An exploration of the experience of co-supervision practice education placements from the practice educator perspective

The practice educator role is complex and becoming more so with changes in placement configurations since the COVID-19 pandemic. The role requires practitioners to manage clinical activities while providing learning opportunities and supervision for students. This can be time-consuming in often stretched clinical settings. This research investigated how experienced practice educators in occupational therapy tailored their approach to supporting student learning to make the most of limited supervision time. The results were developed into the Professional Learning through Useful Support (PLUS) Framework, which revealed how experienced practice educators focused their supervisory approach with students to maximise learning. An Action Research methodology was used across four cycles. Semi-structured interviews and naturally occurring placement documentation were gathered to determine the critical features of practice educator supervision. Template analysis was used to explore the approaches employed by practice educators to support student learning. Key focal points were linked and situated within educational theory to create the PLUS Framework. Three key focal points for practice educators were identified: (1) guiding learning, (2) making the theory-to-practice links explicit and (3) supportively challenging students. The PLUS Framework is an educational tool that describes a set of guidance strategies used by skilled practice educators, whilst acknowledging the critical influences of workplace and university contexts. The proposed key features could be useful target areas for busy practice educators to help make the most of limited supervision time. Future research will explore the PLUS Framework in different countries and professions' practice education environments.

Purpose: This study aims to delineate the experiences of occupational therapy students and clinical educators (CEs) implementing a student-led, group-based community constraint-induced movement therapy program, and to explore what they believe supports a positive placement experience. Methodology: The perspectives and experiences of three CEs and nine students were captured through a qualitative methodology, encompassing focus groups and semi-structured interviews, which were then examined via reflexive thematic analysis. Findings: Two overarching themes were interpreted from the data: ‘the transformational power of a therapeutic group’ and ‘thrown in the deep end’. The benefits of a group environment within this placement were found to be transformative for everyone involved; student learning was enriched and they felt increasingly supported. When students felt well supported in clinical roles within program designs that prioritised student learning, they developed invaluable skills and increased confidence, preparing them for future practice. However, there are complex and inherent dynamics in both the group-based and student led environments that need to be navigated, which can lead to students feeling overwhelmed and overworked. Research implications: This study highlights the relevance of utilising qualitative methodology to examine student placements within the allied health arena, therefore, serving as a foundation for future research. Practical implications: This study provides a foundation that informs practice enhancements in student placement experiences, particularly those innovative in nature. Value: Little is known about student and CE experiences, particularly within community placement settings. This study contributes to illuminating potential gaps within the curriculum design and course delivery, and offers a framework for the evaluation of similar programs – a crucial consideration for occupational therapy education aiming to enhance service and placement experiences. Limitations: Participants in the study were not from geographically diverse regions. Further, other demographic characteristics of the participants were also homogeneous. Both of these aspects may limit the generalisability of findings. Keywords: professional placement, occupational therapy, therapeutic group, clinical educator perspective, student perspective, student-resourced service provision

Purpose The COVID-19 pandemic transformed the delivery of occupational therapy (OT) community mental health services nationally, resulting in the rapid expansion and delivery of services through telehealth. While telehealth technology and its use are not new, widespread adoption was precipitated by the cessation of face-to-face services due to the COVID-19 pandemic. Research in this field has been conducted previously; however, it is not specific to OT in the Irish context. This study aims to explore service users’ experience of telehealth OT interventions in adult mental health services during the COVID-19 pandemic. Design/methodology/approach A descriptive qualitative approach was used to explore service users’ experience of mental health telehealth OT services. Five service users were recruited to participate in a focus group to explore their experience of OT via telehealth. The themes identified from this focus group were then further explored via individual interviews. Four of the service users who participated in the focus group chose to complete in-depth interviews. Reflexive thematic analysis was then completed. Findings Two key themes emerged from the data. The theme of positive telehealth experiences included subthemes of gratitude for the option of telehealth and accessibility. The second theme of learning from experience, included subthemes of human connection, preferred platforms of telehealth methods and future considerations for telehealth interventions. Originality/value These findings provide a unique insight into the importance of continuing OT services via telehealth, from the service users’ perspective.

