Improvement and Retention of Wheelchair Skills Training for Students in Entry-Level Occupational Therapy Education.

Abstract

Although an essential component of best practice, wheelchair skills training is often inadequate; occupational therapy practitioners' professional preparation is a contributing factor. To assess the effectiveness of a boot camp on capacity and self-efficacy in wheelchair skills and self-efficacy in clinical practice, retention of improvements, and effective boot-camp attributes. Concurrent, embedded, mixed-methods cohort design that used blinded, repeated-measures quantitative evaluation with 4-mo follow-up and directed content analysis of a qualitative questionnaire. University entry-to-practice program. Convenience sample (N = 42) of final-year students. A 4-hr boot camp with demonstration and supervised practice. Content incorporated skill performance, training and motor-learning strategies, and safe supervision. Skill performance capacity (Wheelchair Skills Test-Questionnaire), self-efficacy with manual wheelchair use (Wheelchair Use Confidence Scale), confidence in provision of manual wheelchair training services (Self-Efficacy in Assessing, Training, and Spotting test), and a boot-camp experience questionnaire. Within-subjects analysis of variance revealed significant improvements on all measures (p < .001) with large effect sizes (ηp² = .68-.88). All measures except skill capacity demonstrated retention; skill capacity decreased 5.3% (95% confidence interval [2.0, 8.5]) but was significantly higher than baseline. Three themes influenced practice confidence: knowledge acquisition, experiential learning, and client empathy. Results confirm improved wheelchair self-efficacy, capacity, and self-efficacy with clinical intervention skills. Retention of outcomes suggests the potential impact on future practice. Experiential learning supports performance component acquisition and imparts empathy of client experience, which may improve occupational therapy practitioners' perceptions of client potential. A 4-hr experiential boot camp can increase students' capacity and confidence to deliver wheelchair skills training to future clients. Experiential learning increased students' appreciation for clients' experience and expectation of client potential.