The Place of Intuition in the Clinical Reasoning of Occupational Therapists: A Multiple-Case Study

Abstract

Background. Clinical reasoning is a crucial process for healthcare professionals, involving both intuitive and analytical components. Intuition, which can be defined as immediate and context-sensitive thoughts, would play an important role in the clinical reasoning of occupational therapists (OTs). However, understanding of how OTs use their intuition remains limited. Thus, this study aimed to better understand the place of intuition in the clinical decision-making of OTs in a real-life context. Methods. Adopting a constructivist epistemological stance, this qualitative multiple-case study involved four OTs. For each OT, data were collected through a video-recorded clinical session and a subsequent explicitation interview. Conversational analysis of the video data and inductive thematic analysis of the interviews were conducted. Results. The OTs, with 2 to 34 years of experience, demonstrated a nuanced use of intuition in their clinical reasoning. Experienced OTs relied more heavily on intuitive reasoning, seamlessly integrating it into their analytical approach, while novice therapists alternated between the two modes, giving equal importance to both. Key themes highlighted the central role of practice context, professional experience, the therapeutic relationship, and emotional management in the expression of intuition. Conclusion. The study highlights the decisive influence of the practice context whether routine or unusual, on the expression of OTs’ intuition. Additionally, the findings underscore the regulatory role of the clinicians’ emotions and the importance of empathic management of the clients’ emotional aspects, which shape the intuitive reasoning processes.