"(Not) knowing what you know": Exploring educators' perceptions of critical thinking in occupational therapy.

BACKGROUND: Critical thinking is key for responsible occupational therapy practice. However, the degree to which educators understand critical thinking and the conceptualizations of such concept in teaching remains unclear. AIM: This study aimed to describe occupational therapy educators' perceptions and experiences of teaching critical thinking. MATERIAL AND METHODS: Social constructivism underpins the study. Eight participants were included in three online synchronous focus groups. One participant was interviewed in person due to time constraints. Data were analysed using content analysis. RESULTS: This study reveals a considerable diversity of perceptions and experiences of ambiguity regarding educators' perceptions of what they know about and how to teach critical thinking. Most educators interpret critical thinking in ways that differs from their colleagues. Furthermore, educators encounter divergent expectations pertaining to their role as educators and the readiness of their students. CONCLUSIONS: This study reveal a paradox within the occupational therapy profession, where critical thinking is highly valued yet educators experience ambiguity, differing expectations of their role, time constraints, and lack of formal education to support students' development of critical thinking. SIGNIFICANCE: This study provides the foundation for further inquiry into the invisible effects and benefits of different understandings of critical thinking on occupational therapy practice.

Cognitive stimulation in activities of daily living for individuals with mild-to-moderate dementia (CS-ADL): Study protocol for a randomised controlled trial.

BACKGROUND: Multi-component CS programs incorporating practice of activities of daily living (ADL) into intervention have reported benefits for ADL outcomes in individuals living with mild-to-moderate dementia. A randomised controlled trial (RCT) within community occupational therapy services in Ireland, is planned to evaluate the effects of CS-ADL, an ADL-focused, multi-component CS program, on ADL outcomes for individuals living with mild-to-moderate dementia. METHOD: A single-blind RCT with a calculated sample size of 34 participants has been planned to compare the effects of CS-ADL versus treatment as usual on the outcomes of basic ADLs and instrumental ADLs. Cognition, mood, communication, and quality of life will also be evaluated as secondary outcomes. CS-ADL sessions will run once weekly for a total of seven weeks, lasting approximately two hours each. Outcome data will be collected at baseline, within sessions and post-intervention at week eight. Descriptive statistics will be used to analyse the data. This study has been registered at clinicaltrials.gov (NCT06147479). DISCUSSION: CS programs are commonly conducted by occupational therapists working with individuals living with mild-to-moderate dementia. This study aims to demonstrate the effectiveness of a multi-component CS program delivered through an occupational therapy lens, potentially influencing the approach to CS and ADL interventions undertaken by occupational therapists.

Developing a Global Strategy for strengthening the occupational therapy workforce: a two-phased mixed-methods consultation of country representatives shows the need for clarifying task-sharing strategies.

INTRODUCTION: Occupational therapy has been underdeveloped and often neglected in the global health workforce agenda, contrasting with the global rise of population needs for services. The World Federation of Occupational Therapists (WFOT) is utilizing a research-based, multi-step process for developing a Global Strategy for strengthening the occupational therapist workforce. A multi-pronged scoping review, situational analysis, and expert input process enabled the drafting of a provisional Global Strategy. Here, feedback on that draft from representatives of WFOT member organizations was obtained and analyzed as one key intermediate step toward shaping the in-developing Strategy's content and structure. METHODS: Two-phased, mixed-methods consultation consisting of: (1) online survey with score ratings and comments on the utility of each strategy and (2) four in-person focus groups discussions on low-scoring items involving a total of 76 representatives of WFOT member organizations. The focus group discussions were analyzed using an inductive thematic analysis approach. RESULTS: Strategies involving 'task shifting/task sharing' or the 'harmonization of workforce data-collection requirements' received the lowest scores in the initial survey and were thereby addressed in the focus groups discussions. The overarching theme of the focus groups was the need to: "clarify, specify, and contextualize the strategies", including: (1) "clarify the terminology and specify the application", for example, describe the meaning of task shifting, specify which tasks can (and cannot) be shifted and to whom, to address concerns regarding scope-of-practice, service demand, and safety; and (2) "outline the context of need and the context for the implementation" of the strategies, elucidating why the strategies are needed and how they can be feasibly implemented across the different jurisdictional contexts. CONCLUSION: Within a mixed-methods consultation, WFOT representatives identified challenging topics on the draft workforce strategies and suggested methods to improve the Global Strategy, its acceptability, and implementation. The terms 'task shifting/task sharing' raised the greatest discussion among the profession leaders, when the strategy was not sufficiently clarified, specified, or contextualized.

