Occupational therapy students' paradigms: A passage from beholder to practitioner

The present study explores the development of occupational therapist paradigms among occupational therapy students at the Occupational Therapy Educational Program at the University College of Health Sciences, Jönköping, Sweden. The study is an explorative, comparative study of nearly qualified (last year) and newly enrolled (first week) occupational therapy students' world views and field of action views regarding occupational therapy. The students answered essay questions on paradigmatic matters, and their answers were analysed qualitatively. A study structure comprising three themes with appurtenant categories allowed comparisons between the two groups of students. A major finding was that the nearly qualified occupational therapy students' notions (in contrast to those of the newly enrolled students) gave expression to a more holistic health perspective in which there were numerous examples of interrelations between themes belonging to different paradigm components. According to Törnebohm interrelations between different paradigm components are characteristic of paradigms.     

A longitudinal study on the transformation of 15 occupational therapist students' paradigms into occupational therapists' paradigms

Background and Aim:  This study describes the transformation of 15 occupational therapist students' paradigms into occupational therapists' paradigms according to Törnebohm's theory of paradigms over a period of 6 years. This research particularly considers the paradigm components world view and field of action view in Törnbohm's sense.
Method:  Qualitative data were collected using essay questions on three occasions: first week and last semester at the Occupational Therapy Programme at the School of Health Sciences, Jönköping, Sweden, and after 3 years of occupational therapy practice. A content analysis of the collected materials was performed.
Conclusion:  The transformation of the informants' views could be characterised as comprising three different perspectives: a 'public' view in 1995, a 'theoretical' view in 1998 and an 'experiential/contextual' view in 2001.     

Learning style preferences of Australian occupational therapy students

Background/aim:  The learning styles and teaching implications for nursing and health science students have been well researched in other countries. Less research has considered the learning styles and implications for occupational therapy students. The current study examines the learning styles of occupational therapy students at one Australian university.
Methods:  The learning style preferences of first year undergraduate occupational therapy students ( n  = 120) were investigated. The students completed the Kolb Learning Style Inventory (LSI) and Fleming's VARK (Visual, Aural, Read/Write, and Kinaesthetic) Questionnaire in the first weeks of their course.
Results:  The response rate was 97% ( n  = 116). Learning style preferences as determined by the Kolb LSI were spread over all four Kolb LSI learning styles with 'diverging' (30.2%) and 'converging' (28.4%) being the most preferred. Instructional preference as measured by the VARK Questionnaire was kinaesthetic learning (33%), followed by the multimodal preference VARK (18.1%). Visual and aural categories were these students' least preferred methods of learning.
Conclusions:  The results of the current study support previous research indicating a range of teaching methods should be utilised to accommodate for the variability of students' learning styles within educational programs. To accommodate the range of learning experiences encountered in fieldwork and later in professional practice, students need to strengthen their capacities to use a variety of learning styles. This paper proposes that student learning for evidenced-based practice be facilitated by a range of learning opportunities including practical experiences.     

Facilitating professional identify in occupational therapy students

The purpose of this study was to explore how a graduate course in occupational therapy theory can help prepare students to develop a professional identity. Thirty students participated in the study. The course included content on the history of occupational therapy, models of practice and the social, philosophical, political and economic factors that impact on occupational therapy. The students were divided into groups of four or five where they discussed issues assigned by the instructor. An electronic blackboard was used to share the discussion with the class. Surveys of the students' opinions were used to collect data on what the students viewed as the strengths and weaknesses of the course. The students felt that the class discussions were the strongest part of the course. They felt that the course improved their critical thinking and problem solving significantly. It was concluded from the results that the course facilitated their professional identity through the connection made between theory and practice. There is a recognized need to explore the issue of developing a professional identity in occupational therapy students through courses integrating philosophical topics and clinical practice. Specifically, it is recommended that further research be carried out in educational settings with larger samples, using comparison groups and other methodologies to evaluate the issue of facilitating professional identity in occupational therapy students.     

