Occupational Therapy Program Research Articles

Therapeutic-Use-of-Self as Relational Pedagogy in Occupational Therapy Education: A Qualitative Description Study.

Amid growing calls for relational teaching approaches in higher education to improve student learning outcomes and student and educator well-being, a need remains for effective relational pedagogies. Therapeutic-use-of-self (TUS) is an occupational therapy skill that centers the client-occupational therapist relationship, yet there is a dearth of research exploring its application as a pedagogy. This presents an opportunity for a widely used occupational therapy skill, TUS, to be adapted as a much-needed relational pedagogy. Objective. We explored the experience of TUS as a relational pedagogy in occupational therapy education from educator and student perspectives. Method. This qualitative description study borrowed from the evocative methodology of collaborative autoethnography. We, six researcher-participants, across two Canadian entry-to-practice occupational therapy programs, engaged in five discussions exploring the relationship between participant stories and contexts. Reflective memoing and reflexive thematic analysis were applied for analysis. Findings. Four themes were described: (a) education as transaction, (b) authenticity in learning, (c) experiencing TUS, and (d) relationship as resistance. Conclusion. With an emphasis on authenticity, empathy, power equity, and critical reflexivity, TUS challenges status quo approaches to education. Although neoliberalism challenges the feasibility of relational pedagogy in higher education, TUS holds promise as a relational and critical pedagogy.

Democratic Civic Engagement in Occupational Therapy

Democratic adult education (AE) promotes social change through active and pragmatic learning. This learning considers the impact of individual, community, organization, and broader cultural influences. Democratic civic engagement (DCE) in higher education institutions (HEIs) emphasizes inclusive participation and reciprocity. These values are deeply grounded in democratic adult education (AE) practice and community problem-solving processes in practice-based professions like Occupational Therapy (OT). In this article, we examine a new graduate OT program in the northeast region of the US and the roles of OT stakeholders as co-creators and co-educators in both institutional and community education settings. We highlight how this program is grounded in DCE which helps bridge the gap between an academic program (OT within HEI) and the broader social environment (interlocking systems not built to support diverse lived experiences) using a DCE model.

Associations between an open-response situational judgment test and performance on OSCEs and fieldwork: implications for admissions decisions and matriculant diversity in an occupational therapy program

BackgroundCasper, an online open-response situational judgement test that assesses social intelligence and professionalism [1], is used in admissions to health professions programs.MethodThis study (1) explored the incremental validity of Casper over grade point average (GPA) for predicting student performance on objective structured clinical examinations (OSCEs) and fieldwork placements within an occupational therapy program, (2) examined optimal weighting of Casper in GPA in admissions decisions using non-linear optimization and regression tree analysis to find the weights associated with the highest average competency scores, and (3) investigated whether Casper could be used to impact the diversity of a cohort selected for admission to the program.ResultsMultiple regression analysis results indicate that Casper improves the prediction of OSCE and fieldwork performance over and above GPA (change in Adj. R2 = 3.2%). Non-linear optimization and regression tree analysis indicate the optimal weights of GPA and Casper for predicting performance across fieldwork placements are 0.16 and 0.84, respectively. Furthermore, the findings suggest that students with a slightly lower GPA (e.g., 3.5–3.6) could be successful in the program as assessed by fieldwork, which is considered to be the strongest indicator of success as an entry-level clinician. In terms of diversity, no statistically significant differences were found between those actually admitted and those who would have been admitted using Casper.ConclusionThese results constitute preliminary validity evidence supporting the integration of Casper into applicant selection in an occupational therapy graduate program.

Efficacy of an Animal-Assisted Therapy Program in the Development of Children With Down Syndrome

ABSTRACT This study aimed to evaluate the efficacy of a dog-assisted intervention program in occupational therapy (OT) sessions in the treatment of children with Down syndrome (DS). A randomized clinical trial was conducted with 14 children with DS (9–12 years old) randomly distributed into two groups: control and experimental. Both received 12 OT sessions, one per week. The experimental group also received dog-assisted therapy. To evaluate the effects of the program, the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI), the Test of Playfulness (ToP), an ethogram of positive and negative social behaviors, and comparisons of vasopressin levels in the urine of children upon awakening and after sessions were used. The results showed that after the conventional intervention, the control group had a significant increase in visual perception and attention scores. The experimental group showed a significantly higher frequency of satisfaction and interactivity behaviors. We found that the presence of the dog maximizes the social skills of children with DS and increases their engagement in positive social interactions; however, conventional OT sessions were more effective with visual-motor performance. No physiological changes were observed in either group after the intervention.

