Perceptions of occupational therapy threshold concepts by students in role-emerging placements in schools: A qualitative investigation

An Exploratory Study: Undergraduates' Perspectives on how Threshold Concepts Influence Professional Identity

Background. Threshold concepts are key to professional identity development, transforming the way individuals think, act, and perceive the world. Purpose. To understand how occupational therapy students describe their professional identity, its importance, and how threshold concepts contribute to identity. Method. Mixed-method survey of final-year occupational therapy students (n = 58) at an Australian University. Findings. (i) High agreement on most identity and threshold questions; but up to 24% uncertain about confidence/competence in understanding specific concepts; (ii) occupation-focus is unique to our professional identity; (ii) identity develops over time; (iii) occupation-based, client-centered, and evidence-based practices are central to thinking like and becoming an occupational therapist; and (iv) practice education provides context for threshold concepts to be transformative. Implications. Identity is defined by a focus on occupation and its relationship to health. Traversing threshold concepts through academic and practice education is essential to developing professional identity.

Developing professional competence in an unfamiliar setting: Practice learning in Zambia

BACKGROUND

Higher education needs to provide students with competencies to meet the health and social needs of a society characterised by increased globalisation and diversity. Occupational therapy students from Norway expressed that learning experiences outside their comfort zone within Zambian placements, have had a profound impact on their professional competence.

AIMS AND OBJECTIVES

Enhanced understanding of how learning experiences in international placement impact on students' professional competence.

MATERIAL AND METHODS

Focus group interviews with three cohorts of students were analysed using thematic cross-case analysis integrated with an iterative reflexive process. Transformative learning was used as a theoretical framework for this analysis.

RESULTS

Three themes emerged from the analysis; 1) Feelings of uncertainty and emotional distress; 2) Drawing on available resources to meet the challenges; 3) Handling challenges promote professional competence.

CONCLUSION

Learning experiences significant for developing professional competence goes beyond students' habitual practice and previous mindset. Students develop generic skills, such as tolerance, flexibility, creativity, awareness of sustainability and professional confidence.

SIGNIFICANCE

New and more appropriate understandings of students' placement experiences leading to more adequate and relevant strategies, are in consistence with skills required for twenty first century occupational therapy practice.

Threshold concepts in health professions education research: a scoping review

Threshold concepts (TCs) are increasingly used in health professions education (HPE) research. TCs are claimed to be conceptual gateways which are often traversed with substantial difficulty. In this paper, we report on a scoping review investigating the following research question: What is the scope and nature of the currently available research on threshold concepts in health professions education literature? We employed Arksey and O'Malley's model for scoping reviews. A search for literature on TCs in HPE research between 2003 and 2020 yielded 999 records of which 59 were included in the review. The data set was subject to quantitative descriptive analysis of article characteristics as well as qualitative thematic analysis of the scope of research on TCs. Among the 59 articles selected for review, there were 30 empirical, 26 conceptual and three reviews. A majority were published in 2015 or later. Almost half of the included articles attempted to identify possible TCs within HPE. Others investigated how TCs can be traversed or suggested how TCs could influence curriculum design. Some critically appraised the framework of TC. Although TCs are increasingly utilised in HPE, the present review identified how researchers came across methodological challenges related to identifying possible TCs and definitional challenges around identifying the essential characteristics of TCs. Before embracing TCs as the next go-to theory for learning in HPE, we acknowledge the need for methodological stringeny and rigour as well as more data to support TCs. Until then, any implementation of TCs in HPE curricula should be done cautiously.

Implementing a digital tool to support meaningful engagement with socially isolated or lonely older adults

Social isolation and loneliness are significant concerns in community dwelling older adults due to associated poorer health outcomes, inadequate crises responsiveness and increased societal burdens of care and cost. Generating Engagement in Networks Involvement (GENIE) is an online evidence-based, client-centred social network tool piloted by community-aged care services in Sydney, Australia. GENIE facilitates access to community resources, activities and people to extend or re-establish a client's social connections. This study aimed to identify GENIE's potential to maintain and promote social connections in older adults from the perspective of allied health professionals who could deliver GENIE. This qualitative exploratory study involved 33 participants on an emerging placement across two organisations who piloted GENIE. Data included consensus and priority statements produced from six nominal group technique-facilitated discussions, and an inductive thematic analysis of student documentation and all consensus statements. The main findings indicated that participants prioritised GENIE's clinical advantages, implementation barriers and recommendations for future implementation. The inductive thematic analysis revealed the two themes of practice applications, and client and professional experiences when using GENIE. As a time-efficient and personalised intervention, the research team concluded that GENIE could empower service providers to address the overarching needs of clients through rapidly connecting older adults to resources of their interests within the overburdened Australian-aged care system.

