Educating for Community-Based Practice: A Collaborative Strategy

SUMMARY

This paper describes creative instruction strategies that prepare students for community-based practice. These educational innovations are designed to prepare graduates to understand occupation-based service delivery in community settings, to develop community-built programs that are responsive to community needs, and to understand how to both secure funding for and market occupational therapy services in the community. The process and products of collaboration between instructors in an administration and a community-based practice course are described. Outcome data from students and community partners are presented. Strategies for successful community partnerships and recommendations for continued development of these educational approaches are presented based on these data.     

Service Learning: The Process of Doing and Becoming an Occupational Therapist

ABSTRACT

The purpose of this phenomenological study was to explore the perceptions and experiences of entry-level occupational therapy students participating in a service-learning experience designed to provide preventive occupation-based social skills groups to low-income urban youth attending after-school care. Reflective journals and focus groups were used to study how the students made sense of their experience. Qualitative data analysis resulted in six major themes revealing the process of professional growth over the eight-weeks. Professional reasoning progressed from mechanical procedural reasoning to flexible forms of conditioning reasoning. Findings emphasize the critical role of active participation in real-life contexts on learning how to become an occupational therapist. Study findings provide a discussion about the possibilities of preparing future occupational therapy practitioners to address society's occupational needs in emerging practice areas.     

Primary Care: A New Context for the Scholarship of Practice Model

ABSTRACT

Interest in the emerging role for occupational therapy in the primary care practice setting has increased due to implementation of the Patient Protection and Affordable Care Act (ACA), which intends to expand health care coverage to uninsured Americans while improving coordination of care, health outcomes, and cost savings. Expanding occupational therapy to encompass promotion of wellness and prevention in a primary care context provides an opportunity for occupational therapy. The purpose of this article is to describe the role of occupational therapy in primary care and how the Scholarship of Practice model can guide the development of occupation-based and evidence-based best practice in primary care.     

The Reindeer of Hope: An Occupational Therapy Program in a Homeless Shelter

SUMMARY

This article describes a successfully designed and implemented program created for mentally ill homeless men by Level II occupational therapy students from Eastern Kentucky University. Outcomes for the clients, the staff and the students were extremely positive and have contributed to the appreciation and acceptance of occupational therapy as a discipline that can contribute to the health of this underserved population. This model demonstrates the effectiveness of University sponsored fieldwork in introducing occupational therapy to the community, creating awareness of what occupational therapy has to offer and developing a climate to bring needed services to clients and provide community-based employment for occupational therapists.     

Group Co-Leadership by Occupational Therapy Students in Community Centers: Learning Transitional Roles

SUMMARY

The experience of contact with community populations and settings at the beginning of fieldwork is essential in expanding the dimensions of non-traditional skills and roles for occupational therapy students. This article describes an initial fieldwork experience which builds on an occupational therapy group process course to enable students to supplement a community-based program with activities designed to meet a need of their group at the appropriate level of group interaction. Pairs of students select a receptive community site prior to the beginning of fieldwork to open dialog with the center's coordinator regarding performance areas, components, or contexts needed by the group. Working to assess the current programmatic offerings and desires of the participants for new activities and planning activities in collaboration with local staff, the students propose to conduct a series of five sessions addressing a theme desired or needed by the group. Upon immersion in the site's program, students are able to provide an in-depth assessment of the community group's psychosocial skill needs using the Group Level of Function Profile (Donohue, 2000).     

Microcomputers

SUMMARY

This paper describes a demonstration program designed by one university Occupational Therapy program to prepare graduates to work in community-based practice settings. Faculty and students are involved in a partnership with designated community agencies to learn to assess needs, plan programs, and evaluate outcomes using a variety of research methodologies. Completion of the project is tied to the completion of a required master's degree research paper. Results of the first year of the project have been largely successful and those involved look forward to continuing the project in the future. The project is described and recommendations for change based on these results are presented.     