A Conceptual Map of Knowledge Transfer in Occupational Therapy Clinical Practice in Central South Africa.

Introduction: Empirical evidence has confirmed that all types of knowledge (propositional, procedural, personal, and client) contribute to evidence-based practice (EBP) and should be transferred in clinical practice to inform quality service delivery. However, it is unclear how the integration of the types of knowledge that are transferred in clinical practice manifests. Given this gap in understanding, the current research sought to build a conceptual map of knowledge transfer in clinical practice in central South Africa. Method: A qualitative approach was followed, and data to build the conceptual map was obtained from a scoping review that explored the landscape of knowledge transfer in occupational therapy clinical practice, nine semistructured interviews with occupational therapists working in central South Africa, and a Q Method survey. Results: The conceptual map-building process delivered a multidimensional, multidirectional conceptual map consisting of four concepts (theory and research, practice experience, patient-therapist relationship, and patient's voice in clinical practice) and four types of knowledge (propositional, procedural, personal, and client). The results show the integration of the types of knowledge and confirm that knowledge transfer in clinical practice is a complex and ongoing process. Conclusion: The conceptual map, a first of its kind in South Africa, presents empirical evidence of knowledge that is created and transferred in clinical practice in central South Africa. The conceptual map might provide a framework for collaboration amongst all stakeholders, such as patients, occupational therapists, and academics, to produce practice guidelines and occupational outcome measures to support evidence-based clinical practice.

A national survey of current rehabilitation service provisions for people living with chronic kidney disease in the UK: implications for policy and practice.

BACKGROUND: National guidance recognises the key role of rehabilitation in improving outcomes for people living with chronic kidney disease. Implementation of this guidance is reliant upon an adequate and skilled rehabilitation workforce. Data relating to this is currently lacking within the UK. This survey aimed to identify variations and good practices in kidney physiotherapy (PT), occupational therapy (OT) and clinical exercise physiologist (CEP) provision; and to understand barriers to implementation. METHODS: An online survey was sent to all 87 UK kidney units between June 2022 and January 2023. Data was collected on the provision of therapy services, barriers to service provision and responses to the COVID-19 pandemic. The quantitative survey was analysed using descriptive statistics. Free-text responses were explored using reflexive thematic analysis. RESULTS: Forty-five units (52%) responded. Seventeen (38%) units reported having a PT and 15 (33%) an OT with a specialist kidney role; one unit (7%) had access to a CEP. Thirty units (67%) offered inpatient therapy services, ten (22%) outpatient therapy clinics, six (13%) intradialytic exercise, six (13%) symptom management and three (7%) outpatient rehabilitation. Qualitative data revealed lack of money/funding and time (both n = 35, 85% and n = 34, 83% respectively) were the main barriers to delivering kidney-specific therapy. Responders saw an increase in the complexity of their caseload, a reduction in staffing levels and consequently, service provision during the COVID-19 pandemic. Exemplars of innovative service delivery, including hybrid digital and remote services, were viewed as positive responses to the COVID-19 pandemic. CONCLUSION: Despite clear evidence of the benefits of rehabilitation, across the UK, there remains limited and variable access to kidney-specific therapy services. Equitable access to kidney-specific rehabilitation services is urgently required to support people to 'live well' with kidney disease.

Quality indicators for occupational therapy: a scoping review.

