Occupational Therapists' Clinical Reasoning: A Qualitative Study

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.