Medicine and Health Sciences Commons^™

Hats On! A Teaching Innovation To Make Theory Visible In Professional Reasoning, Wanda J. Mahoney, Stacy Smallfield

Journal of Occupational Therapy Education

Students often find learning and applying theory difficult and potentially disconnected from practice. Using theory to guide occupational therapy assessment and intervention preserves the distinct value of occupational therapy. One way students develop professional reasoning is by learning how to use theory. Theoretical knowledge guides the professional reasoning questions that students and practitioners seek to answer. Teaching occupational therapy theory needs to involve clear, engaging, and meaningful activities that foster an explicit focus on occupation. This paper presents an innovative way of teaching theory in occupational therapy. We explain a thinking cap analogy to organize the theoretical knowledge that guides …

Advancing Entry-Level Otd Students From Novice To Competent With Foundational Skills Using Cognitive Apprenticeship Constructs, Anna B. Galloway, Truly M. Hardemon

Journal of Occupational Therapy Education

This manuscript describes how one entry-level occupational therapy doctoral (OTD) program used an innovative approach to scaffolding assignments through a cognitive apprenticeship (CA) framework. Cognitive apprenticeship strategies include learning in the context or culture of the profession. This is achieved through observation, coaching, engagement, and discovery of strategies by the instructor. This framework was implemented to facilitate the learning of occupational, activity, and task (OAT) analyses through a four-week module within a first-semester foundations course. Cognitive apprenticeship constructs were used as instructional teaching strategies including active learning, group facilitated assignments, hands on observation, and immediate feedback and modeling of professional …

Examining Minimal Important Change Of The Self-Assessment Scale Of Clinical Reasoning In Occupational Therapy, Sho Maruyama, Reiko Miyamoto, Satoru Amano, Takuto Nakamura, Peter Bontje

Journal of Occupational Therapy Education

The purpose of the study was to establish and quantify the minimal important change (MIC) value necessary to determine gains or losses in clinical reasoning during student fieldwork assignments as measured by the Self-Assessment of Clinical Reasoning in Occupational Therapy (SA-CROT). This multicenter prospective longitudinal study was conducted with students on their occupational therapy fieldwork in Japan. Two anchor-based methods were used to estimate the MIC values: a receiver operating characteristic-based method and a predictive modeling-based method. The MIC was adjusted based on the percentage of participants who exhibited improvement. Administered were the SA-CROT and the Global Rating of Change …

“Putting On Our People Lens”: Lived Experience As Pedagogy, Tessa Zoe Milman, Sarah Bream, Celso Delgado, Erin Mcintyre, Tristan Scremin, Leslie Moreno, Maggie Yeo, Deborah Pitts

Journal of Occupational Therapy Education

In the professional education of mental health practitioners, including occupational therapists, there has been a lack of meaningful inclusion of people labeled with mental illness into curricula, beyond guest speaker panels and presentations. This study explored the experiences of students, faculty, and ‘Experts by Experience’ within a mental health occupational therapy course that incorporated Experts with lived experience as co-facilitators of weekly fieldwork debriefs. The study utilized focus groups and interviews to understand the experiences of students, mental health faculty, and ‘Experts by Experience’. Key themes that emerged from the qualitative data analysis were organized under three broad categories: 1) …

Exploring Clinical Reasoning In Doctor Of Physical Therapy (Dpt) Students Through Computer-Based Simulation, Denise Romano, Alyson Pasquale

Internet Journal of Allied Health Sciences and Practice

ABSTRACT

Purpose: Clinical reasoning is a critical skill required to be an effective clinician in today’s dynamic and complex healthcare environment. Reflective ability is considered foundational for building clinical reasoning skills. The purpose of this mixed methods study was to explore the clinical reasoning strategies used by Doctor of Physical Therapy (DPT) students during a computer-based simulation and the relationship between the quality of reflection and clinical reasoning strategies used. Methods: Forty-five first (n=15), second (n=23), and third (n=7) year DPT students enrolled in six professional DPT programs in the United States participated in an asynchronous computer-based simulation designed to …

Promoting Student Understanding Of Occupation-Centered Practice And Updated Inter-Rater Reliability Of The Occupation-Centered Intervention Assessment, Kelly Little, Yongyue Qi, Vanessa D. Jewell

