Changing times: trials and tribulations of the move to Master's entry-level education in Canada

Perceptions of Preceptors and Audiology Students on Practicum During the COVID-19 Pandemic

PURPOSE

The aim of this study was to assess the perceptions of audiology students and preceptors regarding changes in the practicum as a result of COVID-19.

METHOD

This study was conducted during two different periods, with Internet questionnaires posted on social media forums. Preceptors and newly graduated clinicians were recruited in 2019 for a study prior to COVID-19, and students and preceptors were recruited for comparison during COVID-19. Four groups participated in this study: (a) 101 students who were enrolled in the second, third, or fourth year of an Israeli communication disorders Bachelor of Arts (BA) program during the pandemic; (b) 94 newly graduated audiologists with a BA degree from an Israeli communication disorders program granted in the last 3 years (before COVID-19); (c) 18 audiologist preceptors who supervised audiology practicum in an Israeli communication disorders BA programs (before COVID-19); and (d) 20 audiologist preceptors who, during COVID-19, were supervising an audiology practicum in Israel. Perceptions of the various groups were compared.

RESULTS

Although perceptions of preceptors and students regarding the practicum were revealed to be similar, perceptions of the practicum before COVID-19 underwent changes in the course of the pandemic. In evaluating the COVID-19 experience, both preceptors and students agreed that more hours of practicum were needed, as well as more variety in types of cases and exposure to varied placements.

CONCLUSION

Academic programs and employers should consider implications of changes implemented in the practicum due to COVID-19, which can be addressed either in continuing education and/or by additional supervision in the future workplace.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19855639.

Individual and organizational factors associated with evidence-based practice among physical and occupational therapy recent graduates: A cross-sectional national study

BACKGROUND

Occupational therapy (OT) and physical therapy (PT) programs in Canada have moved to graduate-level entry education to address graduates' readiness for evidence-based practice (EBP). Whether rehabilitation professionals with advanced training in EBP are meeting their responsibilities as evidence-based professionals upon entry into practice and the factors that influence the use of evidence is unclear. The aim of this study was to examine the individual and organizational factors associated with the use of EBP and supporting evidence-based activities among graduates of professional OT and PT master's programs.

METHODS

A cross-sectional design using a survey of recent graduates of the 29 OT and PT programs in Canada. The survey measured six constructs supportive of EBP (ie, knowledge, attitudes, confidence, organizational resources, actual use of EBP, and evidence-based activities). Analyses consisted of descriptive statistics to characterize the sample and the different variables and ordinal multivariate regression analysis.

RESULTS

257 graduates (15%) completed the survey. Attitudes towards EBP was positively associated both with evidence-based activities (odds ratio = 1.36 with a 95% CI: 1.22 to 1.52) and use of EBP (odds ratio = 1.23 with a 95% CI: 1.12 to 1.36); greater confidence was related to greater use of EBP (OR = 1.12, 95% CI: 1.01 to 1.24); and working in a private practice setting was found to be related to performing more evidence-based activities (odds ratio = 3.15, 95% CI: 1.40 to 7.12).

CONCLUSIONS

Despite a greater focus on EBP knowledge in these curricula across Canada, knowledge was not related to EBP use nor evidence-based activities upon entry into practice. On the other hand, attitudes, confidence and working in private practice were. University programs should consider curricular strategies that increase the use of EBP, provide opportunities to engage in evidence-based activities with an emphasis on promoting the development of positive attitudes towards EBP and increasing learners' confidence in their ability to be evidence-based professionals.

What occupational therapists' say about their competencies' enactment, maintenance and development in practice? A two-phase mixed methods study

BACKGROUND

Understanding how professional competencies are actually enacted in clinical practice can help university programs better prepare their graduates. The study aimed to describe 1) the perceived competency level of occupational therapists holding an entry-to-practice master's degree 2) the factors perceived as impacting the enactment of competencies; and 3) the strategies used to maintain and further develop level of competency in the seven practice roles: expert in enabling occupation, communicator, collaborator, practice manager, change agent, scholarly practitioner and professional.

