Borrowed the book "The reflective practitioner" by DA Schon because it was too long to photocopy and I'm glad I did. It was a really interesting and thought provoking chapter on the evolution of the epistemology (? correct usage here?) of the professions. The chapter itself is called "From technical rationality to Reflection-in-action" and I found it useful to read about the history of the "professions" and how the scientific method was valued above all use, about how basic and general science was "higher" than applied, and the divide between theory (guided by non-contextual research) and practice.
He described a dilemma between "rigor" and "relevance" between which practitioners have to choose when inevitably they encounter situations which are not well-formed and mere repetitions of textbook cases. I reflected that as occupational therapists, because we work with human beings, there is little doubt in my mind that it would be rather useless to "stay on the higher ground" and dismiss everything that doesn't fit into theory and "science" as anomalies. I mean, what's "normal" right?
The author conveyed a reasonable mistrust (or maybe rejection) of the Technical Rationality paradigm and I felt that there is still *some* place for research, although we must be ready to realise that not everything will fit nicely into categories (or maybe few things do!)
I felt this reading contrasted a lot with Rogers' (2004) Occupational Diagnosis, which called for better labelling and categories in order to further the knowledge and the profession! She even said that if we had good categories for labelling impairments and aetiology, we could share knowledge better. I must admit I wasn't terribly excited about the idea that differentiating between patient with 1A (can't shower due to visual impairment) and 1B (can't shower due to muscle weakness) was going to revolutionise our practice. My immediate thought was, well what if the patient can't shower, and he has both muscle weakness and visual impairment, but probably could manage if his wife didn't have issues of anxiety and control?
Rogers, J. C. (2004). Occupational diagnosis. In M. Molineux (Ed.), Occupation for Occupational Therapists (pp. 17-31). Oxford: Blackwell Publishing.
Schon, D. A. (1983). The reflective practitioner: How professionals think in action. USA: Basic Books.
Glad that you read Schon - I took this chapter out of the course because I apparently had too many readings. I agree its an interesting read. I could of course, make it accessible to anyone who want to read it. Love your comments about the difference in showering - however, the way you go about addressing the showering difficulty may well depend on the underlying pathology!
ReplyDeleteLinda
That's true, but my point was more that people often don't have clear cut "OT diagnoses" as such, so people would often fall into category 1A, 2B and 2C, for example, and that wouldn't really help clarify matters because none or all of those pathologies are responsible for the occupational dysfunction. In such a case going back to picking up cues and formulating hypotheses would be more useful, in my opinion.
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