Exploring 10 years of dissemination of the F-words for Child Development: A multifaceted case study.

BACKGROUND: There is growing interest in exploring how to move research findings into practice. Since 2014, a team of families and researchers has been working to promote and study the dissemination of the "F-words for Child Development" (Function, Family, Fitness, Fun, Friends, and Future). This case study describes our dissemination strategies and uses the Diffusion of Innovation theory to understand the factors contributing to the uptake of the F-words-a function-promoting, strengths-based, and family-centred innovation in child health and development. METHODS: Between November 2011 and November 2021, we collected data from multiple sources: our dissemination strategies, including affiliated documents/artefacts (e.g., videos and presentations) and evaluation data (e.g., surveys and Google/video analytics). We used a two-step analysis: (1) a chronological time series to describe the processes involved along with indicators of dissemination over time (e.g., increase knowledge and awareness); and (2) Diffusion of Innovation theory to explore the factors that contributed to the uptake of the F-words. RESULTS: Multifaceted dissemination strategies were essential to raise awareness and increase families' and service providers' knowledge of the F-words. These included three primary strategies: (i) development and distribution of educational materials; (ii) presentations at educational meetings; and (iii) educational outreach visits. Additional strategies, such as the use of mass media, collaboration with early adopters/champions, and the involvement of family members further supported dissemination efforts. Diffusion of Innovation factors (innovation characteristics, time, social systems, and communication channels) all contributed to the uptake of this innovation. CONCLUSIONS: Purposeful planned dissemination practice, to increase knowledge and awareness of an innovation, is an important step in the knowledge translation process. Over a period of 10 years, through the use of multiple dissemination strategies conducted in partnership with families and service providers, the F-words have spread globally. Diffusion of Innovation theory has served to help understand how and why the F-words are being shared and adopted around the world.

The Hidden Curriculum: A Good Thing?

Introduction The hidden curriculum is defined as a set of influences that function at the level of the organizational structure and culture to impact learning. Literature supports the significant impact of the hidden curriculum on all levels of learners in medical education. Our project aims to capture the messages being delivered to healthcare providers at our local facility. Methods Multiple one-time educational sessions on the hidden curriculum were provided over a five-year period to healthcare professionals. Participants were asked to share personal examples of their lived experiences with the hidden curriculum. A thematic analysis of the responses was completed and coded by two independent reviewers.  Results Participants consisted of medical students, residents, faculty physicians, and allied health professionals. Their experience of the hidden curriculum emerged in six main themes: Vulnerability, Hierarchy, Privilege, Navigation & Negotiation, Positivity, and Dehumanizing. Conclusion A minority of responses demonstrated the positive impact that the hidden curriculum can have on professional development. This project highlights the importance of formally addressing the hidden curriculum to capitalize on its impact on medical trainees. The results have inspired a project focusing on residents as the population of interest in their unique role as learners and preceptors.

Internationally educated occupational therapists transitioning to practice in Canada: A qualitative study.

BACKGROUND/AIM: While internationally educated occupational therapists (IEOTs) may assist Western countries in addressing workforce shortages, their transition to practice can be difficult. Provincial and national levels of government in Canada have funded initiatives to address the barriers experienced by IEOTs. The purpose of this study is to identify the key forces shaping the experiences of IEOTs transitioning to practice in Canada. METHODS: An interpretive description approach was taken to interview 11 IEOTs who graduated from the Occupational Therapy Examination and Practice Preparation (OTepp) program. Data analysis was guided by the theoretical scaffolding of the occupational therapy profession. Two team members, who are also occupational therapists, developed codes and categories independently and then through discussion reached a higher level of interpretation. RESULTS: The experiences of IEOTs in Canada were shaped by two key forces: Realising that more than exam preparation is required and the impact of previous person, environment and occupation transactions. Participants underestimated their learning needs related to their transition to Canadian practice. As they engaged in the OTepp program, they realised that their learning extended beyond that required for the national certification exam. Also, the extent to which the participant (person), previous context (environment) and previous practice (occupation) were similar to Canadian therapists, influenced IEOTs' performance in OTepp and their overall transition to practice. The Person-Environment-Occupation (PEO) model provided a framework to contextualise this theme. CONCLUSION: IEOTs will benefit from individualised learning needs assessments and education plans to address their specific needs. At an international level, the occupational therapy profession must engage in dialogue about the differences between education programs and the resulting implications for the profession. More research is also needed to understand the experiences of IEOTs who withdraw from or do not engage in formal supports.

A Web-Based Knowledge Translation Resource for Families and Service Providers (The "F-Words" in Childhood Disability Knowledge Hub): Developmental and Pilot Evaluation Study.