BACKGROUND: Occupational therapists are increasingly asked to demonstrate the effectiveness, appropriateness, and efficiency of their interventions to funding bodies. However, the extent to which this is practiced and the health policy context within which such a practice is situated differs internationally. The aim of this scoping review was to establish which quality indicators are used internationally for this purpose. METHODS: We conducted a scoping review, limiting our search to Europe and the English-speaking world. To search for suitable literature, we used specialized databases from medicine, health sciences, and related fields, including CINAHL Complete and MEDLINE, as well as free internet search via Google. Furthermore, we contacted national occupational therapy associations from several countries asking for access to documents found within this search that were only accessible to association members. RESULTS: The screening process identified 32 studies and documents from six national contexts. We identified and described process-level indicators, functional outcome indicators, one outcome indicator based on individual goal attainment (the Goal Attainment Scale, or GAS), and PRO-Ergo, a patient-reported experience measure (PREM). There was little information on the use of quality indicators to demonstrate the effectiveness, appropriateness, and efficiency of occupational therapy services to funding bodies in Europe and the English-speaking world that was openly available. The identified process indicators were in most cases not specific to occupational therapy interventions. Functional outcome indicators were highly specific to certain client groups or health conditions and partially appropriate for use in occupational therapy. The GAS was found to be a highly customizable measure which allowed an evaluation on body structure and function levels as well as activity and participation levels. PRO-Ergo was focused on the clients' subjective view and their experience with occupational therapy interventions. CONCLUSIONS: All identified quality indicators have advantages and disadvantages. Process-level indicators specific to occupational therapy could be a chance to foster the use of best practice methods. GAS and PRO-Ergo seem to be the most versatile assessment, allowing an evaluation on the level of activity and participation. Functional outcome indicators that cover a broad area of client problems may be useful additional quality indicators for some areas of practice.

Developing the First Digital Occupational Therapy Dictionary Worldwide: A Promising Mobile Application Model for Occupational Therapy Service Providers and Recipients.

The purpose of this study was to develop the first English-Arabic occupational therapy dictionary mobile application that could be used by occupational therapy service providers and recipients and help fill the gap in understanding and communicating occupational therapy services. Google Play Store and App Store application stores were searched first to identify any current electronic occupational therapy dictionary. While developing the dictionary concept and structure, end users' needs, language, and culture were taken into consideration applying a user-friendly design, functionalities, and an easy-to-understand language with illustrative visual representations. Our search for currently available electronic occupational therapy dictionaries did not identify any mobile application on the official application stores for iPhone and Android. As a result, a conceptual model was created to develop a mobile application aiming to develop a comprehensive and user-friendly mobile electronic dictionary with over 2400 scientific terms translated and annotated from English to Arabic, more than 350 illustrative pictures, and special features to assist occupational therapy professionals and occupational therapy services recipients in looking up and understanding terminology used in rehabilitation and occupational therapy in the most convenient, fastest, and easiest way possible. The occupational therapy dictionary mobile application has helped create a unified terminology and a common language of shared understanding, proved to be a helpful tool of communicating important messages between Arab occupational therapy professionals and community members through providing an easy access to up-to-date comprehensive English-Arabic lexicography in occupational therapy. It has become the first digital occupational therapy dictionary worldwide and has been made available for everyone to download from Google Play and App Store on their smartphones, computers, or tablets free of charge. Further research is urgently needed for quality improvement and to further enrich Arabic content in occupational therapy through developing evidence-based mobile tools to be used in occupational therapy practice by Arabic-speaking population.

Defining the future of occupational therapy: A concept analysis of leadership development.

BACKGROUND: In occupational therapy, leadership development is a fundamental skill and social process needed to advance the profession. However, there is scant literature on leadership development. Further examination of leadership development in the occupational therapy literature may provide helpful insights and strengthen the opportunity to study this concept and its efficacy. AIMS/OBJECTIVES: The focus of this concept analysis was to conduct a review of the historical and contemporary occupational therapy literature to evaluate how the profession distinguishes the concept of leadership development. MATERIAL AND METHOD: A principle-based concept analysis provides holistic perspectives of a concept by examining its historical and linguistic foundations. RESULTS: Dialogue about leadership development was primarily situated in grey literature with few articles found in empirical-focused, peer-reviewed journals. The analysis revealed that leadership development was understood as both a process and an outcome and was intended to support the promotion of the profession. CONCLUSION: Despite using similar language to describe the concept, the literature did not yield one cohesive definition of leadership development. SIGNIFICANCE: A definition was proposed that integrated the various perspectives to support future empirical research around a centralized understanding of the concept of leadership development.

The concept analysis revealed that occupational therapy leadership development is seen as a process and an outcome. Key themes from an epistemological perspective showed that leadership development is a social and mentored process and can be achieved through engagement in various strategies and contexts.Little empirical evidence exists on the outcome of leadership development strategies in occupational therapy, thus providing a challenge in operationalizing the concept. More research is needed to determine the outcome of occupational therapy leadership development approaches.Based on the existing literature, a theoretical definition of leadership development was proposed with the anticipation to serve as a basis for future research.

