Type of Presentation

Poster Session

Location

University Library

Start Date

4-10-2026 11:30 AM

End Date

4-10-2026 12:45 PM

Description of Program

This study examines how occupational therapy practitioners engage in diagnostic reasoning and differential diagnosis amid the expansion of direct access responsibilities. A national survey revealed strong conceptual understanding but low confidence, citing training gaps and role ambiguity. Findings underscore the need for structured education, clear guidelines, and interprofessional collaboration to promote safe and evidence-based practice.

Abstract

Diagnostic Reasoning and Differential Diagnosis (DD) are increasingly vital in occupational therapy (OT) practice as direct access legislation expands evaluative responsibilities for occupational therapy practitioners (OTPs). Despite this need, little research has explored how OTPs understand and apply diagnostic reasoning in clinical contexts. This study examined processes, strategies, and perceived barriers and facilitators influencing OTPs’ engagement in diagnostic reasoning and DD across diverse settings. A national online survey of licensed OTPs collected quantitative and qualitative data on knowledge, confidence, training, interprofessional collaboration, and clinical behaviors. Data were analyzed using descriptive and inferential statistics, weighted analyses, z-scores, and thematic analysis. Results indicated that while most OTPs understood DD conceptually, confidence in applying diagnostic reasoning was lower. Reported barriers included gaps in training, role ambiguity regarding diagnostic authority, and limited institutional support. Nonetheless, participants routinely identified red flags, recognized diagnostic inconsistencies, and initiated interprofessional collaboration when functional performance suggested underlying conditions. Qualitative themes highlighted OTPs’ ability to detect subtle performance-based indicators of pathology, advocate for client safety, and address diagnostic gaps through holistic evaluation. Despite variability in training, OTPs expressed strong interest in structured educational resources, mentorship, and standardized guidelines to support diagnostic reasoning as direct access expands. Findings suggest OTPs possess foundational skills and clinical insight to contribute meaningfully to diagnosis; however, systemic educational and professional barriers hinder full integration. Addressing these gaps through formalized training, clearer guidelines, and enhanced interprofessional recognition is critical to advancing safe, evidence-based, collaborative practice.

Faculty / Staff Sponsor

Dr. Frank Czuba, DrOT, OTR/L

Presentation File

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Apr 10th, 11:30 AM Apr 10th, 12:45 PM

Investigating Best Practices in Diagnostic Reasoning and Differential Diagnosis: Implications for Occupational Therapy

University Library

Diagnostic Reasoning and Differential Diagnosis (DD) are increasingly vital in occupational therapy (OT) practice as direct access legislation expands evaluative responsibilities for occupational therapy practitioners (OTPs). Despite this need, little research has explored how OTPs understand and apply diagnostic reasoning in clinical contexts. This study examined processes, strategies, and perceived barriers and facilitators influencing OTPs’ engagement in diagnostic reasoning and DD across diverse settings. A national online survey of licensed OTPs collected quantitative and qualitative data on knowledge, confidence, training, interprofessional collaboration, and clinical behaviors. Data were analyzed using descriptive and inferential statistics, weighted analyses, z-scores, and thematic analysis. Results indicated that while most OTPs understood DD conceptually, confidence in applying diagnostic reasoning was lower. Reported barriers included gaps in training, role ambiguity regarding diagnostic authority, and limited institutional support. Nonetheless, participants routinely identified red flags, recognized diagnostic inconsistencies, and initiated interprofessional collaboration when functional performance suggested underlying conditions. Qualitative themes highlighted OTPs’ ability to detect subtle performance-based indicators of pathology, advocate for client safety, and address diagnostic gaps through holistic evaluation. Despite variability in training, OTPs expressed strong interest in structured educational resources, mentorship, and standardized guidelines to support diagnostic reasoning as direct access expands. Findings suggest OTPs possess foundational skills and clinical insight to contribute meaningfully to diagnosis; however, systemic educational and professional barriers hinder full integration. Addressing these gaps through formalized training, clearer guidelines, and enhanced interprofessional recognition is critical to advancing safe, evidence-based, collaborative practice.

 

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