Co-designing an interprofessional digital education resource on delirium: a student-led approach

BackgroundInterprofessional education is crucial for healthcare students to develop collaborative skills and provide effective patient care. However, opportunities for interprofessional learning are often limited in healthcare curricula. The present study aimed to engage students from different health professions in co-designing an educational resource on delirium recognition and management through an interprofessional lens and explore their experiences of this process.MethodsTwo co-design workshops were conducted with students from medicine, nursing, pharmacy, and occupational therapy programmes at two universities across the island of Ireland. Focus groups were held following these workshops to explore students’ experiences of the co-design process. The workshops involved a range of activities, including theme generation, scenario development, resource creation (podcasts, simulations), and focus group discussions. Data from focus groups were analysed thematically.ResultsA total of 19 students participated across the two workshops. Three themes were identified: (1) Relationship development, where students identified the benefits of co-creating the resource and valued the flexibility, collaboration, and social aspects of the co-design approach; (2) Interprofessional collaboration, which challenged students’ assumptions about other disciplines, fostered teamwork and communication, and highlighted the need for early and continuous interprofessional learning; (3) Professional growth, with students reporting increased confidence in managing delirium, working with other professions, and engaging in novel experiences like podcasting and simulation.ConclusionsThe co-design process facilitated interprofessional collaboration, peer learning, and personal growth among healthcare students. Students appreciated the opportunity to co-create an educational resource while developing interprofessional skills. The study demonstrates the potential of co-design as a methodology for enhancing interprofessional education and promoting effective teamwork in healthcare.

The Effectiveness of a Digital Mental Fitness Program (Positive Intelligence) on Perceived Stress, Self-Compassion, and Ruminative Thinking of Occupational Therapy Undergraduate Students: Longitudinal Study.

Health care students often endure numerous stressors throughout their undergraduate education that can have lasting negative effects on their mental well-being. Positive Intelligence (PQ) is a digital mental fitness program designed to enhance self-mastery and help individuals reach their potential by strengthening various "mental muscles." This study aims to evaluate the effectiveness of a 6-week app-delivered PQ program in reducing perceived stress, increasing self-compassion, and decreasing rumination tendencies among health care undergraduates. We hypothesized that students would show reductions in perceived stress, increases in self-compassion, and decreases in rumination tendencies by the end of the PQ program, compared with their preprogram scores. We adopted an exploratory approach for the 5-month follow-up due to the limited research consensus on the sustained effects of app-based programs over varying periods. The PQ program includes weekly hour-long videos, weekly group meetings, and daily 15-minute app-guided practices. Participants were first-year students from the occupational therapy program at a university in Singapore. Participants completed surveys measuring self-compassion, perceived stress, and rumination levels before and after the PQ program, and again at a 5-month follow-up. Data were analyzed using repeated measures ANOVA to assess differences across the pretest, immediate posttest, and follow-up posttest. Out of 87 students enrolled in the study, the final sample consisted of 64 students (n=47, 73%, female; mean age 23 years, SD 5.06 years) with complete data. At the end of the 6 weeks, students exhibited significant increases in self-compassion (before the intervention: mean 3.07, SD 0.35; after the intervention: mean 3.34, SD 0.35; P<.001) and reductions in rumination tendencies (before the intervention: mean 3.57, SD 0.40; after the intervention: mean 3.27, SD 0.34; P<.001). However, no significant change in perceived stress levels was observed (before the intervention: 2.99, SD 0.14; after the intervention: mean 2.97, SD 0.16; P=.50). These effects were not influenced by the daily app-based practice of PQ exercises, and there were no sustained effects on self-compassion (mean 3.17, SD 0.27; P=.09) or rumination tendencies (mean 3.42, SD 0.38; P=.06) at the 5-month follow-up. Additionally, there was a significant increase in perceived stress at follow-up (mean 3.17, SD 0.21; P<.001) compared with pre- and postintervention levels. The PQ program did not directly alter stress perceptions but may have reframed students' automatic negative thought processes, increased their awareness of self-sabotaging behaviors, and enhanced their self-compassion while reducing ruminative thinking. These findings highlight the importance of self-awareness for students' well-being. Students can benefit from practices such as mindfulness and peer discussions to enhance self-compassion and reduce rumination. Educators trained in the PQ program can foster a supportive environment that encourages self-compassion, challenges negative self-talk, and helps students manage stress.

