Editorial: How many courses for how many jobs? Enduring questions in need of research-based answers.

The World Health Organisation has designated 2021 as the International Year of Health and Care Workers (YHCW) under the theme: Protect. Invest. Together. (WHO, 2021). This acknowledges and expresses appreciation for the work of health-care workers, particularly during the COVID-19 pandemic. The WHO has also called for investment in our health workforce to ensure that they are always supported, protected, and equipped to do their work. The 2021 WHO campaign has a range of objectives including ensuring that health-care workers are prioritised to receive a COVID-19 vaccine and that there is political, social, and community support for caring and advocating for health-care workers. There has been global recognition and outward displays of gratitude towards health-care workers during 2020 and 2021. We have seen people standing at their front doors during lockdown to applaud health-care workers, murals painted on city buildings and frequent heartful thanks expressed by politicians and leaders to health-care workers, particularly those at the frontline. We have also been saddened to hear of health-care workers, including occupational therapists who have contracted COVID-19 and lost their lives. The working circumstances of occupational therapists have changed due to COVID-19, utilising more technology to deliver services via telehealth or having to don personal protective equipment in their routine practice. While occupational therapists have been attempting to maintain service provision during the pandemic, there has also been a noticeable increase in demand for occupational therapy services. There have been frequent reports of an inability to service demand and in particular, the private sector unable to recruit occupational therapists (Occupational Therapy Australia, 2021). Although there has been a long-standing maldistribution of workforce creating a chronic shortage of occupational therapists in rural and remote areas, not just due to recruitment issues but also retention (Mills & Millsteed, 2002), we are now experiencing workforce shortages across the nation. It is strange how things can change relatively quickly. In 2014, Dr Tracy Fortune and I wrote a provocative viewpoint published in this journal (McKinstry & Fortune, 2014) proposing that the increase in the number of occupational therapists graduating could provide the profession with opportunities to push into new and emerging areas of practice such as health promotion and increase entrepreneurial endeavours. Future growth for the Australian occupational therapy profession has been predicted to remain very strong (Australian Government Department of Education, Skills, & Employment, 2021). This was also the case in 1999 when Millsteed (1999) stated that workforce modelling expected an 79.9% increase in demand for occupational therapists by 2005 as a highly skilled profession. Millsteed also reported that in 1994, 481 occupational therapy students were graduating. The Occupational Therapy Board of Australia (2020) reported that in 2019/2020, there were 9,843 occupational therapy students (AHPRA, 2020) studying in 42 occupational therapy courses and there were 24,303 registered occupational therapists, a 7.1% increase in registered Australian occupational therapists from the previous year. Interestingly, Millsteed also highlighted the lack of workforce data to inform workforce planning which is unfortunately still the case today with only superficial data publicly available from the Australian Health Practitioners Regulation Authority. The National Rural Health Commissioner also recommended that a National Allied Health Data Strategy using geospatial workforce data, be established to inform rural and remote workforce planning and policy (National Rural Health Commissioner, 2020). With the installation of the Commonwealth Chief Allied Health Officer in July 2020, this recommendation will hopefully be implemented very soon (Australian Department of Health, 2020). Has there been an increase in the awareness and recognition of the role of occupational therapists or have new or expanded funding systems lead to the increase in demand, or both? The roll out of the National Disability Insurance Scheme has certainly created opportunities for people with enduring disabilities to access occupational therapy services to increase involvement in their daily activities, community, employment, education, and improve health and wellbeing which has had a marked impact on demand for occupational therapy services. The recommendations from recent Royal Commissions have also indicated the need for more services from health professionals such as occupational therapists (Commonwealth Royal Commission, 2021; Victorian Royal Commission, 202). While it is comforting to know that occupational therapists are valued members of the Australian health workforce, meeting the current and expected future demands will be a significant challenge. It will require input and commitment from all areas of the profession to increase recruitment and retention to ensure a strong high-quality profession with work informed by accurate data. Celebrate our significant achievements and professional standing during this International Year of the Health and Care Worker for we do make a significant contribution to the health and wellbeing of all who we work.

Is Occupational Therapy Adequately Meeting the Needs of People With Chronic Pain?

