A conceptual framework for international service-learning course planning: promoting a foundation for ethical practice in the physical therapy and occupational therapy professions

As physical therapy (PT) and occupational therapy (OT) educational programs endeavor to foster core values of social responsibility, justice, and altruism in an increasingly global community, the incorporation of local and international service-learning (ISL) into the curriculum is growing. Much of the research has focused on the measurement of student learning, with little written about the impact on the host community. Proponents of global health initiatives are calling for consideration of all stakeholders to ensure ethical practice. This paper explores the current literature related to PT and OT ISL and builds a conceptual framework for ISL course planning. The essential phases in the framework include: 1) pre-experience planning/preparation stage, 2) field immersion experience stage, and 3) postexperience stage. The essential elements are: 1) cultural competency training, 2) communication and coordination with community, 3) comprehensive assessment, and 4) strategic planning. The authors suggest this framework as a practical tool to structure ISL courses with an explicit emphasis on ethical concerns. Additionally, they seek to foster more dialogue and action related to the promotion of ethical practices in ISL in PT and OT education programs.     

Early intervention services in daily family life: mothers' perceptions of ‘ideal’ versus ‘actual’ service provision

Although the occupational therapy and early intervention literature espouses a family-centred approach to intervention, families have rarely been asked about their experiences of these services. This paper describes a qualitative study that aimed to identify and explore parents' perceptions of occupational therapy services and the impact of these services in their daily family life. Ten mothers of children (aged 0–6 years) with disabilities and high support needs completed questionnaires and semi-structured, in-depth interviews. Analysis revealed that mothers thought in terms of early intervention services in general, rather than in terms of occupational therapy specifically. Mothers used early intervention services primarily to enhance their child's abilities, while considering what was best for their family and, as a lesser priority, themselves. Ideally, relaxed and friendly service providers were perceived as having a greater insight into daily family life, and therefore a greater capacity to provide services to meet family needs (e.g., flexible, home-based services). However, the mothers in this study did not experience many ‘ideal’ characteristics of services and service providers, suggesting that changes are needed in occupational therapy practice and in the education of therapists. Implications for occupational therapy education and practice are discussed in the context of the family-centred literature, and recommendations are made for future research with families. Copyright © 1998 Whurr Publishers Ltd.     

Teaching Interprofessional Collaboration: Using Online Education Across Institutions

ABSTRACT

Interdisciplinary courses among students in occupational therapy, physical therapy, and speech-language pathology are important for addressing teamwork, communication, and understanding of professional roles, especially in pre-service training for early intervention and school-based practice where collaboration is essential. Although interprofessional education (IPE) as a part of higher education in the health sciences has been strongly encouraged, IPE courses are difficult to schedule and implement. This article discusses the challenges of developing and delivering two IPE courses in an online format, specifically the innovation that addresses logistics, time factors, and social presence for the IPE courses across two institutions.     

Service Learning: Meaningful,Community-Centered Professional Skill Development for Occupational Therapy Students

The profession of Occupational Therapy advocates for new and emerging areas of practice that more fully embrace our moral responsibility to address significant social injustices that exist in our communities (Kronenberg, Algado, & Pollard, 2005). The service-learning pedagogy is impacted by the philosophical and theoretical influences of John Dewey, the mission and purpose of American higher education including Boyer's (1994) call for an engaged citizenry, and the social vision of occupational therapy. The pedagogy of service learning provides a natural context for students to experience community practice while contributing to reducing existing social injustices. This paper provides an overview of service learning (SL) as a philosophical and pedagogical approach in occupational therapy education, key processes in developing successful service learning experiences and community partnerships to support service learning. Characteristics of effective service learning, assessment of community and institutional outcomes of service learning and the scholarship of service learning are also discussed. Most importantly, strategies for developing service learning scholarship, an important but frequently neglected requisite to validate any educational practice, are delineated. The authors conclude that service learning provides educators with an opportunity to provide students with experiences in natural, community contexts while developing life-long commitment to civic engagement and social responsibility.     

Key factors in planning and implementing interprofessional education in health care settings

Interprofessional education (IPE) is regarded by many health care practitioners (i.e., nurses, occupational therapists, physicians), educators, and policy makers as an important activity to enhance the quality of teamwork and patient care. While the focus on developing an evidence basis for IPE has demonstrated the potential value of IPE for improving collaboration and patient outcomes, exploration of key concepts that underpin IPE has been overlooked. In this commentary, we aim to begin addressing this oversight by identifying and discussing key conceptual factors that are critical for the planning and implementation of IPE. We draw upon our prior IPE curricula development and research experiences, as well as the published literature, to argue that seven interconnecting learner-focused, faculty-focused, and organization-focused factors are key to the successful planning and implementation of IPE. We also argue that IPE planners need to be cognizant of all seven factors and how they interact with one another to help ensure they maximize success in their work.     

