Changes in Epistemic and Ontological Cognition of Occupational Therapy Students During Fieldwork: A Qualitative Study

Abstract

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, the situation, personal experiences, and evolving evidence, 3) Sources of knowledge and ways to justify knowledge include personal experience, clinical reasoning, authority figures, and the client, & 4) Integrating multiple sources of knowledge helps occupational therapists reason and make decisions. Students’ ontological cognition varied, depending on the specific knowledge considered. There were similarities between students’ epistemic cognition post-didactically and post-fieldwork, with differences in emphasis on specific sources of knowledge, e.g., hands-on experiences, critical reasoning, and research. Post-fieldwork, use of multiple sources of knowledge was more widespread and strongly emphasized, suggesting the fieldwork experience may have promoted beliefs about knowledge that were more consistent with the profession’s practice epistemology. Educators who guide students in recognizing, evaluating, and using critical types of knowledge and multiple sources for justification may better prepare students to successfully solve practice problems. This study provides insight into changes in students’ beliefs about knowledge and knowing after their first Level II fieldwork experience and may inform educators seeking to prepare effective practitioners.