Facilitating positive emotions in people with challenges by combining conventional occupational training and a novel farming program: a feasibility study

ObjectiveJapan has a system of occupational therapy programs known as self-reliance training (training for daily living), which helps people with various disabilities lead more meaningful lives. Recently, it has been shown that green care farms are beneficial for dementia care and that agricultural and horticultural work has a positive impact on people with intellectual disabilities and mental disorders. This study examined the health-improving effects of farm activities and developed an attractive program for adolescents with developmental and intellectual disabilities who use independent training facilities. The program comprised agricultural and horticultural activities such as vegetable cultivation and management, flower planting, and flower arrangement.ResultsNo significant differences were observed in any of the measures for positive mood before and after the usual program (UP). However, anger-hostility and depression-dejection improved significantly after the farm program (FP) (p < .05). Self-efficacy improved significantly after both UP and FP (p < .10). Free responses were obtained from UP (131 responses) and FP (126 responses) participants; thematic analysis of FP participants’ statements revealed that positive comments included “confidence in accomplishing tasks,” “anticipation and joy of growing plants,” and “motivation for gardening activities.”

Use of QR Codes to Enhance Learning in a Graduate-Level Clinical Course

AbstractTeaching health professions at the graduate level often involves instructors guiding students through active learning labs for the practical application of content. Clinical courses may necessitate covering a substantial amount of information, requiring instructors to adopt efficient and effective teaching methods to maximize lab time. In a Master of Occupational Therapy Program, students were observed being off-task and disengaged with provided materials during group work in active learning labs. In response to this, Quick Response (QR) codes were introduced as a strategy to enhance self-directed learning and maintain focus on tasks while the instructor offered supplemental assistance as needed. A Microsoft Form survey was administered after classes to assess the effectiveness of QR codes as a technology-supported instructional method and gather students’ perceptions. The survey results overwhelmingly indicated that students were receptive to using QR codes and found them helpful in facilitating learning and maintaining attention during lab activities.

Employment Decisions of Newly Graduated Occupational Therapists.

Introduction. Employment decision-making is essential for understanding workforce trends. Current occupational therapy workforce research describes distribution disparities of occupational therapists within geographic locations, services such as acute care or community health, and private or public sectors. New graduates of occupational therapy programs are critical to meeting the demand and distribution disparities of occupational therapy services in British Columbia. However, recent employment decision-making of new occupational therapy graduates has not been well studied. Purpose. This study aimed to examine factors that influence newly graduated occupational therapists' employment decisions. Methods. This descriptive study sampled 122 occupational therapists who were registered in one province and graduated from a Canadian occupational therapy program between 2017 and 2022. Data was collected through an online survey about intrinsic factors, extrinsic factors, and past fieldwork experiences that affected participants' employment decision-making. Descriptive data analysis was used to organize participants' responses. Findings. Results identified that work-life balance and mentorship were the highest rated factors that influenced participants' current and first employment respectively. Participants agreed that the variety and number of placements they had as students were more influential to their employment decisions than the length of the fieldwork education. Conclusion. This study identified the intrinsic and extrinsic factors in employment choices that may influence recruitment, retention, and workplace planning of new graduates.