The Functional Consequences of Long COVID Need to Be Addressed by Occupational Therapists.

Long COVID-persistent health complications after recovery from coronavirus disease 2019 infection-is associated with activity limitations in nearly 48 million U.S. adults, affecting work, leisure, family, and community functioning. Occupational therapists are experts in customizing interventions to maximize performance of daily routines, and often treat individuals who experience similar functional impacts to those observed in long COVID. The large number of people experiencing new disability, as well as a lack of medical treatment options, make occupational therapy a crucial component of long-COVID research and multidisciplinary management. In this column, we discuss actionable steps occupational therapists can take to place them at the forefront of maximizing functional and quality-of-life outcomes for people with long COVID.

Preventing Surgeon Work-Related Musculoskeletal Disorders: A Pilot Study of the Comprehensive Operating Room Ergonomics (CORE) Program.

IMPORTANCE: Work-related musculoskeletal disorders (WMSDs) among surgeons are markedly increasing. Several proposed interventions to reduce WMSDs among surgeons have been studied, but few follow an occupational therapy-oriented approach addressing biomechanical, psychophysical, and psychosocial risk factors. OBJECTIVE: To design, implement, and assess the potential of the Comprehensive Operating Room Ergonomics (CORE) program for surgeons, a holistic evidence-based ergonomics and wellness intervention grounded in occupational therapy principles. DESIGN: Mixed-methods pilot study with the quantitative strand embedded in the qualitative strand. SETTING: University-affiliated hospital. PARTICIPANTS: Six laparoscopic surgeons. OUTCOMES AND MEASURES: CORE program outcomes were assessed using qualitative and quantitative data to indicate changes in posture, physical discomfort, sense of wellness, and operating room (OR) ergonomic performance. The Rapid Upper Limb Assessment (RULA) was used to quantify surgeons' WMSD risk level before and after intervention. RESULTS: There were 12 baseline observations (two for each participant), and two or three post-CORE implementation observations. A statistically significant difference, F(1, 6) = 8.57, p = .03, was found between pre- and post-occupational therapy intervention RULA scores. Thematic analysis of surgeon feedback, which was overwhelmingly positive, identified five themes: postural alignment, areas of commonly reported physical pain or discomfort, setup of the OR environment, surgical ergonomics training, and ergonomics in everyday life. CONCLUSIONS AND RELEVANCE: The CORE program effectively decreased ergonomic risk factors to optimize surgeons' occupational performance in the OR. This study demonstrates a potential solution to how occupational therapists can holistically support surgeons and health care providers who are at risk for WMSDs. Plain-Language Summary: By 2025, a surgeon shortage is expected, partly because of the increase in surgeons' work-related musculoskeletal disorders, which affect their health and job continuity. This pilot study shows that the Comprehensive Operating Room Ergonomics program effectively addresses these problems. The study also serves as a framework for occupational therapy professionals to work with health care providers on ergonomics, benefiting population health. Results suggest that this approach could enhance surgeons' work conditions, supporting the American Occupational Therapy Association's Vision 2025 to improve health and quality of life.

School-Based Occupational Therapists' Roles Supporting Transitions Into and Throughout Kindergarten to Grade 12: A Scoping Review.

IMPORTANCE: Large educational transitions occur when students enter and exit school or move between grades or divisions within the kindergarten to Grade 12 (K-12) school system. For students with disabilities, the quality of large educational transitions affects academic and postschool outcomes, which is germane to school-based occupational therapists. OBJECTIVE: To explore the school-based occupational therapy literature to describe the roles of occupational therapists in supporting large educational transitions and to identify relevant terminology. DATA SOURCES: We searched six databases (CINAHL, EMCare, Embase, ERIC, MEDLINE, and PsycINFO) for peer-reviewed publications in English with no date limitations. STUDY SELECTION AND DATA COLLECTION: We included articles focused on children and youth with disabilities and school-based occupational therapy services supporting large transitions within K to 12 education. Using directed content analysis, we reported on publication characteristics, occupational therapy roles, and terminology. FINDINGS: We included 46 publications spanning 37 yr that addressed transitions into school (n = 3), within K to 12 grades or divisions (n = 10), or to exit secondary education (n = 33). Occupational therapists assumed many roles in supporting large transitions, some much more frequently than others; 125 transition terms were used across included articles with few terms explicitly defined. CONCLUSIONS AND RELEVANCE: School-based occupational therapists' involvement in educational transitions is extensive, with potential for expansion. Consistency in terminology would support future research and practice. Plain-Language Summary: A large educational transition occurs when students move between a school, grade, or division as part of their K to 12 education. For students with disabilities, the quality of a large educational transition affects their academic and postschool outcomes. This review provides an understanding of how school-based occupational therapists support educational transitions for youth with disabilities. The review found that occupational therapists took on many roles, with the potential for expanding their roles. The review also identified 125 transition terms that were used across the literature review and found that few terms were explicitly defined. Consistency in terminology would support future research and expanded occupational therapy practice in this area.