International fieldwork placements and occupational therapy: lived experiences of the major stakeholders

Introduction: Occupational therapy students obtain a great deal of their professional preparation and experience through fieldwork placements. Although many occupational therapy students have taken part in international fieldwork placements, there is little research on this topic. As fieldwork placements are an integral part of the education of occupational therapy students, literature on the subject of international fieldwork placements is necessary. Accordingly, the aim of this study was to examine the personal and professional experiences of occupational therapy students, supervisors, and on‐site staff who have taken part in an international fieldwork placement. Methods: Qualitative interviews for this phenomenological study were administered with 14 participants who had taken part in an international fieldwork placement in Trinidad and Tobago. Data were analysed using thematic analysis. Findings: Three themes emerged: collaborative learning, cultural negotiations and thinking on my own. Discussion: Considering fieldwork is a critical component in the occupational therapy curriculum, it is reassuring to uncover that international placements can be of benefit to all stakeholders while achieving its primary goal of preparing students to become competent therapists. All participants developed a greater cultural awareness and appreciation, which is necessary as occupational therapists are increasingly working in diverse settings with diverse client groups. This information can also be used to enhance international fieldwork education as students continue to travel abroad to complete their mandatory fieldwork hours.     

‘I now have a visual image in my mind and it is something I will never forget’: an analysis of an arts-informed approach to health professions ethics education

This paper reports on a study of an arts informed approach to ethics education in a health professions education context. The purpose of this study was to investigate students’ reported learning experiences as a result of engagement with an arts-informed project in a health professions’ ethics course. A hermeneutic phenomenological methodological approach was adopted for the study. The data were collected over 5 years, and involved analysis of 234 occupational therapy students’ written reflections on learning. Phenomenological methods were used. Five key themes were identified with respect to students’ reported learning including: becoming aware of values, (re) discovering creativity, coming to value reflection in professional life, deepening self-awareness, and developing capacities to imagine future practices. There appear to be a number of unique ways in which arts-informed approaches can contribute to health professions education including: activating imaginative engagement, fostering interpretive capacity, inspiring transformative understandings, offering new ways of knowing, deepening reflection, and heightening consciousness, while also enriching the inner life of practitioners. Innovative approaches are being used to introduce arts-informed practices in health professions curricula programs. The findings point to the promise of arts-informed approaches for advancing health sciences education.     

Establishing a practice climate in academic settings

This article describes an innovative educational approach that was introduced and developed in one occupational therapy program, favorably assessed by students, and promoted within the occupational therapy literature. A review of educational literature from other disciplines suggests that the approach characterized as creating a practice climate, may be useful to most allied health educators. We discuss (1) the meaning of the term practice climate, (2) the rationale for creating such a climate in larger classroom sessions, (3) nine process strategies that can establish this climate, and (4) an assessment of the approach by two groups of undergraduate students. Although introduced in a senior-level undergraduate course, the approach has merit for implementation in less advanced courses and in graduate education.     

Community mobility in the context of universal design: Inter‐professional collaboration and education

Background/aim: The design of built environments is a critical factor in facilitating participation for all community members. This study aimed to explore key stakeholders’ views on the role and collaboration of occupational therapists and architects in relation to universal design and the built environment. This study is currently the only research to focus on the needs and practices of both occupational therapy and architecture in universal design. The results have implications for both clinical practice and professional education, and highlight an area of developing interest in occupational therapy. Methods: Focus groups and semi‐structured telephone interviews were conducted with key stakeholders involved in the design of built environments. Data from these interviews were analysed qualitatively, using codes of interpreted meaning which were then organised into themes. Results: Three main themes emerged in relation to inter‐professional collaboration around universal design: ‘form vs. function’, ‘the earlier the better’ and ‘universal design as a specialist area’. Discussion/conclusions: Although there are areas of synergy between occupational therapy and architecture in universal design, each profession has its own strengths and skills to bring to the design process. Given the multidisciplinary nature of ensuring designs support participation in occupations and roles, both professions could benefit from opportunities to meaningfully collaborate during professional education and in the workplace.     