From student to therapist: Follow up of a first cohort of Bachelor of Occupational Therapy students

Aim:  This study aimed to investigate the perception of graduate students on their preparation for practice, at 7 months post graduation.
Method:  Using an anonymous postal questionnaire, 18 respondents (58% response rate) provided data on the nature of current employment, the experience as a graduate therapist, and perceptions of their undergraduate experience in preparing them for practice.
Results:  Fifty percent of the respondents were practising in a rural environment. There was a significant positive relationship between respondents perception of their curriculum and fieldwork experiences and their preparation for practice ( rho = 0.52, p  < 0.05, and rho = 0.55, p  < 0.05, respectively). Of the fieldwork experiences, respondents rated block placements as more beneficial to practice than non-traditional placements. However, a correlational analysis showed the non-traditional placement was significantly related to preparation for practice ( rho = 0.54, p  < 0.05). On a seven-point Likert scale, respondents rated themselves from 5.2 to 5.7 for perceived self-competence as a newly graduated practitioner with community-based graduates having the higher rating. Confidence in clinical decision-making was rated 5.0 to 5.6 with community-based graduates having higher rating. Respondents reported a positive perception that the undergraduate program prepared them to enter the workforce and practise as an occupational therapist (mean ratings 5.5 to 6.2).
Conclusion:  Respondents felt adequately prepared to enter the occupational therapy profession and workforce. Strengths and weaknesses in their preparation are discussed as well as the need for further research.     

Active Participation in Fieldwork Level I: Fieldwork Educator and Student Perceptions

ABSTRACT

Fieldwork experiences bridge the gap between a student's education and entry-level practice. Academic programs, faculty members, and fieldwork educators are challenged to prepare occupational therapy students for entry-level practice. The Accreditation Council for Occupational Therapy Education (ACOTE) standards advocate for both active participation and guided observation in Level I fieldwork experience (. Students report their most meaningful learning experiences, which include performance of clinical skills and participation in clinical reasoning. However, many students enrolled in the author's entry-level master's program and the other schools within a regional consortium report their Level I fieldwork experience is primarily observation. This article describes the results of a survey administered to fieldwork educators and occupational therapy students eliciting their perceptions of active participation in Level I fieldwork. Results indicate that perceptions of the groups are dissimilar. Recommendations and implications for increased active participation in Level I fieldwork are discussed.     

Evidence-Based Practice in Occupational Therapy Curricula

ABSTRACT

The purpose of this study is to describe currently used educational strategies for teaching evidence-based practice (EBP) in entry-level master's degree occupational therapy programs in the United States. Fifty-eight entry-level occupational therapy program directors completed a survey. Results showed that occupational therapy programs consistently use a wide variety of EBP resources for teaching EBP including database searches, literature reviews, and the development of a research proposal. Less commonly used strategies include the use of case stories and journal clubs. The current study provides a baseline of existing strategies taught in entry level programs that may be built upon to gather more information about the content of EBP coursework, and determine ways to foster implementation of EBP in practice.     

Development of a Community-Based Return to Work Program for People with AIDS

SUMMARY

This article overviews the needs assessment and program development process conducted by an occupational therapist in partnership with a community-based agency. The resulting work rehabilitation program for persons living with HIV/AIDS and based on the Model of Human Occupation is utilized as a case example to illustrate the process. The needs assessment of the target population, the processes of organizational and environmental assessment and the resulting program design and program evaluation are discussed.     

A Framework for Promoting Scholarship Productivity in Occupational Therapy Curricula

ABSTRACT

This paper describes a curricular model to support the production of quality research and development of occupational therapy professional students, prepared to become leaders in the production and utilization of evidence for practice. This model is designed for programs with faculty challenged by the dual mandate of program excellence and expectations for scholarly productivity needed for tenure and promotion: typically programs at research universities. The essence of the model is the paralleling of research and competencies for clinical practice where faculty and students participate as a community of scholars. It is based on the literature that addresses the tensions between achieving excellence in research and scholarly productivity, and excellence in teaching. The experience of one university with this model over a five-year period of time is shared with the student-faculty productivity outcomes. These outcomes include dissemination of 55 collaborative peer reviewed products and faculty has generated support for 25 paid graduate assistantships. The combination of student outcomes and faculty support for their research has strengthened the ability of the faculty to excel in meeting the University mandate of scholarship while providing a high quality professional educational program.     

