Identification of occupational therapy clinical expertise: Decision making characteristics

Rassafiani, Mehdi, Ziviani, Jenny, Rodger, Sylvia and Dalgleish, Lenard (2009) Identification of occupational therapy clinical expertise: Decision making characteristics. Australian Occupational Therapy Journal, 56 3: 156-166. doi:10.1111/j.1440-1630.2007.00718.x

Author Rassafiani, Mehdi
Ziviani, Jenny
Rodger, Sylvia
Dalgleish, Lenard
Title Identification of occupational therapy clinical expertise: Decision making characteristics
Journal name Australian Occupational Therapy Journal   Check publisher's open access policy
ISSN 0045-0766
Publication date 2009-06
Year available 2008
Sub-type Article (original research)
DOI 10.1111/j.1440-1630.2007.00718.x
Volume 56
Issue 3
Start page 156
End page 166
Total pages 11
Place of publication Richmond, Vic., Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2009
Language eng
Subject C1
110321 Rehabilitation and Therapy (excl. Physiotherapy)
920201 Allied Health Therapies (excl. Mental Health Services)
1103 Clinical Sciences
Formatted abstract
Experts are usually determined on the basis of length of experience, reputation, peer acknowledgment, and certification. While these characteristics are important they may, however, not be sufficient for this purpose. Another method for determining clinical expertise is to look at how individuals make decisions in their area of expertise. This study aims to identify clinician expertise on the basis of participants’ decision performance and examines this in relation to their length of experience, and type of decision making.

Cochran-Weiss-Shanteau (CWS) is a statistical method which can be used to examine individuals’ expertise on the basis of how they discriminate between hypothetical cases and consistency in their decision making. Participants comprised eighteen occupational therapists each with more than 5 years experience working with children with cerebral palsy. They were required to make treatment judgements for 110 cases (20 of which were repeated) of children with cerebral palsy. The CWS was calculated for each participant.

Results and Conclusions:
Two groups of participants were identified on the basis of their CWS index – one with both high consistency in decision making and the ability to discriminate between cases, the other with low consistency and poor discrimination. These two groups did not differ significantly on the basis of length of experience or work setting but did on the basis of intervention chosen and their type of decision making. The CWS method seems to offer promise as a means of determining clinical expertise on the basis of clinical decision making. Its application to the investigation of clinical reasoning and education is discussed.
© 2008 The Authors
Journal compilation © 2008 Australian Association of Occupational Therapists

Keyword Cerebral palsy
Professional competence
Upper limb function
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online April 2008

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Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 17 Apr 2008, 14:14:30 EST by Mr Mehdi Rassafiani on behalf of School of Health & Rehabilitation Sciences