IntroductionAustralian and New Zealand accreditation standards for occupational therapy courses mandate consumer involvement in the design, delivery, and evaluation of courses. Consumer involvement in medical, dental, and nursing education has been evidenced as a factor for increasing student empathy. To date, there has been no known research on the impact of mental health consumer involvement on occupational therapy students' empathy. The aim of this study was to investigate if occupational therapy students who receive teaching from a mental health consumer demonstrate higher levels of empathy compared with students who receive teaching delivered by occupational therapy academics.MethodsPre–post, quasi experimental, two group comparison design was used to measure second‐year student empathy pre and post a consumer‐led teaching tutorial. Students (N = 217) were randomised into two groups across three university campuses: ‘teaching as usual group’ (control) or ‘consumer‐led’ group (experimental group). The Jefferson Scale of Empathy was used to measure student empathy.ResultsN = 138 matched scales were returned. Little difference in empathy scales was detected between groups. The ‘consumer‐led’ group increased for the empathy scale by 3.4(95% CI: 0.7,6.1, p = 0.014) but was not statistically significant compared to 1.3(95% CI: −1.0,3.5, p = 0.267) for the control group. Both groups scored highly on empathy.ConclusionThis study found that occupational therapy students had pre‐existing high levels of empathy. The challenge for future research is to identify appropriate ways to measure the impact of mental health consumer involvement on occupational therapy curriculum and students.

History, Current Practice, and the Future of Wound Care for Occupational and Physical Therapists.

Adult attachment theory has been portrayed as a framework from which to conceptualise career choice, with evidence that occupational therapy students report both a high rate of secure attachment and high levels of satisfaction with their career choice (Roney et al 2004). These findings appear to support the notion that those with secure attachment styles are drawn to the people-oriented, care-giving nature of occupational therapy. The present study was undertaken to test this assumption further by comparing students from first-year occupational therapy and commerce courses: two courses perceived to differ in their focus on care giving. One hundred and fifty-three university students (n = 53 occupational therapy, n = 100 commerce) completed a questionnaire encompassing demographic information, adult attachment styles, factors influencing career choice and the level of satisfaction with this choice. A significant difference in the attachment styles between the two groups (p <0.03) was noted, with more occupational therapy students identified as ‘secure’, and fewer as ‘preoccupied’ or ‘dismissing’, compared with students from the commerce courses. Occupational therapy students were also more satisfied with their choice of career. This result lends support to the theory that securely attached students are both attracted to and satisfied with the more caring professions, such as occupational therapy.

The formation of Occupational Therapists has become the subject of analysis and debate in recent decades after several changes in health policies in Brazil, among them the implementation of the National Curriculum Guidelines (NCGs) directing teaching practices in line with the Health Unic System and International Classification of Functioning, Disability and Health (ICF). Given these paradigms, the Occupational Therapy courses passed with several adjustments in their course of pedagogical political projects (PPPs) and their teaching practices. The study’s goal was to characterize the Occupational Therapy courses and analyze their PPPs focusing on changes in the health care model and the inclusion of ICF. The research was exploratory and was conducted through documentary analysis. By 2013 there were 63 occupational therapy courses working in the country, 44 in private institutions and 19 in public, demonstrating a lack of supply in public. The Occupational Therapy courses are still guided by the biomedical model, and the applicability of the ICF as well as the insertion of the biopsychosocial model are incipient in teaching practice.

The purpose of this study was to examine the existence of preprofessional stereotypes in physical therapy (PT) and occupational therapy (OT) students at an urban midwestern university. Forty-two junior PT students and 42 junior OT students completed the Health Team Stereotyping Scale (HTSS) as a self-administered survey questionnaire. The students' total and individual word-pair scores on the HTSS were then compared. The first comparison, between the PT students' and the OT students' views of the PT profession, indicated that the PT students' assessment of the PT profession was more positive than that of the OT students. The second comparison, between the OT students' and the PT students' views of the OT profession, indicated that the OT students' perception of the OT profession was more positive than that of the PT students. Each student group chose both positive and negative descriptors for the other group. Some positive adjectives chosen by the OT students to describe PT students were "proud," "passive," and "precise." The PT students chose "casual" and "intentional" to positively describe OT students. Some negative adjectives chosen by the OT students to describe PT students were "overrated," "competitive," and "strict." The PT students described OT students as "passive," "dull," and "narrow." Both groups thought the other group was conventional and conservative. Awareness of the existence of positive and negative stereotypes may influence behaviors in preprofessional and professional environments.

