A Historical Cross-Professional Perspective on the Fellowship in Occupational Therapy.

Health professions education is increasingly creating learning experiences after one's entry-level practice degree. Such experiences include residency and fellowship experiences for health professions practitioners. This review of residency and fellowship programs across several health professions includes the development of residency programs and the implications these developments have on occupational therapy. The analysis across health professions includes medicine, pharmacy, physical therapy, speech-language pathology, and occupational therapy. This thorough analysis can help guide the development of occupational therapy fellowships. This background provides a foundation to focus on the implications for emerging fellowships within occupational therapy. The findings can be utilized to assist in the development of new successful fellowship programs.

Meeting Global Rehabilitation Needs: The Development and Evaluation of an International Visiting Rehabilitation Student Program.

Collaboration to increase capacity for healthcare professionals requires careful planning, open communication, implementation, formative and summative evaluation, and sustainability. International collaboration to meet the rehabilitation needs of China requires a supportive structure of faculty and staff implementing the program. The purpose of this article is to explore the development of a collaborative international rehabilitation education program and illustrate outcomes as they relate to professional development, cultural competency, and healthcare team skills. A retrospective analysis of program assessment data was completed including pre and posttest survey results and focused interviews. Results indicate that program participants had a significant positive change in values and beliefs towards cultural diversity and increased awareness of interdisciplinary team skills which contributed to overall professional development as future rehabilitation practitioners. The description and assessment of the program also serves as a framework for the development of future collaborative international rehabilitation education programs. Future research could explore institutional growth and faculty development of collaborating educational institutions.

Occupational and Physical Therapists' Perception of Evidence-Based Practice.

BACKGROUND: The significance of evidence-based practice (EBP) cannot be overstated. However, literature on the perception of occupational and physical therapists toward EBP is scarce. METHODS: This survey study was intended to examine occupational and physical therapists' perceptions of EBP. A total of 47 of 261 practicing therapists in a health care system in the Midwest U.S. responded to the questionnaire previously developed by Rubin et al. RESULTS: The results of the study showed that therapists reported familiarity with the EBP process and maintained an overall positive attitude toward EBP. Of the five subscale measures of EBP, familiarity with EBP process had the greatest average score (3.82±0.48) followed by attitude about EBP process (3.73±0.37). The smallest mean subscale score was found on the measure of current engagement in EBP process (2.93±0.55). Therapists reported intent to engage in the EBP process but were less favorable to engage in EBP and only reported engagement in EBP a little less than "some of the time." Barriers to engaging in EBP included time, access, and the constraints of the responders' practice setting. Implications of this study resulted in recommendations for clinical practice and educational programs.

CHIP: Facilitating Interprofessional and Culturally Competent Patient Care Through Experiential Learning in China.

Health care professionals have advocated for educating culturally competent practitioners. Immersion in international experiences has an impact on student cultural competency and interprofessional development. The China Honors Interprofessional Program (CHIP) at a university in the Midwest is designed to increase students' cultural competency and interprofessional development. From 2009 to 2013, a total of 25 professional students including twelve occupational therapy students, ten physical therapy students and three nursing students were enrolled in the programme. Using a one group pre and posttest research design, this study evaluated the impact of CHIP on the participating students. Both quantitative and qualitative data were collected in the study. Findings of the study revealed that CHIP has impact on students' cultural competency and professional development including gaining appreciation and understanding of the contributions of other healthcare professionals and knowledge and skills in team work. The findings of the study suggested that international immersion experience such as CHIP is an important way to increase students' cultural competency and interprofessional knowledge and skills. Limitations of the study included the small sample in the study, indirect outcome measures and the possible celling effect of the instruments of the study. Future research studies should include a larger and more representative sample, direct outcome measures such as behaviour observation and more rigorous design such as prospective experimental comparison group design. Future research should also examine the long-term effects of international experience on the professional development of occupational therapy students. Copyright © 2016 John Wiley & Sons, Ltd.

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.

Comparison of on-campus and hybrid student outcomes in occupational therapy doctoral education.

