Development and Implementation of an Evidenced-Based Practice (EBP) Educational Program for a Multidisciplinary Rehabilitation Department.

OBJECTIVE: Describe the development and implementation of an evidence-based practice (EBP) training program for occupational and physical therapists in a large pediatric hospital. CONTEXT: EBP is valued, but a known knowledge-to-practice gap between academic training and clinical practice limits routine use. This gap was addressed through an academic-clinical partnership to develop an EBP training program. RESULTS: Sixty-one therapists completed the program. Therapists demonstrated improved EBP skills, knowledge, and confidence following training and a positive trend in change score for clinical outcomes and decision-making scores was noted. CONCLUSION: Academic-clinical partnerships have a unique and valuable role to support professional EBP knowledge and skill development. Stakeholder support and engagement supported program development, execution, and meaningful outcomes. IMPACT STATEMENT: The knowledge-to-practice gap for EBP is a challenge to regular EBP use. The described program addressed this challenge and improved therapists' knowledge, skills, and confidence. It provides a model for professional development.

"(Not) knowing what you know": Exploring educators' perceptions of critical thinking in occupational therapy.

BACKGROUND: Critical thinking is key for responsible occupational therapy practice. However, the degree to which educators understand critical thinking and the conceptualizations of such concept in teaching remains unclear. AIM: This study aimed to describe occupational therapy educators' perceptions and experiences of teaching critical thinking. MATERIAL AND METHODS: Social constructivism underpins the study. Eight participants were included in three online synchronous focus groups. One participant was interviewed in person due to time constraints. Data were analysed using content analysis. RESULTS: This study reveals a considerable diversity of perceptions and experiences of ambiguity regarding educators' perceptions of what they know about and how to teach critical thinking. Most educators interpret critical thinking in ways that differs from their colleagues. Furthermore, educators encounter divergent expectations pertaining to their role as educators and the readiness of their students. CONCLUSIONS: This study reveal a paradox within the occupational therapy profession, where critical thinking is highly valued yet educators experience ambiguity, differing expectations of their role, time constraints, and lack of formal education to support students' development of critical thinking. SIGNIFICANCE: This study provides the foundation for further inquiry into the invisible effects and benefits of different understandings of critical thinking on occupational therapy practice.

[Agency: occupational therapists' perspectives on their sense of competence and their skills following training]. / Agentivité : perspectives des ergothérapeutes quant à leur sentiment de compétence et quant à leurs compétences à la suite d'une formation.

Context: To tackle the systemic injustices experienced by people in vulnerable situations, occupational therapists' agency, i.e. their power to act, is necessary. However, occupational therapists feel ill-equipped to exercise this power, and would like to develop their skills. The general aim of this research was therefore to document occupational therapists' perception of their skills before and after agency training. Methods: We used a mixed sequential explanatory design, comprising a quantitative component consisting of a pre- and post-training self-administered questionnaire and a descriptive qualitative component with group interviews. Results: A total of 103 occupational therapists completed the training between January 19 and October 19, 2019. Their sense of competence improved, especially for those with no prior training in agency. The skills perceived as having developed the most corresponded to the skills deemed a priority for development, namely effective communication, intentional collaboration, and observation and analysis. On the other hand, occupational therapists emphasized that they had not mastered the exercise of these skills in a real-life context. Conclusion: Although continuing education is one way of improving the skills needed to exercise agency, questions remain as to the optimal modalities for ensuring their full and lasting development.

Educating the Educator: Applying a Growth Mindset Approach to Prepare Educators for Major Changes in Occupational Therapy Education.

Several necessary shifts have been proposed in occupational therapy education, including antiracist pedagogies, inclusive teaching, competency-based education, and holistic admissions. These shifts are intended to prepare competent practitioners who serve diverse groups of clients and advocate for themselves and the profession. This shift may also call for significant changes to curriculum designs and instructional methods. Such changes require not only time, effort, and resources, but also a mindset open to change. Educators may resist this change for various reasons, including personal views on the proposed changes, limited time and resources, professional obligations, and lack of training necessary for successful implementation of change. Fostering a growth mindset for educators may facilitate accepting, implementing, or transitioning to new educational practices. Here, we propose an eight-step model for implementing change while following Kotter's model for implementing major changes. The model provides a road map for implementing major changes at various levels of systems that shape occupational therapy education.