INTRODUCTION: The first year occupational therapy course at the University of Cape Town focusses on developing an understanding of occupation. Two first semester modules form the foundation for this understanding. This study aimed to describe the impact of these modules on first year students' knowledge of, and attitudes towards, the core constructs of occupation. METHODOLOGY: A pre-experimental one-group pre-test post-test design was used with a convenience sample recruited from the 2013 first year occupational therapy class. A self-administered questionnaire was developed for the study based on an extensive literature review and consultation with international occupational therapy experts. Data were gathered before and after participating in the modules. Content and construct validity, test-retest and inter-rater reliability were determined using the expert panel and a pilot test. Data were analysed with STATISTICA. RESULTS: Forty-five (N=60) participants completed pre-test and post-test questionnaires and were included in the analysis. Knowledge improved significantly (p<0.001) between pre-test and post-test, and positive attitudinal changes were noted. CONCLUSION: Knowledge and attitudes improved after completing the modules suggesting that students were equipped with a sound foundational understanding of the core constructs of occupation. Key words: Occupation; core constructs; knowledge; attitudes; education; occupational therapy

Students’ attitudes towards people with a disability, their perceptions of the characteristics of a successful occupational therapist, and their future career plans were surveyed on entry to and exit from the Bachelor of Occupational Therapy course at the University of Queensland in Brisbane, Australia. Factors impacting on students’ career plans were also examined. Questionnaires were administered to 84 students on the first day of the course in 1994 and to 59 students on the last day of the course in 1997. Descriptive statistics were used to summarise and compare the data. While generally positive on entry to the course, students’ attitudes were even more positive on completion. Entry and exit perceptions of the characteristics considered important to being a successful occupational therapist were closely aligned with the values and ideals of the profession. At both survey points, students indicated a reluctance to pursue work in non‐metropolitan areas and in psychosocial, research and academic fields. Clinical placements and particular clinicians were identified as having the greatest impact on students’ career plans. These findings provide support for the notions that student self‐selection into occupational therapy may assist in bringing aware students to the course and that clinical experiences during the course serve as potent influences on future career plans. Tailored use of the processes of socialisation within occupational therapy courses may assist in attracting therapists to particular geographical and clinical areas.

IntroductionWhile sexuality is gaining recognition as a relevant domain of occupational therapy practice, the scope of empirical research involving occupational therapy practitioners or students in relation to sexuality remains unclear. This study aimed to map the extent and focus of this research.MethodsA scoping review was conducted using four databases: MEDLINE, Embase, CINAHL, and PsycINFO. The search strategy included keywords related to ‘Occupational therapy’ and ‘Sexuality’. Two independent reviewers screened the references by title and abstract, and then by full text. The team conducted a bibliometric and collaborative inductive content analysis of included papers to categorise them by themes addressed.Consumer and community consultation.Consumer and community were not involvedFindingsOf the 4491 references screened, 136 studies were included. The papers addressed at least one of seven themes: (1) Influencing factors reported by occupational therapy practitioners and students regarding sexuality (41.9%); (2) Assessment or intervention implemented by occupational therapists to address sexuality (27.2%); (3) Educating occupational therapy practitioners and students regarding sexuality (13.2%); (4) Development or validation of assessment tools regarding sexuality (7.4%); (5) The role of occupational therapists regarding sexuality (5.1%); and (6) Frameworks, models, practice guides or guidelines related to sexuality (4.4%). Several studies (41.9%) addressed more than one topic.ConclusionThe occupational therapy literature on sexuality reveals a disproportionate emphasis on certain topics, while others remain underexplored. Most studies examined the challenges encountered by occupational therapy practitioners and students in incorporating sexuality into practice. Future studies should not only focus on developing and implementing evidence‐based assessments and interventions but also on advancing theoretical understanding at the intersection of sexuality, occupation, and occupational therapy practice.

