Mattingly C
Department of Occupational Therapy, University of Illinois at Chicago 06012.
Am J Occup Ther. 1991 Nov;45(11):979-86. doi: 10.5014/ajot.45.11.979.
This paper offers a concept of clinical reasoning that differs from many of the traditional definitions of clinical reasoning in occupational therapy and the health professions in general. Here, clinical reasoning in occupational therapy is described as a largely tacit, highly imagistic, and deeply phenomenological mode of thinking. It is argued that clinical reasoning involves more than the ability to offer explicit reasons that justify clinical decisions because it is also based on tacit understanding and habitual knowledge gained through experience. Clinical reasoning also involves more than a simple application of theory, particularly theory as understood in the natural sciences, because complex clinical tasks often require that the therapist improvise a treatment approach that addresses the unique meaning of disability as it relates to a particular patient.
本文提出了一种临床推理的概念,它不同于职业治疗及一般健康专业中许多传统的临床推理定义。在此,职业治疗中的临床推理被描述为一种主要是隐性的、高度形象化的且深刻的现象学思维模式。有人认为,临床推理不仅仅是提供明确理由以证明临床决策的能力,因为它还基于通过经验获得的隐性理解和习惯性知识。临床推理也不仅仅是简单地应用理论,特别是自然科学中所理解的理论,因为复杂的临床任务通常要求治疗师即兴创造一种治疗方法,以应对与特定患者相关的残疾的独特意义。