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

Introduction: Professional reasoning is important in making informed and autonomous decisions and practice-based learning provides an opportunity for students to develop this. This study explores the experience of professional reasoning during practice-based learning from the student’s perspective. Method: A dialogical approach was used, and this is a qualitative approach rooted in the analysis of dialogue and subjectivity. It is based on the philosophy of Mikhail Bakhtin. Bakhtin suggests speech is composed of different genres indicating how we position ourselves in relation to others. Twelve occupational therapy students were interviewed after their final practice placement. Findings: Professional reasoning during practice-based learning was experienced as complex, multifactorial and contextually influenced. It was a means of enacting, affirming, and negotiating a professional identity, and of being socialised into the reasoning of the profession. Person and occupation-centred values, narrative and empathy influenced students’ reasoning but could conflict with educator and institutional demands. The findings also illustrate the emotionality of learning to reason. Conclusion: Both the cognitive and affective aspects of learning to reason need consideration when supporting students. Educators and universities need to address the emotionality associated with reasoning and support students to develop person and occupation-centred practice within the pragmatic constraints of practice.