Clinical reasoning models: what ’ s wrong with them?

I’ve been interested in clinical reasoning and models used in clinical reasoning for quite some time. Occupational therapy has several models, including the “occupational therapy problem solving process” by Lela Llorens, the Model of Human Occupation by Gary Kielhofner, and the Canadian Model of Occupational Performance by Polatajko, Townsend and Craik in 2007. All of these models were designed to support occupational therapy clinical reasoning processes, and to capture the essence of what occupational therapy is about. When it comes to pain rehabilitation, I’ve found the occupational therapy models a little lacking in specificity for my clinical reasoning. I’ve also noticed similar problems with proposed clinical reasoning models for physiotherapy when considering pain. Here’s the thing: if pain involves so many factors (call them biopsychosocial for want of a better all-encompassing term), and we don’t know which factors are relevant for this person at this time, clinical reasoning in pain rehabilitation is complex. Why? Well the problem with pain is that it’s full of ambiguity. Not so much for the person experiencing them, but certainly for the clinician trying to help. Bear with me a minute. To me, clinical reasoning models help shape the factors we include and those we omit. In writing that sentence I realise I’m assuming something crucial: that models are designed to help us predict and control what...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Clinical reasoning Occupational therapy Pain Pain conditions Physiotherapy Professional topics Psychology Research Science in practice hypotheses models theory Source Type: blogs