1st March 2016 – Clinical Reasoning: From Novice to Expert

This week Lisa Forrest @LisaForrestOT and her colleague Dr Fiona Kennedy @FionaKennedyOT are hosting #Otalk 

The development of clinical reasoning is an essential component of pre-registration Occupational Therapy programmes and everyday professional growth and development.

Clinical reasoning can be defined as;

“The process that practitioners use to plan, direct, perform and reflect on client care” (Schell, 2009)

Clinical reasoning draws on empathy, intuition, judgment and common sense.

Dreyfus and Dreyfus (1996) outlined a model of expertise.  They outlined 5 critical elements offering an enhanced understanding of what distinguishes novices from experts.  The 5 critical elements include:

  1. Expertise is more about knowing how – knowing how to do things, knowing information and facts
  2. Expert knowledge is embedded in the action of the expert
  3. Experience is crucial in the development of expertise
  4. Much of expert knowledge is automatic and non-reflective (but in this does not stop deliberation before action when a situation requires it)
  5. Intuition of experts or the knowing how to do things is both experiential and tacit.

It is proposed that the development of clinical reasoning occurs on a continuum and not a static state.  However how do we develop our clinical reasoning skills from novice > expert?  And how can the profession and higher education institutions support and facilitate the learning required for professional practice and development?



Post Chat Updates:

Online transcript 

PDF transcript. #OTalk 1st March 2016

The Numbers

1,187,892 Impressions
676 Tweets
94 Participants

#OTalk Participants


#OTalk 23rd Feb 2016 – Maintaining mental health in an acute hospital setting

Are Occupational Therapists able to maintain psychological well-being in physical acute hospital settings?As a newly qualified Occupational Therapist (OT) it was embedded throughout university to be client-centred, provide choice all whilst looking at the individual holistically (COT, 2015) and I was very eager to start fulfilling this role.
My first post as a qualified OT is in an NHS acute hospital whereby the OT’s main role is to increase patient’s independence to facilitate safe discharge from hospital. There is a great pressure to get patients out of acute hospital beds once medically fit– this can often mean that the role of maintaining patient’s psychological well-being is often forgotten possibly due to a lack of resources or time constraints. This could potentially lead to an increased number in admissions as evidence suggests decreased mental well-being is linked to a decrease in physical well-being (Department of Health, 2011), especially throughout long hospital admissions.

In the NICE guidelines (2011) there are a number of quality statements that emphasise the need for patients to engage in meaningful and appropriate occupations daily whilst in hospital yet in reality this doesn’t always appear to be happening.

Do you think OT’s in acute physical settings are truly able to work holistically on the wards?

What do you think the barriers/implications are to maintaining psychological well-being in a physical hospital setting?

How do you address psychological well-being in acute hospital settings?

Ares OT’s involved in activities/groups on physical hospital wards or do other professions take the lead?

Hope to see you there on Tuesday 23rd February at 8pm!

Laura Reid, B5 OT- @laurareidOT


College of Occupational Therapist. (2015). Code of Ethics and Professional Conduct. London: COT.
HM Government. (2011). No Health Without Mental Health: A cross-government mental health outcomes strategy for people of all ages. London: Department of Health.
National Institute of Mental Health (2011) Service User Experience in Adult Mental Health. Available at: http://guidance.nice.org.uk/CG136 [Last accessed 10-02-2016].

Post Chat Updates:

Online Transcript can be found here: Healthcare Social Media Transcript

PDF of Transcript: #OTalk 23 Feb 2016

The Numbers

1,633,987 Impressions
786 Tweets
62 Participants

#OTalk Participants

Tuesday 16th Feb 2016- Ask not what your regional committee can do for you, but what you can do for your regional committee.

This weeks #Otalk will be hosted by the current chair of the Northern and Yorkshire regional committee, and newly appointed Otalk team member Rachel Booth @OT_rach

The closing date for nomination to BAOT regional committees is this month on 26th February.

I became involved in my regional committee soon after qualifying in 2006, but 10 years on, still have weekly conversations with OT’s who are not aware of regional committees, or their role.  I in part blame myself for this, and in one of my last acts as current chair for the Northern and Yorkshire regional committee I aim to improve awareness and encourage others to get involved.

