Toward Robust Assessments of Student Knowledge of Occupation.

IMPORTANCE: Occupational therapy students must master knowledge of occupation, yet how educators assess such knowledge has not been explored. In this study, we elucidate robust assessment practices that can help students master knowledge of occupation. OBJECTIVE: To examine practices that educators use to assess knowledge of occupation. DESIGN: Basic qualitative research. Using inductive and constant comparative methods, we coded 25 interviews and 82 educational artifacts for assessment practices, categorized practices as direct or indirect, and analyzed their alignments with features of robust assessments. SETTING: Twenty-five randomly selected occupational therapy and occupational therapy assistant academic programs in the United States, stratified by geographic region and institution type. PARTICIPANTS: Twenty-nine educators who represented selected programs. RESULTS: We found occupation at instruction and program levels primarily in relation to practice using indirect more than direct practices. Assignments were often highly creative and experiential, yet varied in their alignments with established criteria of robust assessments. CONCLUSIONS AND RELEVANCE: Knowledge of occupation was often intertwined with practice-oriented learning experiences and skills; hence, it was not assessed as a distinctly indispensable learning outcome. Educators can build on current practices to design robust assessments that require students to demonstrate knowledge of occupation in practice contexts and everyday life. WHAT THIS ARTICLE ADDS: In this study, we elucidate a continuum of prevalent educational practices used to assess knowledge of occupation; we also review best practices for robust assessments of such knowledge not only related to practice but also as a dynamic instrument of individual and societal well-being more broadly.

Assignment Artifacts and What They Reveal About How Occupation Is Addressed in U.S. Occupational Therapy Curricula.

IMPORTANCE: Artifacts convey essential skills, tools, and concepts to students. Studies of artifacts can therefore illumine priorities for learning. OBJECTIVE: To describe the skills, tools, and concepts that assignment artifacts required students to learn, especially in relation to occupation. DESIGN: Educators submitted 243 artifacts that illustrated how their programs addressed occupation. Artifacts included syllabi, lectures, assignments, rubrics, study guides, texts, and learning objectives. A sociocultural research paradigm informed a secondary analysis of all assignment artifacts. Assignments were coded for the skills, tools, and underlying concepts students were to use, particularly related to occupation. SETTING: U.S. occupational therapist and occupational therapy assistant academic programs. PARTICIPANTS: Twenty-five U.S academic programs selected through stratified random sampling that targeted representation by geographic region and the Carnegie Classification of Institutions of Higher Education. Fifteen occupational therapy and 10 occupational therapy assistant programs consented. RESULTS: Assignment artifacts required students to interview, observe, analyze, and teach (skills); artifacts emphasized learning the Occupational Therapy Practice Framework: Domain and Process (tool). Few artifacts required students to relate skills and tools to broader concepts, including occupation. Those that did used prompts that were ancillary to the assignment. Grading rubrics seldom measured students' ability to connect skills and tools to occupation. CONCLUSIONS AND RELEVANCE: By emphasizing skills and tools detached from the concepts supporting their relevance to occupation, the artifacts reflected black box learning. Creating artifacts that reflect glass box learning can improve education. In glass box learning, artifacts are transparent and clearly delineate the skills, tools, and conceptual understandings to be gained. WHAT THIS STUDY ADDS: For researchers, the study highlights the importance of including artifacts in studies of occupational therapy education. For educators, the study gives guidance for creating assignments that clearly delineate skills, tools, and concepts.

A National Survey of Learning Activities and Instructional Strategies Used to Teach Occupation: Implications for Signature Pedagogies.

IMPORTANCE: Occupational therapy practitioners' professional identities and distinctive contributions to health care connect essentially to their knowledge of occupation. Thus, the strategies educators use to convey occupation to students and the perspectives embedded in those strategies are critical topics for researchers. OBJECTIVE: To generalize findings from a previous qualitative study of how educators in 25 U.S. occupational therapy assistant and occupational therapy programs addressed occupation to a national sample of educators. DESIGN: As part of an exploratory sequential design, a national survey of U.S. occupational therapy and occupational therapy assistant educators explored activities and strategies used to teach occupation. Data were analyzed using descriptive statistics. SETTING: An online survey about educators' practices in the academic education setting. PARTICIPANTS: Occupational therapy and occupational therapy assistant educators (N = 1,590) from all programs in the United States. Of these, 634 returned surveys, 315 of which were complete and included in the analysis, for an overall response rate of 19.8%. RESULTS: Respondents identified similar learning activities and instructional strategies as those identified in the qualitative phase of the design. Most instruction was active and experiential, requiring students to integrate various skills and content areas. Definitions of occupation, as a basis for teaching, varied. CONCLUSIONS AND RELEVANCE: The combined survey and qualitative results offered initial empirical support for occupational therapy's proposed signature pedagogies and the importance of attending to the deep and implicit structures within those pedagogies. Such structures are believed to support students' formation of a professional identity and an occupational perspective. WHAT THIS ARTICLE ADDS: This study provides evidence for the instructional strategies that educators use to convey knowledge of occupation to students. The predominant strategies support proposed signature pedagogies in occupational therapy: relational learning, affective learning, and highly contextualized active learning.

Curriculum-Level Strategies That U.S. Occupational Therapy Programs Use to Address Occupation: A Qualitative Study.