Perceived stress in occupational therapy students

The purpose of this study was to examine perceived stress of entry-level master's occupational therapy (OT) students enrolled at a Texas university. A total of 29 students including nine men and 20 women participated in the study. Questionnaires and interviews were used for data collection. The participants were interviewed during the end of the first and second year of the entry-level master's programme in OT. Questionnaires, given at the same time, contained demographic data, open-end questions and force choice questions rated on a Likert scale. The results indicated that the majority of students (66.4%) rated their current level of stress as above average or the highest in their lives. The students expressed feelings of being overwhelmed, confused regarding course expectations and wanted more hands-on experience. When responding to how they managed stress, more than half of the students in the study took an active approach by utilizing exercise. Limitations of the study include using a non-standardized questionnaire, a small number of participants, and that the participants did not represent diversity and were for the most part Hispanic. It is recommended that future research address the cultural and generational issues that may affect perceptions of stress and how students cope with stress.     

Attitudes of entry level occupational therapy doctoral students towards inclusion for students with disabilities

Background/Aims:  The increasing popularity of inclusive education for students with disabilities and the attitudes towards it inevitably affect school-based occupational therapy practice. This survey study investigated the attitudes of entry-level occupational therapy doctoral (EOTD) students towards inclusive education and the effect of professional education on their perception.
Methods:  A total of 62 EOTD students responded to a self-developed questionnaire, Attitudes and Inclusive Education Survey , yielding a response rate of 91.2%.
Results:  Results of the study revealed that entry level occupational therapy doctoral students have positive attitudes towards inclusive education and believe that the inclusion movement has an inevitable impact on school-based occupational therapy practice. Professional education in occupational therapy might positively affect students' attitudes.
Conclusion:  Given the close association between one's attitude and behaviour, the findings of the study are particularly encouraging. Future research needs to further examine school-based occupational therapy practice in inclusive environments.     

Has undergraduate education prepared occupational therapy students for possible practice in palliative care?

Background: It has been argued that the unique nature of the occupational therapy role in palliative care (PC) warrants dedicated attention in undergraduate programmes to improve the confidence of occupational therapy graduates to work in this setting. Nevertheless, little is known about either the present PC education or the preparedness of graduates to work in this field. In addressing each of these issues, this study also sought information to guide the development of occupational therapy‐specific undergraduate teaching resources. Methods: Survey information was gathered from two participant groups: (i) six occupational therapy schools from Australia and New Zealand and (ii) 24 occupational therapists employed in PC in Australia and New Zealand. Two different surveys were used, targeting issues specific to each of these two groups. Where possible, data were analysed quantitatively, whereas open‐ended questions were interpreted thematically. Results: Occupational therapy schools reported 2–10 hours of PC‐specific content and requested teaching resources specific to the occupational therapy role. Less than half of the clinicians (45.8%) recalled receiving undergraduate content in PC, and 75% reported having felt unprepared to work in this field. Clinicians who had received PC‐specific content at university felt more prepared to work in this field than those who had not. Several recommendations for teaching PC were made. Conclusions: The link between the extent of PC education received and perceived readiness to work in this field, together with the relatively small amount of dedicated undergraduate PC‐specific content, supports the need to optimise teaching in this unique field.     

The linkage between patterns of daily occupations and occupational balance: Applications within occupational science and occupational therapy practice

Patterns of daily occupations (PDO) and occupational balance (OB) are recurring phenomena in the literature. Both are related with health and well-being, which makes them central in occupational therapy practice and occupational science. The aim was to review how PDO and OB are described in the literature, to propose a view of how the two constructs may be linked, and elaborate on how such a view may benefit occupational science and occupational therapy. The literature was analysed by latent and manifest content analysis and comparative analysis. The findings were summarized in a model, framing PDO as the more objective and OB as the more subjective result from an interaction between personal preferences and environmental influences. The proposed model does not assume a cause–effect relationship between the targeted constructs, rather a mutual influence and a joint reaction to influencing factors. Indicators of PDO and OB were identified, as well as tools for assessing PDO and OB. The authors propose that discerning PDO and OB as separate but interacting phenomena may be useful in developing a theoretical discourse in occupational science and enhancing occupational therapy practice. Although the scope of this study was limited, the proposed view may hopefully inspire further scrutiny of constructs.     