BACKGROUND: The "F-words in Childhood Disability" (Function, Family, Fitness, Fun, Friends, and Future) are an adaptation and an attempt to operationalize the World Health Organization's (2001) International Classification of Functioning, Disability and Health (ICF) framework. Since the paper was published (November 2011), the "F-words" have attracted global attention (>12,000 downloads, January 2018). Internationally, people have adopted the "F-words" ideas, and many families and service providers have expressed a need for more information, tools, and resources on the "F-words". OBJECTIVE: This paper reports on the development and pilot evaluation of a Web-based knowledge translation (KT) resource, the "F-words" Knowledge Hub that was created to inform people about the "F-words" and to provide action-oriented tools to support the use of the "F-words" in practice. METHODS: An integrated research team of families and researchers at CanChild Centre for Childhood Disability Research collaborated to develop, implement, and evaluate the Knowledge Hub. A pilot study design was chosen to assess the usability and utility of the Web-based hub before implementing a larger evaluation study. Data were collected using a brief anonymous Web-based survey that included both closed-ended and open-ended questions, with the closed-ended responses being based on a five-point Likert-type scale. We used descriptive statistics and a summary of key themes to report findings. RESULTS: From August to November 2017, the Knowledge Hub received >6,800 unique visitors. In 1 month (November 2017), 87 people completed the survey, of whom 63 completed the full survey and 24 completed 1 or 2 sections. The respondents included 42 clinicians and 30 family members or individuals with a disability. The majority of people visited the Knowledge Hub 1-5 times (n=63) and spent up to 45 minutes exploring (n=61) before providing feedback. Overall, 66 people provided information on the perceived usefulness of the Knowledge Hub, of which 92% (61/66) found the Knowledge Hub user-friendly and stated that they enjoyed exploring the hub, and a majority (n=52) reported that the Knowledge Hub would influence what they did when working with others. From the open-ended responses (n=48), the "F-words" videos (n=21) and the "F-words" tools (n=15) were rated as the best features on the Knowledge Hub. CONCLUSIONS: The "F-words" Knowledge Hub is an evidence-informed Web-based KT resource that was useful for respondents, most of whom were seen as "early adopters" of the "F-words" concepts. Based on the findings, minor changes are to be made to improve the Knowledge Hub before completing a larger evaluation study on the impact at the family, clinician, and organizational levels with a wider group of users. Our hope is that the "F-words" Knowledge Hub will become a go-to resource for knowledge sharing and exchange for families and service providers.

Linking occupational therapy models and assessments to the ICF to enable standardized documentation of functioning.

BACKGROUND.: The International Classification of Functioning, Disability and Health (ICF) can serve as reference for standardized documentation of health in clinical practice. PURPOSE.: This study aims to bridge the gap between the ICF and occupational therapy specific concepts, represented by occupational therapy models and their derived assessments. METHOD.: Occupational therapy assessments in relation to their models were systematically linked to the ICF, and a compatibility analysis was conducted. To strengthen reliability of the linkings, feedback from the respective assessment hosts was obtained. FINDINGS.: Linking tables were developed for the Assessment of Motor and Process Skills, the Canadian Occupational Performance Measure, and the Model of Human Occupation Screening Tool. Similarities and differences between the ICF and the three assessments and their associated models show how they differ from and complement each other. IMPLICATIONS.: The findings of this study lay the foundation for standardized documentation in occupational therapy and enhance the practicability of the ICF.

Using the ICF in transition research and practice? Lessons from a scoping review.

BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) and subsequent ICF-CY (child and youth version) recognize the importance of personal and environmental factors in facilitating holistic transition planning and service delivery for youth with chronic health conditions (YCHC). AIMS: The objective of this scoping review is to investigate the degree to which the ICF and ICF-CY have been used in transition research and practice since its initial publication. METHODS: Arksey and O'Malley's five-stage methodological framework guided the scoping review using the following databases: AMED, CINAHL, EMBASE, HealthSTAR, MEDLINE, and PsycINFO. Keywords included: 'ICF', 'ICF-CY', and 'transition', which were adapted to each database. RESULTS: 25 articles met final inclusion. Two key themes emerged regarding use of the ICF: 1) the ICF enhances transdisciplinary processes to inform transition planning and interventions; and 2) the ICF facilitates comprehensive and developmentally appropriate transition services over a youth's lifecourse. The strengths and limitations of the ICF in guiding the planning and delivery of transition services are discussed. Some limitations include the large number of items inherent within the ICF and a lack of clarity between the components of activity and participation. CONCLUSION: Key recommendations include: i) further explanation and development of items for quality of life and well-being, personal factors, and psychological issues; and ii) additional research to advance knowledge towards developing empirically- based evidence for the application of the ICF in clinical practice to facilitate transition.