The COVID-19 pandemic exacerbated healthcare practice education placement shortages. In Ireland, four occupational therapy programmes developed the blended onsite/offsite practice education placement model to increase placement capacity. Offsite learning included projects, supervision and telehealth, while clinical contact was prioritised when onsite. The aim of this study was to investigate the experiences of practice educators (PEs) who had supervised students using this model. The study used a qualitative interpretive methodology. PEs with experience of supervising a blended placement took part in semi-structured interviews. Reflexive thematic analysis was used to explore themes in the data. PEs felt the model benefitted students’ self-directed learning and independence. The study found that PEs valued the time apart from the student to be able to manage their own workload. Some were concerned about reduced clinical contact and operational challenges. Overall PEs were positive about the model’s use beyond COVID-19. Participants in this study value ongoing use of the blended onsite/offsite placement model. The flexibility of the model for the practice educator is key to its sustainability. Information gathered in this study facilitated the development of a Blended Onsite/Offsite Model (BOOM) Planning Tool, applicable to other health and social care professions. There is a need to promote this model as part of a wider strategy to address placement capacity challenges.

Background One approach to promote students’ use of research in future practice involves integrating students’ research use in supervision during practice placements. Studies examining this aspect of supervision in practice placements are lacking. Aim To explore how practice educators perceive and emphasise research in their supervision of occupational therapy students during practice placements. Materials and methods A qualitative study was conducted. A purposive sample was recruited, consisting of participants from community-based health services and hospitals in Norway. We conducted three focus groups and one individual interview with occupational therapists (n = 9). The qualitative data analysis was based on interpretive description. Results We identified four themes: ‘emphasis on research in supervision of students’; ‘practice educators’ research competence and awareness of research’; ‘institutionalisation of research use in everyday practice’; and ‘communication and cooperation between education and practice regarding research’. Despite highlighting several benefits of research use, the practice educators focused rarely on students’ research use in practice placements. Conclusions and significance: Cooperation between practice educators and faculty members regarding students’ training in research use seems essential. Practice educators may need additional training in how research should be emphasised in supervision.

Although occupational therapists work within mental health settings, there is limited research regarding their role in seclusion. This study aims to explore occupational therapists' experiences of delivering occupational therapy in seclusion whilst working as part of a multi-disciplinary team. An exploratory qualitative approach using a semi-structured virtual interview approach was adopted. A convenience sample of six participants with experience of working in inpatient mental health seclusions settings were recruited at a national level. Interviews were recorded, transcribed verbatim and analysed using reflexive thematic analysis. Four key themes were identified: (1) the perception of seclusion as a punitive approach, (2) the role of occupational therapy in improving the patient's journey through seclusion, (3) grading and adapting occupations to manage risk and increase engagement, and (4) promoting the role of occupational therapy in seclusion. Occupational therapists can play an important role in improving the experience of patients in seclusion. They have unique skills that enable them to work in this challenging environment. It has also highlighted the lack of understanding about occupational therapy within the multi-disciplinary team and how important it is for occupational therapists to promote their role.

Background: Reflexive thematic analysis is widely used in qualitative research published in Palliative Medicine, and in the broader field of health research. However, this approach is often not used well. Common problems in published reflexive thematic analysis in general include assuming thematic analysis is a singular approach, rather than a family of methods, confusing themes and topics, and treating and reporting reflexive thematic analysis as if it is atheoretical. Purpose: We reviewed 20 papers published in Palliative Medicine between 2014 and 2022 that cited Braun and Clarke, identified using the search term ‘thematic analysis’ and the default ‘relevance’ setting on the journal webpage. The aim of the review was to identify common problems and instances of good practice. Problems centred around a lack of methodological coherence, and a lack of reflexive openness, clarity and detail in reporting. We considered contributors to these common problems, including the use of reporting checklists that are not coherent with the values of reflexive thematic analysis. To support qualitative researchers in producing coherent and reflexively open reports of reflexive thematic analysis we have developed the Reflexive Thematic Analysis Reporting Guidelines (the RTARG; in Supplemental Materials) informed by this review, other reviews we have done and our values and experience as qualitative researchers. The RTARG is also intended for use by peer reviewers to encourage methodologically coherent reviewing. Key learning points: Methodological incoherence and a lack of transparency are common problems in reflexive thematic analysis research published in Palliative Medicine. Coherence can be facilitated by researchers and reviewers striving to be knowing – thoughtful, deliberative, reflexive and theoretically aware – practitioners and appraisers of reflexive thematic analysis and developing an understanding of the diversity within the thematic analysis family of methods.

