Impact of Educational Strategies to Develop Professional Reasoning in Occupational Therapy Students and Therapists: A Systematic Review

Abstract

Purpose: Professional reasoning (PR) in occupational therapy (OT) is a central theme in the health professions. Understanding how it is taught and which strategies demonstrate a measurable impact is fundamental to strengthening professional training. This systematic review aimed to evaluate the scientific evidence on the reported impact of different educational strategies for fostering PR development in OT students and practitioners. Methods: The review was conducted according to the PRISMA guidelines and registered in PROSPERO. Databases and journals were searched, including studies published between 2014 and 2024. Eligible articles were quantitative or mixed-methods designs, and the risk of bias was assessed using RoB 2 or ROBINS-I V2. Results: Twenty-one studies were included (12 mixed, 9 quantitative). One randomized controlled trial showed a low risk of bias, while the remaining 20 quasi-experimental studies presented risks ranging from moderate to critical. The identified educational strategies were classified into five categories: case-based learning; curricular innovation and pedagogical redesign; simulation; fieldwork and service-learning; and the use of structured resources. The findings suggested a positive impact of various educational strategies, especially those based on real or simulated contexts, including supervision, structured feedback, and repetition of the strategy at different times. Conclusions: Despite the results, the heterogeneity of the designs, measures, and methodological limitations restricted the generalizability of the findings. This review highlighted the need for stronger and more transferable evidence to inform future pedagogical innovation in occupational therapy training, providing a starting point for comparative research in other health disciplines.