School performance readiness of elementary students with disabilities before starting the occupational therapy program in special education schools

Background: School-based occupational therapists (SBOTs) work as health professionals in educational settings. School performance readiness is within the scope of SBOTs in providing a service for students who might have experienced decreasing performance during their school life. Objective: This study aimed to explore the school performance readiness of elementary students with disabilities before starting the occupational therapy program in special education schools. Materials and methods: The school performance readiness checklist for students with disabilities in special education schools was the research instrument. It comprised four areas: physical, social and emotional, pre-academic, and self-care readiness. Seventy-five elementary students with disabilities participated in this study. They consisted of 41 students with intellectual disability, 21 students with physical disability, and 13 students with sensory disability. Results: Results from the initial semester in special education schools showed that most of the students with disabilities (85.33%) needed support in promoting their school performance readiness, particularly in pre-academic readiness. This included most of those with intellectual disability (33.33%) and all of those with sensory disabilities, while all of the students with physical disabilities needed support in promoting physical readiness. Conclusion: Most students with disabilities needed support in promoting their school performance readiness according to their type of disability. Although the special education schools had enrolment criteria, SBOTs and school professionals should be concerned with providing related intervention programs to promote school readiness, particularly pre-academic readiness.

Occupational Therapy Program to Develop Sensorimotor Performance and Adaptive Behavior Skills in Children With Moderate Intellectual Disability

Occupational Therapy Program to Develop Sensorimotor Performance and Adaptive Behavior Skills in Children With Moderate Intellectual Disability

Investigating the Maintained Motor Skill Achievements in a Visual Praxis Based Occupational Therapy Program: Single Blind Randomized Follow up Study.

To examine the long-term effects of Visual Praxis Based Occupational Therapy Program on the motor skills of children with Specific Learning Disabilities. Ninety-six boys and girls were divided into two groups: Experimental (n = 48) and Control (n = 48). The Experimental group received Visual Praxis Based Occupational Therapy Program in two weekly sessions for 8 weeks. All participants were assessed with the Bruininks-Oseretsky Motor Proficiency Test-2 Brief Form at three-time points; pre-test, post-test, and follow-up. The experimental group showed superior results, Bruininks-Oseretsky Motor Proficiency Test-2 Brief Form's Fine Motor Precision, Fine Motor Integration, Bilateral Coordination, Balance, Speed and Dexterity, Upper Extremity Coordination and Total Score significantly increased after the intervention (p ≤ 0 0.05) and the scores were maintained at the follow-up (p > 0.05). The Visual Praxis Based Occupational Therapy Program intervention provided a retained positive effect in the development of motor skills in children with Specific Learning Disabilities.

Essential Occupational Therapy Competencies for Low Vision and Blindness.

Background. The prevalence of low vision and blindness in persons across the lifespan means that occupational therapists will encounter these conditions across all areas of practice. Practitioners must be equipped with competencies necessary to recognize and respond to vision loss-related concerns. Purpose. This study sought to identify essential occupational therapy competencies when providing services to people with low vision and blindness. Method. The study employed a three-phase modified Delphi methodology administered through online surveys and focus group. Respondents included people with low vision or blindness, professionals with special expertise in low vision/blindness, and occupational therapists in other practice areas. Data were analyzed using an iterative, consensus-generating strategy involving quantitative analysis of competencies, qualitative input, and expert panel review. Findings. The process yielded a 51-item competency framework organized into six domains. Implications. The framework provides the foundation for a common curriculum for Canadian occupational therapy programs and for the creation of educational resources.

Addressing Bias in the Occupational Therapy Admissions Process

This study investigated the impact of a workshop in reducing unconscious bias in admissions committee members of an occupational therapy program to determine if workshop participation increased the number of underrepresented students in the program. A convenience sample of 50 committee members was used. A Wilcoxon matched pairs signed rank test indicated a significant increase in the post-test survey question scores. A chi-square test of independence revealed a significant increase in the number of students in the program from underrepresented groups. These results suggest that an online workshop can reduce perceived bias and increase diversity in an occupational therapy program.

Correction to effects of a visual perception-based occupational therapy programme on reading and motor skills in children with developmental dyslexia: Single blind randomised crossover study design.

This study aimed to examine the effects of a visual praxis-based occupational therapy (VPOT) programme on reading and motor skills for children with developmental dyslexia (DD). Forty-two children were included in the study. Additionally, before VPOT, the Reading-Aloud and Reading-Comprehension Test 2 (ORSRC-2) and the Bruininks-Oseretsky Motor-Proficiency-Test-2-Brief Form (BOT2-BF) were applied to the participants. According to the study design, VPOT was applied to two sessions per week for 8 weeks to group A. During this period, group B was accepted as the control group. At the end of these 8 weeks, evaluation tests were applied to both groups. Then, group A was defined as the control group and Group B as the intervention group, and VPOT was applied to Group B. At the end of another 8 weeks, evaluation tests were applied to both groups for the third time. When the final ORSRC-2 results were examined, VPOT was found to be an effective programme for improving reading skills. Additionally, when the final BOT2-BF results were examined, VPOT was determined to be effective in improving motor skills (p < 0.05). We believe that it is important to carry out comprehensive studies such as the VPOT programme to solve problems in the physical and learning activities of children with DD.

