It's the final countdown...

(Those of you who know that song, you're showing your age!!)

Well it's getting close. Deadlines next Tuesday and I'm still working through my final assignment for clinical reasoning. It's getting better I think but I'm still unsure about the balance of literature/reflection/"I did this and thought that". After talking to A I thought I better send in my draft too, even if grossly incomplete. I know I will struggle with word count too! (I always do).

No time to waste, onwards and upwards! It's the final countdown.....

My new model

Just got the okay for my model for the assignment. I was concerned because while I initially didn't think my thinking had changed that much (see previous post), once I sat down and put all the elements together, suddenly I realised that it had changed A LOT. So much so that I wasn't even sure it qualified as a clinical reasoning model anymore. The reason for that is that in my mind clinical reasoning is quite allied to problem-solving. And problem-solving is quite narrow, as in what is the problem, and how do we fix it. And my approach to therapy in general now has broadened SO MUCH! That is why I was concerned my model wouldn't be accepted.

Well now my task is to put down in words the thinking behind the picture. I even managed to come up with a visual representation of my thinking - me the reader/writer. Haven't I stretched myself this semester! :p

I'm not quite sure yet what I will write. Because it's a bit of a journey into my own mind, and it'll take a bit more reflection to uncover why I think that I think the way I think I do, it's also going to be a bit of a surprise, I think. Hmm.

Beginning of the end

We have received our assignment marks and God has been very generous to me again! I am really looking forward to reading the comments though because I think it will be helpful and useful for my final assignment. Well, I haven't really gotten into the final assignment yet but I'm gonna! I got out my original model from week 1 today and had a look. Nope, still looks the same. Has my reasoning changed? Yes I think so. But how, aha, that is the million dollar question... I'm going to have to trawl through all the past weeks' readings again, consolidate, review and all that and figure out my current model of reasoning. I suspect it'll be fleshing out the original one more than devising a completely new one. I can't have changed THAT dramatically in less than a semester can I?

At the moment feeling both excited and still not quite ready. Just been wokring hard on another course so my mind is sort of still stuck on other matters. But it'll be good now to turn my hand to something different, and hopefully I'll get my assignment and be inspired by the comments on that! And hopefully I'll get it from the post before the rain gets it!

Mid term and ethics

Hmm a bit of a lull here, not that I haven't been reflecting but reflects that I have been busy getting my assignments in (not only for this course but two others as well, and submission to PG forum!)

Actually I really enjoyed getting back to course work and being done (for now) with assignment deadlines. Was quite relaxing and enjoyable reading some interesting articles and answering some questions! I particularly enjoyed Mary's session on Monday because ethics is always so interesting to think and talk about, because there is no "right answer". It's very enriching to be in a diverse class, especially with a mix of practice experience, study experiences, life experiences, ages, because everyone's opinion is a bit different (sometimes a lot different) and really gets the thinking going. It's easy to fall into established patterns of thinking within ourselves or within a close community of like-minded people so I find it really good to stimulate a bit of debate especially when things seem so "obvious", to go hang on, take a step back and think about "who says its obvious" and "why do I think it's obvious"?

Very stimulating conversations on Monday, it was great to be surrounded by people in practice who each contribute a slightly different take based on their practice settings. I think there is real value in this because as students our examples (or I should only speak for myself, so my examples) are theoretical or taken from very meagre placement memories or generalised. Usually quite generalised, maybe deducted/derived from theory. Or my own stereotyped thinking/accepted and unchallenged beliefs and prejudices.

And it really made sense to me to talk about ethics and ethical reasoning as part of this course (I must admit I did not see this coming! Duh!) because it's all about how we reason and why. We've touched on ethics before, in other courses in undergrad level but I think the literature shows people don't really consciously apply models of reasoning and a lot of action stems from intuition (which people then reflect upon afterwards). So it'd be useful to think about situations and principles that may guide us, before we are faced with ethical conundrums. I love being challenged by "what would you do" scenarios because it really makes me stop and go, "That's right, what WOULD I do?" Often, it's not that "obvious".

Anyway one assignment down and one to go. And 2 more other courses' assignments. This semester has gone/is going so fast!

the assignment

Reflecting on my assignment, or reflecting on what to put in my assignment, has been a confusing and illuminating process. It's not been clear cut, although starting out I kind of thought/hoped it would be. But clinical reasoning is not clear cut, so how can an assignment be clear cut? It's about reading and understanding, and re-reading when I realise I have not properly understood, and about breaking down and putting back together. Lots of people have said almost the same thing, but not entirely the same, which is why I find it tricky. Cos when you go to put it down on the paper I suddenly feel less confident about who said what and why that is different to the other.

So finding out 3 track mind isn't the be-all and end-all of clinical reasoning was quite a shock... They seem to be the gurus and their study was so earth shattering I guess I never thought to question it. We are still impressed by numbers I guess. A 2 year long ethnography is pretty impressive, although when I went back to look at the study, I found 1) yes there were mental health OTs 2) all hospital based 3) no men!

No men! I bet that skewed the results a lot. Wonder if anyone's thought of that.

Tacit knowledge, expertise and all that unfamiliar stuff...

I found it interesting that people on this course who are experienced practitioners all seemed to have really "hit a spot" when they read about tacit knowledge and expertise, "things we know but can't say" etc... I suppose it makes sense, because reading something that describes one's experience accurately which one never could quite put into words is very cathartic, and I have experienced that myself on other occasions. But not in this area, maybe because I lack that tacit knowledge, I don't have any knowledge that is "hidden" that I don't know of, maybe because I am a novice.

I feel a bit of a pang because I am clearly missing something, some eureka moment, but by the time I get to expert level (when is THAT going to be!) I would not experience the lightbulb going off because I am already armed with this knowledge, this theoretical knowledge so that when I gain that professional craft knowledge and tacit expert understanding, I can't quite be surprised by it. Unless I forget all that I have learned and read about in this course by the time I get there, which is a real possibility of course, seeing as it will be years away and I'm probably going to have other things forefront in my mind when I am in practice trying to "learn the craft" other than my tacit knowledge, or lack of. Hmm. One of those things we can only wait and see I guess. I wonder, like in those time travel stories, now that I know this, when I get there to the future, will this knowledge affect the way my tacit knowledge base is built over the next however many years?

Is any of this making sense? Is this rambling just a product of a sleepy afternoon? Am I having an existential moment or just caffeine/sleep deficiency??

Reflecting on work so far..

I'm glad we have to do this midway assignment because it's really making me think, go back to, re-digest, re-read and understand the material we've covered so far. I suppose that's the point of assignments. I thought I understood the readings and concepts we were going along week by week but it's only when I start to pull the ideas and concepts together for my assignment that I realise I need to dig deeper, and start to do so. I think it's coming together though. Well not quite yet, but I think it should do.

There are so many ideas out there, mostly not really competing with each other, but sort of similar-but-expressed-in-different ways. Almost like no one talked to each other before coming up with this stuff, or, everyone wants to be the one who came up with it! Or, we're all really similar and people are doomed to always repeat what others have said and few can be truly original or novel.

I don't mind. Sometimes reading about something written in slightly different ways helps to increase the depth of understanding and that surely is a good thing.