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.

Occupational Therapy students' Concepts of Learning: Cross-Sectional and Longitudinal Associations With Deep, Strategic, and Surface Study Approaches.

This study aimed to gain knowledge about the cross-sectional and longitudinal associations between learning concepts and approaches to studying among occupational therapy students. A repeated cross-sectional design was combined with a longitudinal study design. Self-report questionnaires assessed sociodemographic variables, learning concepts, and approaches to studying (deep/strategic/surface). Linear regression analyses (n ranging between 109 and 193 in the analyses) showed that higher transforming concept ratings were consistently associated with higher ratings on the deep study approach, both cross-sectionally and longitudinally. Higher reproducing concept ratings were positively associated with higher strategic approach ratings in the second and third study years. In view of the results, students' understanding of what learning is impacts on their study attitudes and behaviors, which in turn is likely to influence learning outcomes and academic performance.

Stable and unstable associations between learning environment factors and study approaches: two consecutive cross-sectional analyses of Norwegian occupational therapy students.

Relationships between learning environment variables and students' approaches to studying have been investigated from many points of view over the last decades. However, few studies have explored whether such relationships are stable over time. In the two consecutive cross-sectional analyses performed in this study, Norwegian occupational therapy students' perceptions of their learning environment and their approaches to studying were assessed in the second (162 students) and third (193 students) year of their study program. Aside from sociodemographic information, the students completed the Course Experience Questionnaire and the Approaches and Study Skills Inventory for Students, with the aim of exploring whether associations between learning environment variables and study approaches were stable across time. The data were analyzed with hierarchical linear regression analyses. Relatively stable associations with students' study approaches were found for the learning environment variables of 'generic skills' and 'appropriate workload'. The learning environment variables of 'clear goals and standards' and 'student autonomy' were directly associated with study approaches in both study years, but the nature of the associations shifted during the study period. Thus, knowledge of stability and change in these relationships could assist faculty in promoting a well-functioning learning environment throughout the study program.

Perceptions of the academic learning environment among occupational therapy students - changes across a three-year undergraduate study program.

INTRODUCTION: Although the learning environment influences students' motivation, learning outcomes, and satisfaction with the study program, less is known about how these factors change as the students' progress through the study program. AIM: The aim of this study was to examine changes in occupational therapy students' perceptions of the academic learning environment during their three-year study program and to examine factors associated with the students' perceptions of the learning environment. MATERIALS AND METHODS: A longitudinal cohort study was conducted throughout the three-year study program. Data were collected annually using the Course Experience Questionnaire (CEQ). In total, 263 students from six occupational therapy programs participated in at least one data gathering point. The number of participants was 186 in the first year, 168 in the second year and 200 in the third year. Of the 263 students who participated in the study, 87 participated in only one point of data collection, 58 at two points and 118 at all three points of the data collection. Data were analyzed with linear mixed models. RESULTS: The results showed statistically significant temporal changes on the "Emphasis on independence", "Good teaching" and "Generic skills" scales. There was a significant decrease in scores from the first to the second year of study and the scores remained at this level in the third study year on both the "Emphasis on independence" and "Good teaching" scales. In addition, associations were found between study effort and educational institution related to the "Appropriate workload" scale, as well as between age and the "Generic skills" scale. CONCLUSION: The temporal changes of the students' perceptions of the "Emphasis on independence" as well as "Good teaching" scales are noteworthy. Both scales indicated a significant decrease in scores, indicating that the students perceived that they were less independent from first to second and third year, as well as a perceived decline in the quality of teaching from first to second and third year. The results of this study are central when planning to facilitate learning, especially related to independence and perceptions of good teaching for students in occupational therapy programs.

Student characteristics associated with dominant approaches to studying: Comparing a national and an international sample.

BACKGROUND: Productive approaches to studying (deep and strategic learning) are associated with a variety of favourable academic outcomes, and may be of particular importance for students in multifaceted and complex disciplines such as occupational therapy. AIM: To explore associations between student characteristics and their dominant approaches to studying in two samples of occupational therapy students: a national sample of Norwegian first-year students, and an international sample of students in different year cohorts (Australia, Hong Kong, Singapore and Norway). MATERIALS AND METHODS: A total of 180 (national sample) and 665 (international sample) students were included in the study. Approaches to studying were measured with the Approaches to Study Skills Inventory for Students (ASSIST). Data were analyzed with adjusted multinomial regression analyses. RESULTS: Age, gender and prior higher education were not associated with the dominant study approach. More time spent on independent study (international sample: OR = 1.07/1.08, p < 0.01/<0.001) and having current study program as the top priority line of education at enrolment (national sample: OR = 2.89, p < 0.05) predicted productive study approaches. CONCLUSIONS AND SIGNIFICANCE: Factors such as age, gender and prior higher education seem to be of limited importance for understanding students' dominant approaches to studying.