Participation Questionnaire for Preschoolers With Autism Spectrum Disorder: Item Development.

Occupational therapists need to comprehensively assess the participation of children with autism spectrum disorder (ASD) in daily activities and evaluate the effectiveness of relevant interventions. Several participation measurement tools have been developed for children with ASD, but these tools require expert involvement, which is a barrier to large-scale surveys. To address these concerns, a caregiver-administered questionnaire-the Participation Questionnaire for Preschoolers (PQP)-was developed. However, this tool could be improved due to its narrow age range of 48-72 months and because the item development process does not reflect the perspectives of children and caregivers. Therefore, we expanded the PQP's target age range to 36-83 months and developed new items that reflect the perspectives of professionals and caregivers. Interviews were conducted with eight experts in supporting children with ASD and 11 caregivers of children with ASD. The interviews were transcribed, and a content analysis was performed. The number of questions was reduced from 51 to 36, and the order of items was changed for clarity. Two of the eight subdomains were removed to clarify the conceptual difference between activity and participation. The updated version of the PQP has two unique features: (1) it can be administered without expert involvement, and (2) it includes items specific to the challenges faced by children with ASD. Future development of the scale and validation of its measurement properties are needed.

Study approaches mediate associations between learning environment and academic performance.

BACKGROUND: While study approaches have been directly associated with students' academic performance, learning environment factors may play a more indirect role. The aim of this study was (i) to assess learning environment factors as predictors of students' average exam grades, and (ii) whether study approaches mediated associations between learning environment factors and exam grades. METHODS: Three annual surveys (2017-2019) yielded data from a total of 263 Norwegian occupational therapy students. Learning environment factors were assessed with the Course Experience Questionnaire, and the Approaches and Study Skills Inventory for Students were used to assess study approaches. Linear regression analyses and mediation analyses were performed. RESULTS: Higher levels of 'student autonomy' were directly associated with lower averaged grades whereas higher levels of 'appropriate workload' were associated with higher averaged grades. There were statistically significant total indirect effects of 'clear goals' and 'appropriate workload' on grades; these effects occurred through the study approach variables. However, all learning environment variables showed one or more relationships with academic performance that was mediated by study approach variables. CONCLUSION: Learning environment variables appear to be complexly associated with academic performance, both directly and indirectly.

An Argument for Guidelines for Capstones in Unhoused Settings.

In recent years, there has been increased interest in completing occupational therapy doctoral capstones with people experiencing homelessness. Given the complexity of practice with this population and its history of discrimination and marginalization, we argue for the development of guidelines for completing capstones in unhoused settings. In this column, we present background and contextual information, justification for the need for guidelines, and preliminary recommendations for consideration by students and faculty. Our aim is to invite reflection within the profession and among academic institutions and to promote dialogue with community agencies that serve this population to ensure that capstones are developed ethically, sustainably, and without unintentionally perpetuating harm.

Occupational therapists' experiences of photo-supported conversations - An intervention in primary health care.

BACKGROUND: The health-promoting intervention BeWell™, which includes photo-supported conversations, is intended for people with stress-related illnesses. Its focus is on improving the individual's health and well-being by addressing what contributes to well-being from the patient's own perspective. There is no current knowledge of the experiences of occupational therapists of using BeWell™ in primary health care. It is thus important to gain knowledge of their experiences of using this intervention as part of investigating its feasibility. AIM: To describe the occupational therapists' experiences of photo-supported conversations about well-being (BeWell™) with patients diagnosed with stress-related illnesses. MATERIAL AND METHODS: Six occupational therapists, working in primary health care, who had conducted the photo-supported conversations about well-being (BeWell™), were interviewed individually, and one focus group discussion was also conducted. Systematic text condensation was used as the analysis method. RESULTS: Three main themes with two to three subgroups in each were identified; Discovering well-being through images, Enhancing patient's own efforts towards well-being, and Contributing to one's own well-being. CONCLUSIONS AND SIGNIFICANCE: The results provide important knowledge for the continued research work with BeWell™ by investigating how the users of the intervention experienced it.