Transitioning from an occupational therapy student to a clinically competent occupational therapist - A qualitative study.

BACKGROUND: The transition process from being an occupational therapy student to becoming an occupational therapist has been shown to be stressful, with an increased risk of burnout and job turnover. Consequently, there is a need to gain a deeper understanding of this process in order to identify ways of making it easier. AIMS/OBJECTIVES: To describe newly graduated Swedish occupational therapists' experiences of the transition from being an occupational therapy student to becoming a clinically competent occupational therapist. MATERIAL AND METHODS: A qualitative study involving 15 participants was conducted using interviews to collect data and content data analysis was undertaken to capture occupational therapists' experiences of the transition process. RESULTS: A theme emerged: 'Bridging the gap by seeking stability in the transition from occupational therapy student to clinically competent occupational therapist', with two sub-themes, 1) 'Facing a new reality' and 2) 'Establishing one's role', containing categories that encapsulated experiences of the transition. CONCLUSIONS AND SIGNIFICANCE: To bridge the gap in the transition process, universities could review their curricula to identify changes to better prepare newly graduated occupational therapists for the demands of clinical practice. Employers hiring new graduates need to offer comprehensive orientation and access to mentorship for support.

Student experiences in a novel interprofessional neurodevelopmental clinic: a qualitative study.

BACKGROUND: Student-led clinics can provide low-cost speciality care and practical interprofessional education (IPE) opportunities. In Australia, there are currently limited speciality services available that provide neurodevelopmental assessments that consider fetal alcohol spectrum disorder (FASD) as one possible outcome. The aim of the current study was to understand student experiences in a novel interprofessional student-led clinic for children and adolescents with suspected or confirmed prenatal alcohol exposure. METHOD: Seventeen allied health university students (11 occupational therapy; 6 psychology) participated in individual semi-structured interviews following completion of a 10-week clinic placement. Reflexive thematic analysis was undertaken using NVivo12. RESULTS: Four main themes were generated: (1) Interprofessional practice a key for students' development as future healthcare professionals; (2) Meaningful relationships and students' belief they made a difference; (3) Novel challenges tested students' capabilities on placement; and (4) Supervisor attitude and approach to learning supported student development. CONCLUSIONS: The current study demonstrated that the interprofessional student-led neurodevelopmental clinic provided a valuable IPE opportunity for students.

Occupational Therapy Doctoral Capstone Research Agenda: A Scoping Review.

IMPORTANCE: As identified in the American Occupational Therapy Association's (AOTA's; 2023) statement about the purpose and value of the occupational therapy doctoral capstone, there is a lack of evidence about the purpose and value of the doctoral capstone. As an essential element of occupational therapy doctoral degree curricula, the capstone is unique to each program, supports the program's scholarship agenda, and serves the needs of students and the communities served by the profession. OBJECTIVE: To develop a doctoral capstone research agenda in an attempt to prioritize and guide research that can supplement the current paucity of evidence related to capstone efficacy or effectiveness. METHOD: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were used to conduct a scoping review. Peer-reviewed articles published between 1999 and June 2023 were searched using the CINAHL, PsycINFO, PubMed, and Embase databases. RESULTS: The doctoral capstone research agenda was developed and organized into five categories to drive research activities inclusive of the didactic and experiential learning associated with the planning, implementation, and evaluation of the capstone process: (1) teaching and learning; (2) learner characteristics and competencies; (3) shaping professional identity; (4) faculty/mentor development and resources; and (5) promotion of diversity, equity, and inclusion. CONCLUSIONS AND RELEVANCE: A doctoral capstone research agenda was developed in accordance with AOTA's (2018) Occupational Therapy Education Research Agenda. It identifies an array of areas in which research is needed to inform the distinct value and purpose of the doctoral capstone to students, sites, programs, and the profession. Plain-Language Summary: The occupational therapy doctoral capstone is unique to each program, supports the program's scholarship agenda, and supports the needs of students and the communities served by the profession. The American Occupational Therapy Association's official document on the "Occupational Therapy Doctoral Capstone: Purpose and Value" states that there is a lack of evidence about how to identify the distinct purpose and value of the doctoral capstone. This scoping review explored the development of a doctoral capstone research agenda. A research agenda is provided to guide and prioritize research to articulate best practices and the distinct purpose and value of the doctoral capstone in occupational therapy education and for the profession.

