Thursday, May 5, 2011

Thinking Out Loud

You probably don’t give yourself enough credit for all the thinking you do in a day.  You may even think a lot of what you know and do is “common sense”.
Students can’t see all your thoughts, revisions, and detours that can happen in a blink of an eye. In fact, you might not even realize they are happening. By “thinking out loud” you will make your reasoning more explicit and will help the student to understand your thinking.

Thinking Out Loud: Level 1
Explicitly talk through your thought process.  Think of this as the "director's commentary" bonus DVD.  It's one thing to see the movie (or observe the session) but by having a "what the director was thinking" bonus gives students insight into the decisions that were made.
“With yesterday’s client we used the _____assessment, but I don’t think that will work with the woman we’re seeing today because of _____.  That’s why I’ve decided to use ____ as it will be better suited to her.”
“My first thought was that his biggest issue was his mobility, but after talking to him I could see that we needed to explore issues related to ____ as he was clearly depressed”.
“After question 9 of the assessment, I could see that she was fatigued and becoming frustrated.  I decided it was more important to maintain rapport and switch to another activity than to finish this today”.
“You can see here in the chart that he has a diagnosis of _____.  In my experience, this typically means that he will have difficulties with ______ so these are the areas that I will need to make sure are covered in my initial assessment”.
“When the wife said ____ I didn’t really know what to say.  I’m not sure how I’m going to follow this up just yet”.

Thinking Out Loud: Level 2
Engage the student in a dialogue:  have them fill in some of the blanks of what you were thinking.
“When I walked in the room, there were some cues that he wouldn’t be discharged so soon after all.  Were you able to pick up on any of these?”
“Why do you think I ended the assessment early?”

Thinking Out Loud: Level 3
Now that you’ve done all that great role modeling, it’s the student’s turn.  Have them explain the rationale behind their decisions making.  For tips on questions you can ask, check out our blog entry entitled “Who, What, When, Why and How…Coaching Questions to Foster Reasoning”.

Happy educating!

OT Fieldwork Team