Clinical reasoning guideline for home modification interventions

Susan L. Stark, Emily Somerville, Marian Keglovits, Aliza Smason, Kelsey Bigham

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


OBJECTIVE. The objective of this study was to develop and validate a clinical reasoning tool to describe an occupational therapist's clinical reasoning process while delivering home modification interventions. METHOD. We used a two-phase, mixed-methods approach. In Phase 1, we developed a personal factors guideline to support clinical reasoning in home modification interventions based on in-depth interviews, a focus group, and field observations of 6 home modification experts. In Phase 2, the guideline was validated by a second group of 6 home modification experts. RESULTS. During analysis, 16 personal and environmental factors with a corresponding set of conditions and strategies for each factor emerged to form a clinical reasoning guideline, which was validated by a second group of experts. CONCLUSION. Unpacking the "black box" of the clinical reasoning process has yielded a useful clinical reasoning tool that will allow occupational therapists to deliver complex interventions with fidelity.

Original languageEnglish
JournalAmerican Journal of Occupational Therapy
Issue number2
StatePublished - Mar 1 2015


  • Decision making
  • Environment design
  • Guidelines as topic
  • Occupational therapy
  • Patient-centered care


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