The current expansion of Allied Health Profession training places in the UK presents significant challenges for clinical placement provision. Coaching and Peer-Assisted Learning (C-PAL) models have shown success in helping reduce placement pressure in nursing and midwifery, but there is limited evidence around how such approaches might inform traditionally one-to-one physiotherapy placements. Addressing a gap in C-PAL research, which has largely focused on nursing and midwifery, and on learner rather than educator experience, this exploratory qualitative study examined the experiences of Practice Educators (PEs) in implementing a C-PAL intervention during physiotherapy placements in one UK National Health Service trust. An exploratory qualitative study was conducted using semi-structured interviews and Reflexive Thematic Analysis. Ten PEs (seven female, three male; mean 9years PE experience) participated. All had experience of supervising learners in traditional placements. With institutional ethical approval, interviews were conducted online, recorded and transcribed. Four themes emerged: (1) 'Oversight and Management'-initial concerns about managing multiple learners diminished when PEs observed peer support creating effective self-monitoring mechanisms. (2) 'Teamworking and Learning'-a shift emerged from direct teaching to facilitating peer learning, with the collaborative environment viewed as accelerating professional development. (3) 'Patient Contact'-increased therapeutic contact time and continuity of care were highlighted, though direct supervision of clinical skills was more challenging. (4) 'Collaborative Working and Support Networks'-the intervention facilitated collaborative relationships, though required additional administrative effort. Participants found that C-PAL offered a promising alternative to traditional physiotherapy placement supervision, potentially addressing educational capacity challenges while promoting greater learner autonomy and interdisciplinary skills. They also highlighted complex challenges emerging from managing multiple learners across locations and coordinating with colleagues. Preliminary findings suggest that C-PAL approaches may offer potential for expanding placement capacity while maintaining educational quality, though this warrants investigation across a wider range of clinical contexts. Sufficient preparation time, clear role delineation, and educator development focused on facilitation skills are likely to be important enabling conditions.

IntroductionThe rapid shift to digital platforms during the COVID‐19 pandemic enabled occupational therapy practice education to continue while creating unique learning opportunities for students in an environment of high demand for practice education providers. How occupational therapy practice educators experienced fieldwork supervision during this rapid redesign of service delivery is not widely understood. This study aimed to explore the experiences of practice educators who supervised occupational therapy students during the COVID‐19 pandemic in Australia.MethodsFifteen occupational therapy practice educators participated in focus groups and individual semi‐structured interviews. Reflexive thematic analysis was used to understand the experiences of the participants and explore the barriers and facilitators to providing practice education in this context.FindingsThe experiences of the occupational therapy practice educators were interpreted into three themes: (1) Opportunities lost and then created (as two subthemes); (2) The relationship between the student and practice educator (comprising subthemes of practicing self‐care and connection and support); and (3) Signing‐off of students' competencies. While digital platforms were initially viewed as limiting, they also were used to create new opportunities for student learning. Participants spoke of being mindful of their and students' wellbeing and finding ways to provide connection and support. Participants were challenged by the need to adapt how they evaluated students in the context of a pandemic.ConclusionThe findings of this study highlight the complexities of occupational therapy practice education in the rapidly shifting context of the COVID‐19 pandemic in Australia. The outcomes highlight the importance of creating new ways of using digital platforms during practice education while focussing on the relationships with students.