Journal of Occupational Therapy Education

The Occupation-Centered Intervention Assessment (OCIA) was developed as a reflective tool for students to improve their comprehension of occupation-centered practice. Finding new and innovative ways to incorporate occupation-centered assignments can serve as a strategy to develop student integration of occupation-centered practice and allow educators to appraise student comprehension. The purpose of this study was to evaluate student understanding of occupation-centered practice by utilizing various statistical analyses, including updated inter-rater reliability, of the OCIA using student assignments. Utilizing a methodological approach, 121 first-year students analyzed 10 physical rehabilitation videos utilizing the OCIA to rate the interventions for their level of occupation-centeredness. …

Experiential Learning Through Als Caregiver Learning Labs: Occupational Therapy Student Outcomes, Susan Hoey, Jessica Henaughan

Journal of Occupational Therapy Education

Occupational therapy (OT) educators strive to design learning experiences to enhance OT students’ clinical reasoning and promote preparedness for the complexities of clinical practice. Occupational therapy programs have collaborated with the Amyotrophic Lateral Sclerosis (ALS) Association and taken a novel approach to the development of interprofessional experiential learning through student-led ALS Caregiver Learning Labs (CLLs). A retrospective pre-test post-test study was completed to identify outcomes related to participation in three different ALS CLLs embedded into a master’s level OT curriculum. A 6-point rating scale questionnaire was used to assess students’ perception of their clinical reasoning, clinical skills, and comfort level. …

The Clinical Reasoning Assessment Tool For Learning From Standardized Patient Experiences: A Pilot Study, Mary A. Riopel, Sara Benham, Jennifer Landis, Stephanie Falcone, Sarah Harvey

Internet Journal of Allied Health Sciences and Practice

Purpose: Clinical reasoning (CR) is the ability to integrate the knowledge of diagnoses with the use of supporting theories to create effective, client-centered interventions. One means of teaching CR to rehabilitation students is using standardized patient (SP) experiences. The relationship between faculty and student CR ratings after SP experiences has not been researched. The purpose of the study was to determine if there would be correlations between physical therapy (PT) and occupational therapy (OT) student and faculty ratings of CR skills after an SP experience. Method: The Clinical Reasoning Assessment Tool (CRAT) was used by students to self-reflect on their …

Service-Learning And Case-Based Learning’S Impact On Student’S Clinical Reasoning: A Repeated Measures Design Study, Gordon B. Tsubira, Traci Garrison, Sapna Chakraborty, Shana Cerny

Journal of Occupational Therapy Education

Clinical reasoning is crucial for the occupational therapy profession to thrive in an ever-changing healthcare environment but is seldom isolated for explicit instruction and outcome measurement in educational course curricula. A single-factor repeated measures design study was conducted to compare the impact of didactic case-based learning and experiential service-learning on the development of the clinical reasoning of students at a midwestern public university’s entry-level Master of Occupational Therapy program. The participants were sixteen graduate occupational therapy students who had completed their foundation-level courses. Participants explored modes of clinical reasoning in occupational therapy for eight weeks (the first half of the …

The Impact Of A Psychosocial-Focused Experiential Learning Activity On Occupational Therapy Students’ Perceived Clinical Reasoning, Molly Bathje, Kristi Escobar, Meghan Crisp, Catherine Killian, Charlotte Royeen

Journal of Occupational Therapy Education

A primary objective of occupational therapy education is to facilitate development of clinical reasoning skills. These skills are complex and difficult to cultivate in classroom settings, therefore educators often use experiential learning activities to support clinical reasoning development. Most of the literature about experiential learning activities aimed at developing clinical reasoning focuses on activities occurring in-person, with individuals in physical disabilities settings. This research addresses the gap in the literature by evaluating the impact of a group based, psychosocial focused experiential learning activity that occurred virtually and in-person on entry-level occupational therapy students’ perceived clinical reasoning. Students (n=36) …

Exploring Evidence Based Practice Implementation By Occupational Therapists: Implications For Fieldwork, Angela Benfield, Helen Jeffery

Journal of Occupational Therapy Education

A fieldwork education model is used in occupational therapy to develop competency of professional skills, including evidence-based practice (EBP) and clinical reasoning. This quantitative study explored factors influencing implementation rates of EBP in New Zealand registered occupational therapists to better understand students’ experience of evidence-based practice while on fieldwork. An online survey exploring beliefs and practices related to clinical competence, professional reasoning and EBP was conducted. The survey included questions about related beliefs, the measure of Evidence Informed Professional Thinking (EIPT; Benfield & Johnston, 2020), and the Implementation Climate Scale (ICS; Ehrhart et al., 2014). The mean scores on the …

Changes In Epistemic And Ontological Cognition Of Occupational Therapy Students During Fieldwork: A Qualitative Study, Anita W. Mitchell, Lauren Woods