Study approaches mediate associations between learning environment and academic performance.

BACKGROUND: While study approaches have been directly associated with students' academic performance, learning environment factors may play a more indirect role. The aim of this study was (i) to assess learning environment factors as predictors of students' average exam grades, and (ii) whether study approaches mediated associations between learning environment factors and exam grades. METHODS: Three annual surveys (2017-2019) yielded data from a total of 263 Norwegian occupational therapy students. Learning environment factors were assessed with the Course Experience Questionnaire, and the Approaches and Study Skills Inventory for Students were used to assess study approaches. Linear regression analyses and mediation analyses were performed. RESULTS: Higher levels of 'student autonomy' were directly associated with lower averaged grades whereas higher levels of 'appropriate workload' were associated with higher averaged grades. There were statistically significant total indirect effects of 'clear goals' and 'appropriate workload' on grades; these effects occurred through the study approach variables. However, all learning environment variables showed one or more relationships with academic performance that was mediated by study approach variables. CONCLUSION: Learning environment variables appear to be complexly associated with academic performance, both directly and indirectly.

The development of pre-registration occupational therapy student perceptions of research and evidence-based practice: A Q-methodology study.

BACKGROUND: Pedagogically sound curricula are needed for occupational therapy (OT) students to adopt evidence-based practice (EBP) principles and internalise EBP within their professional identities. Exploring students' perceptions of this knowledge area can contribute to effective curriculum design. AIMS/OBJECTIVES: To explore the evolution of pre-registration OT student perceptions of research and EBP over the course of their engagement with undergraduate teaching and learning. MATERIALS AND METHODS: The Q-sort approach synthesises different viewpoints regarding a sample of statements, using by-person factor analysis (respondents = variables; statements = sample). Final year pre-registration OT students completed the same Q-sort at three timepoints (pre-dissertation [n = 18]; post-dissertation submission [n = 12]; post-student research conference [n = 6]). Q-sort responses were intercorrelated and factor-analysed; extraction of factors with an eigenvalue of ¬>0.9 and varimax rotation identified majority viewpoints. RESULTS: Significant factors were revealed at each timepoint: 1a: 'Evidence-inseparable from OT practice', 1b: 'Research for research's sake-inseparable from the occupational therapy identity', 2: 'Who am I to question the gurus?', 3: 'I can do it with confidence…but so what?' CONCLUSIONS: Opportunities for completing 'authentic' student research projects, with 'ownership' of results, may enhance research and EBP confidence and professional identity. SIGNIFICANCE: Findings expand current knowledge regarding effective use of pre-registration educational opportunities to support future research and EBP.

How does mentoring occupational therapists improve intervention fidelity in a randomised controlled trial? A realist evaluation.

BACKGROUND: Integrating complex interventions within healthcare settings can be challenging. Mentoring can be embedded within a randomised controlled trial (RCT) to upskill and support those delivering the intervention. This study aimed to understand, from a realist perspective, how mentoring worked to support implementation fidelity for occupational therapists (OTs) delivering a vocational rehabilitation (VR) intervention within the context of an RCT. METHODS: A realist evaluation using secondary data (emails, mentoring record forms, interviews) collected as part of an RCT. Three researchers coded the data following content analysis, focused on refining or refuting an initial programme theory by exploring the interactions between context, mechanisms, and outcomes. The research team met to further refine the programme theories. RESULTS: Data from 584 emails, 184 mentoring record forms, and 25 interviews were analysed following a realist approach. We developed a programme theory consisting of two contexts (trial set-up, ongoing mentoring), nine mechanisms (collective understanding, monitoring, timely support, positive reinforcement, reflective practice, support data completeness, facilitation strategy, shared learning experience, management of research and clinical duties), and three outcomes (improved confidence, improved fidelity, reduced contamination). CONCLUSIONS: Offering mentoring support to OTs delivering a VR intervention as part of an RCT improves intervention fidelity and reduces the risk of contamination. It improves OTs' understanding of the differences between their clinical and research roles and increases their confidence and competence in trial paperwork completion and identification of potential contamination issues.

Researchers' Theater: Enhancing Student Engagement in an Introductory Research Course.