Occupational Therapy Is a Vital Member of the Interprofessional Team-Based Approach for the Management of Rheumatoid Arthritis: Applying the 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis.

The purposes of this study are to investigate perceptions of occupational therapy (OT) among medical, nursing, and OT undergraduates and to survey their collaborative status with occupational therapists in the fieldwork. Three groups of participants were surveyed: medical students (N=60), nursing students (N=67), and OT students (N=87). The students completed a questionnaire examining (1) knowledge about the profession of OT; (2) appraisal of OT; (3) service needs from occupational therapists; and (4) the current status of teamwork practices. All students indicated that academic education was their main source of knowledge about the profession of OT. Thirty-five percent of medical students and 40% of nursing students reported that they could not distinguish between the professions of OT and physical therapy (PT). Both medical and nursing students appreciated OT for improving patients’ function in activities of daily living (ADL). They also reported that the most service needed from occupational therapists is ”ADL evaluation and training.” Most medical students (77%) and nursing students (84%) reported that they rarely collaborated with OT staff in teamwork training for patient care. Ninety-five percent of medical students and 76% of nursing students agreed that working with occupational therapists during fieldwork could enhance their understanding of the OT profession. The findings indicated that a large proportion of medical and nursing students have inadequate knowledge about the role and function of occupational therapists and few opportunities to collaborate with occupational therapists. However, they also showed specific needs for OT in patient care. Therefore, the development of a clinical collaborative education program to facilitate teamwork between occupational therapists and other medical professionals is necessary.

Knowledge translation in the context of the Asia Pacific region.

Australian accreditation standards for occupational therapy courses require consumer participation in the design, delivery and evaluation of programs. This study investigated whether a mental health consumer - as one of two assessors for an oral assessment in a mental health unit - impacted engagement, anxiety states and academic performance of undergraduate occupational therapy students. Students (n=131 eligible) self-selected into two groups but were blinded to the group differences (assessor panel composition) until shortly prior to the oral assessment. Control group assessors were two occupational therapy educators, while consumer group assessors included an occupational therapy educator and a mental health consumer. Pre- and post-assessment data were successfully matched for 79 students (overall response rate=73.1%). No evidence was found of significant differences between the two groups for engagement, anxiety or academic performance (all P values >0.05). Including mental health consumers as assessors did not negatively impact student engagement and academic performance, nor increase student anxiety beyond that typically observed in oral assessment tasks. The findings provide support for expanding the role of mental health consumers in the education and assessment of occupational therapy students. Development of methods to determine the efficacy of consumer involvement remains an area for future research.

Written examinations are commonly used to assess learning. Different resources made available during testing (closed-note, open-note, and cheat-sheet) may influence student learning. The effect of resource availability on long-term knowledge application is unknown. Understanding the effects of exam resource availability on long-term knowledge application is needed, as application is essential in applied fields such as Occupational Therapy. To explore differences in short-term knowledge retention (course one overall score, midterm exam, and final exam) and long-term knowledge application (course two summative assessment) among occupational therapy students who had different types of exam resource availability during course one (closed-note, open-note, cheat-sheet). Data were extracted from four consecutive cohorts (n = 73) as they completed two sequential occupational therapy courses. Exam resource availability was the independent variable (k = 3), with course one midterm and final exams and overall course grade, and course two summative assessment grade as dependent variables. Kruskal-Wallis tests compared differences across conditions. Concerning short-term retention, no significant differences were observed between groups for course one midterm exam grade or overall course one grade. Course one final exam grades were significantly higher in the cheat sheet condition compared to closed note (3.9%, p = .009). Concerning long-term application as measured by the course two summative assessment grade, the closed note condition scored significantly higher than open note (6.25%, p = .01). No other comparisons were significantly different. In this sample we observed a small difference in short-term knowledge retention in favor of a cheat sheet condition and moderate difference in long-term application in favor of a closed note condition. While results suggest possible differences in performance across exam conditions, findings should be interpreted cautiously due to the small, convenience-based sample. This exploratory analysis offers preliminary insights and identifies directions for future research on the pedagogical impact of exam design.