International Occupational Therapy Research Priorities.

Occupational therapy is a global profession represented by the World Federation of Occupational Therapists (WFOT). International research priorities are needed for strategic guidance on global occupational therapy practice. The objective of this study was to develop international research priorities to reflect global occupational therapy practice. A Delphi study using three rounds of electronic surveys, distributed to WFOT member organizations and WFOT accredited universities, was conducted. Data were analyzed after each round, and priorities were presented for rating and ranking in order of importance. Forty-six (53%) out of 87 WFOT member countries participated in the Delphi process. Eight research priorities were confirmed by the final electronic survey round. Differences were observed in rankings given by member organizations and university respondents. Despite attrition at Round 3, the final research priorities will help to focus research efforts in occupational therapy globally. Follow-up research is needed to determine how the research priorities are being adopted internationally.

Social participation experiences of mothers of children with cerebral palsy in an Iranian context.

BACKGROUND/AIM: Social participation is increasingly of interest in research that investigates the impact of caring for a child with a disability. Little has been investigated about the social participation experiences of mothers of children with cerebral palsy (CP). This study explored social participation among Iranian mothers of children with CP. METHODS: The conventional qualitative content analysis method was utilised. Data were collected via in-depth semi-structured interviews with 14 mothers (aged 26-45 years) of children with CP with the gross motor function classification system expanded & revised levels III-V. Constant comparative analysis was deployed for data analysis. RESULTS: The results were identified and classified into three main themes: (i) polarisation of positive and negative feelings; (ii) challenges to mothers' social activity; and (iii) striving to engage in society. CONCLUSION: In the Iranian context, mothers of children with CP are facing many challenges to social participation and seem to have been neglected by the health-care system. One of the priorities of Iranian health policy makers may be developing, establishing and implementing social support to enable the mothers to participate in social activities. Furthermore, occupational therapists can contribute and guide mothers' social participation by creating programs to develop and utilise skills for them.

Innovative practice: exploring acculturation theory to advance rehabilitation from pediatric to adult "cultures" of care.

INTRODUCTION: This perspective paper explores the application of acculturation and the inherent concepts and ideas associated with this theory in rehabilitation to provide a framework for interpreting patient circumstances, responses and behaviours as they move from one culture to the next. Traditionally acculturation theory has been use to examine changes in culture in an ethnic or country sense, however, this paper is among the first to apply acculturation theory to the rehabilitation service cultures from pediatric to adult care for youth with chronic health conditions. PURPOSE: The objectives of this paper are threefold: (1) to critically appraise key literature in the development of acculturation theory, (2) to discuss how acculturation theory can be applied in rehabilitation practice through a clinical vignette, and finally (3) to discuss how acculturation theory can advance rehabilitation by enhancing client-centered practice. IMPLICATIONS FOR REHABILITATION: Acculturation theory can provide insight into how patients are experiencing a change in health care "cultures", in the context of their overarching life circumstances. This, coming from a broader societal perspective can in turn inform an optimal approach to client-centered practice, and the application of rehabilitation-specific team inputs. This theoretical framework can heighten practitioners' awareness of patients' unique worldviews related to their expectations for care and treatment thus reducing fear of diversity to establish positive partnerships between patients and clinicians. CONCLUSIONS: An understanding of patients' acculturation processes will add new insight into how we can best deliver services and supports to optimise health, opportunities and experiences for youth with chronic conditions.

A new comprehension and communication tool: a valuable resource for internationally educated occupational therapists.

BACKGROUND/AIM: The need was identified for a way to assess internationally educated occupational therapists' skills in understanding and communicating professional terminology used in occupational therapy practice. The project aim was to develop and validate such a resource. METHODS: A scenario-based assessment was developed using a three-phase process for tool development. The development process involved completion of a literature scan of professional terminology used in occupational therapy practice; selection of terms and concepts commonly used in occupational therapy practice; and, creation of practice-based scenarios illustrating key concepts complete with rating rubrics. An advisory group provided oversight, and a sample of internationally educated occupational therapists completed pilot and validity testing. RESULTS: The initial findings showed the assessment to be easy to complete and sensitive to testing understanding of the defined terms. CONCLUSIONS: The final outcome is an assessment tool that has broad application for occupational therapists wishing to enter professional practice in a new country.

Students' perceptions of interprofessional learning through facilitated online learning modules.

