Using problem-based learning to improve educational outcomes

As the health care industry and the occupational therapy profession experience rapid change and growth, our professional preparation and continuing education must prepare graduates and therapists for an evolving practice environment. By exploring and evaluating alternative teaching methods and their impact on educational outcomes, occupational therapy educators demonstrate their commitment to improving the quality of student education. This article proposes that the traditional educational paradigm prepared clinicians for the old health care environment, and that problem-based learning (PBL) is an educational strategy that could prepare occupational therapists for success in a new practice environment that values cost, quality, and customer satisfaction. The PBL approaches used by various international occupational therapy educators are reviewed to highlight the strategies that have been implemented to achieve educational objectives that parallel the requirements of this new practice environment. Copyright © 1996 Whurr Publishers Ltd.     

Development of the student practice evaluation form revised edition package

Background/aim: This paper describes the development of the Student Practice Evaluation Form Revised Edition (SPEF‐R) Package. This assessment tool was based on the Student Placement Evaluation Form (SPEF), which was used nationally to evaluate student performance on professional practice placements. Methods: The SPEF‐R was developed using an action research process through three cycles of action and reflection: (1) national consultation through telephone interviews with participants from three stakeholder groups (10 academics, 28 practice educators and 18 students); (2) development of the SPEF‐R Package; and (3) feedback on draft, piloting and launch. Results: In cycle 1, the most frequently identified strengths of the SPEF included its structure, comprehensiveness and clarity of expectations and utility in planning student placements. Overall, issues/concerns were less frequently identified and included length and the need for more training. In cycle 2, the SPEF‐R package was developed, with key changes made to the SPEF and handbook in response to results and the enhancement of tools for providing feedback on placements and recording practice experience. Cycle 3 involved obtaining feedback on the draft, further revision and launching of the tool. Discussion: Action research is useful for addressing practice issues in higher education. The development of the SPEF‐R was grounded in contemporary views regarding the provision of formative feedback and based on stakeholders’ views. However, further research is required to evaluate its properties as an assessment design. In addition, a training website for professional practice educators was created and an electronic version of the SPEF‐R is in development.     

Occupational therapy student experiences of a university mental health course based on an integrated application of problem-based and team-based learning

Background: The goal of problem-based and team-based learning (PBL/TBL) is to maximize student engagement and encourage interactive learning. Combining these methods in course design is described as a win-win situation that optimizes student learning, professional development, and uses varied teaching approaches that fit well within health science. More research is needed in the effectiveness of such a hybrid approach.

Objectives: The aim of this study was to explore student experiences of a newly developed mental health course based on an integrated application of PBL and TBL in a university occupational therapy program in Sweden.

Methods: In this grounded theory study data were collected through logbooks (n?=?13) and supplemental open-ended interviews (n?=?7) at the end of the course.

Results: The analysis resulted in two core categories: 1) learning is facilitated by a course design based on the integrated application of PBL and TBL, a current topic, and teachers who are perceived as engaging, and 2) a perceived safe setting facilitates learning and creates a good study environment. There were six related sub-categories.

Conclusions: Combining elements of PBL and TBL may have a range of benefits in promoting student learning and professional development. Other aspects may also have a role to play.     

Preparing students for their first fieldwork placement using on-campus practicums

The present study describes and evaluates a programme that aimed to help students make best use of the scarce professional resource of fieldwork placements, in particular the first placement. The placement used a model of self-directed learning as a foundation principle. An on-campus clinical practicum programme was developed following a needs analysis to facilitate attainment of clinical competencies that were a prerequisite to placement commencement. Student self ratings of comfort in doing specific tasks before and after the practicum programme were obtained. Student and supervisor ratings of performance in specific tasks after placement were also made. In addition, supervisors were asked to rate the level of self-directedness of students. Results demonstrate the positive impact of the programme in preparing students for their first placement. Supervisors identified high levels of performance on specified tasks and a view that the students were more self directed than other novice students they had supervised. Recommendations are made for the continuation and further development of the practicum programme.     

Preparing students for practice in a changing community environment: an innovative course

This paper provides an overview of an innovative course in community occupational therapy. The course emphasises and prepares students for community practice in an environment profoundly affected by ongoing changes in Canada's health and social systems. Its rationale, objectives, structure, and content are outlined. In particular, the paper highlights the in vivo, problem-based component of the course, which centres around community-based fieldwork. A summary of the major results of the evaluation of the course is also presented. Although this course was designed for Canadian occupational therapy students, much of the material presented is potentially useful to educators of occupational therapy students in other countries. Copyright © 1996 Whurr Publishers Ltd.     