Person-centred care in the context of higher education – a discourse analysis based on interviews with programme directors

BackgroundAs person centred care (PCC) is being implemented globally, higher educational institutions (HEI) have begun to play a crucial part in enabling this transition. In Sweden, however, the delivery of PCC is inconsistently implemented in medicine, nursing, occupational therapy, and physiotherapy study programmes. This inconsistency is partly the result of a lack of a national strategy across HEI. Program directors are responsible for the PCC content of their programs, so their views influence how PCC is taught. Using interviews with programme directors in higher education, we aim to deepen the understanding of the preconditions needed to implement PCC by exploring discourses and identifying subject positions of how PCC is taught and learned.MethodsWe performed a discourse analysis based on interviews with program directors in the above-mentioned national study programmes. A discourse can be seen as a struggle over identity. The subject position – i.e., discourses designate positions for persons to occupy as subjects – guided our analysis and identification of the subject positions of the teacher and the student in teaching and learning PCC.ResultsThis study unfolded in two main antagonistic aspects with respect to teaching and learning PCC, resulting in four subject positions for the teacher and four corresponding subject positions for the students. First, the teacher and student were given a subject position as change agents towards a more egalitarian healthcare and were assigned a subject position to cope with a practical reality they could not change. Second, the teacher and student were assigned a subject position that embodied profession-specific identities, navigating and valuing these boundaries. Simultaneously, both teachers and students assumed a subject position that required interprofessional interaction and co-creation for teaching and learning PCC.ConclusionThis study demonstrates the discursive tension surrounding the implementation of PCC in HEI, and the findings can serve as a basis for creating future relevant and high-quality learning activities. The process of negotiating diverse and co-existing perspectives as well as building interprofessional trust when incorporating PCC into higher education is essential and requires further exploration.

'We are all bringing, like a unique sort of perspective': The core elements of a strengths-based digital arts mentoring program for autistic adolescents from the perspective of their mentors.

While the adoption of strengths-based approaches to supporting autistic adolescents is growing in popularity, the application of this approach to a digital arts mentoring program has yet to be explored. This study reports on the core elements contributing to the success of a community digital arts mentoring program for autistic adolescents from the mentors' perspective. This paper presents an in-depth exploration of mentors' experiences, comprising a component of a broader line of research investigating a digital arts mentoring program for autistic adolescents emphasising positive youth development. The digital arts mentoring program spanned 20 weeks across two Australian school terms and was attended by two groups of autistic adolescents (N = 18) aged between 11 and 17 years. A qualitative approach was utilised in exploring the perspective of their mentors (N = 6). Qualitative data were collected at the end of each school term for each group with the mentors using an interpretive phenomenological approach and Colaizzi's seven-step analysis method. Thirteen individual interviews were conducted with six mentors. This research was conducted with a disability arts provider to provide a digital arts mentoring program to autistic adolescents. The mentors employed have lived experience with disorders such as attention deficit hyperactivity disorder (ADHD) and anxiety. Five primary themes emerged from the data: positive connections, mentor knowledge and experience, mentoring approaches, autism education, program organisation, resources and environment. Subthemes underpinned the primary themes related to positive connections (three subthemes), mentoring approaches (four subthemes) and program organisation, resources and environment (three subthemes). The findings suggest that prior experience, sufficient training, a supportive environment and a flexible and adaptable approach were essential for success. Understanding the core elements of a strengths-based digitalarts program in occupational therapy provides a comprehensive framework for utilising clients' inherent strengths and creativity as therapeutic tool, creating an empowering environment, fostering meaningful outcomes for clients.

Novel Occupational Therapy Program (Step Up) to Facilitate the Transition from Early Intervention in Psychosis Services.