Background: Mothers serve as primary caregivers and play a pivotal role in shaping children’s oral health behaviors. Despite their central role, limited research exists on how maternal knowledge, attitudes, practices, and socio-cultural factors influence children’s oral hygiene in Pakistan. Objective: This study aimed to explore mothers’ roles as gatekeepers of children’s oral health, examining knowledge, behaviors, socio-cultural influences, and barriers to effective oral health promotion. Methods: A qualitative research design was employed in urban and rural areas of District Nowshehra, Khyber Pakhtunkhwa, Pakistan. Purposive and snowball sampling identified 28 mothers of children aged 3–12 years (16 rural, 12 urban). Data collection included 18 in-depth interviews (IDIs) and 3 focus group discussions (FGDs), conducted in Pashto/Urdu, audio-recorded, transcribed verbatim, and supplemented by field notes. Reflexive thematic analysis (Braun & Clarke, 2021) using NVivo 12 was applied to identify themes and sub-themes. Methodological rigor was ensured through prolonged engagement, triangulation, peer debriefing, member checking, and audit trails. Results: Analysis revealed five interrelated themes: (1) mothers as primary health decision-makers, reflecting responsibility and autonomy in oral health decisions; (2) knowledge gaps and mixed attitudes, indicating uneven oral health literacy and reliance on informal sources; (3) modeling and habit transmission, demonstrating the impact of maternal routines on children’s habits; (4) socio-cultural expectations and family influence, highlighting extended family pressures and cultural norms; and (5) barriers to effective promotion, including financial, geographic, time, and behavioral constraints. Conclusion: Mothers are central gatekeepers of children’s oral health, yet their effectiveness is influenced by knowledge gaps, socio-cultural norms, and structural barriers. Interventions that enhance maternal oral health literacy, engage families, and improve access to preventive services may promote sustainable oral hygiene behaviors in children.

Background: Mothers serve as primary caregivers and play a pivotal role in shaping children’s oral health behaviors. Despite their central role, limited research exists on how maternal knowledge, attitudes, practices, and socio-cultural factors influence children’s oral hygiene in Pakistan. Objective: This study aimed to explore mothers’ roles as gatekeepers of children’s oral health, examining knowledge, behaviors, socio-cultural influences, and barriers to effective oral health promotion. Methods: A qualitative research design was employed in urban and rural areas of District Nowshehra, Khyber Pakhtunkhwa, Pakistan. Purposive and snowball sampling identified 28 mothers of children aged 3–12 years (16 rural, 12 urban). Data collection included 18 in-depth interviews (IDIs) and 3 focus group discussions (FGDs), conducted in Pashto/Urdu, audio-recorded, transcribed verbatim, and supplemented by field notes. Reflexive thematic analysis (Braun & Clarke, 2021) using NVivo 12 was applied to identify themes and sub-themes. Methodological rigor was ensured through prolonged engagement, triangulation, peer debriefing, member checking, and audit trails. Results: Analysis revealed five interrelated themes: (1) mothers as primary health decision-makers, reflecting responsibility and autonomy in oral health decisions; (2) knowledge gaps and mixed attitudes, indicating uneven oral health literacy and reliance on informal sources; (3) modeling and habit transmission, demonstrating the impact of maternal routines on children’s habits; (4) socio-cultural expectations and family influence, highlighting extended family pressures and cultural norms; and (5) barriers to effective promotion, including financial, geographic, time, and behavioral constraints. Conclusion: Mothers are central gatekeepers of children’s oral health, yet their effectiveness is influenced by knowledge gaps, socio-cultural norms, and structural barriers. Interventions that enhance maternal oral health literacy, engage families, and improve access to preventive services may promote sustainable oral hygiene behaviors in children.

