Student perspectives on factors that influence the implementation of evidence-based practice in occupational therapy.

AIM: Evidence-based practice (EBP) is perceived as an integral component of contemporary allied health practice. While allied health clinicians (such as occupational therapists) have generally positive attitudes towards EBP, research suggests that they find its implementation consistently challenging. The professional literature increasingly suggests that more effective EBP learning takes place when social constructivist approaches to learning are adopted. The authors of this study sought to use the pre-existing knowledge and perceptions of occupational therapy students to inform a curriculum review of an EBP unit. Therefore, the aim of this content analysis study was to investigate how occupational therapy students perceive and critically analyse factors that influence the implementation of EBP, specifically strengths, weaknesses, opportunities and threats (SWOT). METHODS: The study sampled students in the third year of a 4-year, Bachelor level Australian Occupational Therapy Program. The students were undertaking the first of two EBP units, and data were collected from the first assignment they submitted for these units. The assignment required the students to complete a SWOT analysis of EBP in occupational therapy, and response to a statement around whether it should be mandatory. Data were collected over 2 consecutive years from a total of 64 occupational therapy students. All data collected were subjected to content analysis, with themes identified by at least 25% of students in each cohort retained for analysis and formation into overall themes. RESULTS: Participating occupational therapy students identified five strengths, four weaknesses, six threats but only one opportunity for EBP. Three key themes were identified within the data: first, the role and purpose of EBP; second, the resources it requires and third, factors that influence its success. The students perceived the main purpose of EBP as supporting positive practice change, and highlighted its roles in building clinician capacity and professional credibility. They also characterized EBP as a separate and specialist practice that requires specific training and resourcing to achieve, and questioned its feasibility as an integrated part of daily practice. Along with previously identified challenges around time and resourcing, the students also highlighted negative attitudes and beliefs from senior colleagues as an important negative influence on the success of EBP. CONCLUSION: The current study consolidates a growing body of international literature about the value of social constructive approaches to EBP in undergraduate education. Vertical constructive alignment that embeds EBP through undergraduate education, rather than the provision of 'EBP'-specific units, should now be considered best practice. However, this embedded approach requires the explicit and repeated communication of the presence of EBP in all learning opportunities, to enable students to recognize opportunities to deploy their existing knowledge and skills.

Integrating family work into the treatment of young people with severe and complex depression: a developmentally focused model.

AIM: Although models of family intervention are clearly articulated in the child and early adolescent literature, there is less clarity regarding family intervention approaches in later adolescence and emerging adulthood. METHODS: This study provides the rationale and intervention framework for a developmentally sensitive model of time-limited family work in the outpatient treatment of complex youth depression (15-25 years). RESULTS: Derived from current practice in the Youth Mood Clinic (YMC) at Orygen Youth Health, Melbourne, a stepped model of family intervention is discussed. YMC aims to provide comprehensive orientation, assessment and education to all families. For some, a family-based intervention, delivered either by the treating team or through the integration of a specialist family worker, offers an important adjunct in supporting the recovery of the young person. Developmental phases and challenges experienced by the young person with respect to family/caregiver involvement are discussed in the context of two case studies. CONCLUSIONS: A developmentally sensitive model is presented with particular attention to the developmental needs and preferences of young people. Formal evaluation of this model is required. Evaluation perspectives should include young people, caregivers, the broader family system (i.e. siblings) and the treating team (i.e. case manager, doctor and family worker) incorporating outcome measurement. Such work determines how best to apply a time-limited family-based intervention approach in strengthening family/caregiver relationships as part of the young person's recovery from severe and complex depression.

Use of touchscreen tablet technology by people with dementia in homes: A scoping review.

BACKGROUND: The aim of this scoping review was to identify the range, extent and nature of research around the use of touchscreen tablets by people with dementia in their home environment, particularly in regards to its use as a means of supporting participation in meaningful and socially connected activity. METHODS: A review of both peer-reviewed and grey literature was undertaken across 61 databases, along with reference list checking for articles published between 2010 and 2016. RESULTS: Twelve articles were included in this review, predominantly from Western European cultures and community-based home environments. The studies were exploratory in nature, with the majority focusing on the development of applications for people with dementia. CONCLUSIONS: The study identified a range of exploratory research related to the use of touchscreen tablets by people with dementia. However, there were significant gaps within this evidence base, which provide opportunities for further research using more robust methodologies. Given the ubiquitous nature of touchscreen tablets in modern communities, further research could facilitate their use as a minimally stigmatizing and culturally appropriate form of support for people with dementia.