Impact of physical therapy and occupational therapy student placements on supervisor productivity: a scoping review.

INTRODUCTION: Clinical educators may perceive that student supervision is time consuming and reduces productivity. This perception is in contrast to research conducted in the 1990's that found students do not negatively impact productivity. There is a need to review the current literature on this topic as a result of health care cost-containment measures that emphasize efficiency. The purpose of this scoping review was to map and examine the impact of physical and occupational therapy student placements on productivity in the clinical environment. METHODS: PRISMA Scoping review methodology was used to identify relevant papers. A search was completed in MEDLINE, CHINAL, ERIC and Business Source Premier. Included studies measured clinician productivity while supervising a physical or occupational therapy student. Two reviewers independently reviewed studies according to pre-determined eligibility criteria. RESULTS AND DISCUSSION: Fourteen studies met the inclusion criteria and were included in the review. Overall, the studies suggest that the supervision of students does not have a negative impact on productivity. However, the productivity measures varied in the type and methods which limits comparisons. This variability, along with the experience of stress by clinical educators as they attempt to satisfy multiple roles may account for the discrepancy between the perception and actual measure of productivity. CONCLUSIONS: This scoping review found some evidence that students do not negatively impact productivity. This contrasts with the perception held by the supervising physical and occupational therapists. Further research is recommended to explore this discrepancy and determine optimal productivity measures matched to the characteristics of the environment.

INTRODUCTION: Les cliniciens éducateurs peuvent avoir l'impression que la supervision des étudiants prend du temps et réduit la productivité. Cette perception diffère de celle d'une recherche menée dans les années 1990 qui concluait que les étudiants ne modifiaient pas négativement la productivité. Il faut revoir la littérature actuelle sur ce sujet en raison des mesures de compression budgetaire dans les soins de santé qui mettent l'accent sur l'efficacité. L'objectif de cet revue exploratoire était de cartographier et d'examiner l'impact des stages en physiothérapie et en ergothérapie sur la productivité dans un milieu clinique. MÉTHODES: La méthodologie de revue exploratoire selon Tricco et coll.1 a été utilisée pour identifier les articles pertinents. Une recherche a été réalisée dans MEDLINE, CHINAL, ERIC et Business Source Premier. Les études incluses ont mesuré la productivité des cliniciens lors de la supervision d'un étudiant en physiothérapie ou en ergothérapie. Deux examinateurs ont examiné indépendamment les études selon des critères d'éligibilité préétablis. RÉSULTATS ET DISCUSSION: Quatorze études ont satisfait les critères d'inclusion et ont été incluses dans la revue. Dans l'ensemble, les études suggèrent que la supervision des étudiants n'a pas eu de répercussions négatives sur la productivité. Toutefois, les mesures de productivité avaient des types et des méthodes variables, ce qui limite les comparaisons. Cette variabilité, ainsi que l'expérience de stress que vivaient les cliniciens éducateurs qui tentent de satisfaire de multiples rôles pourrait expliquer la différence entre la perception et la mesure réelle de la productivité. CONCLUSIONS: Cet revue exploratoire conclut que les étudiants ne réduisent pas la productivité. Ceci diffère de la perception actuelle des physiothérapeutes et des ergothérapeutes qui supervisent ces étudiants. D'autres recherches sont recommandées pour explorer cette différence et déterminer les mesures de productivité optimales qui correspondent aux caractéristiques de l'environnement.

Doing what's right: A grounded theory of ethical decision-making in occupational therapy.

Background: Ethical decision-making is an important aspect of reasoning in occupational therapy practice. However, the process of ethical decision-making within the broader context of reasoning is yet to be clearly explicated.Objective: The purpose of this study was to advance a theoretical understanding of the process by which occupational therapists make ethical decisions in day-to-day practice.Method: A constructivist grounded theory approach was adopted, incorporating in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings and years of experience. Initially, participants nominated as key informants who were able to reflect on their decision-making processes were recruited. Theoretical sampling informed subsequent stages of data collection. Participants were asked to describe their process of ethical decision-making using scenarios from clinical practice. Interview transcripts were analyzed using a systematic process of initial then focused coding, and theoretical categorization to construct a theory regarding the process of ethical decision-making.Findings: An ethical decision-making prism was developed to capture three main processes: Considering the Fundamental Checklist, Consulting Others, and Doing What's Right. Ethical decision-making appeared to be an inductive and dialectical process with the occupational therapist at its core.Conclusion: Study findings advance our understanding of ethical decision-making in day-to-day clinical practice.