Journal of Occupational Therapy Education

The purpose of this study was to represent occupational therapy students’ perspectives of their beliefs about knowledge and knowing, or epistemic and ontological cognition (EOC), before and after their first level 2 fieldwork experience. Twenty participants from four classes of entry-level Master of Occupational Therapy (MOT) students who had successfully completed 18 months of didactic coursework provided written explanations of self-ratings on the modified Four-Quadrant Scale of Ontology and Epistemology and written responses to four open-ended questions. Four major themes emerged: 1) Concrete knowledge may have a specific right or wrong answer, 2) Knowledge can change depending on the client, …

Collaborating With A Transitional Care Unit To Provide Student Hands-On Time: A Win-Win For Hospital And Academic Institution, Emily Grattan, Amanda K. Giles

Journal of Occupational Therapy Education

Occupational therapy students crave hands-on learning experiences that take place in authentic environments. This study describes an innovative experiential learning activity involving collaboration between an academic institution and an inpatient transitional care unit (TCU). Three cohorts of second year occupational therapy students (N=138) participated in the TCU learning activity, which involved reviewing the electronic medical record, planning and delivering a treatment, documenting the therapy session, and intentionally reflecting on the experience. Based on an optional, anonymous survey, one hundred percent of students reported that “this learning experience was valuable” and “provided opportunity to practice clinical reasoning.” Ninety-nine percent of students …

Establishing Inter-Rater Reliability Of The Occupation-Centered Intervention Assessment For Student Observation Of Rehabilitation Interventions, Vanessa D. Jewell, Joy Burkley, Taylor Wienkes, Ted K. Kaufman

Journal of Occupational Therapy Education

The Occupation-Centered Intervention Assessment (OCIA) is a tool designed to capture and rank occupational therapy interventions through an occupational lens to improve occupational therapy students’ professional reasoning skills. The purpose of this study was to determine the inter-rater reliability of the OCIA for occupational therapy interventions provided to adults with physical rehabilitation needs as observed by occupational therapy students. Utilizing a methodological research approach, 111 students completed training for application of the OCIA and independently scored five standardized videos of occupational therapy interventions. Results indicated an overall agreement of α=0.856 using Krippendorff’s alpha. Student raters demonstrated good agreement for rating …

Occupational Therapy Students’ Experiences Of Team-Based Learning: A Multi-Year Study, Bhing-Leet Tan, I-Ling Yeh, Phyllis Liang

Journal of Occupational Therapy Education

Many health sciences disciplines have adopted team-based learning (TBL) as part of their education pedagogy, with studies showing increased classroom participation and learner satisfaction. However, it will be beneficial to explore the learning experiences of occupational therapy students in TBL using a mixed methods approach. In an undergraduate occupational therapy program, students undertook three clinical modules using TBL in years two and three. This study explored their perceptions and experiences of TBL. This was a mixed methods prospective cohort study, during which two cohorts of students from Academic Year (AY) 2016 and AY2017 completed the Team-Based Learning Student Assessment Instrument …

Clinical And Professional Reasoning Development In Level Ii Fieldwork: Occupational Therapy Assistant Students’ Perception, Marie-Christine Potvin, Jeanne M. Coviello, Eden Rothacker, Caitlin Taylor, Taryn Pettigrew, Mary Beth Thomas, Laronda Lockhart-Keene

Journal of Occupational Therapy Education

Occupational therapy academic programs are tasked with preparing occupational therapy assistant (OTA) students to develop and use clinical and professional reasoning in practice. A component of this academic education, Level II fieldwork (FW), develops clinical and professional reasoning by allowing students to practice this skill. Although numerous studies have investigated this topic in occupational therapy students, only one small study has previously investigated this in OTA students during Level II FW. Thus, we designed a mixed methods study of OTA students during Level II FW (n = 58) to confirm and expand our knowledge of learning experiences that develop …

Fieldwork Educators’ Expectations Of Level Ii Occupational Therapy Students’ Professional And Technical Skills, Jessica Mason, Cynthia L. Hayden, Renee Causey-Upton

The Open Journal of Occupational Therapy

Fieldwork educators are critical to the development of successful occupational therapy students, and the fieldwork experience is vital to the growth of each occupational therapy student in the profession. The purpose of this research was to explore perceptions held by Level II fieldwork educators of occupational therapy students’ professional and technical skills at the beginning of Level II fieldwork. This study used a convergent parallel mixed-method design and surveyed 54 fieldwork educators. The survey participants expected students to possess a variety of professional and technical skills in a multitude of areas. Fieldwork educators identified communication as the most essential professional …

Effectiveness Of Electronic Documentation: A Case Report, Christie Raymond, Susan Zapf, Ellen Hudgins

The Open Journal of Occupational Therapy

Background: This case report aims to inform the occupational therapist and other health care professionals of documentation best practices.