We compared the graduate outcomes of doctoral students in a traditional on-campus occupational therapy program with those in a hybrid program. Participants were 81 students from an on-campus program and 13 students from a hybrid program. Graduate outcomes were measured with student grade-point average (GPA) at the end of each academic year, cumulative GPA, Fieldwork Performance Exam, National Board for Certification in Occupational Therapy (NBCOT) practice exam scores, and final NBCOT pass rate. Consistent with previous research, our results revealed no significant differences on most outcome variables, suggesting that hybrid programs are an effective delivery model for postsecondary higher education. These findings may provide guidance to occupational therapy programs in curriculum design, content delivery, and program refinement and development. Replication of this study is needed with a larger sample and inclusion of qualitative data. Future studies should compare the affective domain of graduate outcomes in on-campus and online or hybrid programs.

International practice experiences in pharmacy education.

OBJECTIVES: To identify reasons for inclusion of international practice experiences in pharmacy curricula and to understand the related structure, benefits, and challenges related to the programs. METHODS: A convenience sample of 20 colleges and schools of pharmacy in the United States with international pharmacy education programs was used. Telephone interviews were conducted by 2 study investigators. RESULTS: University values and strategic planning were among key driving forces in the development of programs. Global awareness and cultural competency requirements added impetus to program development. Participants' advice for creating an international practice experience program included an emphasis on the value of working with university health professions programs and established travel programs. CONCLUSION: Despite challenges, colleges and schools of pharmacy value the importance of international pharmacy education for pharmacy students as it increases global awareness of health needs and cultural competencies.

Fostering cultural competency, clinical reasoning, and leadership through international outreach.

ABSTRACT The Centennial Vision of the American Occupational Therapy Association (AOTA) has called for occupational therapy to be globally connected. Students can gain cultural competency, clinical reasoning, and leadership from attending didactic coursework and participating in discussions and clinical simulations. Immersing oneself in international settings, however, tends to have a greater impact on learning. The authors describe the outcomes of two international outreach programs: China Honors Immersion Program (CHIP) and Institute for Latin American Concern (ILAC). The outcomes of these programs indicate that students believe that such international experiences greatly affect their development, both professionally and personally. Implications of the program outcomes to current professional education are discussed. Future research directions are also proposed.

Occupational therapy students' attitudes towards inclusion education in Australia, United Kingdom, United States and Taiwan.

This international, cross-cultural study investigated the attitudes of occupational therapy students from Australia, United Kingdom, United States and Taiwan towards inclusive education for students with disabilities. The possible impact of professional education on students' attitudes was also explored. A total of 485 students from 11 entry-level occupational therapy education programmes from Australia, the United Kingdom, the United States and Taiwan participated in the study. Among them, 264 were freshmen (first-year students) and 221 were seniors (final-year students). Data collected from a custom-designed questionnaire were analysed both quantitatively and qualitatively. In general, the occupational therapy students reported having positive attitudes towards inclusion. Considerable differences, however, existed among the student groups from the four countries. Professional education appeared to have a significant impact on students' attitudes towards inclusion from first year to senior year. Although students were in favour of inclusion, they also cautioned that their support for inclusive practices depended on various factors such as adequate preparation, support and assistance to students with disabilities. Limitations of the study included the small, convenience sample and different degree structures of the participating programmes. Future research studies need to compare occupational therapy students' attitudes with students from other health care professions. A longitudinal study on the impact of the professional education programme on students' attitudes towards inclusive education is warranted.

Occupational therapy students' attitudes towards individuals with disabilities: a comparison between Australia, Taiwan, the United Kingdom, and the United States.

INTRODUCTION: Students who are enrolled in professional education programs such as occupational therapy may have inherent attitudes towards the future clients they work with. These attitudes may be influenced by the level of their professional education as well as cultural values of their country of origin. PURPOSE: The purpose of the study was to examine occupational therapy students' attitudes towards individuals with disabilities from an international, cross-cultural perspective and to investigate the possible impact of professional education on students' attitudes. METHOD: 485 occupational therapy students from 11 university programs (3 from Australia, 3 from the United Kingdom, 3 from the United States, and 2 from Taiwan) completed the Interactions with Disabled Person's (IDP) scale. RESULTS: Significant differences were found between occupational therapy students from Australia, Taiwan, the United States, and the United Kingdom on the following IDP variables: overall attitude towards individuals with disabilities, 'discomfort', 'sympathy', 'uncertainty', 'coping', 'fear', and 'vulnerability'. Significant differences between first year students as a total group and final year students as a total group were found on their overall attitudes towards individuals with disabilities, 'discomfort', and 'uncertainty'. CONCLUSION/IMPLICATIONS: The attitudes towards individuals with disabilities among first year and final year occupational therapy students varies between countries and the students' year level also impacts on their attitudes towards individuals with a disability.