I truly believe our profession is worth fighting for, and if you value, occupational therapy, it is your duty to become an active member of the British Association of Occupational Therapy, and avoid becoming a moaner, actions speak loader that words. Once you get involved in BAOT you understand how valuable your monthly membership fee is in keeping the profession alive, but COT/ BAOT needs more that your monthly contribution it needs your action.

You can do this is so many ways here a few –

  • attending and presenting at national conference;
  • writing for BJOT and OT news;
  • joining and getting involved in sectional sections,
  • and of course, getting involved in with your regional committee by attending a meeting, offering to write something for the regional newsletter, offering to help plan a local CPD event or standing for a position with your regional committee.

In this weeks Otalk, I hope to inspire you to become involved.

The first part I will be asking questions  of those how have chosen to join in the chat

Don’t be put off if you know little about regional committees this is your chance to learn,

Questions during the chat will ask if you have hard of your regional committee?

What you think they should be doing with your region?

I am hoping others from regional committee’s across the county will be joining in and this is your chance to ask them questions.

Louise Cusack @louisecusack from COT whose role it is to to manager regional committees and specialist sections, is also hoping to join in although this will be her first twitter chat so please bear that in mind.

In the mean time if your interested in finding out which region you’re a member of, what vaccinates they have and how to apply please visit the below link, you will need to login to your BAOT account to access.




Post Chat Updates.

On-line transcript of chat from Health Care Hashtags

PDF of Transcript

The Numbers

731,625 Impressions
398 Tweets
37 Participants
318 Avg Tweets/Hour
11 Avg Tweets/Participant

#OTalk Participants


#OTalk 9th Feb 2016 – Should there be changes to the way OT is taught in the UK?

This week’s @OTalk_ will be hosted by @hawki1989 (Thomas Hawksworth) on the topic of ‘Should there be changes to the way OT is taught in the UK?’ It looks to be an interesting discussion topic. Hopefully see you on Tuesday at 8pm (UK time) for #OTalk.

You can find Thomas’s intro blog post below:

Following the spending review by the government in the UK in November 2015, students applying for Occupational Therapy courses will see grants replaced by loans, leading to educators and professional bodies concerns that access into vital health careers would stagnate.

Interestingly, Janet Davies CE of the Royal College of Nursing, has stated that she is concerned that this will potentially direct nurses into other careers paths and this ‘link severing’ between universities and the NHS might impact the right number of future professionals, being in the right place, with the right skillset.

As these changes take place, this has also led to conversations about what is being offered as a ‘product’ by the universities and how this might differ; in terms of placement, in terms of content and in terms of projected destinations for students.

How can universities plan for the smooth transition from this severing? How might the curriculum change – and should it?

As newly-labelled consumers, should the student population want more from their education? Thinking back as students, is there anymore you would have wanted from your education had you needed to pay for it?

What can we learn from other countries in terms of how they teach OT to students without an NHS as a funder and shareholder?

Should role emerging placements become the norm?

Looking forward to this discussion – Tuesday at 8pm

Thomas Hawksworth @hawki1989


BBC (2016) Student nurses and midwives protest over grants cuts [Online] Available at: http://www.bbc.co.uk/news/uk-35263402 (Accessed on 2nd February 2016)

College of Occupational Therapist (2015) College of Occupational Therapists Response to the Comprehensive Spending Review [Online] Available at: https://www.cot.co.uk/news/comprehensive-spending-review/college-occupational-therapists-response-comprehensive-spending-r (Accessed on 2nd February 2016)

Royal College of Nursing (2016) RCN Students march in protest at student bursary cuts [Online] Available at: https://www.rcn.org.uk/news-and-events/news/rcn-students-march-in-protest-at-student-bursary-cuts (Accessed on 2nd February 2016)

Post Chat Updates.

On-line transcript from Health Care Hashtags 

PDF of Trancript: #OTalk – 9 Feb 2016

The Numbers

1,335,513 Impressions
865 Tweets
82 Participants

#OTalk Participants