The Perspectives of Fieldwork Educators Regarding Level II Fieldwork Students

ABSTRACT

Ten occupational therapists employed in pediatric and adult rehabilitation settings participated in focus groups to discuss their perceptions of the benefits and drawbacks in working with occupational therapy students. Participants identified professional values, opportunities for continued professional development, recruitment of future employees, and pride in learning experiences available as incentives for working with students. Fieldwork educators who had supervised students lacking foundational communication, problem-solving, and clinical skills were cautious about accepting future Level II students. Time constraints and lack of preparation for the educator role were perceived as barriers to working with students. Fieldwork educators expected the academic institution to provide efficient support, including training for the educator role, information regarding the expectations of the academic program, and ongoing communication over the fieldwork experience. Strategies for strengthening the ties between academic programs and fieldwork sites were explored.     

The Occupation-Based Intervention of Bathing: Cases in Home Health Care

Abstract

Although bathing skills can be an indicator of long term placement, documentation of occupational therapists doing bathing as an occupation-based intervention is limited. Five clients were referred to a hospital-based home health agency with various diagnoses and at different levels of functioning. Each client was assessed at admission and discharge using the Outcomes and Assessment Information Set and the occupational therapists used the Activities of daily living (ADL) of bathing as the intervention based on client centered expressed needs. Findings reveal a statistically significant change in individuals pre- and post-assessment of bathing (Z?=?–2.032, p?=?.042) supporting occupation-based interventions, specifically bathing, should be further researched as a means of significantly improving the functional status of clients.     

Summative evaluation of a pilot aquatic exercise program for children with disabilities

BackgroundChildren with disabilities have lower physical activity levels and participate less in community-based sport and exercise programs than do children without disabilities. This in part is due to environmental barriers and lack of appropriate resources in these programs. Adaptive programs encouraging increased physical activity for children with disabilities are needed, and as these programs are developed, they should be critically evaluated.PurposeThe purposes of this article are to describe a pilot aquatic exercise program for children with disabilities, to evaluate the program, and to determine areas of strength and areas needing modifications.MethodsA summative program evaluation design was used to assess this twice per week aquatic exercise program lasting 14 weeks. Sixteen children, ages 6-12 years, with developmental disabilities participated in the program. Children swam laps, participated in relay races and water basketball games, and performed arm and leg strengthening exercises using aquatic noodles, foam barbells, and water for resistance. Swimming skills, program evaluation questionnaires, physical activity questionnaires, and interviews of pool site directors were used to determine program outcomes.ResultsFindings suggest that children made improvements in their swimming skills, parents were satisfied with the program, and children increased their physical activity levels during the program and maintained the increased physical activity levels six months after the program ended. The program continued in some form after the 14-week intervention ended.ConclusionsThe program was successful in achieving its objectives and recommendations for application of this program are provided.     

Qualitative Evaluation of a Management Course Project: Creating New Job Possibilities for Occupational Therapy

SUMMARY

A qualitative analysis of a ten-step management course project in occupational therapy education demonstrates the students changed perception of future job possibilities. The assignment, designed using a student-centered approach, bridges individual skills and interests with the creation of an occupational therapy position in an emerging market. The thematic analysis indicated the outcomes of the assignment were: a changed perception in the importance of a good fit between practitioner skills and the agency or program needs, added confidence in the students' skills based on a review of the two years of academic education, and a positive, anticipated transition of the academic knowledge base into real world experience. Student presentations served to measure the ability to articulate the services of occupational therapy within arenas unfamiliar to the profession.