Peer Assisted Study Sessions (PASS) preparing occupational therapy undergraduates for practice education: A novel application of a proven educational intervention.

BACKGROUND/AIM: With rapid growth in occupational therapy education programmes across Australia and a corresponding increase in demand for placements, there is a need to ensure that students are well prepared for practice education. An occupational therapy education programme at a Victorian university introduced a specific Peer Assisted Study Sessions (PASS) programme to develop students' preparedness for practice education, supplementing core and existing teaching activities. The aim of this study was to explore the experiences of occupational therapy students, including their perception of its impact on learning and preparation for practice education. METHODS: Using a phenomenological approach, semi-structured interviews were undertaken with 15 students who participated in PASS for Placement, 2 of whom were the student leaders. Interviews were transcribed verbatim and thematically analysed. RESULTS: Seven themes emerged from the data: a safe environment; skill development; one of us; feeling connected; student-centred and student-led; different motivations; and learning through leading. Students were positive about the impact of the programme on their confidence and readiness for practice education. Student leaders also reported that it contributed to the development of leadership skills and overall levels of confidence regarding practice education. CONCLUSIONS: This study supports the use of PASS to promote practice education preparedness, as there were positive outcomes for both students and student leaders. However, it indicates that participation in such programmes should be voluntary rather than mandatory. This study addresses a clear gap both in current practice and research, describing the application of a proven educational intervention in a new and innovative way. It is the first reporting of the use of PASS to support the preparation of students for practice education in any health discipline and subject to feasibility studies, could be adopted more broadly by disciplines beyond health, where work integrated learning is a mandatory element of the education programme.

Threshold concept acquisition in occupational therapy: A mixed methods study of students and clinicians.

BACKGROUND/AIM: Demand for occupational therapy graduates able to work in complex and diverse workplaces is increasing. The threshold concepts framework has emerged as one pathway to assist in the development of work-ready graduates. A previous Australian study identified 10 threshold concepts for occupational therapy; the aim of this study was to explore the acquisition of these. METHOD: A mixed-methods study using observational, cross sectional design and a triangulation design convergence model was undertaken. A survey using Likert scales and open response questions was developed by the authors. Seventy-three surveys were completed by 13 first and 20 final year Victorian occupational therapy students. Twenty recent graduates and 20 experienced clinicians from across Australia also participated. Seven first and 10 final year occupational therapy students, 10 recent graduates and 10 experienced clinicians also took part in in-depth interviews. Likert scales were used by participants to rate confidence that they had acquired the threshold concepts, they also answered open-response questions (via survey or interview) asking them to provide examples of how they would use threshold concepts in practice. RESULTS: Fourth year students were statistically significantly less confident than experienced clinicians for the threshold concepts Understanding the models and theories of occupational therapy and Applying clinical reasoning (P < 0.05). When whole group data were analysed, participants were most confident for Occupation and Client centred practice (P < 0.05). These results resonated with the qualitative findings which demonstrated a shift from surface to deep knowledge with increased experience. Fourth year students reported responses that suggested some threshold concepts were still in development, while experienced clinicians used a web of threshold concepts. CONCLUSION: This exploratory study provides provisional data to suggest that students appear to still be acquiring some threshold concepts at graduation and experienced clinicians make use of a web of threshold concepts in their clinical practice.

Transformation from student to occupational therapist: Using the Delphi technique to identify the threshold concepts of occupational therapy.

BACKGROUND/AIM: Understanding and facilitating the transformation from occupational therapy student to practitioner is central to the development of competent and work-ready graduates. However, the pivotal concepts and capabilities that need to be taught and learnt in occupational therapy are not necessarily explicit. The threshold concepts theory of teaching and learning proposes that every discipline has a set of transformational concepts that students must acquire in order to progress. As students acquire the threshold concepts, they develop a transformed way of understanding content related to their course of study which contributes to their developing expertise. The aim of this study was to identify the threshold concepts of occupational therapy. METHOD: The Delphi technique, a data collection method that aims to demonstrate consensus in relation to important questions, was used with three groups comprising final year occupational therapy students (n = 11), occupational therapy clinicians (n = 21) and academics teaching occupational therapy (n = 10) in Victoria, Australia. RESULTS: Participants reached consensus regarding 10 threshold concepts for the occupational therapy discipline. These are: understanding and applying the models and theories of occupational therapy; occupation; evidence-based practice; clinical reasoning; discipline specific skills and knowledge; practising in context; a client-centred approach; the occupational therapist role; reflective practice and; a holistic approach. CONCLUSION: The threshold concepts identified provide valuable information for the discipline. They can potentially inform the development of competencies for occupational therapy and provide guidance for teaching and learning activities to facilitate the transformation to competent practitioner.

Readiness for interprofessional learning: a cross-faculty comparison between architecture and occupational therapy students.