METHODS

Descriptive two-phase mixed methods sequential design. The quantitative phase consisted of an online survey sent to all occupational therapists holding an entry-to-practice master's degree in Quebec, Canada (n = 1196), followed by focus group discussions with a subset of participants. Analysis used descriptive statistics and the Framework Approach for content analysis of focus group data. Competencies were theoretically anchored into the Profile of Occupational Therapist Practice in Canada (an equivalent to CanMEDS framework) and we used the Theoretical Domain Framework to collect and describe perceived factors and strategies.

RESULTS

Response rate to Phase 1 was 26.5% (n = 317/1196). The communicator, collaborator and professional roles were perceived as highly solicited in practice, valued and were rated more frequently at a higher competency level as compared to the other four roles (expert, manager, change agent and scholar roles). Focus group participants (n = 16) mentioned that both individual and organisational factors influence enactment of competencies. Consulting colleagues was the preferred strategy to support the scholar role, often described as foundational for the development of expertise.

CONCLUSION

This descriptive study provides valuable information as to how the seven roles are enacted in practice. Though the scholar role is highly valued by clinicians and organizations, insufficient time is allotted to searching for evidence and reflection in practice. Strategies emerging from the results are mainly directed toward this role with an emphasis on using of peers as a source of evidence. Future studies could explore how contextual factors influence the enactment of competencies across different professions as well as how these evolve over time.

The entry-level occupational therapy clinical doctorate: The next education wave of change in Canada?

BACKGROUND

Currently, Canada and the United States are the only two countries that mandate entry to the occupational therapy profession at the master's level. There was a recommendation considered by the American Occupational Therapy Association that by 2025 all education programs would move to the clinical doctorate level. In August 2015, the Accreditation Council for Occupational Therapy Education made the formal decision that for now, the entry-level qualification for occupational therapists in the United States will remain at both the master's and clinical doctorate levels.

PURPOSE

This article presents an overview of the types of doctorates available, the pros and cons of moving to the clinical doctorate, and some potential questions that will need to be considered.

KEY ISSUES

Is the next step in the educational progression of occupational therapy in Canada the entry-level clinical doctorate? What are the potential implications for the profession, our clients, and funders?

IMPLICATIONS

Further discourse and investigation of this issue is needed.

The Next Paradigm Shift in Occupational Therapy Education: The Move to the Entry-Level Clinical Doctorate

The occupational therapy profession in the United States is considering another shift in the level of entry-to-practice education. Currently, all accredited U.S. occupational therapy education programs offer graduate-entry master's degrees or clinical doctorates. In 2014, the American Occupational Therapy Association Board of Directors published a position statement supporting the idea of moving all entry-level occupational therapy education programs to the clinical doctorate level by 2025. This article provides an overview of the proposed reasons for doing so and the potential impact of this move on future students, education providers, clients and families, employers, and third-party payers and funding bodies along with the implications for the occupational therapy profession internationally. An open, informed, transparent, multiperspective, comprehensive debate about this education paradigm shift is recommended. In August 2015 the Accreditation Council for Occupational Therapy Education decided that the entry-level qualification will remain at both the master's and the doctoral degree; it is anticipated, however, that the move toward the entry-level clinical doctorate will continue.