The Nature of Theory Used in Practice Education: A Scoping Review

Background. Placements are key contexts for occupational therapy students to connect theoretical knowledge (theory) with practice. Theory relates to the prevailing ideas and concepts used by a profession. It can be derived within and outside the profession (discipline-specific knowledge and related knowledge, respectively). Purpose. This scoping review aimed to identify what is known about the nature of theoretical knowledge used in occupational therapy practice education. Method. A search of 4 electronic databases identified 19 relevant publications, data from which was extracted deductively. Findings. Inconsistent descriptions related to discipline-specific knowledge while related knowledge was often presented as not integrated with, or complementing, discipline-specific knowledge. Some authors referred to educational knowledge and methods informing student's theory use during placements. Implications. Educational methods need to provide a foundational platform, enabling novice learners to structure their thinking about ways discipline-specific and related knowledge can be used within an occupational framework on placement.

A Q-method approach to perceptions of professional reasoning in occupational therapy undergraduates

BACKGROUND

Professional reasoning provides a firm basis for the development of teaching and assessment strategies to support the acquisition of skills by healthcare students. Nevertheless, occupational therapy educators should use diverse methods of learning assessment to examine student learning outcomes more fully with an evaluation that supports the overall complexity of the process, particularly learners' subjective experience. The aim of this article is to identify the range of perspectives among occupational therapy undergraduates regarding terms or concepts that are key for improving their professional reasoning.

METHODS

Q-methodology was used to address the aim of the study. A concourse relating to a series of ideas, phrases, terminology, and concepts associated with various studies on professional reasoning in occupational therapy, specifically on students in this field, was generated. The terms that had the clearest evidence, the most relevance or the greatest number of citations in the literature were collected (n = 37). The P-set was assembled by non-probabilistic sampling for convenience. It comprised undergraduate university students in occupational therapy. Factor analysis was conducted using Ken-Q Analysis v.1.0.6, reducing the number of Q-sets to smaller groups of factors representing a common perspective.

RESULTS

Through statistical analysis of the Q-sorts of 37 occupational therapy students, 8 default factors were identified. The four factors in accordance with the selection criteria were rotated by varimax rotation to identify variables that could be grouped together. Each viewpoint was interpreted, discussed and liked to different aspects of professional reasoning in occupational therapy.

CONCLUSIONS

The observed perceptions were linked to the various aspects of professional reasoning that have been widely discussed in the occupational therapy literature. For most of the students, there was a strong correspondence between the narrative, interactive and conditional aspects of the various components.

Student and supervisor perspectives on the effectiveness of community-based placements for occupational therapy students

Background

Using a community-based model as an integral part of occupational therapy students' practice experiences can enable the development of new emerging practices within the community. The aims of this study were to examine the experiences of students and supervisors in community-based role-emerging practice placements, and to compare the two types of placements (full-time and part-time).

Methods

Data was collected from 41 undergraduate occupational therapy students and seven supervisors using pre-post questionnaires, as well as qualitative data through focus groups and a short online questionnaire. Conventional content analysis was used for qualitative data, Wilcoxon tests were used to examine the change in scores, and Mann-Whitney tests compared the two types of placements.

Results

A significant decrease was evident in students' scores from pre- to post-placement regarding setting and supervision (z = -3.557, p < .001), with a non-significant decrease regarding community. Significant increases in scores were seen regarding students' personal and professional skills (z = -2.805, -3.152, p < .01). Close-to-significant differences in personal skills scores were found between role-emerging types. Overall, students and supervisors expressed positive impressions, while students addressed challenges relating to setting and supervision.

Conclusions

Community-based role-emerging practice placements may contribute to the professional and personal development of occupational therapy students. The results supported the positive aspects of role-emerging practice placements; they also identified the challenges of such placements with regard to students' expectations from the settings and supervision. Exposing students to role-emerging models, and seeking better compatibility with their expectations from community partnerships and supervisors, may contribute to their professional development, which can in turn develop and expand areas of practice in the community. Additionally, role-emerging practice placements can serve as a valuable contribution to professionals and stakeholders within communities, who do not as yet benefit from occupational therapy services.