A cooperative inquiry study to identify strategies for group supervision in occupational therapy fieldwork placements

The purpose of this study was to identify effective strategies for supervising small groups of second-year students in an occupational therapy fieldwork programme based on a collaborative group model. Contemporary models for fieldwork education over the past decade have involved more placements for students working in peer groups, to address the shortage of fieldwork placements and to create opportunities for students to work in a team environment. Discussion about these fieldwork options has focused on the perceived value of the programmes rather than on the processes used for supervising students in groups. The research methodology chosen for this study was cooperative inquiry because of its congruence with the qualitative nature of group supervision and the collaborative model on which the fieldwork programme was based. Thirteen of a total of 18 occupational therapy supervisors volunteered to participate in the study. Data about supervision skills that would enhance student learning were generated through a series of experiential action cycles in the fieldwork setting, interspersed with regular peer reflection meetings. The results highlighted a range of supervision strategies such as student orientation, the facilitation of peer discussion and reflection on practice, and encouragement by the supervisor for students to use resources in the fieldwork environment and to take responsibility for their own learning. The depth of data gained from the study may have been limited owing to time constraints and other commitments of research participants. A social culture of mutual learning and support was established through the cooperative inquiry process, with potential for building ongoing relationships and participant awareness of educational innovations. Copyright © 1999 Whurr Publishers Ltd.     

Perceptions of fieldwork education in Malta: Challenges and opportunities

Academic upgrading of the occupational therapy programme in Malta has necessitated exploration of current fieldwork practices through a qualitative study. Data were collected through one-to-one interviews with 18 recently qualified occupational therapists. The findings showed the multi-faceted and complex nature of the fieldwork process, confirming the strong influence and relationships between the fieldwork context, the fieldwork supervisor and the different values and attitudes each learner brings to the fieldwork situation. The various practices as voiced by the participants affected the quality of their fieldwork experiences in different ways. Awareness of these key influences will pave the way forward for fieldwork education planners to provide meaningful experiences.     

The effect of first year mental health fieldwork on attitudes of occupational therapy students towards people with mental illness

Background and Aims:  Despite recent initiatives to reduce stigma towards people with mental illness, negative attitudes persist both in the community and among health professionals. Fieldwork experience has been identified as the most powerful way of modifying the attitudes of health professional students. Research to date suggests that later placements tend to have a more positive effect on attitudes than do earlier placements. However, inconsistencies within the literature suggest that it is the nature of the fieldwork experience that is the critical factor. We set out to investigate whether a program of fieldwork that included a tutorial component would bring about positive attitudinal change in first year occupational therapy students.
Methods:  We conducted secondary analysis of data collected from first year students before and after first year fieldwork experience in mental health settings. Student statements were rated to identify positive versus negative attitudes, and attitudinal themes were analysed.
Results:  Quantitative analysis revealed that students made significantly more statements reflecting positive attitudes following fieldwork than they did before. From pre- to post-fieldwork, attitudinal themes changed from: people with mental illness as different, fear of people with mental illness, and a deficit focus of mental illness, to: the 'ordinariness' of people with mental illness, students' understanding of people with mental illness, and an enabling approach to people with mental illness.
Conclusions:  A program of fieldwork that includes a structured tutorial component can bring about positive changes in the attitudes of first year students towards people with mental illness.     

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.     

Development of critical thinking in occupational therapy students

Do students who use the Guided Reciprocal Peer Questioning (GRPQ) method increase their ability to think critically? When compared to students in a traditional senior seminar course, the results of this study indicated no significant difference between the groups regarding changes in scores on the California Critical Thinking Skills Test. However, the students in the experimental group asked more questions labelled as critical thinking than the seminar control group. These findings suggest the use of the GRPQ may improve students' skills in asking questions that include application, analysis, and synthesis. Future research regarding the role of questions in stimulating critical analysis and the role of context in the learning environment is warranted. Copyright © 2006 John Wiley & Sons, Ltd.     

Client Perspectives on Occupational Therapy in Rehabilitation Services

The purpose of this qualitative study was to explore clients’ perspectives on the outcome of occupational therapy practice in rehabilitation and, furthermore, to look at certain components of practice and explore whether and how they may influence clients’ practice experience. Data were gathered through open, unstructured interviews with 20 adult clients after discharge from rehabilitation institutions in Iceland. Analysis of data was performed using both the constant comparative method and the coding procedures of the grounded theory approach. Results emerged around three interwoven categories: balance and enjoyment, enabling everyday life, and building a new future. Although mainly positive, people did also offer some negative points of view. Positive outcomes of occupational therapy are experienced at different levels and enhanced by organization of the therapy process, purpose and meaning of occupations, and the relationship between client and therapist. It is concluded that occupational therapists working in rehabilitation may have to pay more attention to their clients’ occupational issues and needs and involve them more in a goal-directed therapy process. Occupations used in therapy should be more balanced to meet the different needs of men and women and reflect the whole occupational spectrum of each individual.