Method: This qualitative case report uses an exploratory approach to compare the quality of one participant’s handwritten documentation to her electronic documentation. Outcome measures include the Accuracy Rationale Completeness (ARC) Audit to score the quality of the notes and quantity of words, and an informal discussion with the participant about her experiences using both types of documentation.

Results: The participant’s 25 handwritten notes scored a sum of 321 and the 25 electronic notes scored a …

Educational Perspectives: Integrating A Student Post-Stroke Clinic Within A First-Year Occupational Therapy Kinesiology Course, Mark Blanchard, Barbara M. Doucet

Internet Journal of Allied Health Sciences and Practice

ABSTRACT
Purpose: In many occupational therapy graduate programs, student experiences with actual patient evaluation and intervention typically occur following several semesters of didactic instruction. We explored the impact of an early immersive and reflective hands-on patient experience on student learning and clinical skill development. Method: Following participation in five task-specific occupational therapy clinical sessions that were embedded into an applied kinesiology course, students performed reflections on the experience. These reflections included thoughts on kinesiology course content and clinical skill development through patient sessions over the semester. Results: A qualitative thematic analysis of student reflections was conducted. Findings reflected …

Occupational Therapy Assistant Students’ Perspectives About The Development Of Clinical Reasoning, Jeanne M. Coviello, Marie Christine Potvin, Laronda Lockhart-Keene

The Open Journal of Occupational Therapy

A mandatory component of the training of occupational therapy assistant (OTA) students is the development of their clinical reasoning skills. As the demand for OTAs continues to increase in response to the growing need for occupational therapy services, the number of academic programs to prepare these future therapists has expanded. Unfortunately, there is no empirical literature addressing the preparation of OTA students, specifically the development of their clinical reasoning skills. Artifact analysis, focus groups, and questionnaires were used to explore OTA students’ perceptions of what Level II fieldwork learning experiences facilitated the development of their clinical reasoning skills. The results …

An Investigation Of Entry Level Doctor Of Physical Therapy Student Perspectives Of Peer Evaluation, Dawn James, Natalie Weeks-O'Neal, Jennyfer Oh, Teressa Brown

Internet Journal of Allied Health Sciences and Practice

Purpose: To describe the perceptions of peer evaluation as an instructional method when used by entry-level doctor of physical therapy (DPT) students as preparation for practical examinations within a clinically oriented course.

Methods/Description: Forty first year, entry-level doctor of physical therapy students participated in structured peer-skills checks prior to practical exams as part a clinically based course. Each student was required to observe and provide critical feedback for at least four other students as they performed simulated patient care activities. Peer-evaluators rated the students on their level of competency with the skills using a Visual Analog Scale and …

Use Of Case Studies To Promote Critical Thinking In Occupational Therapy Students, Denise D. Allen, Susan Toth-Cohen

Journal of Occupational Therapy Education

Critical thinking is a necessary component of clinical reasoning that should be addressed as part of the graduate curriculum for occupational therapists. For students to apply critical thinking in practice they must also have confidence and minimal anxiety about their abilities. Case-based learning was chosen to address critical thinking skill development, increase confidence, and decrease anxiety. The purpose of this mixed methods pilot study was to evaluate progressively independent engagement with case-based learning on student performance, confidence, and anxiety in applying critical thinking skills in the clinical setting. Critical thinking was measured using a rubric to assess students’ performance in …

Using Case-Based Learning To Facilitate Clinical Reasoning Across Practice Courses In An Occupational Therapy Curriculum, Lynne F. Murphy, Jennifer C. Radloff

Journal of Occupational Therapy Education

Although occupational therapy educators have historically used cases as a means to prepare students for clinical practice, there is little evidence that this instructional method actually facilitates clinical reasoning. This convergent, parallel mixed methods study examined how the use of varied case formats, built on the tenets of case-based learning, facilitated specific components of clinical reasoning, and explored how the cases contributed to readiness for professional practice. Case formats included text, video, role-playing, simulated patients, and a client. Case-based learning activities included application of models and frames of reference, conducting assessments, planning and implementing interventions, clinical documentation, and identification of …

The Impact Of Online Video Cases On Clinical Reasoning In Occupational Therapy Education: A Quantitative Analysis, Lynne F. Murphy, Wendy B. Stav

