Instruments for Assessing Professional Reasoning in Occupational Therapy: A Systematic Review

Following PRISMA-COSMIN 2024 guidelines, this systematic review assessed the quality of evidence for quantitative instruments (OMIs) designed to measure professional reasoning in occupational therapy students and professionals between 2016 and 2025. Thirteen OMIs (~1,500 participants) were identified, revealing a substantial geographical bias toward the Global North. Although 61.5% (n = 8) were classified as Category A (Recommended), only the Evidence-Based Professional Thinking Tool (EIPT) demonstrated a "high" level of certainty of evidence. Critical shortcomings persist: while only one instrument reported minimal important change values, none identified minimal important differences. Current assessment tools exhibit methodological weaknesses and limited parameters for interpreting scores. Given that the evidence base is largely in a pilot stage, future research should prioritize cross-cultural adaptation, establish interpretive thresholds, and include observable, performance-based measures to improve the quality of assessment and evidence-based practice in occupational therapy education and clinical settings. Trial registration: PROSPERO (CRD420251270730).