BACKGROUND: Asynchronous e-learning is an appealing option for interprofessional education (IPE) as it addresses the geographic and timetabling barriers often encountered when organizing activities across educational programs. AIM: This study examined the extent to which pre-licensure students were able to learn with, from, and about each other through completion of innovative online IPE learning modules. METHODS: Seventy-seven students completed e-learning modules developed through a consortium of educational institutions. Evaluation was primarily qualitative through focus groups, interviews, analyses on off-line discussions and an online feedback form. RESULTS: Qualitative analyses of the discussion fora revealed that students were able to solve problems collaboratively, clarify their professional roles, and provide information from their professional perspective. Focus groups and interviews reinforced that students recognized the importance of working together and implicate clinical education as an important venue to reinforce learning about collaborative practice. Analyses of the online feedback form suggest the need for clear processes related to group assignments and deadlines. CONCLUSION: Students learned about each other's role, solved problems together and had positive perceptions of the online modules as a venue for interprofessional learning. Results are encouraging to those interested in using e-learning in IPE as part of an overall curriculum.

Online interprofessional health sciences education: From theory to practice.

Online learning (e-learning) has a nascent but established history. Its application to interprofessional education (IPE), however, is relatively new. Over the past 2 decades the Internet has been used increasingly to mediate education. We have come past the point of "should we use the Internet for education" to "how should we use the Internet for education." Research has begun on the optimal development of online learning environments to support IPE. Developing online IPE should follow best practices in e-learning generally, though there are some special considerations for acknowledging the interprofessional context and clinical environments that online IPE is designed to support. The design, development, and deployment of effective online IPE must therefore pay special attention to the particular constraints of the health care worker educational matrix, both pre- and postlicensure. In this article we outline the design of online, interprofessional health sciences education. Our work has involved 4 educational and 4 clinical service institutions. We establish the context in which we situate our development activities that created learning modules designed to support IPE and its transfer into new interprofessional health care practices. We illustrate some best practices for the design of effective online IPE, and show how this design can create effective learning for IPE. Challenges exist regarding the full implementation of interprofessional clinical practice that are beginning to be met by coordinated efforts of multiple health care education silos.

Recovery after hip fracture: what can we learn from the Canadian Occupational Performance Measure?

This study sought to determine the extent to which the Canadian Occupational Performance Measure (COPM) assessed performance in elderly people after hip fracture. Correlations were found between the COPM and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Although functional improvement was noted, participants did not attain the functional status they had before hip fracture. The greatest recovery occurred within the first 130 days after surgery. These findings suggest some central implications for occupational therapy practice, although further research is required to determine the optimal time for intervention to begin. Because the COPM is sensitive to change in function in patients recovering from hip fracture, COPM use with this population is desirable and advisable.

Targeted applications of the Canadian Occupational Performance Measure.

BACKGROUND: The Canadian Occupational Performance Measure (COPM) is an outcome measure designed to assess performance and satisfaction with occupation. It was developed to coincide with the occupation-focused, client-centred Canadian Model of Occupational Performance. PURPOSE: The COPM has been a feature of the occupational therapy landscape for approximately 15 years and has pervaded the consciousness of occupational therapists around the world. In this paper, we examine issues associated with application of the COPM in targeted clinical and non-clinical situations. RESULTS: The paper suggests considerations required to ensure that the highest quality of information is derived from the COPM in all situations. PRACTICE IMPLICATIONS: Although the paper emphasizes the centrality of the client-centred approach, it also demonstrates the flexibility and adaptability of the COPM to different situations, clients, settings and purposes.

The Canadian Occupational Performance Measure: a research and clinical literature review.

BACKGROUND: It has been 13 years since the Canadian Occupational Performance Measure (COPM) was published. In that time there has been a remarkable growth in its acceptance as an outcome measure within the occupational therapy practice and research. PURPOSE: The purpose of this paper is to review the emerging research and clinical literature related to the COPM since 1994 and to document its impact upon occupational therapy practice and research throughout the world. METHOD: A systematic search was conducted to the professional and research literature in English publications (primarily occupational therapy). Eighty-eight papers that met the inclusion criteria were reviewed, 86% of which examined the COPM in relation to its psychometric properties (19 papers), research outcomes (33 papers) or practice (33 papers). RESULTS: Overall, although there are a few limitations discussed in the review, the conclusion is that the COPM is a valid, reliable, clinically useful and responsive outcome measure acceptable for occupational therapist practitioners and researchers. PRACTICE IMPLICATIONS: The COPM is used with a wide variety of clients, enables client-centred practice, facilitates evidence-based practice and supports outcomes research.