Predictors of students' participation in a learning environment survey with annual follow-ups.

BACKGROUND: Longitudinal research is one effective way to gauge changes in a student cohort over time, however attrition in these studies is typically high, which can result in study bias. This study explored learning environment factors, approaches to studying, and academic performance as predictors of occupational therapy students' consistent participation in data collection conducted over three years of their professional program. METHOD: A longitudinal study of Norwegian occupational therapy students (analyzed n = 240) was conducted. Logistic regression analysis was used to explore occupational therapy students' perceptions of the learning environment, their approaches to studying, and exam grades as they related to the likelihood of consistent participation at three annual surveys. RESULTS: Annual response rates varied between 55.1%, and 65.6%, and consistent participation was observed among 49.2%. The fully adjusted regression models showed that higher strategic approach scores increased the odds of consistent participation (adjusted OR: 1.04, p < 0.01), whereas higher surface approach scores decreased the odds of consistent participation (adjusted OR: 0.95, p < 0.05). Neither sociodemographic factors, learning environment factors nor academic performance predicted participation over time. CONCLUSIONS: Researchers can anticipate relatively high levels of attrition in longitudinal studies of occupational therapy students, but attrition seems to be largely proportional between groups. However, completers in longitudinal studies may be somewhat more well-organized and academically oriented than drop-outs.

Rasch analysis of the Self-Efficacy for Therapeutic Use of Self questionnaire in Norwegian occupational therapy students.

BACKGROUND: Research suggested combining modern test theory with classical test theory to achieve comprehensive evaluation of an assessment tool. However, the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire has not yet been examined by the modern test theory. AIMS/OBJECTIVE: This study aims to examine psychometric properties of the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire by using Rasch analysis. MATERIAL AND METHODS: One hundred and eleven occupational therapy students from two universities in Norway completed the questionnaire across four time points. Rasch analysis was used to examine the appropriateness of the rating scales, unidimensionality, person response validity, item/person separation, and the Wright map. RESULTS: The ten-point rating scale did not fully maximise the measurement potentials. Unidimensionality was confirmed except for two items. Person response validity needs further investigation. Excellent person/item separation and Wright map were found. CONCLUSION: This study supports the psychometric properties of the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire in assessing self-efficacy in therapeutic encounters. Further research is needed to address the misfit items and the rating scale issue. SIGNIFICANCE: Rasch analysis showed that the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire is promising to be used as a reliable and valid tool.

Psychometric properties and associations between subscales of a study approach measure.

The purpose of this study was to (i) confirm the factor structure of the Approaches and Study Skills Inventory for Students (ASSIST) in the current sample of undergraduate occupational therapy students and (ii) explore the pattern of associations between the 13 ASSIST subscales. Occupational therapy students (n = 171) across Norway completed the ASSIST. A three-factor structure was confirmed. Several positive associations were found between the deep and strategic approach subscales, whereas several surface approach subscales were negatively associated with the deep and strategic approach subscales. In conclusion, the study showed that the Norwegian ASSIST has a well-functioning three-factor structure in line with its theoretical underpinnings, and it can therefore readily be adopted as a study process measure in Norwegian occupational therapy education programs. In view of the associations between subscales, there is support for a higher-order concept of "productive" study approaches that encompasses both deep and strategic behaviors. The analysis of associations also suggests that students demonstrating unproductive study behaviors may need guidance and intervention that extends beyond the first detected problematic behavior.

Associations between learning environment variables and students' approaches to studying: a cross-sectional study.

BACKGROUND: Aspects of the learning environment may be related to students` approaches to studying, but few studies have investigated these relationships in the context of occupational therapy education. OBJECTIVE: To examine associations between occupational therapy students' perceptions of the learning environment and their approaches to studying. METHOD: One hundred eighty-seven first-year occupational therapy students in Norway (response rate 61.3%) participated in this study. Aside from sociodemographic information, the students completed the Course Experience Questionnaire and the Approaches and Study Skills Inventory for Students. Associations between learning environment variables and study approaches were investigated with hierarchical linear regression analyses. RESULTS: Higher scores on Generic skills were associated with higher scores on the deep and strategic approach scales (ß ranging 0.18-0.51), while lower scores were associated with higher surface approach scale scores (ß = - 0.24). Lower scores on Clear goals and standards and Appropriate workload were associated with higher surface approach scores (ß ranging - 0.16 - -0.42). CONCLUSION: By improving aspects of the learning environment, there may be a potential for influencing occupational therapy students' approaches to studying. Based on this study, emphasizing how generic skills developed in the study program may become useful in practising a profession, ensuring clarity of goals and standards, and maintaining an appropriate workload on students appear to be important.