Physical therapists' perspectives on practice errors in geriatric, neurologic, or orthopedic clinical settings.

While practice errors have been studied extensively in medicine and pharmacy, little research exists in physical therapy. The purpose of this study was to explore the phenomenon of physical therapy practice errors in geriatric, adult neurologic, and orthopedic clinical settings. Thirty physical therapists with three or more years of practice experience participated in the study, representing four geographically distinct regions of the United States. Four focus groups were conducted via guided discussion questions in four different states. Collected data were transcribed and analyzed by using constant comparative method. Data analysis yielded five major themes including: 1) taxonomy of error, 2) aversive outcomes, 3) individual and systematic causes, 4) post hoc actions, and 5) prevention of future errors. Because human errors are inevitable in physical therapy practice, understanding of causes and prevention strategies is necessary to minimize harm to patients. In addition, physical therapists must recognize their role and responsibility in creating a culture of error analysis and error prevention.

Impact of an interprofessional community-based educational experience on students' perceptions of other health professions and older adults.

Caring for older adults has become increasingly complex due to multiple health and societal factors. The purpose of this study was to evaluate the impact of an interprofessional community-based educational project on students' attitudes toward other health care professions and older adults. A pretest and posttest quasi-experimental research design was implemented with 64 participating students from four health care professions (nursing, occupational therapy, physical therapy, and pharmacy). These students completed the Interdisciplinary Education Perception Scale (IEPS) and Survey of Attitudes on Aging Scale (SAAS) before and following an educational experience with older adults. Qualitative data were collected through student reflection journals and focus groups with participating students. The results of the study showed that interprofessional community-based learning had a significant impact on some students' attitudes toward older adults. The difference between pretest and posttest reached a statistically significant level on the SAAS in occupational therapy (p = 0.013) and physical therapy students (p = 0.044). No significant differences, however, were found between the pretest and posttest in pharmacy (p = 0.097) or nursing students (p = 0.144). Similarly, the experience also had a positive impact on some students' perceptions of other health care professions as measured by the IEPS. A significant difference was found between the pretest and posttest in occupational therapy (p = 0.000) and physical therapy students (p = 0.028). This study indicates that interprofessional community-based learning can be an effective method for some students to increase their understanding and respect toward other health professionals and older adults.

Preventing practice errors and improving patient safety: an examination of case studies reflecting common errors in occupational therapy practice.

Like other health care professionals, occupational therapists make errors in clinical practice. Only recently have we systematically studied errors in occupational therapy practice. In this report, key findings from two grant projects in occupational therapy practice errors are further examined. Specifically, this report includes an in-depth analysis of five examples of occupational therapy practice errors in physical rehabilitation and geriatric settings. These examples from the five most commonly reported causes of errors found in a national survey study on occupational therapy errors are misjudgment, lack of preparation, lack of experience, lack of knowledge, and insufficient communication. For each of the five examples, hypothesized causes of errors and their implications for professional education training and current occupational therapy practice are explored. It is hoped that this report helps to better inform practice and educational approaches to contribute to the prevention and reduction of occupational therapy and other health care practice errors.

Development of the Sensory Processing Measure-School: initial studies of reliability and validity.

OBJECTIVE: The history and development of the Sensory Processing Measure-School are detailed, and findings of initial pilot studies are reported. METHOD: Multiple reviews, focus groups, case studies, and two pilot studies were used to develop the early versions of the tool. Internal consistency and discriminatory ability were examined. RESULTS: Internal consistency measured with Cronbach's alphas ranged from .93 to .99 in the first pilot study and .70 to .99 in the second pilot study. Children who were typically developing were correctly classified 92.3% of the time, and children with sensory issues were correctly classified 72% of the time. CONCLUSION: Initial results suggest that the tool is reliable and valid and discriminates children with and without sensory processing issues. Further research is under way with larger samples.