Background A strict gluten-free diet (GFD) is the only effective treatment for celiac disease (CeD); however, maintaining adherence can be challenging for many adults. Barriers vary across populations and settings. Understanding these factors is essential to improve adherence and optimize clinical outcomes in CeD. Aims To identify factors influencing adherence to a GFD among adults with CeD and to explore the care and support needs that healthcare teams should address to improve adherence. Methods A qualitative study was conducted using semi-structured interviews with adults (18–75 years) with biopsy-confirmed CeD who had followed a GFD for at least 30 days. Purposive sampling ensured variation in GFD duration and self-reported adherence. Interviews were conducted virtually, audio-recorded, and transcribed verbatim. Data were managed in NVivo and analyzed using reflexive thematic analysis. Two researchers independently coded transcripts to identify key themes and subthemes, resolving discrepancies through discussion to ensure analytical rigour. Results From July 2024 to June 2025, 38 participants were enrolled (83% female; mean age 37 years). Most (97.6%) reported strict GFD adherence, and 87.8% had followed the diet for over one year. Participants described multiple, interrelated factors affecting adherence. Social pressures, cross-contamination risks, cravings, and financial or workplace constraints were frequent challenges. Supportive family and friends, effective planning, flexible work arrangements, and adequate income facilitated adherence. Cultural barriers emerged when traditional foods were difficult to adapt, while supportive hosts and adaptable recipes promoted inclusion. 73.7% of participants have experienced some form of stigma related to GFD. Limited access to trained dietitians and inconsistent guidance were key healthcare barriers, whereas multidisciplinary care, practical education, and peer support were strong facilitators. Conclusions Adherence to a GFD in CeD is shaped by social, personal, financial, cultural, and healthcare factors. Strengthening family, workplace, and healthcare support—particularly through improved dietitian access and practical education—may enhance adherence and long-term disease management. Funding Agencies Balsam Douglas Foundation

Occupational therapists work with forensic mental health patients in solitary confinement to counter impacts of mental illness and occupational deprivation, to promote well-being and support transition to less restricted environments. There is little literature describing occupational therapy in this context. This study aimed to explore and describe the work, context and professional reasoning of occupational therapists working in solitary confinement settings within a large forensic mental health service in Victoria, Australia. A qualitative design used semi-structured interviews with 11 occupational therapists and reflexive thematic analysis. Three central organising themes, it's all about risk, the work we do and why we do what we do, provided rich description of the context and work of occupational therapists in solitary confinement settings, including approaches used to engage patients in occupation and how the Model of Human Occupation and recovery principles informed their professional reasoning. Despite the setting restrictions, participants engaged in core elements of the occupational therapy practice process and described creative work that offered patients choice and meaningful occupation. They described occupational enrichment to address occupational deprivation and create opportunities for change within the highly restrictive and risk-focussed environment of solitary confinement. Assessment was mainly unstructured, and the need for better evaluation of therapy outcomes acknowledged. Goal setting often focussed on immediate needs. Working in a risk-focussed environment influenced participants' professional reasoning and work with patients, and while they advocated for occupational opportunities for patients, frustration was experienced in response to limits to occupational therapy involvement in risk assessment. The findings address a gap in the literature about the work of occupational therapists in forensic solitary confinement. Though participants' reasoning was informed by occupational and recovery principles, and they described working in occupation-based ways, they did not always articulate explicit connections between theory and practice.