Research coursework can be challenging for occupational therapy students, thus potentially compromising their engagement in learning. A student engagement framework was used to design and implement an innovative assignment called Researchers' Theater with a cohort of 38 first-semester occupational therapy students. At the beginning of each class, a small group of students led a creative activity to review topics from the preceding week. Student feedback survey results and instructors' observations suggest this framework contributed to students' affective, behavioral, and cognitive engagement. Findings also highlight the potential value of student-led, game-based learning for reinforcing course content.

Training and learning support for people with vision impairment in the use of smartphones and applications (apps): an exploratory Australasian survey.

INTRODUCTION: Occupational therapists working in low vision rehabilitation make recommendations for assistive technology (AT) and provide training in AT use for people with vision impairment (PVI) to support participation and independence. Smartphones and apps are an important AT for PVI, yet little is known about the training needs of PVI or what training is currently provided. Research exploring PVI's learning and training experiences is required to inform training development. PURPOSE: This study aimed to explore the perspectives, needs, and recommendations of PVI from Australia and Singapore on smartphone training methods. METHODS: An online survey collected data between November 2020 to February 2021. Participants were recruited from Australia and Singapore using purposeful sampling. The survey had three sections: (i) demographics, (ii) use of smartphones and apps, and (iii) training. It consisted of 26 closed and open-ended questions. The quantitative results from the survey were analysed descriptively, and responses to open-ended questions were analysed using content analysis. RESULTS: Sixty-eight PVI responded to the survey, with 34 (50%) participants from each country. There were more Australians (n = 19/34, 55.9%) who had accessed formal training compared to Singaporeans (n = 11/34, 32.3%). Participants valued both formal and informal training, and self-training was the most used method for informal training (Australia: n = 29/34, 85%, Singapore: n = 22/34, 64.7%). Participants stated they preferred individualised formal training that caters to their learning needs and is provided by patient and knowledgeable trainers. They also preferred formal training, which is flexible and convenient to access, including online training with peers. CONCLUSION: Findings such as providing individualised training, ensuring increased awareness of formal training, and using both formal and informal training methods can be considered by occupational therapists to enhance and develop training for PVI in the use of smartphones and apps. CONSUMER AND COMMUNITY CONSULTATION: Consumers were involved at the development stage. Three people with vision impairment reviewed and provided feedback on the survey's accessibility and content.

Developing an entrustable professional activity for providing health education and consultation in occupational therapy and examining its validity.

BACKGROUND: Entrustable Professional Activities (EPA)-based assessment is easily and intuitively used in evaluating the learning outcomes of competency-based medical education (CBME). This study aimed to develop an EPA for occupational therapy focused on providing health education and consultation (TP-EPA3) and examine its validity. METHODS: Nineteen occupational therapists who had completed online training on the EQual rubric evaluation participated in this study. An expert committee identified six core EPAs for pediatric occupational therapy. TP-EPA3 was developed following the EPA template and refined through consensus meetings. The EQual rubric, a 14-item, five-point criterion-based anchor system, encompassing discrete units of work (DU), entrustable, essential, and important tasks of the profession (EEIT), and curricular role (CR), was used to evaluate the quality of TP-EPA3. Overall scores below 4.07, or scores for DU, EEIT, and CR domains below 4.17. 4.00, and 4.00, respectively, indicate the need for modifications. RESULTS: The TP-EPA3 demonstrated good validity, surpassing the required cut-off score with an average overall EQual score of 4.21 (SD = 0.41). Specific domain scores for DU, EEIT, and CR were 3.90 (SD = 0.69), 4.46 (SD = 0.44), and 4.42 (SD = 0.45), respectively. Subsequent revisions clarified observation contexts, enhancing specificity and focus. Further validation of the revised TP-EPA3 and a thorough examination of its reliability and validity are needed. CONCLUSION: The successful validation of TP-EPA3 suggests its potential as a valid assessment tool in occupational therapy education, offering a structured approach for developing competency in providing health education and consultation. This process model for EPA development and validation can guide occupational therapists in creating tailored EPAs for diverse specialties and settings.

What are the experiences, preparation, and support needs of early career clinical educators within an Australian tertiary health service?: a qualitative study.

