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Clinical Narrative

The Professional Advancement and Recognition program is designed to support professional development and to recognize professional contributions by occupational therapists and physical therapists at all points in one's career.

The program serves as the formal process for promotion and advancement to develop and recognize clinical expertise
 
The Clinical Narrative
 
The Clinical Narrative is a written document that serves as a tool to assist therapists with self reflection and professional growth. It is considered during the review process for advancement to the next professional level.
 
The Clinical Narrative is a tool that allows therapists to describe and demonstrate their practice within a specific case (over a number of days or treatment sessions) or at a specific point in time.
 
The Clinical Narrative is a document written in an informal manner in the first person used to facilitate reflection by the therapist regarding their practice and their thought processes. It provides an opportunity to show a therapist's practice level across the themes and sub themes of the Practice Model Continuum (pdf)
 
The Clinical Narrative provides the writer with the opportunity to address critical components of care including communication, teamwork, patient advocacy, critical thinking skills and other areas.

What is a Clinical Narrative?
  • It is a story written from the therapist's perspective describing a specific clinical case that happened within the last year
  • It provides the therapist with a tool for self reflection on their current practice
  • It enables the therapist to depict her/his current clinical practice
  • It presents information in a way that promotes discussion with colleagues

What should the Clinical Narrative be about?

  • A patient interaction in which your intervention made an impact on the patient's outcome
  • A situation that was challenging or particularly meaningful to you, but could also be rather ordinary in nature, as an example of your current practice
  • A situation that you frequently experience that highlights your role in the patient care team that gives you new insight into your role as a therapist

What should be included in the Clinical Narrative?

  • A detailed account of the case that helps the reader to visualize and understand the situation even if they are unfamiliar with your specific clinical role
  • A discussion of your thoughts, feelings and actions surrounding the situation - your description should indicate the rationale for your actions
  • Aspects of the situation that concerned you at the time
  • Why this situation was important to you
  • Conversations you had with others including, but not limited to the patient, family members and the patient care team
What are some of the tips for writing an effective Clinical Narrative?
  • Present the story from your point of view, changing the patient's name and any other identifying information
  • You may find it helpful to review the story with a colleague who is familiar with the patient's case
  • Have someone who is unfamiliar with the patient read your Narrative to identify areas that lack clarity
  • Include your thought and decision making process to help illustrate how and why you made your choices in this situation as it took place
  • Be specific. Give the reader an accurate picture of the situation. Avoid general or summary statements
Additional Resources

Benner P. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Addison-Wesley Publishing Company. 1984; 2001.

Jensen GM, Gwyer JM, Hack LM, Shepard KF. Expertise in Physical Therapy Practice. Second Edition. St. Louis: Saunders. 2007.

Mattingly C. Healing dramas and clinical plots: The narrative structure of experience. Cambridge University Press. 1998.