Clinical Reasoning 1

Today, we had our 1st (Clinical Reasoning) CR lesson.

We were asked what we think is CR, what we like and dislike about our own CR, what are the CR that we like about our supervisors/OTs who we have worked with, etc.

What we gave for what CR is:

• Logical thinking - systematic analysis of patients and intervention
• analysis of data related to patient
• generate choices of mgt
• asking why, how , when (I gave this answer.... haha)
• being pragmatic/ realistic about choices of mgt
• formulation of ideas about patients to assist decision making
• using knowledge/ theory practically
• interested in your client
• being observant about pt. output
• trial and error to achieve the best for pt.
• interest in the field that you are in
• seeing the "big" picture (evironmental relationship with pt.)
• subjective observation is validated/shared by others (shared reality)
• see things from multi-perspective

We were also told to list out what we like and dislike about our own CR as a class:

Likes:

• good @ trial & error
• focus/ devoted/ serve society when I focus planning mgt for pt.
• experience a "high" when getting the correct Rx for pt.
• communication opportunties

Dislikes:

• not enough knowledge
• chaotic
• too much trial and error
• lack of confidence
• not enough exposure

What we like about the "experts":

• excellent observation skill (attention to details)
• feel the "vibes"
• effortless efficiency in making decisions that appear profound
• reflective skills + ability to faciliate reflection in others
• systematic
• "like a fish in the water"

HB mentioned that expert clinicians can be classified in any of the following:

Clinicians with/have

• intellectual abilities (likes to read) OR
• passion (have the drive to achieve towards their dreams) OR
• very good ability to teach what they do and able to communicate their thoughts across (like to communicate with people, likes to talk)

But there is still existance of clinicians with more than one of the above qualities.

HB asked us where do we see ourselves to be in. I don't think I will fall under the 1st category. Thus most likely either the 2nd or the 3rd. But there is higher chance to be the latter. (cos I like to listen and talk to people. ;) )

So..... what do you gather about CR?

Clinical Reasoning is:

• a cognitive process (knowledge, integration/applying, meta-cognition)
• affective
• contextual (E.Q during work/clinical, communication with pt.)
• communication (asking the right qn, the ability to communicate to other professionals)
• comfortable with the chaos (the ability to create a structure out of it)

What is a reflective practitioner? (gold standard of clinical reasoning)

• knowing-in-action
• reflection-IN-action
• reflection-ON-action