Clinical and Professional Reasoning Development in Level II Fieldwork: Occupational Therapy Assistant Students’ Perception

Abstract

Occupational therapy academic programs are tasked with preparing occupational therapy assistant (OTA) students to develop and use clinical and professional reasoning in practice. A component of this academic education, Level II fieldwork (FW), develops clinical and professional reasoning by allowing students to practice this skill. Although numerous studies have investigated this topic in occupational therapy students, only one small study has previously investigated this in OTA students during Level II FW. Thus, we designed a mixed methods study of OTA students during Level II FW (n = 58) to confirm and expand our knowledge of learning experiences that develop clinical and professional reasoning skills. Six major aspects of Level II FW were identified by participants as contributing to the development of their clinical and professional reasoning skills: “hands-on experience,” “thinking on your feet,” “the value of community-based placements,” “the supervision approach of the FW educator,” “application of evidence-based practice,” and “interprofessional interactions.” Three of these themes were novel as they did not emerge from the previous study. According to most participants their clinical and professional reasoning development was positively impacted when their FW educator chunked information (88.5%), modeled best practice (84.6%), asked questions (84.6%), or engaged in story-telling (84.6%), with the latter two being perceived as most impactful. The study results suggest that the development of clinical and professional reasoning may be highly individualized and driven by what students experience.

Keywords

• occupational therapy assistant
• clinical reasoning
• learning experiences
• level ii fieldwork
• professional reasoning