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.

Meeting the challenge of assessing clinical competence of occupational therapists within a program management environment.

BACKGROUND: Program management models have raised concerns among occupational therapists about professional standards related to clinical competence, performance review procedures, and quality improvement initiatives. PURPOSE: This paper describes how a chart-stimulated recall (CSR) peer-review process and interview tool was revised, implemented, and evaluated as a pilot project to assess the clinical competence of occupational therapy staff at a large urban health centre in southern Ontario. METHODS: Fourteen pairs (n=28) of occupational therapists representing various practice areas participated in this project. Half served as peer assessors and half as interviewees. Peer assessors conducted an independent chart review followed by a one-hour personal interview with a peer partner to discuss clinical management issues related to the client cases. Each interviewer rated his or her partner's clinical competence in eight areas of performance using a 7-point Likert scale. FINDINGS: Results indicated that the CSR tool could discriminate among occupational therapists in terms of overall levels of clinical competence and also identify specific areas of concern that could be targeted for professional development. Feedback from participants was positive. CONCLUSIONS: The CSR tool was found to be useful for assessing clinical competence of occupational therapists in this large health centre as a quality improvement initiative within that discipline group. Further research is needed to establish the reliability and validity of the CSR tool.

The effect of defined violations of test security on admissions outcomes using multiple mini-interviews.

INTRODUCTION: Heterogeneous results exist regarding the impact of security violations on student performances in objective structured clinical examinations (OSCEs). Three separate studies investigate whether anticipated security violations result in undesirable enhancement of MMI performance ratings. METHODS: Study 1: low-stakes: MMI station stems provided to a random half of 57 medical school applicants 2 weeks in advance of participation in a research study. Study 2: high-stakes: 384 medical school applicants sat a 12-station MMI to determine admission. Each half received 1 of 2 pilot MMI station stems 2 weeks in advance. Study 3: high-stakes: 38 interviewees with dual applications to occupational therapy and physiotherapy experienced the same 7-station MMI twice on the same date. RESULTS: No statistically significant differences in MMI performances were detected. CONCLUSIONS: Predictable violations of MMI security do not unduly influence applicant performance ratings.

Integration of persons with HIV in a problem-based tutorial: a qualitative study.

BACKGROUND: This qualitative study examined the effect of using persons with HIV-AIDS (PHAs) as facilitators of learning in an interdisciplinary problem-based learning curriculum. DESCRIPTION: Ten students representing 5 professions (medicine, occupational therapy, physical therapy, nursing, and social work) volunteered to participate in an 8-week course on rehabilitation issues in HIV. Two tutorial groups met weekly to discuss problems with the assistance of a faculty tutor and a PHA. Students completed a weekly journal outlining their experiences. At completion of the course, students participated in semistructured interviews. A qualitative analysis of the transcribed interviews and the journals was undertaken. EVALUATION: The PHA provided a unique perspective on living with HIV, acted as a resource, and challenged the students' values and assumptions. The presence of the PHA also presented challenges in that the students worried their comments might offend them. CONCLUSIONS: PHAs contributed significantly to students' learning and can be successfully incorporated into problem-based tutorials.

An interprofessional problem-based learning course on rehabilitation issues in HIV.

This study examined students' perceptions of their learning through participation in an interprofessional problem-based course on rehabilitation and HIV. Students representing five health professions participated in an eight-week tutorial course. Qualitative analysis of journals that the students completed throughout the course, and of interviews of the students at completion of the course, revealed that they valued their learning experience. Students gained an appreciation of the roles of others and developed a sense of confidence through justifying their professional role. Through the interprofessional discussions, students were able to increase the breadth and depth of their learning and also gained a rehabilitation perspective. Learning related to HIV and rehabilitation is ideally suited to an interprofessional, problem-based environment.

Learning from today's clinicians in vocational practice to educate tomorrow's therapists.

BACKGROUND: In response to the demand for therapists and changes in vocational practice, a needs assessment was conducted to update an occupational therapy educational program. METHOD: Employing focus groups, interviews and questionnaires, 66 therapists from a wide range of graduating institutions working in vocational practice were asked to: a) identify the essential knowledge, skills and professional behaviours required for vocational practice; b) determine to what extent training is preparing students for vocational practice; and c) make recommendations for curriculum revision and/or for additional curriculum development. Participants and their jobs were profiled together with the challenges and issues of vocational practice. RESULTS: There was strong agreement among participants regarding what is required to practice effectively but disparate views concerning the extent they were prepared for practice. CLINICAL IMPLICATIONS: Recommendations were given for entry and postgraduate level curricula. Findings were compared to a past community practice survey. Implications for practicums, professional integrity and ethical issues were discussed.