Supporting occupational therapists implementing a capacity-building model in schools: Appuyer les ergothérapeutes mettant en œuvre un modèle de renforcement des capacités dans les écoles.

BACKGROUND: Adopting a new model of clinical practice is complex. Professional development programs based on best-practice principles may facilitate this process. PURPOSE: This paper describes the development and evaluation of a multifaceted professional development program designed to support school-based occupational therapists to deliver a capacity-building model of service. METHOD: Twenty-two therapists participated in the program; completed pre-post evaluations of knowledge, skills, and beliefs; evaluated specific components of the training program; and participated in focus groups. Quantitative data were analyzed using descriptive and inferential statistics. Qualitative data were analyzed using a directed content analysis. FINDINGS: Therapists' perceptions of their knowledge and skills showed statistically significant change. Both training and mentorship were highly valued; however, having opportunities to build peer networks was considered essential. IMPLICATIONS: Multifaceted professional development programs designed using best-practice principles are an important mechanism for facilitating practice change. Including a process for peer support is advised.

Executive functioning: a scoping review of the occupational therapy literature.

BACKGROUND: Increasingly recognized as an important factor in the performance of complex, goal-directed tasks, executive functioning is understood in different ways across disciplines. PURPOSE: The aim was to explore the ways in which executive functioning is conceptualized, discussed, described, and implied in the occupational therapy literature. METHOD: A scoping review of the occupational therapy literature was conducted following Levac, Colquhoun, and O'Brien's (2010) recommended methodology. RESULTS: Executive functioning is described both as a set of performance component skills or processes and as the executive occupational performance inherent in complex occupations. Executive functioning is implicit in occupational performance and engagement, and some health conditions seem to be commonly associated with impaired executive functioning. Assessing executive functioning requires dynamic occupation- and performance-based assessment. Interventions targeting executive functioning are grounded in metacognitive approaches. CONCLUSION: Executive functioning is a complex construct that is conceptualized with considerable variance within the occupational therapy literature, creating barriers to effective service delivery.

Technology supporting written productivity in children with learning disabilities: a critical review.

BACKGROUND: Occupational therapists working with school-aged children are often in the position of recommending technology to enhance written productivity. The outcome of using technology on the writing of children with learning disabilities has not been reviewed critically, and this knowledge is necessary for evidence-based practice. PURPOSE: To review evidence regarding the use of technology to support written productivity in children with learning disabilities. METHODS: A systematic search of seven databases, plus a manual search, retrieved 864 papers published between 1985 and March 2012. Twenty-seven papers (28 studies) met inclusion criteria. FINDINGS: The evidence is of a moderately low level and results are inconclusive; however, trends suggest a positive influence of some technology on children's performance and behaviour. Methodological limitations exist in most studies and the description of specific technology intervention is often combined with teaching instructions. IMPLICATIONS: The available research is encouraging, but high-quality investigations with newer technologies are needed.

Administration of the Canadian Occupational Performance Measure: effect on practice.

BACKGROUND: The Canadian Occupational Performance Measure (COPM) is recommended as a systematic approach to identify issues and determine client progress in occupational therapy, yet little empirical evidence is available that supports this practice. PURPOSE: To determine if COPM administration was associated with changes in eight dimensions of occupational therapy practice. METHODS: Twenty-four occupational therapists on eight geriatric rehabilitation sites completed a before-and-after study with a repeated baseline. The eight practice dimensions were assessed after three months of usual care (no COPM use) and after three months of intervention (COPM use) using chart stimulated recall (CSR) interviews and chart audit. FINDINGS: Mean practice scores for CSR interviews indicated a statistically significant practice improvement (p < .0001) across the eight dimensions, including knowledge of client perspective, clinical decision making, clinician ability to articulate outcomes, and documentation. Chart audit indicated that COPM use resulted in identifying more occupation-focused issues. IMPLICATIONS: COPM administration could improve occupational therapy practice.

"Support for everyone": Experiences of occupational therapists delivering a new model of school-based service.

BACKGROUND: Occupational therapists working in school health have recognized the need to move away from a one-to-one direct service delivery model towards a more collaborative, classroom-based approach. Partnering for Change (P4C) is an innovative service delivery model that may enhance school-based collaborative care. PURPOSE: To capture the experiences of occupational therapists implementing P4C and to elicit their perspectives about how this model differs from the direct service approach. METHODS: Semi-structured, face-to-face interviews were conducted with seven therapists who had delivered P4C in 10 Ontario schools. Thematic analysis was utilized with themes verified through member checking. FINDINGS: Five themes (a year of growth, becoming a community, the key ingredients of P4C, a balancing act, and providing services that make an impact) reflected therapists'personal and professional growth, aspects of the model they believed were key, challenges they encountered, and the impact they felt they had made. IMPLICATIONS: Partnering for Change has the potential to transform school-based occupational therapy and overcome existing barriers to collaboration. This model also may better address the needs of children with motor coordination difficulties.

Partnering for change: an innovative school-based occupational therapy service delivery model for children with developmental coordination disorder.

BACKGROUND: Developmental coordination disorder (DCD) is a common, chronic health condition that is poorly recognized and understood in school settings. Without appropriate support, children with DCD are at increased risk of depression, decreased fitness, and obesity. Evidence shows that occupational therapy intervention needs to shift from remediation of impairment to chronic disease management. PURPOSE: This paper describes Partnering for Change (P4C), an innovative, empirically derived school health service delivery model for children with DCD. KEY ISSUES: The model emphasizes the partnership of the occupational therapist with educators and parents to change the life and daily environment of a child. The P4C partnership focuses on capacity building through collaboration and coaching in context. The model uses a tiered approach which includes whole class instruction, dynamic performance analysis, and monitoring response to intervention. IMPLICATIONS: P4C is a model that responds to the needs of this population, addresses issues identified in research, and provides a continuum of services designed to build capacity.

A scoping review of the use of theory in studies of knowledge translation.

BACKGROUND: Advancing the science of knowledge translation (KT) in occupational therapy is critical. Explicit application of theory can advance this science; yet, how theory is applied and the degree to which it can guide research remain poorly defined. PURPOSE: To understand how theory is applied within KT research. METHODS: A scoping review was conducted to examine and summarize the extent, range, and nature of the application of three specific KT theories: Diffusion of Innovations, Promoting Action on Research Implementation in Health Services framework, and Theory of Planned Behaviour. FINDINGS: Theory use was seen most frequently in medicine and nursing. Only 3 of 90 articles were in rehabilitation. Five approaches to theory application were found, the most common being the use of to predict success of KT (57/90). IMPLICATIONS: In-depth study of the importance and methods of theory application in KT research is needed, in particular in occupational therapy.