The Partnering Model: Occupational Therapy Assistant and Occupational Therapy Students Working Together

SUMMARY

Establishing a partnering relationship between the occupational therapy assistant (OTA) and the occupational therapist (OT) is imperative in order to create an optimal working environment and deliver effective client care. A developmental model that provides students with opportunities to practice such a relationship has been used by an OTA and OT program in southwestern Ohio. This developmental Partnering Model gives students an opportunity to interact, work as teams, and collaborate during their educational experience. Each aspect of the model provides students with experiential learning opportunities. Educators will serve their OTA and OT students well in providing opportunities for them to develop and practice the skills they will need to create an optimal working environment and deliver effective client care as occupational therapy practitioners.     

Knowledge and Attitudes: Aspects of Occupational Therapy Students' Perceptions of the Handicapped

Scales measuring attitudes towards the handicapped fail to evaluate accuracy of knowledge. Occupational therapy students' (N = 233) knowledge of the handicapped was tested by 18 factual questions. Students also completed the Attitudes Toward Disabled People (ATDP) Scale (Yuker, Block and Younng, 1970). Students revealed negatively biased perceptions of the problems and skills of the handicapped, overestimated community assistance received, and were largely unaware of sex differences in handicaps. Senior students had more positive attitudes on the ATDP, and were somewhat better informed than first year students. There was no association between knowledge and ATDP scores. The need to address cognitive as well as affective and behavioural aspects of negative attitudes is discussed.     

Occupational Therapy Master-Level Students' Evidence-Based Practice Knowledge and Skills Before and After Fieldwork

ABSTRACT

Evidence-based practice (EBP) has become a universal standard for practice among healthcare professions, but due to barriers to EBP, the most effective ways of teaching EBP are not well understood. The purpose of this study was to report students’ EBP knowledge and skill gained from an entry-level Master's of Science in Occupational Therapy course in EBP. The Adapted Fresno Test of EBP was administered at the beginning and end of the course and after fieldwork experience. Results indicated that EBP knowledge and skills increased between the precourse and postcourse measurements (t = ?7.98; p < 0.001), but declined between postcourse and postfieldwork measurements (t = 6.65; p < 0.001) indicating that the course improved basic EBP skills and knowledge, but was ineffective in giving the students the strategies to retain and use those skills beyond the classroom. Suggestions are made to strengthen the student retention and use of EBP skills and knowledge after graduation.     

Examining Intraprofessional Competencies for Occupational Therapist and Occupational Therapy Assistant Collaboration

Abstract

This study examined competencies perceived by occupational therapists and occupational therapy assistants as important for intraprofessional collaboration. While interprofessional practice is well defined, less is known about collaboration within professions with varied levels of practice credentials. Occupational therapy practitioners (N?=?351) rated 20 competencies in four domains (Intraprofessional Teamwork, Roles/Responsibilities, Communication, and Values/Ethics) through an online survey. A high percentage of respondents perceived all competencies as important or very important. There were significant differences between occupational therapists and occupational therapy assistants in ratings of five competencies, including: seeking information/support from the team partner, flexibility for effective partnership, engagement in professional development for collaboration, communicating ideas, and providing feedback about performance. Outcomes contribute to understanding intraprofessional collaboration for occupational therapy practice. Competencies can serve as guidelines for education and professional development.     

Physician Practice Characteristics Influencing Nurse Practitioner and Physician Assistant Care in Nursing Homes: A Scoping Review

ObjectivesPhysicians, nurse practitioners (NPs), and physician assistants (PAs) are key to the effective delivery of medical care in nursing homes (NHs). Although several studies have reported on the relationship between the care delivered by a given discipline and specific clinical outcomes, the mediating effect of physician practice characteristics is unknown. A scoping review was conducted to determine whether studies examining the impact of NP and PA care in NHs have accounted for both the collaborative relationship between themselves and physicians as well as physician practice size and type.DesignScoping review.Settings and ParticipantsNH and NH residents.MethodsPapers eligible for review included peer-reviewed studies written in English and that were quantitative in nature. Inclusion criteria required that more than 1 NH and more than a single NP or PA be included for the analysis. Further, the size of the NH studied must have equaled or exceeded 100 residents and more than 1 clinical outcome reported. Databases searched included Ovid MEDLINE, Cochrane Library, Web of Science; CINAHL, and AgeLine.ResultsA total of 1878 studies underwent abstract review of which 1719 were excluded. A full-text review of the remaining articles was completed (n = 157, as 2 articles could not be retrieved), of which 16 met eligibility criteria. The study designs were generally retrospective and quasi-experimental in nature. No randomized controlled studies were identified. Physician practice variables such as number of physicians, total practice case load, case mix, and the nature of the collaborative practice between NP/PA and MD were infrequently specified. In no reports was the type of physician practice characterized and no physician practice variables were adjusted for with regard to outcomes.ConclusionsNone of the studies included in the review were found to have incorporated any physician variables into their outcome analyses. Before purporting equivalency between medical provider disciplines in NHs, future studies must, at the very least, consider the mediating effect of physician practice characteristics.     