Health and wellbeing includes a need for built environments to accommodate and be inclusive of the broadest range of people and a corresponding need to ensure graduates are ready to engage in this field of interprofessional and inter-industry practise. All too often, interprofessional education in higher education is neglected with a tendency towards educational silos, particularly at a cross-faculty level. This paper reports on an initiative that embedded universal design practice education into the curricula of first year architecture and third year occupational therapy students and evaluated the impact on students' readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) was given to students at the beginning and end of the semester during which students participated in a variety of online and face-to-face curriculum initiatives. Results showed that at the beginning of semester, occupational therapy students were significantly more positive about interprofessional learning than their architecture counterparts. Post-results showed that this trend continued but that occupational therapy students became less positive on some items after the interprofessional learning experience. This study provides insights into the interprofessional learning experiences of a group of students who have not previously been studied within the available literature.

Community mobility in the context of universal design: inter-professional collaboration and education.

BACKGROUND/AIM: The design of built environments is a critical factor in facilitating participation for all community members. This study aimed to explore key stakeholders' views on the role and collaboration of occupational therapists and architects in relation to universal design and the built environment. This study is currently the only research to focus on the needs and practices of both occupational therapy and architecture in universal design. The results have implications for both clinical practice and professional education, and highlight an area of developing interest in occupational therapy. METHODS: Focus groups and semi-structured telephone interviews were conducted with key stakeholders involved in the design of built environments. Data from these interviews were analysed qualitatively, using codes of interpreted meaning which were then organised into themes. RESULTS: Three main themes emerged in relation to inter-professional collaboration around universal design: 'form vs. function', 'the earlier the better' and 'universal design as a specialist area'. DISCUSSION/CONCLUSIONS: Although there are areas of synergy between occupational therapy and architecture in universal design, each profession has its own strengths and skills to bring to the design process. Given the multidisciplinary nature of ensuring designs support participation in occupations and roles, both professions could benefit from opportunities to meaningfully collaborate during professional education and in the workplace.

Working with Policy and Regulatory Factors to Implement Universal Design in the Built Environment: The Australian Experience.

Built environments that are usable by all provide opportunities for engagement in meaningful occupations. However, enabling them in day to day design processes and practice is problematic for relevant professions. The purpose of this phenomenological study was to gain greater understanding of the policy and regulatory influences that promote or hinder the uptake of universal design in built environments, to inform better future design. Focus groups or telephone interviews were undertaken with 28 key building industry and disability stakeholders in Australia. Four themes were identified: the difficulties of definition; the push or pull of regulations and policy; the role of formal standards; and, shifting the focus of design thinking. The findings highlight the complexity of working within policy and regulatory contexts when implementing universal design. Occupational therapists working with colleagues from other professions must be aware of these influences, and develop the skills to work with them for successful practice.

Adults with cerebral palsy benefit from participating in a strength training programme at a community gymnasium.

PURPOSE: This study examined whether a community-based progressive resistance strength training programme could improve muscle strength and functional activity in a group of adults with cerebral palsy with high support needs. METHOD: Using a single group pre-post clinical design, 10 adults (7 males, 3 females; mean age 47.8 SD 5.7 years) with cerebral palsy and high support needs completed 4 weeks of introduction and familiarization, followed by a 10-week progressive resistance strength training programme in a community gymnasium. Participants were measured for muscle strength, locomotion speed and timed sit-to-stand. RESULTS: After establishment of a stable baseline from weeks 2 to 5 with no systematic change and a high degree of association (r>0.86), participants increased leg strength by 22.0% (p=0.02), arm strength by 17.2% (p=0.01) and improved performance of sit-to-stand (p=0.02) during the 10-week strength training intervention. CONCLUSIONS: This study adds to the accumulating evidence that strength training can be beneficial for people with cerebral palsy by demonstrating benefits for adults with cerebral palsy and high support needs who are subject to decline in physical function associated with the ageing process.

Strength training can be enjoyable and beneficial for adults with cerebral palsy.

PURPOSE: To explore the positive and negative perceptions of participating in a strength- training programme for adults with cerebral palsy. METHOD: Ten adults aged over 40 years with cerebral palsy participated in a group-based 10-week progressive resistance strength-training programme in a community gymnasium. After the programme, each participant was interviewed using an in-depth semi-structured format and the results coded thematically. RESULTS: Participants perceived that their strength, and ability to perform everyday activities had improved. However, the main benefit for participants was enjoyment and social interaction. The only negative perceptions related to fatigue, short-term muscle soreness and a feeling that they had not improved as much as they had expected. CONCLUSIONS: Enjoyment, a factor that can promote adherence and sustainability, was a key benefit of this strength-training programme for adults with cerebral palsy that led to perceptions of increased strength and physical functioning. These findings suggest that exercise programmes for adults with cerebral palsy should be conducted in a group in the community, thereby promoting community inclusion. In addition, it is important to provide education to participants about the normal responses and expectations of an exercise programme.