Integrating health literacy into occupational therapy: findings from a scoping review

This paper aims to report ways of integrating health literacy into occupational therapy practice. Health literacy is defined as the ability to access, understand, evaluate, and communicate information as a way to promote, maintain, and improve health in various settings over the life-course. A scoping study of the scientific and grey literature on health and, specifically, occupational therapy and health promotion was done from 1980 to May 2010. Five databases were searched by combining key words (i) "health literacy" with (ii) "rehabilitation", "occupational therapy", or "health promotion". Data were extracted from 44 documents: five textbooks, nine reports, and 29 articles. The literature on health literacy needs enhancing in both quantity and quality. Nevertheless, six ways of integrating health literacy into occupational therapy practice were identified (frequency; %): occupational therapists should (i) be informed about and recognize health literacy (27; 61.4), (ii) standardize their practice (10; 22.7), (iii) make information accessible (37; 84.1), (iv) interact optimally with clients (26; 59.1), (v) intervene (29; 65.9) and (vi) collaborate to increase health literacy (21; 47.7). Since health literacy can directly impact on intervention efficacy, further studies are needed on how to integrate health literacy into occupational therapy practice.     

Icelandic occupational therapists' attitudes towards educational issues

The purpose of this study was to assess the readiness of occupational therapists in Iceland to accept a professional as opposed to a technical view of the profession. Most Icelandic occupational therapists were educated in other countries, with little emphasis on liberal arts, sciences and research. The first Icelandic occupational therapy programme, a university-level programme, was founded in 1997. All Icelandic occupational therapists were surveyed. Eighty-seven questionnaires were sent out and 80 (92%) were returned and used for statistical analysis. The results of the study showed that Icelandic occupational therapists valued academic skills over technical skills, emphasizing occupational therapy theory unique to the profession and research to validate practice. More recognition among other health professionals was considered the most needed change in the profession. The results of the study showed that the clinicians' attitudes confirmed in general what is emphasized in the curriculum and in students' fieldwork. Further research is needed to explore whether the Icelandic occupational therapy profession succeeds in promoting research and recognition by other health professions.     

Integrating health literacy into occupational therapy: Findings from a scoping review

Abstract

This paper aims to report ways of integrating health literacy into occupational therapy practice. Health literacy is defined as the ability to access, understand, evaluate, and communicate information as a way to promote, maintain, and improve health in various settings over the life-course. A scoping study of the scientific and grey literature on health and, specifically, occupational therapy and health promotion was done from 1980 to May 2010. Five databases were searched by combining key words (i) “health literacy” with (ii) “rehabilitation”, “occupational therapy”, or “health promotion”. Data were extracted from 44 documents: five textbooks, nine reports, and 29 articles. The literature on health literacy needs enhancing in both quantity and quality. Nevertheless, six ways of integrating health literacy into occupational therapy practice were identified (frequency; %): occupational therapists should (i) be informed about and recognize health literacy (27; 61.4), (ii) standardize their practice (10; 22.7), (iii) make information accessible (37; 84.1), (iv) interact optimally with clients (26; 59.1), (v) intervene (29; 65.9) and (vi) collaborate to increase health literacy (21; 47.7). Since health literacy can directly impact on intervention efficacy, further studies are needed on how to integrate health literacy into occupational therapy practice.     

Continuing professional development for occupational therapy emergency department services

Aim: To explore continuing professional development (CPD) resources and needs of Australian emergency department occupational therapists. Method: Australian websites and occupational therapy newsletters were searched to identify CPD resources/opportunities. Occupational therapists with recent clinical experience in Australian emergency departments were surveyed on strengths, weaknesses, opportunities and threats to their service, research information needs, supervision/mentor arrangements and quality assurance activity. Results: No Australian CPD opportunities were identified; 1.3% of the 2008 OT AUSTRALIA conference topics were emergency department specific. Forty‐one Australian hospitals employed a total of 51 occupational therapists of whom 30 responded. Half were supervised by occupational therapists; 20 had occupational therapy mentors; 23 perceived that they were very independent; seven did quality assurance projects; 25 had unmet research needs; 27 thought their service was effective; and service strengths, weaknesses, opportunities and threats to service could be identified by most occupational therapists. Conclusion: Australian occupational therapists in emergency departments need specialised CPD opportunities. The information needs and strengths, weaknesses, opportunities and threats provide a CPD topic planning guide.     