The Utilization of Spirituality in Occupational Therapy: Beliefs,Practices, and Perceived Barriers

Spirituality has become an increasingly important topic in healthcare and specifically in occupational therapy. This study utilized a survey design to examine occupational therapists' current beliefs and practices regarding spirituality, and to identify barriers to the use of spirituality in OT treatment. No statistically significant relationship was found between the use of spirituality and different practice settings or therapists' demographics However the participants' response indicated that the beliefs and practices regarding spirituality in occupational therapy may be changing Therapists reported discussing spiritual issues with clients more frequently than in previous studies. Lack of education or experience in taking a spiritual history was reported as the major barrier impeding the therapists' ability to incorporate spirituality into OT practice.     

Nursing Assistant Beliefs About Their Roles and Nursing Home Residents: Implications for Nursing Home Social Work Practice

The purpose of this study is to examine beliefs and assumptions held by nursing assistants working in nursing homes using a qualitative approach. Unchallenged notions about residents and the roles held by nursing assistants influence their way of interacting with residents, which inevitably influences quality of care in nursing homes. When nursing assistants have an opportunity to be heard and mentored by social workers, they can address and resolve the dilemma of providing informal care as a formal caregiver by discussing what is acceptable and appropriate in nursing home care.     

Occupational Therapy with Children: Understanding Children's Occupations and Enabling Participation

When the occupational therapist meets the patient or client consumer of rehabilitation services, a therapeutic relationship is begun between persons who may have varying developmental backgrounds, value perspectives, social and physical environmental experiences, cultural ties, and lifestyle patterns. In order to develop significant evaluation and treatment strategies appropriate to the personal context of the consumer's life experience, it is the responslbility of the therapist to develop an understanding of the consumer's perspective. The following discussion describes a qualitative research project designed to explore the relationships of work, play, balance, and health in the life continuum of a 38-year-old woman who'suffered severe trauma at the age of 17 and regained control of her life through the development of a pattern of personal responsibility for her health. The study is discussed with regard to project procedures using tape-recorded interviews, outcomes, and applications to academic and clinical education.     

Trends in Nurse Practitioner and Physician Assistant Practice in Nursing Homes, 2000–2010

Objective

To examine nurse practitioner (NP) and physician assistant (PA) practice in nursing homes (NHs) during 2000–2010.

Data Sources

Data were derived from the Online Survey Certification and Reporting system and Medicare Part B claims (20 percent sample).

Methods

NP/PA state average employment, visit per bed year (VPBY), and providers per NH were examined. State fixed‐effect models examined the association between state regulations and NP/PA use.

Principal Findings

NHs using any NPs/PAs increased from 20.4 to 35.0 percent during 2000–2010. Average NP/PA VPBY increased from 1.0/0.3 to 3.0/0.6 during 2000–2010. Average number of NPs/PAs per NH increased from 0.2/0.09 to 0.5/0.14 during 2000–2010. The impact of state scope‐of‐practice regulations was mixed.

Conclusions

NP and PA scope‐of‐practice regulations impact their practice in NHs, not always as intended.     

Role Delineation of the Registered Occupational Therapist and the Certified Occupational Therapy Assistant in Child Psychiatry

This article describes the complementary roles of Registered Occupational Therapists and Certified Occupational Therapy Assistants working in an inpatient child psychiatry unit. Collaborative functions include assessment, treatment, program development and evaluation, and supervision. Supervisory strategies are also described.     

Promoting Awareness and Understanding of Occupational Therapy and Physical Therapy in Young School Aged Children: An Interdisciplinary Approach

SUMMARY

Public awareness and understanding of the professions of occupational therapy and physical therapy are limited. In this study, we examined perceptions of young school-aged children about occupational therapy and physical therapy as part of a larger grant project funded by the National Institute on Drug Abuse (R25 DA 12168 and R25 DA13522). One hundred three elementary school children (55 boys and 48 girls), grades 3 to 7, from local schools attended a one-day neuroscience and allied health profession exposition held at a local Boys & Girls Club. Children's understanding of occupational therapy and physical therapy was assessed through a pre/post questionnaire prior to and immediately after attending the exposition. At five of the 18 exhibition booths, faculty members and students from occupational therapy and physical therapy introduced and explained what occupational and physical therapists do at their work through interactive demonstrations. The results of the current study revealed that prior to attending the exposition, children's understanding of occupational therapy and physical therapy was limited. On pre-test, children reported they have some understanding of occupational therapy (18.6%) and physical therapy (34.9%). Children's understanding of occupational therapy and physical therapy, however, dramatically increased after the exposition (75.6% vs. 18.6%, 98.9% vs. 34.9%, respectively). Furthermore, the scope and depth of children's understanding also improved considerably. This finding suggests that an interactive neuroscience exposition including occupational therapy and physical therapy is an effective way to promote children's awareness and understanding of the professions. Implications for practice and future research directions are discussed in the study.     

