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Becoming “At Home” in Home Modifications: Professional Reasoning Across the Expertise Continuum

ABSTRACT Professional reasoning used by occupational therapists in home modifications as they develop from novice to expert was explored in this grounded theory study. Eight occupational therapists participated in multiple interviews and member checks about home modifications training and practice. Formal academic and experiential learning provided the foundation for reasoning systems and habits of practice. As therapists gained expertise, they were able to shift their primary focus from systematic reasoning steps to focus on the comprehensive, client-centered, and contextual picture. Creative educational strategies support confidence in engaging in home modifications practice.