BACKGROUND: There is increasing demand for professional practice placement opportunities, supported by health professional educators, to enable future health workforce development. Early career health professionals performing the educator role is one strategy that can help meet this demand. However, there is a need to consider how best to prepare and support early career health professionals to become educators. This study aimed to explore the experiences and perspectives of early career occupational therapy clinical educators including their preparation and support needs. METHODS: Semi-structured interviews were completed with ten early career occupational therapists who had supervised their first or second student on a professional practice placement. The participants worked within an Australian tertiary hospital and health service in various clinical settings. Interviews were completed within six weeks of placement completion and lasted approximately one hour. They were recorded and transcribed verbatim and reflexive inductive thematic analysis was undertaken to identify key themes. RESULTS: Ten occupational therapists, who had been working for an average of two years and two months, consented to participate. Initially, participants expressed mixed emotions about taking on the clinical educator role. They then described their adjustment to the role responsibilities, challenges encountered, and the development of the educator-student relationship. Participants found that the experience of supervising a student enhanced their educator, clinical, and professional skills and confidence. The important support elements of tailored educator preparation, placement design, and timely access to relevant resources and experienced staff were identified. CONCLUSIONS: This study demonstrated how early career health professionals can possess desirable educator attributes, such as enthusiasm for taking on the role and cultivating collaborative learning relationships with their students. The experience of being an educator also presents a professional development opportunity for early career health professionals. Insights gained about the specific preparation and support needs of early career clinical educators warrant consideration by organisations and staff involved in the provision of student professional practice placements. Overall, this study's findings signify the importance of engaging and investing in early career health professionals to support student clinical education and to develop our current and future healthcare workforce.

Inter- and Intrarater Reliability of the Gap-Kalamazoo Communication Skills Assessment Form Among Occupational Therapy Interns.

IMPORTANCE: Effective communication skills (CS) are essential for occupational therapists. The Gap-Kalamazoo Communication Skills Assessment Form (GKCSAF) is a standard tool for assessing the CS of medical residents. However, the interrater reliability for the nine CS domain scores ranges from poor to good. The intrarater reliability remains unclear. OBJECTIVE: To examine the inter- and intrarater reliability of the GKCSAF's nine domain scores and total score among occupational therapy interns. DESIGN: Repeated assessments with the GKCSAF. SETTING: Medical center psychiatry department. PARTICIPANTS: Twenty-five interns and 49 clients with mental illness, recruited from August 2020 to December 2021. OUTCOMES AND MEASURES: The transcripts of 50 evaluation interviews between clients and interns were used. Three independent raters assessed each transcript twice, at least 3 mo apart. RESULTS: The GKCSAF demonstrated poor interrater reliability for the nine domain scores (weighted κ = .08-.30) and the total score (intraclass correlation coefficient [ICC] = .22, 95% confidence interval [CI] [.10, .35]). The GKCSAF showed poor to intermediate intrarater reliability for the nine domain scores (weighted κ = .27-.73) and fair reliability for the total score (ICC = .69, 95% CI [.60, .77]). CONCLUSIONS AND RELEVANCE: The GKCSAF demonstrates poor interrater reliability and poor to intermediate intrarater reliability for the nine domain scores. However, it demonstrates fair intrarater reliability in assessing the overall CS performance of occupational therapy interns. Significant variations were observed when different raters assessed the same interns' CS, indicating inconsistencies in ratings. Consequently, it is advisable to conservatively interpret the CS ratings obtained with the GKCSAF. Plain-Language Summary: It is essential for occupational therapists to effectively communicate with clients. The Gap-Kalamazoo Communication Skills Assessment Form (GKCSAF) is a standard tool that is used to assess the communication skills of medical residents. The study authors used the GKCSAF with occupational therapy interns in a medical center psychiatry department to assess how effectively they interviewed clients with mental illness. This study aids occupational therapy personnel in the interpretation of GKCSAF results. The study findings also highlight the importance of developing reliable and standardized measures to assess communications skills in the field of occupational therapy.

Experiences of occupational therapy students undertaking an Aboriginal and Torres Strait Islander health module: embedding cultural responsiveness in professional curricula.

Objective Along with other Australian health professionals, occupational therapy students need to understand Aboriginal and Torres Strait Islander culture and health issues to develop their capacity to work effectively with this community and meet accreditation standards. The study aimed to explore the learning experiences of occupational therapy students during a module focused on Aboriginal and Torres Strait Islander peoples' health issues and approaches. Methods A qualitative descriptive method was used. Individual interviews were audiotaped, transcribed and analysed thematically following the module. Participants were asked about their prior experience with Aboriginal and Torres Strait Islander peoples, feelings about undertaking the module, difficulties and highlights of the module, and how the module contributed to their learning. Results In all, 18 students participated in interviews. Interview themes were (1) student context of learning about Aboriginal and Torres Strait Islander peoples' heath and culture, (2) experiencing the module with others and (3) student learning gains following the module. Conclusion Students developed in their self-awareness and understanding of Aboriginal and Torres Strait Islander peoples' issues of relevance to occupational therapy. Further research is needed to evaluate educational activities with occupational therapy and other health professional students across Australia, and ongoing culturally responsiveness training for health professionals (post-registration).

