Purpose: Transitioning into occupational therapy practice is a complex process in which new graduates develop their skills and professional identity. Evidence suggests this process requires guidance and support through supervision. This study investigated final year students’ and newly graduated occupational therapists’ perceptions and expectations of the role and efficacy of supervision as they transition into practice. Methods: A cross sectional online survey was sent to final year students and newly graduated occupational therapists within Australia and New Zealand, to explore experiences, perceptions, and the content of supervision received in practice. Results: Of 151 participants, 96% received supervision from an experienced occupational therapist and reported it facilitated skill development and enhanced quality of service to clients; however 4% reported they do not receive supervision in practice. The frequency of supervision decreased between students (63% weekly) and new graduates (41% monthly) and perceptions of supervision effectiveness changed over time. Conclusions: The transition to occupational therapy practice is complex and perceptions of the effectiveness of supervision change. Provision of education regarding supervision within undergraduate curriculum, and training for supervisors may alleviate associated stressors. Increasing the frequency of supervision and understanding the supervisory role may support transitioning into practice.
Introduction: Occupation-focused models are one method of integrating occupation into occupational therapy education programmes. They offer a theoretical basis for practice by providing explanations about the process and practice of the profession. Method: This exploratory study used a quantitative research framework to investigate which occupation-focused models are included in occupational therapy programmes, the rationale for their inclusion and how the models are integrated into curricula. A survey was sent to 193 occupational therapy programmes in Australia, Canada, the United Kingdom and the United States. Results: The response rate was 33.8% (n = 65). The data showed that each programme included between 3 and 10 occupation-focused models. The Canadian Model of Occupational Performance and Engagement and the Model of Human Occupation were included in 98.5% of all curricula surveyed. Conclusion: The educators used a multilayered decision-making process to determine which occupation-focused models to include in a curriculum. The instructional methods varied, but most programmes used practice placement education as a teaching strategy. Further research is required into how curriculum design influences a practitioner's future use of occupation-focused models in practice. A better understanding is needed of how professional practice education affects students' values and attitudes towards the use of occupation-focused models.
How do individuals living with musculoskeletal disorders perceive the concept of prognosis?Exploratory phenomenological study.Individuals aged 18 years or older currently experiencing a musculoskeletal disorder.Single semi-structured one-on-one interviews were conducted. Data was analysed using inductive coding and thematic analysis.Five themes were identified. First, participants defined prognosis as the likely outcome associated with their diagnosis. Their prognosis was often associated with outcomes related to pain, tissue health, and function. Second, participants perceived pain as having a negative impact on their prognosis by limiting their function and having a psychological impact. Third, participants held biomedical views in that tissue health was perceived as a cause for their pain and that tissue healing was essential for pain cessation. It was also difficult for participants to distinguish between pain related to tissue damage, and pain that was not. Fourth, participants use their ability to complete leisure and functional activities to determine the success of their recovery. Finally, participants perceived receiving individual prognoses for pain, tissue health, and function that may be simultaneously occurring as both important and beneficial.Overall, participants viewed receiving prognostic information as important and beneficial. When constructing their views on prognosis participants perceived that pain, tissue health, and functional ability could all impact upon prognosis, whilst having a prognosis of their own. Physiotherapists should consider conceptualising and discussing prognosis in terms of pain, tissue health, and function when managing musculoskeletal disorders.
Abstract The development of student‐practitioners' practical clinical skills is essential in health professional education. Objective Structured Clinical Examinations are central to the assessment of students performing clinical procedures on simulated patients (actors). While feedback is considered core to learning providing timely, individualised student OSCE feedback is difficult. This study explored the perceptions of students about the multiple factors which shape the utility of e‐feedback following an electronic Objective Structured Clinical Examinations, which utilized iPad and specialised software. The e‐feedback was trialled in four courses within occupational therapy and physiotherapy pre‐professional programs with a cohort of 204 students. Evaluation of student perceptions about feedback was collected using two surveys and eight focus groups. This data showed three factors shaped perceptions of the utility of e‐ Objective Structured Clinical Examinations feedback: 1) timely accessibility within one day of the assessment, 2) feedback demonstrating examiners' academic literacy and 3) feedback orientated to ways of improving future performance of clinical skills. The study found training in the provision of feedback using IPads and software is needed for examiners to ensure e‐feedback meets students' needs for specific, future‐oriented e‐feedback and institutional requirements for justification of grades.
This study aimed to investigate rehabilitation staff perceptions of factors influencing stroke survivor activity outside of dedicated therapy time for the purpose of supporting successful translation of activity promoting interventions in a rehabilitation unit.Purposive sampling of multi-disciplinary teams from four rehabilitation units was performed, and semi-structured interviews were conducted by telephone, digitally audio-recorded and then transcribed verbatim. A stepped iterative process of thematic analysis was employed until data saturation was reached.All but one of the 22 participants were female, the majority were either physiotherapists or occupational therapists, with a median of 4 years (interquartile range, 2-10) working at their respective rehabilitation units. Analysis of the data revealed three themes: (i) stroke survivor characteristics influence their activity outside therapy, (ii) the rehabilitation environment influences physical, cognitive, and social activity, and (iii) institutional priorities, staff culture, and attitude can be barriers to activity. Rehabilitation units were perceived to be unstimulating, and visitors considered enablers of activity when resources were perceived to be scarce.Our results suggest careful consideration of the involvement of visitors, an individual's needs and preferences, and the institution's priorities and staff attitude may result in greater stroke survivor activity during rehabilitation.Implications for rehabilitationStaff should consider stroke survivor impairments and a rehabilitation unit's institutional priorities and staff attitudes when aiming to enhance stroke survivor engagement in activity.The physical and social environment of a rehabilitation unit can be optimised by rehabilitation staff to promote activity.Utilisation of visitors of stroke survivors on a rehabilitation unit may be one way to enhance engagement in activity.Discussion within the rehabilitation team concerning "ownership" of the role of supporting stroke survivor activity outside of structured therapy time may support better engagement in same.
