“Tears in My Eyes ’Cause Somebody Finally Understood”: Client Perceptions of Practitioners Following Brain Injury

Objective: The purpose of this study was to identify practitioner qualities and traits that clients with brain injury see as important. Method: An opportunistic sample of 51 participants with brain injury was interviewed about perceptions of service access and effectiveness. An interview guide was used to gather data for this phenomenological qualitative study. Four interviewers individually conducted audiotaped interviews, which were then transcribed. Coding and theme development were completed using HyperRESEARCH™ software. Results: Three themes regarding practitioner qualities emerged from the data: (a) roles of the provider, (b) perceived helpfulness of services, and (c) personal characteristics of the providers. Beneficial provider roles included advocate, friend, mentor, and team member. Perceptions of helpfulness of the services included relevance, meaningfulness, practical application, skill development potential, and whether periodic feedback on progress was provided. Personal characteristics of the provider valued by the participants were clear and honest communicator, supportive, respectful, good listener, and understanding. Conclusions: Practitioners need to pay increased attention to the perceptions of care and services of clients with brain injury. The current study closely supports previous research related to quality of care in the medical and community arenas and offers some additional suggestions to professionals who work with persons with brain injury, including learning how to time giving information to clients and how to understand client concerns without being prescriptive. Future research in this area needs to focus on and describe providers who demonstrate an ability—through their willingness to don a variety of roles, their helpful services, and their personal characteristics—to meet the unique needs of clients with brain injury

Relationships Between Reasoning, Reflective Practice, and Evidence-Based Practice: Educators’ Perspectives

Many models of professional thinking exist within occupational therapy, but the relationships among reasoning, reflective practice, and evidence-based practice as essential skills for practice are not clear. Because occupational therapy educators impart these skills to students, understanding how educators conceptualize relationships among skills is necessary. We used Delphi methodology to explore educator conceptualizations of the relationships among clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Inclusion criteria were: an educator in an occupational therapy program for at least three years at the master’s level or higher, currently an occupational therapy educator based in the United States, and available across multiple survey rounds. Nine participants completed all three survey rounds. Participants agreed that the four skills are reciprocally related to one another, with some discrepancies surrounding differing conceptualizations of clinical and professional reasoning. Additionally, relationships were understood to be non-linear and complex. Continued exploration of how these essential skills are related to one another is needed to support future exploration of how they are integrated in occupational therapy education and how this influences practice

Defining Reasoning, Reflective Practice, and Evidence-Based Practice in Occupational Therapy Education: A Delphi Study

Reasoning, reflective practice, and evidence-based practice are essential skills for occupational therapy practitioners, but it is unclear how these skills are defined in occupational therapy education. We used Delphi methodology to explore educator conceptualizations of clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Eligible participants on the Delphi expert panel were required to have been an educator in an occupational therapy program for at least three years at the master’s level or higher, to be a current occupational therapy educator, based in the United States, and available across multiple survey rounds. Nine participants completed all three survey rounds. Among members of the expert panel there was continued moderate disagreement about terminology related to reasoning and there were some discrepancies between expert perspectives and the occupational therapy literature. However, these educators largely agreed on key features of the complex constructs. Consistency about the use of these terms will support both education and research related to essential professional skills