Cognitive strategies utilised by early learners when writing alphabet-letters from memory.

INTRODUCTION: Occupational therapy handwriting studies have shown cognitive instructional techniques are effective methods to assist beginning or challenged handwriters. However, information about how children's cognitive (thinking) skills impact their handwriting development is scarce. This study examined the cognitive strategy efficiency of early learners while writing the alphabet-letters from memory. METHODS: Participants included 408 mainstream children in their first two years of formal schooling (Year 1 and Year 2). Children were asked to write the 26-lowercase alphabet-letters from memory. Data were collected using alphabet-letters generated by the children and observation of their cognitive strategy use while writing. The measurement tool employed was the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis (Stage Two). RESULTS: The results found that Year 1 and Year 2 children had difficulties applying cognitive strategies across all four PRPP quadrants while writing the lowercase alphabet-letters from memory. Application of the cognitive strategies from the Plan and Recall quadrants showed the most inefficiencies. The lowest PRPP subquadrant scores were observed in Evaluating, Recall Facts, Sensing, and Programming. Except for the Attending subquadrant and the descriptor 'Regulates', Year 2 children were significantly better than Year 1 children at applying cognitive strategies from all other PRPP quadrants and subquadrants. CONCLUSION: The findings provide beginning evidence that efficient use of cognitive strategies from all four PRPP quadrants is important for children achieving proficiency in accurate and automatic alphabet-letter-writing skills. Recommendations for occupational therapy handwriting assessment and intervention are provided. PLAIN LANGUAGE SUMMARY: Research suggests that occupational therapists can best help children with handwriting difficulties by using a cognitive approach. This approach involves instructing children how to form letters correctly, encouraging self-evaluation, and providing opportunities to practice handwriting. However, the cognitive (thinking) skills required for children to write alphabet-letters accurately are not well understood. To investigate this, a study was conducted on 408 mainstream children in their first two years of formal schooling (Year 1 and Year 2). The study examined how accurately the children could write lowercase alphabet-letters from memory and which cognitive skills they used to do so. The cognitive skills investigated were related to attention, perception, recalling, planning, and performing. The assumption tested was that mistakes in correctly writing alphabet-letters could be attributed to difficulties in using these cognitive skills effectively. The study found that Year 1 and Year 2 children made errors in over half of the 26-lowercase alphabet-letters they wrote. The cognitive skills, which scored the lowest were children's ability to evaluate their writing, recall how and where to write letters, gather information from their vision, and think carefully to ensure accuracy while writing. This implied that these thinking skills had the most impact on the children's ability to write alphabet-letters correctly. More research is needed to confirm these findings and determine the reliability of the tool used in this study to measure the children's thinking skills.

Screening, Brief Intervention, and Referral to Treatment Plus (SBIRT-Plus): A Novel Interprofessional Training for Rehabilitation Science Professional Students.

IMPORTANCE: With the increasing amount of substance use-related health conditions in the United States, it is important for rehabilitation science professionals to receive screening and prevention training. OBJECTIVE: To describe and examine the preliminary effectiveness of a novel educational program, Screening, Brief Intervention, and Referral to Treatment Plus (SBIRT-Plus), that combines traditional SBIRT training with new modules for cannabis, stimulant, and opioid use. DESIGN: Prospective, cohort design. SETTING: Academic institution. PARTICIPANTS: One hundred eighty-one rehabilitation science graduate students. INTERVENTION: SBIRT-Plus curriculum. OUTCOMES AND MEASURES: Outcomes included satisfaction with training, perception of interprofessional training, attitudes, knowledge, and stigma, as assessed with the Readiness for Interprofessional Learning Scale, Alcohol and Alcohol Problems Perception Questionnaire, Drug and Drug Problems Perception Questionnaire, Knowledge Screening Scale, and two stigma instruments. RESULTS: Most students (>80%) expressed satisfaction with their training, would recommend the training to a colleague, and believed that the training would influence and change the way they practiced with patients at risk for substance use disorders. Students' attitudes and knowledge increased from pre- to post-training, and stigma perceptions were significantly reduced. CONCLUSIONS AND RELEVANCE: SBIRT-Plus is an evidence-based interprofessional training that is feasible to implement in graduate-level education programs. Integrating SBIRT-Plus into professional graduate programs may be an optimal and low-cost model for training rehabilitation health care professionals. Plain-Language Summary: Screening, Brief Intervention, and Referral to Treatment Plus (SBIRT-Plus) is an evidence-based interprofessional training that can be easily adopted in curricula to train professional students about the importance of screening for substance use disorders.