The Open Journal of Occupational Therapy

Clinical reasoning, the cognitive process of a skilled occupational therapist, is a complex and necessary component of evaluating clients and implementing interventions that facilitate each client’s achievement of relevant and meaningful participation in daily occupations. Clinical reasoning encompasses a set of skills that must be integrated into college curricula for the preparation of occupational therapists, but it is not easily taught in a classroom setting. This quasi-experimental, quantitative research explored how specific instructional techniques, constructed on the tenets of case-based reasoning, influenced the development of clinical reasoning in occupational therapy students. The experimental group with video cases improved significantly in …

Self-Determination Theory And Professional Reasoning In Occupational Therapy Students: A Mixed Methods Study, Tiffany Bolton, Evan Dean

Journal of Occupational Therapy Education

Occupational therapy (OT) education frequently utilizes experiential learning as an effective instructional method to develop professional reasoning in OT students. However, there is little information about the development of professional reasoning. The researchers used a mixed-methods design to determine the extent to which an experiential learning course was effective in supporting professional reasoning ability with thirty-six OT students. Participants were students enrolled in an experiential learning course, which was part of their didactic graduate curriculum. Students attended an assigned setting weekly for sixteen weeks. Researchers collected data using the Self-Assessment of Clinical Reflection and Reasoning (SACRR) as well as reflective …

First Year Occupational Therapy Students’ Clinical Reasoning Approach To Addressing Challenging Behaviors Related To Sensory Processing Using A Simulated Case Study, Bryan M. Gee, Kelly E. Thompson, Jane Strickland, Lucy Jane Miller

Journal of Occupational Therapy Education

Occupational therapy students must be prepared to use clinical reasoning to select appropriate interventions for children with sensory processing disorders (SPDs). Although these interventions are typically taught in entry-level occupational therapy programs, there is little information regarding the method by which occupational therapy students are taught a clinical reasoning process to determine which sensory processing intervention to use with pediatric clients. A problem-solving framework called A SECRET was used to teach students clinical reasoning for children with SPDs, via an online, module-based course. Following the module, the students were tested with an online assessment tool regarding their ability to discriminate …

Why The Veracity Of Data Matters In Health Care Research, Diane Powers Dirette

The Open Journal of Occupational Therapy

No abstract provided.

Digital Storytelling As Poetic Reflection In Occupational Therapy Education: An Empirical Study, Lisebet S. Skarpaas, Grete Jamissen, Cecilie Krüger, Vigdis Holmberg, Pip Hardy

The Open Journal of Occupational Therapy

Stories are powerful aids to reflection. Thus, the use of stories may be a pathway to enhanced reflective practice and clinical reasoning skills. The aim of this study was to evaluate whether and how digital storytelling can contribute to occupational therapy (OT) students’ learning through reflections on experiences from placement education. A cohort of OT students (n = 57) participated in a 2-day workshop to create digital stories. Data were generated through a questionnaire with a response rate of 100% of students who completed the workshop (n = 34). Quantitative analysis methods were used to reveal a level of agreement …

Assessing Volition In Pediatrics: Using The Volitional Questionnaire And The Pediatric Volitional Questionnaire, Anne Kiraly-Alvarez

The Open Journal of Occupational Therapy

Evidence suggests that pediatric occupational therapists predominantly use bottom-up, impairment-focused theoretical frameworks and assessments to guide their practice, despite the current trends promoting top-down, occupation-based approaches. Understanding a child’s volition, guided by the use of the Model of Human Occupation, contributes to a more occupation-based, client-centered, holistic, and strength-based approach to therapy. Two assessment tools, the Volitional Questionnaire and the Pediatric Volitional Questionnaire, contribute to a therapists’ understanding of children’s volition. These assessments facilitate therapists’ clinical reasoning and the ability to assess and address volition throughout the occupational therapy process.

How Patient Educators Teach Students: “Giving A Face To A Story”, Natalie Hedge, Marsha A. Neville, Noralyn Davel Pickens

The Open Journal of Occupational Therapy

Patient Educators are persons with specific pathologies that have participated in an education program in which they learn how to instruct students on physical examinations. The aim of this study was to explore the impact of graduate student experiences with Patient Educators during coursework on occupational therapy clinical internships. A phenomenological design was used to explore the lived experiences of students through a qualitative interview. As participants described their experiences with the Patient Educators, three primary themes emerged: (a) self-awareness, (b) confidence, and (c) empathy. The quotes from the transcriptions were organized into four sequential plot categories: (a) Before the …