Interprofessional Educational Experience to Assist in Student Readiness Toward Neurorehabilitation

ABSTRACT. Occupational and physical therapy professionals are natural partners in neurorehabilitation especially in the acute stages of recovery. To enhance student-learning experiences from both disciplines, we have developed an interprofessional (IP) learning unit that was embedded in neurorehabilitation tracks of each respective program. The primary goal of this project was to examine interprofessional attitudes and perception toward interprofessional learning and practice. A total of 117 occupational therapy (53) and physical therapy (64) students completed an IP case-based learning module with the goal of developing an IP care plan typically seen in neurorehabilitation. Using a sequential explanatory mixed methods design, we collected data pre- and postintervention using the Readiness for Interprofessional Learning Survey (RIPLS). We also utilized a postintervention questionnaire and focus groups intended to solicit information regarding IP competencies. At pretest, students had high ratings on the RIPLS that led to minimal changes at posttest (p = .157). However, common threads from the questionnaire and focus groups showed positive effects on student learning and attitudes toward interprofessionalism. Students reported positive experiences with the IP module. An IP case-based educational module has the potential to facilitate professional development and readiness for future IP practice. Students from different disciplines appreciate the value of IP education (IPE) in reinforcing their professional identity and understanding the professional contributions of others. Our findings are consistent with literature on best practices for IPE.     

A Course in Autoethnography: Fostering Reflective Practitioners in Occupational Therapy

This paper describes an academic course designed to lay the foundation for reflective practice in occupational therapy. In this course, students conduct highly personalized research based on experiences in Level II fieldwork that leads to writing an autoethnography. The paper describes autoethnography, details its use in occupational therapy literature, and discusses the design and outcomes of the course. Students' experiences with this autobiographical genre of qualitative research are illustrated. In the writing process, students find clinical stories that must be told and learn to “move around” in their stories. The outcomes of the course include integration of personal and professional experiences, closure to academic preparation, and deep reflection about what it means to be an occupational therapist.     

Occupational groups at risk of voice disorders: a review of the literature

BACKGROUND: Occupational voice health is becoming more important as more people rely on their voices for their work. A number of studies have identified certain occupational groups at increased risk of developing occupational voice disorders, namely teachers, singers and aerobics instructors. Aim The paper aims to review the literature on occupational groups at risk of voice disorders and identify areas for future research. METHOD: A literature review of key databases using key words such as 'occupational', 'voice health', 'voice loss', 'dysphonia' and 'work related' was undertaken. RESULTS: The review identified case reports, studies of attendees at hospital voice clinics and a few cross-sectional studies of occupational groups in the workplace. There were no longitudinal studies found or intervention studies looking at reduction of risk. CONCLUSION: Further research on occupational voice disorders needs to be based in the workplace, and to look at the risk factors for the development of voice problems and for the efficacy of controls.     

The influence of fieldwork on the preferred future practice areas of final year occupational therapy students

The student fieldwork experience has been recognised as an important influence on the areas of occupational therapy practice pursued by clinicians after graduation. The recruitment patterns of graduate occupational therapists is a key issue, especially in clinical areas such as rural practice and mental health. This study aimed to investigate the future practice preferences of 50 final year occupational therapy students from two occupational therapy schools in New South Wales, in relationship to their fieldwork experience, using a focus group and a survey. General physical dysfunction was the most popular area of future practice for this group. Results suggested that fieldwork influenced students through the programme content, the timing of placements, supervision, and students' personal responses to their experiences. The study also demonstrated that students use the fieldwork experience to guide their decision to enter an area of practice.     

Mapping an Australian Occupational Therapy curriculum: Linking intended learning outcomes with entry‐level competency standards

Background

Curriculum mapping involves systematic charting of programme content against professional competencies. This process can reveal strengths, gaps and redundancies within educational programmes.

Methods

Curriculum mapping occurred using intended learning (ILOs) as documented in individual courses and linking them to units and elements within the occupational therapy minimum competency standards (ACSOT) and Miller's Framework of competency. Five occupational therapy academics and two impartial research assistants identified links between ILOs and units and elements of the ACSOT. Analysis of each course in the curriculum was completed by two reviewers. A systematic protocol was developed that enabled a transparent process and resolution of discrepancies between reviewers.

Results

There were many links (47% of total) between the documented curriculum and ACSOT Unit 1 Professional attitudes and behaviours. The other six units of the ACSOT had between 5% (Unit 7) and 16% links (Unit 3). No links were made between ILOs and the elements of evaluation (4.4), cessation (3.7) and quality assurance of services (7.3). Difficulties mapping ILOs to units and elements revealed inconsistencies in specificity and language in the ILOs and also ambiguities and gaps within the standards themselves. Mapping against Miller's framework showed a steady increase in performance expectations of students across the four years levels.

Conclusion

Curriculum mapping is recommended for critical reflection about content of occupational therapy programmes and to review pedagogical approaches. This process revealed strengths and weaknesses of the occupational therapy curriculum being mapped but also revealed insight into the current ACSOT that may inform future iterations.     

