So often we (occupational therapists) are told that reasoning is complex, multifaceted, tacit, etc. While there is some truth in all of this, I believe that suggesting that reasoning can’t possibly be understood and made explicit is an excuse for not explaining what we do. That was a strong statement to begin this topic! However, I had to start somewhere and everytime I read an article about clinical reasoning and OT I notice it invariably talks about the difficulty of explaining our practice because it deals with complex problems and much of our knowledge is implicit so difficult to access and convey to others. My argument is that if this were the case ie. we are constantly dealing with demanding problems we would all be burnt out and unable to carry on. You may feel like this! Is this because of complexity in reasoning or because of inflexibility of work environments, lack of challenge (the other end of the spectrum) lack of support or… I’m sure you can think of more ideas here.
One topic that I have been reading about lately is the ideal of holism and its application to acute care practice. Linda Findlay writes a good article about the notion of ‘holism’ and suggests that it is a elusive fiction that our profession espouses but has never really teased out what is meant by this. Interestingly, she puts forward the idea that it is possible to encompass both reductionistic and holistic approaches in the same practice area. This is at odds with other authors conclusions (McColl; Barnitt). Linda makes the point that individual therapists are different and that some would always be ‘holistic’ despite their surroundings. This to me, is about the complexity of reasoning. Variations are evident because of our individual approaches, the environments we work in as well as such things as our level of experiential knowledge (actually I prefer the idea of ‘craft’ knowledge – it has a nice ring to it!). Anyway, I would be interested in hearing comments about his topic.