OBJECTIVE: This study's objective was to describe curriculum-level strategies used to convey occupation to occupational therapy students. METHOD: The study used a descriptive qualitative research design. Fifteen occupational therapy and 10 occupational therapy assistant programs participated in interviews, submitted curriculum artifacts such as syllabi and assignments, and recorded teaching sessions. Data were coded both inductively and deductively and then categorized into themes. RESULTS: Occupational therapy programs designed strategies on two levels of the curriculum, infrastructure and implementation, to convey knowledge of occupation to students. The degree to which strategies explicitly highlighted occupation and steered instruction fluctuated depending on how differentiated occupation was from other concepts and skills. CONCLUSION: Two arguments are presented about the degree to which occupation needs to be infused in all curricular elements. To guide curriculum design, it is critical for educators to discuss beliefs about how ubiquitous occupation is in a curriculum and whether curricular elements portray occupation to the extent preferred.

A Way of Seeing: How Occupation Is Portrayed to Students When Taught as a Concept Beyond Its Use in Therapy.

OBJECTIVE: The concept of occupation is core to learning occupational therapy, yet how occupation is taught has not been widely studied. We explored how occupation is addressed in 25 U.S. occupational therapist and occupational therapy assistant programs. METHOD: We used a basic qualitative research design, collecting data through interviews, artifacts, and video recordings of teaching. We secondarily analyzed 8 programs in which occupation was taught beyond its application in practice. RESULTS: Educators portrayed occupation as (1) a way of seeing self (students learn about themselves as occupational beings), (2) a way of seeing others (students learn about others as occupational beings), and (3) a way of seeing the profession (students learn occupation as the central focus of occupational therapy). Varied learning experiences promoted these perspectives. CONCLUSION: Three concepts-subject-centered learning, threshold concepts, and transformative learning-formed the theoretical foundation for teaching occupation as a way of seeing.

Explicit or Hidden? Exploring How Occupation Is Taught in Occupational Therapy Curricula in the United States.

OBJECTIVE: Occupation is considered core and threshold knowledge for occupational therapy, yet how it is conveyed through education is not well understood. This study examined how the concept of occupation was taught in occupational therapy and occupational therapy assistant curricula in the United States. METHOD: Using a qualitative descriptive research design, in-depth interviews, video recordings, and artifacts of teaching occupation were collected from 25 programs, chosen using stratified random sampling. Interview data were analyzed using an inductive, constant comparative approach; video and artifact data were analyzed deductively using findings from the interviews. RESULTS: Instructional methods were innovative and ranged from didactic to experiential. The degree to which occupation was present in instruction ranged from explicit to implicit to absent. CONCLUSION: Although educators valued teaching occupation, the concept was still elusive in some instructional methods and materials. Occupation knowledge and pedagogical content knowledge may have influenced how explicitly occupation was taught.

Energizing Occupation as the Center of Teaching and Learning.

The concept of occupation has experienced a renewal in the past 3 decades and is widely accepted as the core subject in occupational therapy. Professional education has a critical stewardship role in continually enhancing how occupation is taught and understood to enrich new occupational therapy practitioners' ability to grasp the purpose of the profession and reason clinically in complex practice environments. The authors discuss three questions that frame approaches educators can use to effectively centralize occupation in teaching and learning environments: (1) To what degree is a curriculum and its courses and class sessions subject centered? (2) To what degree do instructional processes create links to occupation? and (3) To what degree do instructional processes expose and promote complex ways of knowing needed for learning occupation? Keeping occupation in the foreground is important to facilitate new research, teaching methods, and curricular relevance to practice.

Scholarship and research in occupational therapy education.

OBJECTIVE. The purpose of this study was to identify a baseline or benchmark for faculty engagement and productivity in occupational therapy education scholarship and research. METHOD. A custom-designed survey was emailed to 2,225 faculty members. The survey included questions on basic demographic information and education scholarship (e.g., use of evidence to inform teaching, frequency and nature of involvement in education scholarship. RESULTS. A total of 520 faculty members (23%) completed the survey. Of these, 450 (86.5%) identified themselves as full-time core faculty, and only their responses were analyzed. Although 90% of the faculty respondents engaged in scholarly teaching, only 34% identified education as an area of content expertise, and only 16% reported frequent involvement with education scholarship. Instructional methods were the primary area of study. CONCLUSION. A need exists to build research capacity for education research and more diversification of education research topics, including professional socialization and competencies.

Value and challenges of research on health professions' core subjects in education.

Professions are organized around central concerns, or core subjects. Knowledge of a field's core subject is indispensable to effective practice, reasoning, and professional identity. In health professions education, however, core subjects are often obscured by the plethora of topics and skills that must be taught, rendering them largely implicit in the learning process. Core subjects and how they are addressed in curricula thus remain under-researched in health professions education. The scarcity of research can be attributed to the need for (1) explicating core subjects as the basis for learning, (2) language that describes professional education as connecting all learning to a field's core, and (3) research methods that go beyond early phases of research development, including a conceptual framework for understanding and studying core subjects. This paper presents strategies addressing each of these challenges that were developed through a pilot and a subsequent large national study of occupational therapy education. These strategies provide a foundation for dialogue and future research on the nature and function of core subjects in health professions education.