As I join the roster of Eleanor Clarke Slagle lecturers, I am keenly aware of the privilege and responsibility of being so honored by my professional colleagues. Since my selection for the award was based on a recognition of a synthesis of skills in occupational therapy practice, education, and research, it seemed fitting for me to pursue a topic that would in some way enable me to reflect this synthesis. Thus, in developing the theme of clinical reasoning, I have taken a practice issue, studied it from an educational perspective, and formulated a conceptual framework for guiding the development of a clinical science of occupational therapy.