The entry-level occupational therapy clinical doctorate: advantages, challenges, and international issues to consider

Internationally, occupational therapy education has gone through several paradigm shifts during the last few decades, moving from certificate to diploma to bachelors to masters and now in some instances to clinical doctorate as the entry-level professional credential to practice. In the United States there is a recommendation under consideration by the American Occupational Therapy Association (AOTA) that by 2025, all occupational therapy university programs will move to the clinical doctorate level. It should be noted, however, that the AOTA Board can only make recommendations and it is the Accreditation Council for Occupational Therapy Education (ACOTE) who has regulatory authority to approve such a change. What are the potential implications for the profession, our clients, and funders of occupational therapy services? What are the primary drivers for the move towards the clinical doctorate being the educational entry point? Is the next step in the evolution of occupational therapy education globally a shift to the entry-level clinical doctorate? This article reviews current literature and discusses issues about the occupational therapy entry-level clinical doctorate. The published evidence available about the occupational therapy entry-level clinical doctorate is summarized and the perceived or frequently cited pros and cons of moving to the clinical doctorate as the singular entry point to occupational therapy practice are considered. The potential impacts of the introduction of the clinical doctorate as the entry-to-practice qualification across the United States on the occupational therapy community internationally will be briefly discussed. If the United States moves toward the entry-level clinical doctorate as the only educational starting point for the profession, will other jurisdictions follow suit? Further discourse and investigation of this issue both inside and outside of the United States is needed so that informed decisions can be made.

Transition of graduates of the Master of Occupational Therapy to practice

BACKGROUND/AIM

The transition from classroom to clinical practice is a necessary and challenging journey for occupational therapy students. In recent years, worldwide trends in occupational therapy education are moving towards graduate-entry in professional preparation courses. Little is known about the journey experienced by these graduates when they enter practice. This qualitative study aimed to explore the lived experience of these graduates in their transition from student to practitioner within first six months of practice.

METHODS

A phenomenological approach was adopted for this study. Using purposive sampling, eight participants from a recent graduate cohort of the Master of Occupational Therapy from the University of Sydney were recruited. Data was collected via in-depth, face-to-face interviews. The focus of inquiry was on the experience of transition. Interviews were audio-taped, transcribed and analysed thematically. Member checking and consensus coding were conducted to increase trustworthiness of the study.

RESULTS

Four themes emerged from the interview data. The themes were (i) valuing maturity; (ii) being new; (iii) needing skills; and (iv) pursuing satisfaction. Participants described metaphors about their experience across and within these themes.

CONCLUSIONS

Recognising the experience of transition from student to practitioner has the potential to assist university staff in the development of the educational curriculum. Understanding this transition can also help employers and therapists in providing adequate support and supervision for new graduates. Furthermore, awareness of the transition experience allows students to better prepare themselves for their own transition to practice.

Occupational therapy entry-level education in Australia: which path(s) to take?

BACKGROUND/AIM

There has been an increase in the number of occupational therapy educational programmes offered in Australia over recent years. Although universities offer bachelor, masters and graduate-entry masters programmes, there is a push to consider phasing out occupational therapy bachelor degrees. The aim of this study was to identify advantages and disadvantages associated with current and future credentials needed for entry into the profession.

METHODS

This article reviews current literature and other issues concerning entry-level occupational therapy education.

RESULTS

The underlying issues are complex and require great consideration as a profession.

CONCLUSION

As a profession we need to take charge of our destiny before governments, universities and other stakeholders/professions determine the basic level of entry for our profession.

Developing information literacy skills in nursing and rehabilitation therapy students

The environment in which nurses and rehabilitation therapists practice is rapidly evolving, resulting in changes in the skill sets and competencies required of new graduates. Evidence-based practice models, for example, require that entry-level nurses, physical therapists, and occupational therapists have the ability to identify, locate, and critically appraise research findings. This paper will describe curriculum-integrated, for-credit information literacy programs developed by the authors in collaboration with faculty members from the Schools of Nursing and Rehabilitation Therapy at Queen's University in Kingston, Ontario. The short-term goal of these programs is to teach undergraduate and graduate students advanced search strategy skills and critical appraisal techniques that will enable them to explore the implications of their literature findings. The long-term goal is to graduate practitioners who not only will have the skills to practice evidence-based health care but also will participate in scholarly activities and thus contribute to the evidence base in their disciplines.