A qualitative research study was undertaken in order to ascertain the scope and nature of clinical reasoning in community occupational therapy. Thirty occupational therapists based in social work departments in Scotland participated in this study, which required them to describe the content and meaning of their thinking during routine interventions with clients and carers living in their own homes.
The findings indicated that the participants adopted patterns of reasoning that consisted of three elements: reflection, decision making and reasoning. Reflection-in-action was commonplace during the home visits, while decision making was found to be concerned more with interactive than with technical or procedural issues. Reasoning was relativistic or pragmatic in response to contextual influences. In addition, it was found that the respondents tended to use coded meaning when explaining their thinking, which may in part account for the difficulties in articulating the reasoning that underpins clinical action. These issues are discussed in the context of current research on thinking.
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