Development of a Smart Home Modification Program: A Delphi Survey of Multidisciplinary Health Care Experts.

IMPORTANCE: There is a critical gap between the potential of smart home technologies to enhance the lives of people with physical disabilities (PwPD) and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. OBJECTIVE: To bridge this gap and ensure that PwPD can fully benefit from smart home advancements to improve their daily living and quality of life by developing a smart home modification program. DESIGN: A Delphi survey involving three rounds was conducted with experts in disability and smart home technologies. SETTING: Online survey. PARTICIPANTS: Thirty multidisciplinary health care experts. OUTCOMES AND MEASURES: Experts rated the level of relevance in smart home modification with each survey. Consensus was set at ≥75%, content validity (CVR) was ≥.33, and convergence was ≤.5. RESULTS: The first Delphi result selected 26 items, and the second included 59 items after adjusting for values that fell below a CVR of .33. In the third Delphi survey, 59 items were selected. The final Delphi study had an average CVR of .96 and a coefficient of variation of .10. The last survey's consensus point was .92, indicating a high level of agreement among participants. CONCLUSIONS AND RELEVANCE: On the basis of expert consensus, the study provides a validated framework for smart home modifications to aid PwPD. Plain-Language Summary: This research highlights the role of smart home adaptations to promote responsible, independent living for people with physical disabilities. There is a critical gap between the potential of smart home technologies to improve the lives of people with physical disabilities and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. The study authors developed a smart home modification program with the goal of closing this gap and to ensure that people with physical disabilities can fully benefit from smart home advancements to improve their daily living and quality of life. Based on expert ratings, the study findings provide a validated framework that occupational therapists can use to recommend smart home modifications to help people with physical disabilities. The framework can also be used by occupational therapists to identify people who may need more extensive environmental modifications and interventions.

Occupational Therapy Doctoral Capstone Research Agenda: A Scoping Review.

IMPORTANCE: As identified in the American Occupational Therapy Association's (AOTA's; 2023) statement about the purpose and value of the occupational therapy doctoral capstone, there is a lack of evidence about the purpose and value of the doctoral capstone. As an essential element of occupational therapy doctoral degree curricula, the capstone is unique to each program, supports the program's scholarship agenda, and serves the needs of students and the communities served by the profession. OBJECTIVE: To develop a doctoral capstone research agenda in an attempt to prioritize and guide research that can supplement the current paucity of evidence related to capstone efficacy or effectiveness. METHOD: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were used to conduct a scoping review. Peer-reviewed articles published between 1999 and June 2023 were searched using the CINAHL, PsycINFO, PubMed, and Embase databases. RESULTS: The doctoral capstone research agenda was developed and organized into five categories to drive research activities inclusive of the didactic and experiential learning associated with the planning, implementation, and evaluation of the capstone process: (1) teaching and learning; (2) learner characteristics and competencies; (3) shaping professional identity; (4) faculty/mentor development and resources; and (5) promotion of diversity, equity, and inclusion. CONCLUSIONS AND RELEVANCE: A doctoral capstone research agenda was developed in accordance with AOTA's (2018) Occupational Therapy Education Research Agenda. It identifies an array of areas in which research is needed to inform the distinct value and purpose of the doctoral capstone to students, sites, programs, and the profession. Plain-Language Summary: The occupational therapy doctoral capstone is unique to each program, supports the program's scholarship agenda, and supports the needs of students and the communities served by the profession. The American Occupational Therapy Association's official document on the "Occupational Therapy Doctoral Capstone: Purpose and Value" states that there is a lack of evidence about how to identify the distinct purpose and value of the doctoral capstone. This scoping review explored the development of a doctoral capstone research agenda. A research agenda is provided to guide and prioritize research to articulate best practices and the distinct purpose and value of the doctoral capstone in occupational therapy education and for the profession.

Student experiences in a novel interprofessional neurodevelopmental clinic: a qualitative study.