Deinstitutionalisation of Occupational Therapy and Health Care Administrators Knowledge

Administrators of 100 Brisbane health care agencies were surveyed about their level of knowledge of traditional and nontraditional roles of occupational therapy and other allied health professions. Administrators were found to have reasonable levels of knowledge of the allied health professions, poor knowledge of occupational therapy, and very low levels of knowledge of the nontraditional roles of occupational therapy. Lack of health care administrator awareness of occupational therapy is a barrier to the transition of the profession from institutionally based models of practice to working in community health settings.     

Factors Influencing Nursing Career Choices and Choice of Study Program

In advance of a recruitment campaign, Israeli first-year nursing students of all ethnicities were surveyed to elucidate what factors had influenced them to make nursing their career and what sort of training track they preferred. The responses made it clear that different factors influence different groups differently. There were noticeable differences by gender, age, and ethnicity. Overall, training institutions were chosen for their closeness to the student's home but other factors also operated among particular groups, such as institutional prestige and flexible entry criteria. There was a blatant preference for academic, particularly university-sited, programs over diploma programs.     

Occupational Therapy Students' Learning Styles and Application to Professional Academic Training

SUMMARY

Methods of optimizing students' learning have been a major concern of educators over time. If occupational therapy educators know the students' learning styles at the onset of their training, teaching can be designed to enhance students' optimal learning throughout their education. This study determined learning styles of 201 junior students (age range = 18–57, mean age = 30.9), enrolled in an urban occupational therapy program from 1990 to 1999. Kolb's Learning Style Inventory, a 12-item questionnaire, was administered to the students in the spring of their junior years. Their learning styles were determined using Kolb's criteria. Results yielded: variations in students' preferred learning styles in each class from year to year; higher percentage of convergers (mean = 35%), fewer divergers (mean = 18%). Overall, students were mostly convergers (mean = 35%) and assimilators (mean = 25%). Applications of the findings to teaching students are discussed.     

98例经皮给药佐治小儿腹泻的疗效观察

目的　观察经皮给药佐治小儿腹泻的疗效 ,采取相应护理对策。方法　在补液、纠正脱水、酸中毒及电解质紊乱 ,针对不同病因选用抗感染制剂、微生态制剂、肠粘膜保护剂、助消化药的基础上对 98例腹泻患儿加用经皮给药 ,并与对照组 6 5例腹泻患儿比较。结果　经皮给药组在大便次数减少 ,大便外观性状好转 ,水份减少 ,临床症状好转、满意度、住院日数方面明显优于对照组。结论　经皮给药治疗小儿腹泻是一种内病外治 ,安全有效 ,操作简单 ,便于护理 ,易被患儿及家长接受的新的治疗技术。     

Hand Rehabilitation and Occupational Therapy

Occupational therapy for hands has been recognized as a speciality within the profession since the 1940s. The growing numbers of patients with acquired or congenital problems affecting their hands as well as the newer surgical procedures now available to restore lost function has challenged therapists. To manage the highly specialized needs of the complicated hand problems seen in the clinical setting, there is emphasis on perfecting technical skill. Equally required is the ability to remediate not only the physical dysfunction but also the patient's response to this dysfunction. For it is in this holistic approach to patient care that occupational therapy has its true strength in helping to successfully remediate the difficulties of the patient with a hand problem. Practical application of this principle is shown in a case study.     

Occupational Therapy Practitioners’ Knowledge and Perceptions of Childhood Asthma and Cystic Fibrosis

ABSTRACT

This study surveyed pediatric occupational therapy practitioners regarding their knowledge and perceptions about the chronic respiratory diseases (CRDs) asthma and cystic fibrosis which affect the functioning and quality of life for millions of children. Surveys were mailed to 250 members of the Ohio Occupational Therapy Association's pediatric member support group. Though 104 occupational therapy practitioners returned completed surveys, only the 82 who were currently practicing in pediatric settings were included in analysis. Respondents scored an average of 77% (SD = 10%) on a test of knowledge about asthma and cystic fibrosis. Respondents demonstrated several misperceptions about of the effects of these diseases on everyday life. A large majority (91%) endorsed one or more roles for occupational therapy with children with chronic respiratory diseases. Respondents indicated that confusion about the role of occupational therapy is a barrier to practice with children with CRDs. The results may prompt educational curricula to make adjustments, while continuing education courses may expand in addressing CRDs.