The Course of Self-Efficacy for Therapeutic Use of Self in Norwegian Occupational Therapy Students: A 10-Month Follow-Up Study.

BACKGROUND: Occupational therapy students need to develop self-efficacy for managing the therapeutic relationship in practice. This study examined the 10-month trajectories of Norwegian students' self-efficacy for use of self. METHODS: Eighty-nine students completed self-efficacy questionnaires related to the use of self after a workshop and at 3- and 10-month follow-up. Changes on the three outcome measures (self-efficacy for therapeutic mode use, for recognizing clients' interpersonal characteristics, and for managing interpersonal events) were analyzed with repeated measures ANOVA. RESULTS: Across the follow-up period, the students improved their self-efficacy for therapeutic mode use (partial η2 = 0.44, p < 0.001), for recognizing clients' interpersonal characteristics (partial η2 = 0.81, p < 0.001), and for managing interpersonal events (partial η2 = 0.32, p < 0.001). CONCLUSION: The increased self-efficacy for use of self that was found at 3-month follow-up was maintained at 10-month follow-up. The results indicate that students may experience a boost in self-efficacy for therapeutic use of self after a brief workshop and that these changes can be sustained over time.

Psychometric properties of the Norwegian self-efficacy for therapeutic mode use (N-SETMU).

BACKGROUND: According to the Intentional Relationship Model (IRM), the intentional use of relational approaches in therapy (therapeutic modes) is essential for obtaining successful relationships to clients. There have been no attempts to combine the IRM with self-efficacy theory, and instruments for measuring self-efficacy for therapeutic mode use are lacking. AIM: This study aimed to examine the component structure and internal consistency of the Norwegian version of the Self-Efficacy for Therapeutic Mode Use (N-SETMU). METHODS: Occupational therapy students (n = 111) from two education programs completed the N-SETMU along with sociodemographic information. Principal Components Analysis (PCA) was performed and component extraction was controlled using Parallel Analysis. Internal consistency was assessed with Cronbach's α and inter-item correlations. RESULTS: All items on the N-SETMU loaded on the same latent dimension, tentatively called Self-Efficacy for Therapeutic Mode Use. Cronbach's α for the scale was 0.82. CONCLUSIONS: The N-SETMU is a unidimensional measure of self-efficacy for therapeutic mode use in general. The N-SETMU may be a useful tool for occupational therapy research and audits focusing on occupational therapists' use of therapeutic modes in client interactions.

Therapeutic mode preferences and associated factors among Norwegian undergraduate occupational therapy students: A cross-sectional exploratory study.

BACKGROUND: The Intentional Relationship Model is specifically focused on the relational aspect of therapy. The model describes six therapeutic modes; these represent different types of interaction for the therapist. However, preferences for therapeutic mode use are under researched. AIMS: This study aims to describe preferences for therapeutic modes in undergraduate occupational therapy students, as well as to explore factors associated to each of the therapeutic modes. METHODS: A sample of 96 occupational therapy students, based at two different Norwegian universities, participated in the study. They completed the Norwegian Self-Assessment of Modes Questionnaire along with sociodemographic information. Descriptive analysis, bivariate correlation and linear regression analysis were employed. RESULTS: The problem-solving mode was most frequently endorsed. There were generally weak associations between the variables, but female sex and being a student in the education program in Trondheim were associated with higher preference for collaboration. CONCLUSION: There is diversity in students' preferences for the modes, but the problem-solving mode was the most preferred. Students need to be aware of the mode they feel more comfortable with and make sure they use modes that fit with the specific client. SIGNIFICANCE: The occupational therapy education programs need to incorporate raising awareness about therapeutic modes.

Differences and similarities in therapeutic mode use between occupational therapists and occupational therapy students in Norway.

BACKGROUND: The Intentional Relationship Model (IRM) is a new model of the therapeutic relationship in occupational therapy practice. Two previous studies have focused on therapist communication style, or 'mode' use, but to date no group comparisons have been reported. AIM: To explore differences between occupational therapists and occupational therapy students with regard to their therapeutic mode use. METHODS: The study had a cross-sectional design, and convenience samples consisting of occupational therapists (n = 109) and of second-year occupational therapy students (n = 96) were recruited. The Self-Assessment of Modes Questionnaire was the main data collection tool. Group differences were analysed with independent t-tests. RESULTS: The occupational therapists responded more within the collaborative and empathizing modes than the students did. The students responded more within the advocating and instructing modes than the occupational therapists did. CONCLUSION AND SIGNIFICANCE: There may be systematic differences between occupational therapists and students concerning their therapeutic mode use. Some modes, such as the collaborating and empathizing modes, may be viewed as requiring more experience, whereas other modes, such as the advocating mode may be related to more recent rehabilitation ideologies. These factors may contribute to explaining several of the group differences observed.