academic year 2017/2018 was 62.4% for 2015’s students, and 64.6% for 2016’ students. The lowest competency achievement of 2015’s students was diagnosis and differential diagnosis. For the 2016’s students, it was farmacology treatment. Practice/ procedure skills achievement in OSCE of first term academic year 2017/2018 was 61.34% (2015’s students) and 74.4% (2016’s students). The clinical reasoning skills achievement was 62.80% (2015’s students), and 58.77% (2016’s students). Based on indept interview, the things that make student’s achievement low were the clinical reasoning ability of students was still low, the standard patient that involved in OSCE didn’t acted properly, the students’ knowledge about medicine and prescription was poor, and there were lot of learning schedules and learning subjects that students must did and learned. Conclusions:  Students’ achievement in OSCE of first term academic year 2017/2018 is need to  be improved.

The Use of a Modified Script Concordance Test in Clinical Rounds to Foster and Assess Clinical Reasoning Skills

2021 ◽  
Author(s):  
Jordan D. Tayce ◽  
Ashley B. Saunders
Keyword(s):  
Clinical Reasoning ◽  
Assessment For Learning ◽  
Learning Activity ◽  
Free Text ◽  
Valuable Insight ◽  
Script Concordance Test ◽  
Concordance Test ◽  
Script Concordance ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills

The development of clinical reasoning skills is a high priority during clinical service, but an unpredictable case load and limited time for formal instruction makes it challenging for faculty to foster and assess students’ individual clinical reasoning skills. We developed an assessment for learning activity that helps students build their clinical reasoning skills based on a modified version of the script concordance test (SCT). To modify the standard SCT, we simplified it by limiting students to a 3-point Likert scale instead of a 5-point scale and added a free-text box for students to provide justification for their answer. Students completed the modified SCT during clinical rounds to prompt a group discussion with the instructor. Student feedback was positive, and the instructor gained valuable insight into the students’ thought process. A modified SCT can be adopted as part of a multimodal approach to teaching on the clinic floor. The purpose of this article is to describe our modifications to the standard SCT and findings from implementation in a clinical rounds setting as a method of formative assessment for learning and developing clinical reasoning skills.

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