Brains Rule!: a model program for developing professional stewardship among neuroscientists.

Brains Rule! Neuroscience Expositions, funded through a National Institute on Drug Abuse Science Education Drug Abuse Partnership Award, has developed a successful model for informal neuroscience education. Each Exposition is a "reverse science fair" in which neuroscientists present short neuroscience teaching modules to students. This study focuses on results of assessments conducted with neuroscientist presenters during Expositions at two sites, Atlanta, Georgia and Corpus Christi, Texas. The effects of participating in the Expositions on presenters' perceptions of their own presentation and communication skills were evaluated, as was the potential for increased active participation by neuroscientists in future outreach programs. In four of the five Expositions studied, pre- versus post-event surveys demonstrated significant changes in presenters' perceptions of their own abilities to explain neuroscience concepts to children. Over the course of an Exposition, presenters learned to fit their approaches to conveying neuroscience concepts to fifth through eighth graders and learned to link information they presented about the brain and nervous system to children's past experiences to improve comprehension. The present data suggest that Brains Rule! Neuroscience Expositions are effective in improving communication and teaching skills among neuroscience professionals and contribute to professional stewardship by increasing motivation to participate in future informal education programs.

Occupational therapy practice errors in physical rehabilitation and geriatrics settings: a national survey study.

OBJECTIVES: The purpose of this survey study was to investigate occupational therapy practice errors in physical rehabilitation and geriatric practice settings. METHOD: Two hundred and forty-five (245) out of 994 surveyed occupational therapists who have practiced or currently practice in physical rehabilitation or geriatrics settings responded to a self-developed questionnaire. Descriptive statistical analysis was used to describe practice errors as to the types, causes, impact on, and responses of occupational therapists and work sites. Inferential statistical analysis was used to explore the relationships among different variables of interest including: the effect of the number of years of practice experience on the perceived impact of making errors on practice; the relationship between disclosure or nondisclosure of errors; and the types of coping strategies used by occupational therapists and work site administrators' responses to errors. RESULTS: The vast majority of practice errors occurred during the intervention phase of the occupational therapy process. Misjudgment, lack of preparation, and lack of experience were reported as the top three causes of practice errors. Various coping strategies-such as compensating for the errors by voluntarily devoting additional time for care of the patient, making and following a corrective plan, concentrating on the next step, or not letting errors interfere with daily work-were used by the occupational therapists when errors occurred. The types of coping strategies and work site responses appeared to be associated with the disclosure or nondisclosure of errors. CONCLUSION: Errors occur in occupational therapy practice. Making errors has considerable impact on occupational therapists as well as their future practice. However, disclosure of errors can often lead to positive outcomes.

Teacher education professionals as partners in health science outreach.

Medical school and other health science outreach programs to educate and recruit precollege students always have relied on successful collaborative efforts. Creighton University shares the value, significance, and strategies of involving teacher education professionals in several of its current outreach programs, including HPPI, Brains Rule! Neuroscience Expositions, and HHMI Build a Human Project. The education department partner serves as an essential team member in the development, implementation, assessment, and dissemination of these projects to promote science and mathematics achievement and interest in medical careers. Specific examples and mistakes to avoid are included.

Facilitating participation of students with severe disabilities: aligning school based occupational therapy practice with best practices in severe disabilities.

School-based occupational therapy is the largest employer of occupational therapists. School-based occupational therapists work extensively with students with severe disabilities. Over the past decade, one significant change in the field of severe disabilities has been the advocacy of best practices. This paper discusses the implications of best practices for school-based occupational therapy practice and examines strategies that occupational therapists use to tackle such challenges. Focuses of the discussions are centered on the issues relative to curriculum, educational setting and instructional strategies. The theme of Activity and Participation proposed in International Classification of Functioning (WHO, 2001) guides our discussions. Specific strategies in aligning school-based occupational therapy practice with best practices in severe disabilities are proposed and highlighted.