BACKGROUND: Student-led clinics can provide low-cost speciality care and practical interprofessional education (IPE) opportunities. In Australia, there are currently limited speciality services available that provide neurodevelopmental assessments that consider fetal alcohol spectrum disorder (FASD) as one possible outcome. The aim of the current study was to understand student experiences in a novel interprofessional student-led clinic for children and adolescents with suspected or confirmed prenatal alcohol exposure. METHOD: Seventeen allied health university students (11 occupational therapy; 6 psychology) participated in individual semi-structured interviews following completion of a 10-week clinic placement. Reflexive thematic analysis was undertaken using NVivo12. RESULTS: Four main themes were generated: (1) Interprofessional practice a key for students' development as future healthcare professionals; (2) Meaningful relationships and students' belief they made a difference; (3) Novel challenges tested students' capabilities on placement; and (4) Supervisor attitude and approach to learning supported student development. CONCLUSIONS: The current study demonstrated that the interprofessional student-led neurodevelopmental clinic provided a valuable IPE opportunity for students.

The Healing Elements of an Eclectic Life Skills Programme: Clients' Perspectives.

Introduction: The article reports the healing elements of an eclectic life skills programme (ELSP) from the perspective of group members. An ELSP utilising open groups was developed to manage clients with mixed diagnostic profiles and different stages of recovery simultaneously. The aim was to explore the healing elements of an ELSP. Methods: Maximum variation purposive sampling was used to select six participants for the phenomenological inquiry. Data collection is comprised of observations, semistructured interviews, and reflective journals. Data analysis comprised an inductive thematic analysis. Consumer Involvement: Participants all attended groups offered within the ELSP. They participated in two semistructured interviews: the first interview in the week following admission and the second just before discharge. In addition, they documented their experiences in reflective journals for the duration of their participation. Findings: The analogy of a kaleidoscope portrayed the four themes; three pertained to structural dynamics, namely, programme mirror, facilitator mirror, and mirror of other group members. The fourth theme, namely, the magical pattern, pertained to personal sense-making by individual group members. Conclusions: The dynamic interplay of healing factors, captured in the themes, facilitated healing. Self-reflection was integral to the creation of a bespoke, facilitated self-learning process with direct application in group members' own lives.

Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial.

BACKGROUND: Occupational therapy (OT) is an effective evidence-based intervention that positively influences stroke patients'independence recovery, leading to new opportunities for better quality of life outcomes. OBJECTIVES: To explore the effectiveness of an early OT intervention program (EOTIPS) in the process of hospital to home discharge after stroke in Spain. MATERIAL AND METHODS: We conducted a prospective, randomized controlled clinical trial that included 60 adults who suffered a stroke and were discharged home. Participants assigned to the experimental group (n = 30) were included in EOTIPS and compared with a control group (n = 30). Evaluations assessed quality of life (Stroke and Aphasia Quality of Life Scale [SAQOL-39]), functional independence (Modified Rankin Scale [mRS], Barthel Index [BI] and Stroke Impact Scale-16 [SIS-16]), perceptual-cognitive skills (Montreal Cognitive Assessment [MoCA]), upper limb function (Fugl Meyer Assessment [FMA]), mobility (Berg Balance Scale [BBS] and Timed Up & Go [TUG]), communication skills (Communicative Activity Log [CAL]) and mood disorders (Beck Depression Inventory-II [BDI-II] and Hamilton Anxiety Scale [HAM-A]); they were completed within two weeks post-stroke and after three months follow-up. Statistical analysis included intent-to-treat analysis, considering all participants (dropouts as failures), and efficacy analysis, considering only end-of-treatment participants. RESULTS: Participants in the intervention group showed a significant better evolution in the main outcome measure of quality of life (SAQOL-39 p = .029), as well as for independence (mRSp = .004), perceptual-cognitive skills (MoCA p = .012)and symptoms of depression (BDI-II p = .011) compared to the control group. CONCLUSIONS: EOTIPS was effective in improving quality of life, as well as enhancing perceptual-cognitive skills, independence and reducing levels of depression for patients who suffered a stroke in a Spanish cohort and could be considered as an applicable non-pharmacologic therapeutic tool that can lead to patients' positive outcomes after stroke. This study was registered on ClinicalTrials.gov with the identifier NCT04835363.