Clinical reasoning in neurology: Use of the repertory grid technique to investigate the reasoning of an experienced occupational therapist

Kuipers, Kathy and Grice, James W. (2009) Clinical reasoning in neurology: Use of the repertory grid technique to investigate the reasoning of an experienced occupational therapist. Australian Occupational Therapy Journal, 56 4: 275-284. doi:10.1111/j.1440-1630.2008.00737.x


Author Kuipers, Kathy
Grice, James W.
Title Clinical reasoning in neurology: Use of the repertory grid technique to investigate the reasoning of an experienced occupational therapist
Journal name Australian Occupational Therapy Journal   Check publisher's open access policy
ISSN 0045-0766
Publication date 2009-08-01
Sub-type Article (original research)
DOI 10.1111/j.1440-1630.2008.00737.x
Open Access Status
Volume 56
Issue 4
Start page 275
End page 284
Total pages 10
Place of publication Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Formatted abstract
Background/aim:
The aim of this paper is to describe the use of a structured interview methodology, the repertory grid technique, for investigating the clinical reasoning of an experienced occupational therapist in the domain of upper limb hypertonia as a result of brain injury.

Method:

Repertory grid interviews were completed before and after exposure to a protocol designed to guide clinical reasoning and decision-making in relation to upper limb neurological rehabilitation. Data were subjected to both qualitative and quantitative analyses.

Results:
Qualitative analysis focussed on clinical reasoning content. Common themes across the pre- and post-exposure interviews were the use of theoretical frameworks and practice models, the significance of clinical expertise, and discrimination of 'broad' and 'specific' aspects, as well as differentiation between 'therapist and client-related' aspects of the clinical situation. Quantitative analysis indicated that for both pre- and post-exposure repertory grids, clinical reasoning was structured in terms of two main concepts. In the pre-exposure grid, these were related to the therapist's role, and to the 'scope' of practice tasks (either broad or specific). In the post-exposure grid the two main concepts were upper limb performance, and client-centred aspects of the therapy process.

Conclusions:

The repertory grid technique is proposed as an effective tool for exploring occupational therapy clinical reasoning, based on its capacity for accessing personal frames of reference, and elucidating both the meaning and the structure supporting clinical reasoning.
Keyword Brain injury
Clinical reasoning
Participatory research
Upper limb function
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 03 Sep 2009, 17:51:49 EST by Mr Andrew Martlew on behalf of School of Health & Rehabilitation Sciences