The purpose of this program evaluation was to examine preliminary outcomes associated with a novel stepdown program for clients of early intervention in psychosis services ("Step Up") that featured occupational therapy (OT) as a critical treatment component. Clients participated in Step Up for at least 6 months and were administered pre-post assessments of clinician-rated performance of daily living activities and self-perceived performance and satisfaction with daily occupational functioning. Paired samples Wilcoxon tests were used to compare outcomes across the two time points. Data from 23 participants of Step Up were analyzed. Clinician-rated performance of daily living (especially in the areas of money and time management and leisure engagement) and client-rated performance and satisfaction with daily occupational functioning improved significantly over time. Results demonstrate the promise of programs such as Step Up that capitalize on OT and promote functional outcomes during the transition from early intervention.

Burnout, Exhaustion, Experiences of Discrimination, and Stress Among Underrepresented and First-Generation College Students in Graduate Health Profession Education.

Mental health disorders are increasing among health profession students. Compounding this, students from underrepresented backgrounds may face additional stressors and challenges. The aims of this study were to: (1) assess the extent to which burnout, exhaustion, experiences of discrimination, and stress exist among students in dentistry, nursing, occupational therapy, pharmacy, and physical therapist professional education programs; (2) determine if there are significant differences by key demographic characteristics (those who are first-generation college students [FGCSs], a member of an underrepresented minority [URM] group, or both); and (3) highlight strategies and solutions to alleviate these challenges identified by students. Cross-sectional survey using a mix of question types of a sample of graduate students from dentistry, nursing, occupational therapy, pharmacy, and physical therapy programs from February to June 2020. Utilizing the Maslach Burnout Inventory Student Survey and campus climate and stress survey, mean subscale scores were calculated for the following outcomes of interest: MBI-SS burnout, dimensions of stress, and observed racism. Logistic regressions examined student factors that may help explain these outcomes. Content analysis examined participants' responses to open-ended questions. There were 611 individuals who completed all survey questions. FGCSs were significantly more likely than non-FGCSs to report exhaustion (adjusted odds ratio [aOR]: 1.50; 95% CI = 1.04-2.16), family stress (aOR: 3.11; 95% CI = 2.13-4.55), and financial stress (aOR: 1.74; 95% CI = 1.21-2.50). URM students reported not feeling supported in their program and mentioned needing additional support, particularly for well-being, from staff and faculty. Findings from this study are consistent with literature that FGCSs experience additional stressors that may lead to burnout and exhaustion. URM students reported not feeling supported in their programs. This study's findings point to the need for leadership and faculty of health professional schools to implement or strengthen current policies, practices, and strategies that support URM students and FGCSs. Research demonstrates that a diverse student body and faculty enhances the educational experience for health professional students, and that diversity strengthens the learning environment and improves learning outcomes, preparing students to care for an increasingly diverse population. However, this study finds that students from underrepresented backgrounds may still experience more burnout, exhaustion, discrimination, and stress than their peers. Programs and policies to support URM students and FGCSs throughout their academic careers can help improve graduation and retention rates, leading to improved workforce diversity.

Preparing healthcare professional students for rural, regional and remote practice: demonstrating the effectiveness of an interprofessional simulation learning experience

ABSTRACT Undertaking an authentic interprofessional simulation experience may be a useful and consistent strategy for healthcare professional students to build competencies required for a rural healthcare context. An observational comparative study design was adopted to evaluate a clinical simulation experience created to develop the interprofessional competencies of a sample of healthcare professional students at a regional university situated on multiple campuses in New South Wales (NSW), Australia. Over 200 students across three campuses of the university were involved in a simulation experience that included four interprofessional activities. Of these students, 189 (89%) agreed to participate in the study. The healthcare professional students who participated in the study were from second year occupational therapy, physiotherapy, and podiatry, and third year speech pathology programs. Retrospective pre and post self-assessed interprofessional collaborative competencies were compared for all students using the revised Interprofessional Collaborative Attainment Survey (ICCAS). Results demonstrated a statistically significant improvement in self-perceived scores using the validated revised ICCAS survey. The findings of this study suggest that carefully designed and authentic interprofessional simulation experiences can facilitate the development of competencies required for effective interprofessional practice, which are necessary for successful rural practice.