Cultural Safety and professional practice in occupational therapy: A New Zealand perspective

This research examined occupational therapists' attitudes to Cultural Safety for Maori clients. The main research tool was a semi-structured qualitative research interview. A cross-case analysis method was used to determine the major recurring themes. Thirteen participants with varied occupational therapy training backgrounds were interviewed. Current Cultural Safety education is designed to challenge health professionals' attitudes towards those culturally different from themselves. Results suggest that maturity and personal experiences had significant bearing on these attitudes. Implications for occupational therapy include implementing a policy that stipulates compulsory Cultural Safety education as part of professional development. Findings may have relevance for other countries where significant ethnic differentials in health service success exist, such as Australia.     

The educational interaction between physical therapy and occupational therapy students

The objectives of this study were to identify the prevalence of shared learning in U.S. physical therapy (PT) and occupational therapy (OT) education programs; determine what terminology is used for these courses; and identify perceived barriers, benefits, and challenges of the educational interactions. A survey, designed to collect information about the educational interaction between PT and OT students, was mailed to all program directors (n = 206) at each of the academic institutions (N = 103) in the United States with accredited or developing entry-level programs in PT and OT. A census study was conducted, and the entire study population received a survey. A total of 206 surveys were mailed, and 123 were retured (59.7% response rate). Of program directors, 40 (67.8%) of the PT and 42 (65.6%) of the OT program directors reported that their students shared courses with each other. None of the PT and only 8 (12.5%) of the OT directors reported that students shared clinical experiences. The term interdisciplinary was used most frequently to refer to shared educational experiences. Benefits of shared learning included sharing resources, collaboration, learning about the other profession, and gaining respect for the other profession. Challenges to shared learning included resource constraints, curricular differences, competition and differences between disciplines, relevance of course work, and different faculty expectations. Barriers reported by program directors whose students did not engage in interdisciplinary education were resource constraints, curricular differences, faculty attitude, and failure of past attempts. A model of interdisciplinary education that seeks to instill collaboration and understanding among professions is difficult to implement without shared clinical experiences. Most students in entry-level PT and OT programs in the United States do not currently have the opportunity to practice the teamwork that will be essential when they enter their respective professions.     

A pilot study of a pulmonary rehabilitation programme evaluated by four adults with chronic obstructive pulmonary disease

The purpose of this qualitative study was to analyse participants' perceptions of a pulmonary rehabilitation programme, which combined occupational therapy with physical therapy. Semi-structured interviews were used to collect data from four adults with chronic obstructive pulmonary disease (COPD) who attended an outpatient pulmonary rehabilitation programme in New York City. Features of the occupational therapy programme reported to be valuable were biofeedback and clinician support. Participants reported more control of dyspnoea, improved mental health and confidence in performing daily activities, less fatigue, more physically active lifestyles and hope for the future. Limitations of the study were that participants were interviewed only once and themes were not verified with participants. The study results also cannot be generalized. Further research is needed to evaluate the effectiveness of occupational therapy in promoting self-management and coping skills and restoring occupational performance in adults with COPD. Participants' responses provide additional support for developing cognitive-behavioural protocols in occupational therapy and measuring their effectiveness in relieving anxiety symptoms and promoting dyspnoea management.     

A Study on Developments in Occupational Therapy Undergraduate Education in WA: 1961–1991

1991 marks thirty years of formal education in occupational therapy in Western Australia. From its humble origins in an old hotel, the undergraduate occupational therapy programme in Western Australia has evolved from one which had a very strong vocational focus, was largely steeped in medical traditions and which had an emphasis on teaching technical skills, to one which is more academic and outward looking in its orientation. However, as we enter the 1990s undergraduate education in occupational therapy must face the challenges associated with the National Training Board's move to competency-based standards and assessment in the workplace. This study of historical material compares the three major stages of development in the thirty years of undergraduate education in occupational therapy in Western Australia. Reflection on these developments may guide future directions in undergraduate education and result in outcomes which will equip occupational therapists for leadership in the provision of health services.     

A Systematic Review of Occupational Therapy Interventions With Homeless People

ABSTRACT

A systematic review of the occupational therapy literature 1990–2008 was undertaken with the aim to assess the quality of evidence that supports the role of occupational therapy with homeless people. Forty articles were initially identified and critically appraised, including 16 research studies. Seven quantitative articles were included in this review and demonstrated the effectiveness of occupational therapy in providing interventions that increase employment and education prospects, money management, coping skills, and leisure activities. The literature suggests that occupational therapy has an appropriate role with people experiencing homelessness.