IntroductionAutistic children commonly receive simultaneous services from various health‐care and other professionals, including occupational therapy, throughout their journey of diagnosis and consequent therapeutic support. Current best practice guidelines for supporting autistic youth emphasise the importance of interprofessional collaboration. Despite this, collaboration among health‐care professionals does not always occur, and little is understood about clinicians' experiences of collaborative care. The aim of this study was to explore Australian paediatric occupational therapists' experiences of interprofessional collaboration and their perception of factors influencing collaboration when supporting autistic children.MethodsThis study employed an exploratory qualitative descriptive design. Semi‐structured interviews were conducted with 13 Australian paediatric occupational therapists involved in service provision to autistic children. Questions explored clinicians' experiences and perceptions of interprofessional collaboration. Reflexive thematic analysis was used to inductively analyse data.Consumer and Community ConsultationThis study was conceptualised and conducted by a team of researchers with a range of personal and professional experiences with the autistic community. The research design was strongly informed by the Autism CRC'S research guidelines.FindingsThree themes were generated highlighting factors that influence collaboration between occupational therapists and other professionals. The first emphasised that ‘clinicians' capacity to collaborate’ at both organisational and individual levels was understood to be greatly influenced by funding structures. The second emphasised that ‘relationships are key to collaboration’ with these often established through shared workplaces or clients. The third, ‘shared perceptions make collaboration easier’ described how shared perceptions of collaboration, the occupational therapy role, and autism‐related frames of reference were perceived to influence interprofessional collaboration.ConclusionFindings indicate that, while occupational therapists perceive interprofessional collaboration as valuable in the support of autistic children, there are barriers to effective collaboration, particularly in the context of a marketised service delivery model.PLAIN LANGUAGE SUMMARYThis study looked at how Australian occupational therapists work with other professionals to support autistic children. Even though it is recommended that professionals work together to support autistic children and their families, this does not always happen. In this study, researchers interviewed 13 occupational therapists and asked what it is like working with other professionals, what is helpful, and what makes working together difficult. From these interviews, it was found that many things affect how well occupational therapists can work with other health professionals and teachers to support autistic children. Factors like funding and workplace rules affect how professionals work together. Having someone take on the role of leader and having good relationships between professionals made it easier to work together. It was also helpful when occupational therapists and other professionals shared similar ideas on how to support autistic children. The study could be improved if it had gathered more information about the occupational therapists' education and what they have learnt about working with other professionals. Overall, the therapists in this study believed that working together to support autistic children and their families was important, but that there are many challenges to making this happen. More research on this topic would be helpful.

Background: Occupational therapists face many challenges in evidencing their impact and evaluating the complexity of practice including resource constraints, capability and capacity issues. Case study research may offer a potential solution. To date, however, research on the use of case study research within occupational therapy has been anecdotal or limited to a specific type of case study research, which has added to a lack of clarity on what case study research is. There is a need for high-quality, evidence-informed studies that explore what case study research is and how it can be used to contribute to the evidence-base. Whilst literature on case study research is growing in the complex intervention field, there is limited research specific to occupational therapy and no research has yet considered practitioner perceptions of it. This body of work aims to address this gap by building capability for the use of case study research in contributing to the occupational therapy evidence-base. Methodology: This thesis uses a multi-method methodology, consisting of two studies and is underpinned by pragmatism. A scoping review explored the range and characteristics of case study research methodologies used to contribute to the evidence-base for occupational therapy. A search of opinion, text and empirical studies from 2016 onwards within an occupational therapy context was carried out using the Joanna Briggs Institute method. A qualitative appreciative inquiry study explored occupational therapists’ perceptions of case study research and co-created resources to increase the capability for the conduct of case study research in occupational therapy practice. University ethical approval was granted and eight occupational therapists with a range of practice experience were recruited from a Scottish Health Board. Data collection consisted of six online appreciative inquiry workshops, including methods of group discussion, break-out groups and whiteboard activities. Collaborative software MURAL was also used for the co-creation of resources using idea generation, prioritisation and prototyping creative group activities. Data was analysed in Computer-Assisted Qualitative Data Analysis Software using reflexive thematic analysis. Findings: The scoping review identified 88 studies consisting of 84 empirical and four non-empirical papers. Findings suggested case study research has been conducted globally, adopted quantitative, qualitative and mixed-methods designs and were used across a range of occupational therapy settings. It identified methodological inconsistencies, particularly identifying the ‘case’. This led to the development of a novel conceptual model and definition for case study research in occupational therapy. Four themes were generated from the appreciative inquiry study; understanding case study research as similar to practice, the benefits of case study research create buy-in, embedding case study research into practice and co-created resources for capability building. Practitioners co-created a video resource explaining the GAS-light outcome measure, an overview of training for case study research in practice and case examples. Overall findings suggest practitioners perceived case study research to be of value to practice but it also highlighted broader issues about the use of outcome measures and professional identity within occupational therapy practice. Conclusion: Case study research appears to be viable for developing the occupational therapy evidence-base, particularly when large scale inquiry is not appropriate. It is perceived positively by practitioners due to its perceived similarity to practice however the feasibility of collecting case data in practice with a larger sample requires exploration to substantiate these findings.