Continuing competency in ethical decision making: An interpretive description of occupational therapists' perspectives.

BACKGROUND.: Competency in ethical decision making is a criterion for ethical practice, and it is expected to advance with ongoing professional development. However, research exploring continuing competency needs of occupational therapists regarding ethical decision making is limited. PURPOSE.: The purpose of this study was to explore potential gaps and directions for development related to continuing competency in ethical decision making from the perspective of practicing occupational therapists. METHOD.: Interpretive description informed secondary data analysis of professional narratives from a grounded theory study regarding ethical decision making. In-depth interviews were conducted with a purposive sample of 18 occupational therapists. Data analyses focused on identifying gaps and future directions regarding continuing competency. FINDINGS.: Two main themes regarding gaps were identified: "I didn't have the knowledge" and "I don't have anybody." Education, tool development, and ethics mentorship were identified directions for development. IMPLICATIONS.: Findings advance understanding of continuing competency needs of occupational therapists regarding ethical decision making.

On-line ethics education for occupational therapy clinician-educators: a single-group pre-/post-test study.

Purpose: Ethics education is a critical component of training rehabilitation practitioners. There is a need for capacity-building among ethics educators regarding facilitating ethical decision-making among students. The purpose of this study was to evaluate the utility of an on-line ethics education module for occupational therapy clinician-educators (problem-based learning tutors/clinical placement preceptors/evidence-based practice facilitators).Method: The Knowledge-to-Action Process informed development and evaluation of the module. Clinician-educators (n = 33) viewed the module and reported on its impact on knowledge and facilitation practices via pre, post, and follow-up questionnaires.Results: Pre- and post-test data indicated improvement in self-reported ethics knowledge (t = 8.275, p < 0.01). Follow-up data indicated knowledge did not decrease over time (t = -1.483, p = 0.075). There was improvement in self-reported intent to change practice (t = 4.93, p < 0.01); however, actual practice change was not indicated (t = -1.499, p = 0.072).Conclusion: This study provides preliminary data regarding an on-line ethics education module for clinician-educators. Future recommendations include broader consideration of context, adding supplemental knowledge translation components, and further research exploring outcomes with larger samples, longer follow-up and randomized trial methodology.Implications for RehabilitationThe on-line ethics module has potential to improve rehabilitation practice by addressing the noted gap in knowledge among clinician-educators.Viewing an on-line module regarding approaches to ethics education may not be sufficient to change clinician-educators' teaching practices.More time and opportunities to discuss ethics with student occupational therapists may be required to effect practice change among clinician-educators.Developing ethics education tools for clinician-educators requires ongoing and iterative input from knowledge users to optimize translation of ideas to practice.

Staff perceptions of collaboration on a new interprofessional unit using the Assessment of Interprofessional Team Collaboration Scale (AITCS).

The aim of this study was to obtain baseline information on staff attitudes and perceptions of interprofessional collaboration on a newly formed interprofessional education unit. The Assessment of Interprofessional Team Collaboration Scale (AITCS) was administered to 54 interprofessional team members on a 30-bed medical interprofessional education (IPE) unit. We found that the team members respected each other but felt they needed more organisational support to further develop team skills. Additionally, team members noted that they did not have enough time for team reflection or to make changes to the team processes. The results obtained from this study will help to develop and refine educational strategies to assist the staff working on the IPE unit.

Forensic Occupational Therapy in Canada: The Current State of Practice.

Although occupational therapists have been practicing in forensic settings for many years, there is a paucity of literature regarding the nature of this practice in Canada. The purpose of this study was to describe the practices of Canadian occupational therapists in forensic mental health. An online survey was designed based on the Canadian Practice Process Framework. Following purposive and snowball sampling, responses were analysed with descriptive statistics and content analysis. Twenty-seven clinicians responded (56% response rate). Respondents indicated commonalities in workplaces, client caseloads and practice challenges. The outstanding need in Canada to demonstrate client outcomes through the use of evaluation instruments reflects those practice gaps identified internationally. Education, advocacy and research are critical areas for the development of Canadian forensic occupational therapy. Although findings heavily reflect one provincial context and may not be generalizable to nonhospital settings, a number of priority areas were identified. Future efforts should clarify the role of forensic occupational therapy to stakeholders, and validate their contributions through research that evaluates intervention efficacy and meaningful outcomes. Copyright © 2016 John Wiley & Sons, Ltd.

