OTQualitativeThe British journal of occupational therapy2025

Occupational therapy students experience professional reasoning during their practice-based learning: A dialogical analysis.

Clare Beanlands, Nicki Thomas, Lynn Summerfield-Mann and 1 others

PMID 40599215

WHAT IT FOUND

Students described reasoning as overwhelming, comparing it to a 'nine-track mind' rather than simple models.

Fast acute settings and being observed stifled their thinking, while autonomy, time, and SOAP notes helped them manage the complexity.

Key findings

01Students experienced professional reasoning as complex and overwhelming, with one describing it as a 'nine-track mind' rather than a simple three-track model.

02The fast pace of acute settings and the anxiety of being observed inhibited students' reasoning, causing them to shut down or miss cues.

03Autonomy, time to reflect, and structured documentation like SOAP notes helped students scaffold their reasoning and manage the complexity of practice.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The study used a small sample of 12 students from a single cohort, which limits the transferability of the findings to other educational contexts. The first author was known to the students as a lecturer, which may have influenced how openly they shared their experiences, despite not being involved in their assessment. The dialogical analysis focused on narrative genres, which provides rich descriptive detail but does not offer a direct measure of reasoning skill development or effectiveness. The study did not explore the perspectives of practice educators or service users, offering a one-sided view of the practice-based learning experience.

Declared interests

The authors declared no potential conflicts of interest and no financial support for the research.

The easy way to misread this

Do not interpret the identified narrative genres as stages of reasoning development or as evidence of a specific teaching method's effectiveness. The study describes how students narrated their experiences, not how well they reasoned or what outcomes they achieved.

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