Virtual communities of practice for novice occupational therapists: a vehicle for learning, support and professional identity strengthening?

INTRODUCTION: Healthcare practitioners delivering services in rural and underserved areas need timely access to appropriate knowledge to optimise the care they deliver. Novice generalist occupational therapists in South Africa experience this need as they respond to a high demand for hand therapy. Embedded within a study aimed at identifying their support and development needs, this article describes participants' experience of a virtual community of practice. METHODS: A qualitative case study design was employed. Nine occupational therapists participated in a virtual community of practice that met fortnightly for meetings and interacted on WhatsApp. Data were collected through photo elicitation, facilitated reflection, and case discussions. An online survey questionnaire was used to evaluate participants' experience of this virtual community. Thematic analysis was applied to the anonymous responses submitted by participants (n=7). A number of strategies were employed to ensure the trustworthiness of results including prolonged engagement, member checking, peer examination, reflexive reading and writing, triangulation, and a dense description of participants to enable readers to evaluate the transferability of results. RESULTS: Three themes were generated from analysis. The first theme, versatile support, describes participants' experience of being helped and supported, appreciating the immediacy of support, and being able to share resources. A vehicle for learning captures participants' experience of mutual learning, opportunity to reflect, to acquire knowledge and skills, and develop their clinical reasoning. Finally, the community of practice was grounding: learning opportunities were contextually relevant and participants were able to consolidate their professional values and identity. Participants raised the importance of using online platforms that were accessible, recommended a group size of 5-10 members, and proposed 60-90-minute meetings held weekly or fortnightly. CONCLUSION: A virtual community of practice provided both support and professional development opportunities for therapists delivering hand therapy. Careful planning and implementation to upscale this intervention are recommended for rehabilitation personnel delivering care to underserved communities in South Africa. The logistics of virtual communities need to mitigate for connectivity difficulties, and online platforms should enable real-time support. Participant satisfaction and the evaluation of implementation outcomes should be considered in the design of virtual communities of practice.

Occupational therapy students' perceptions of their experience in a role-emerging Level II fieldwork within higher education student services.

BACKGROUND: Role-emerging settings - those where occupational therapy (OT) services have not traditionally been provided - are common sites for practice placements of entry-level occupational therapy students. A growing body of literature has attempted to determine the value and drawbacks of such practice placements on the professional preparedness of OT students with mixed findings. Benefits have been identified, including increased cultural understanding, advocacy, creativity, initiative, and problem-solving skills. However, OT students have been reported to perceive such placement as limiting their professional growth and preparedness to practice compared to traditional placements. METHODS: A phenomenological study was conducted seeking the perceptions of OT students (n = 14) about their clinical placement at a role-emerging site. Recorded semi-structured interviews were conducted by trained interviewers within two weeks of the end of clinical placement. The recordings were transcribed verbatim and then coded using an iterative multi-coder inductive approach. Inter-coder agreement, reflectivity, and audit trail were maintained. RESULTS: Three themes emerged from the analysis: (1) integrating independence and support, (2) becoming occupational therapists, and (3) filling a gap. These themes reflect students' positive perceptions of their role-emerging clinical placement. They felt that this placement allowed them to develop self-confidence and professional identity as occupational therapists and learn new skills while simultaneously filling a gap in services for clients. Most importantly, they felt that this placement prepared them for their future OT practice. CONCLUSION: This finding and their resounding support of the experience suggest that OT students can perceive role-emerging placement as a solid foundation for clinical practice. Factors, included in this placement, that may have contributed to their experience include the level of support provided, time available for learning including space to make mistakes, and freedom from productivity and payor requirements.