The application of concept analysis in the occupational therapy treatment process in mental health

The objective of this study was to construct a coding schema for analysing the occupational therapy process, often described as formulating the treatment goal, implementing treatment and evaluating the effect of treatment. The concepts underlying the terms treatment goal, treatment intervention and effect or outcome of treatment, as used in occupational therapy, were defined and an analytical template of questions was constructed, using the analysis method designed by Walker and Avant (1995). The method included a third part; definitions of the three concepts were formulated on the basis of excerpts from occupational therapy textbooks in mental health that are well known in Sweden. The results showed that the concept of treatment goal included the attributive components planning goals, step-by-step goal, and group goal; the concept of treatment intervention included the components planning process, available resources and level; and the concept of effect or outcome of treatment included type and measurement. The excerpts for each of the components were then summarized as statements. These statements were converted into the questions that constituted the template. Third, these questions were used to test the usefulness of the template in analysing the occupational therapy content of 10 scientific reports on individuals with psychosis. All but two questions served to identify attributes of the three concepts. The template was useful for analysing the content of 10 research studies relevant to the occupational therapy process in mental health. Copyright © 1998 Whurr Publishers Ltd.     

Levels of empathy in undergraduate occupational therapy students

Empathy is an important attribute for occupational therapists in establishing rapport and in better understanding their clients. However, empathy can be compromised by high workloads, personal stressors and pressures to demonstrate efficacy. Occupational therapists also work with patients from a variety of diagnostic groups. The objective of this study was to determine the extent of empathy and attitudes towards clients amongst undergraduate occupational therapy students at one Australian University. A cross‐sectional study was undertaken using a written survey of the Jefferson Scale of Physician Empathy (JSPE) and the Medical Condition Regard Scale. Overall, a strong level of empathy was reported amongst students. Four medical conditions that occupational therapists work with (stroke, cerebral palsy, traumatic brain injury and depression) were held in high regard. Substance abuse, however, was held in comparatively low regard. Overall, the year of study appeared to have no significant impact on the students' empathy. Despite having a lower reported empathy level than found in health professions from other studies using the JSPE, occupational therapy students were found to have a good level of empathy. Of concern, however, was the bias reported against the medical condition of substance abuse, highlighting that the there may be a need to reinforce that patients from this diagnostic group are equally deserving of quality care irrespective of their clinical condition. Recommendations for future research include completing a longitudinal study of occupational therapy students' empathy levels and investigating the empathy levels of occupational therapists working with different client groups. Limitations of the study include the convenience sampling of occupational therapy students enrolled at one university which limits the generalizability of the results to groups of participants with similar characteristics. Copyright © 2010 John Wiley & Sons, Ltd.     

Evaluation of the effect of using online database to enhance students’ learning of occupational therapy theories in occupational therapy education

BackgroundLearning about occupational therapy theories is crucial to occupational therapy education, and an online database is developed to facilitate students’ learning of occupational therapy theories in this study.AimThis study was conducted to evaluate the effect of this database on users’ experiences.MethodsA mixed-method approach, including surveys and focus groups, was used. First- and third-year students who had studied occupational therapy theory at a university participated in this study.ResultsOne-hundred-and-twenty students completed the surveys, and 11 students participated in the focus groups. The students demonstrated a significant increase in the number of theories they named and their perceived understanding of theories after the semester. They rated the content, utility and satisfaction with the database in facilitating their understanding/learning of theories as moderate-good. Based on qualitative data, it appeared that the database provided specific information about occupational therapy theories and facilitated students’ learning and level of interest in learning about them. However, the first-year students who accessed the database showed a significantly decreased level of interest in learning about theories, but such the decrease was not found in the third-year students.ConclusionThe study findings suggest that the use of an online database may enhance students'' learning about occupational therapy theories in educational settings.     

Seeing white: a critical exploration of occupational therapy with Indigenous Australian people

This paper aims to critique current occupational therapy practice and theory using Indigenous Australian people as a case example. Critical race theory will be used to help question the privileged position of an occupational therapist from a dominant Westernized culture. In-depth interviews were conducted with 15 (eight female and seven male) Indigenous Australian young people about their perspectives of health and physical activity. In addition, the Kawa model was used as an alternative data-collection tool and detailed field notes and researcher reflections were used as data sources. Preliminary analysis of data is used to illustrate the ways in which critical race theory can inform occupational therapy practitioners and researchers about the ways Indigenous Australian young people view their health. Methodological dilemmas are also discussed. The paper is based on preliminary findings and further analysis needs to continue. Cross-cultural research is inherently complex but can offer those from the dominant culture valuable insights into their taken-for-granted assumptions. Further use of critical race theory may prove useful as the occupational therapy profession continues to evolve its understanding of cultural safety.