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.

Intraprofessional fieldwork education: occupational therapy and occupational therapist assistant students learning together.

BACKGROUND: In the past 10 years, the use of support personnel in Canada has generated significant interest from occupational therapists, professional associations, regulatory bodies, employers, educational institutions, and government agencies. PURPOSE: The purpose of this study was to explore the impact of a combined collaborative fieldwork placement and weekly tutorial as a teaching strategy for intraprofessional education. METHODS: Seven pairs of student occupational therapists and occupational therapist assistants were assigned to fieldwork placements. Tutorials were scheduled during the placements to discuss intraprofessional issues and provision of occupational therapy services in the clinical setting. Journaling and focus groups were used to collect data from students, tutors, and preceptors. FINDINGS: Three key themes emerged from the data: (1) developing the relationship, (2) understanding roles, and (3) recognizing environmental influences on learning. IMPLICATIONS: Intraprofessional learning experiences prior to graduation can help prepare occupational therapy and occupational therapist assistant students for future collaborative practice.

Becoming a tutor: exploring the learning experiences and needs of novice tutors in a PBL programme.

The tutor plays an important role in facilitating learning in a problem-based learning (PBL) curriculum. This paper explored the ways that novice tutors were educated in a PBL programme at McMaster University. Thirteen novice tutors were interviewed in this qualitative, ethnographic study to identify their learning needs and culture at the entry phase of 'becoming a tutor'. Ten tutor guides were also interviewed to provide additional information and perspectives regarding the data generated by the novice tutors. Categories that emerged were: (1) benefiting from the experience, (2) managing the challenges, (3) transitioning to a new role, (4) uncovering learning opportunities, (5) maintaining vigilance, and (6) explicating the implicit. The overarching framework that wove the categories together was that of the theme of storytelling in the teaching-learning process. Implications for practice for tutor training are addressed considering the oral tradition.

The effectiveness of community-based occupational therapy education and functional training programs for older adults: a critical literature review.

BACKGROUND: This paper examines the results of a critical literature review describing the provision of education and functional training programs by occupational therapists with older adults to maximize their occupational performance. PURPOSE: The critical review addressed the following question: What is the effectiveness of education and functional training programs in improving occupational performance and quality of life for older adults? Review methods are described and the outcomes of the critical review discussed. RESULTS: The results indicate that there is evidence that programs are effective in three areas: prevention of functional decline and falls, stroke and rheumatoid arthritis. Methodological limitations exist in some studies. There are several randomized controlled studies in this area, though the description of specific occupational therapy interventions is often vague and the programs could not be easily duplicated by occupational therapists. PRACTICE IMPLICATIONS: Occupational therapists are provided with information through this critical review to facilitate evidence-based practice when working with older adults.

Collaborative fieldwork education with student occupational therapists and student occupational therapist assistants.

The profession of occupational therapy has a long history of working collaboratively with support personnel. This paper describes the process of a fieldwork education partnership developed between the McMaster University, BHSc (OT) Program and the Mohawk College, Occupational Therapist Assistant and Physical Therapist Assistant Program. Eight student occupational therapists and eight student occupational therapist assistants learned together in a variety of fieldwork settings, either in pairs or in groups. Both groups of students kept weekly journals of the experience and completed a post placement questionnaire. The journals were inductively analysed using a retrospective content analysis. The four emergent themes identified from the data are learning about each other's role, collaborative learning, impact on client care and future practice, and resistance to roles. Recommendations for future collaborations are discussed.

Problem-based learning in occupational therapy: why do health professionals choose to tutor?

For over 20 years the occupational therapy programmes offered by McMaster University and Mohawk College, Hamilton, Ontario have used small-group, problem-based learning tutorials as a major component of their curriculum. These programmes were among the first occupational therapy programmes in the world to use a problem-based tutorial format. The inclusion as tutors of both full-time faculty and clinicians, from all clinical practice areas, was central to the design of the problem-based learning courses. A survey of all tutors from the last 20 years collected information about why health professionals are motivated to tutor and what they see as challenges to maintaining this educational role. Three primary themes emerged from the data: being an educator; being a learner and present and future challenges to continuing with the tutoring role. Within the educator theme there was a secondary theme of professional duty or obligation. In addition, the participants identified suggestions for enhanced support and continuing education for tutors. This article summarizes the findings of the survey.