Guillain-Barré syndrome is a rare neurological condition. Although some people make a substantial functional recovery, almost half require intensive rehabilitation. Data were collected using a cross-sectional survey which investigated the assessments and interventions used by occupational therapists and physiotherapists for people with Guillain-Barré syndrome. Seventy valid responses were received from 10 countries. The survey highlighted four factors about current practice: (i) practitioners did not identify the use of formal clinical guidelines or protocols for Guillain-Barré Syndrome treatment of the upper limb; (ii) a range of standardized and non-standardized assessment and goal-setting tools are utilized; (iii) interventions include passive and active range of motion exercises, and the prescription of upper limb/hand splints; and (iv) interdisciplinary practice is common in the intensive care unit and during acute phases of Guillain-Barré syndrome, whereas discipline-specific work is more common during rehabilitation. A range of goal-setting and assessment tools are used by occupational therapists and physiotherapists during the hospitalization of people with Guillain-Barré syndrome. The type and duration of interventions vary and may reflect the lack of international protocols for Guillain-Barré syndrome rehabilitation.
Background: Art-making-as-therapy has been used by occupational therapists in mental health since the inception of the profession. It aims to enable people to gain mastery and produce art. This review synthesizes the research on the use of art-making as therapy by occupational therapists in adult mental health practice.
Purpose: Growing demands placed upon healthcare systems require more health professionals to be trained. Clinical placement education is an integral component of health professional training, however accommodating increasing numbers of student placements is a challenge for health services. Personal digital assistants such as iPads™ may assist in delivery of clinical education, by facilitating transfer of knowledge and skills from clinical educators to health professional students, however such an initiative has not been formally investigated. The present study sought to explore perceptions of clinical educators and allied health students regarding the impact of an iPad™-based feedback delivery system on student reflection and learning. Methods: A pilot study was performed using iPads™ with specialised software to deliver electronic formative feedback to physiotherapy, occupational therapy and speech pathology students during clinical placements. Students and clinical educators completed a questionnaire exploring advantages and disadvantages of the technology. Results: Nine clinical educators and 14 students participated and completed the survey. Clinical educators largely (n=7, 78%) reported the electronic feedback system was easy to use and 67% (n=6) reported it improved the quality of feedback provided to students. Five (56%) clinical educators thought electronic feedback improved student performance. Most students (n=10, 71%) reported electronic feedback facilitated reflection upon performance, and 64% (n=9) reported improved performance as a result. Disadvantages included poor wireless internet access and software inefficiencies (n=7 [78%] clinical educators, n=7 [50%] students), and difficulties using iPads™ in settings requiring infection control (n=2 [22%] clinical educators). Conclusions: Clinical educators and students perceived electronic feedback as a positive adjunct to student learning on clinical placement, however technological and software interface factors need to be considered for implementation in some settings.
Background/aim Professional practise placements in occupational therapy education are critical to ensuring graduate competence. Australian occupational therapy accreditation standards allow up to 200 of a mandated 1000 placement hours to include simulation‐based learning. There is, however, minimal evidence about the effectiveness of simulation‐based placements compared to traditional placements in occupational therapy. We evaluated whether occupational therapy students completing a 40 hour (one week block) Simulated Clinical Placement ( SCP ) attained non‐inferior learning outcomes to students attending a 40 hour Traditional Clinical Placement ( TCP ). Methods A pragmatic, non‐inferiority, assessor‐blinded, multicentre, randomised controlled trial involving students from six Australian universities was conducted. Statistical power analysis estimated a required sample of 425. Concealed random allocation was undertaken with a 1:1 ratio within each university. Students were assigned to SCP or TCP in one of three settings: vocational rehabilitation, mental health or physical rehabilitation. SCP materials were developed, manualised and staff training provided. TCP s were in equivalent practice areas. Outcomes were assessed using a standardised examination, unit grades, the Student Practice Evaluation Form‐Revised and student confidence survey. A generalised estimating equation approach was used to assess non‐inferiority of the SCP to the TCP . Results Of 570 randomised students (84% female), 275 attended the SCP and 265 the TCP ( n = 540, 94.7% retention). There were no significant differences between the TCP and SCP on (i) examination results (marginal mean difference 1.85, 95% CI : 0.46–3.24; P = 0.087); (ii) unit score (mean ( SD ) SCP : 71.9 (8.8), TCP : 70.34 (9.1); P = 0.066); or (iii) placement fail rate, assessed using the Student Practice Evaluation Form‐Revised (100% passed both groups). Conclusion Students can achieve equivalent learning outcomes in a 40 hour simulated placement to those achieved in a 40 hour traditional placement. These findings provide assurance to students, educators and professional accreditation bodies that simulation can be embedded in occupational therapy education with good effect.
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