Occupational therapy in primary care: Results from a national survey: L'ergothérapie dans les soins primaires : Résultats d'un sondage national.

BACKGROUND.: To support integration of occupational therapy in primary care and research in this area, it is critical to document examples of occupational therapy in primary care. PURPOSE.: This study describes occupational therapy roles and models of practice used in primary care. METHOD.: An electronic survey was sent to occupational therapists across Canada. Participants were identified using purposive and snowball sampling strategies. Descriptive statistics were used to analyze the data. FINDINGS.: Respondents ( n = 52) were almost exclusively working on interprofessional teams. Intervention was provided most frequently to individual clients, and services were provided both within the home/community and in the clinic. Occupational therapists offered a range of health promotion and prevention services, predominantly to adults and older adults. A number of supports and barriers to the integration of occupational therapy were identified. IMPLICATIONS.: A growing number of occupational therapists are working in primary care providing a broad range of services across the life span.

Enhancing student occupational therapists' client-centred counselling skills.

BACKGROUND: Client-centred practice is the cornerstone of the occupational therapy profession. However, there has been little focus on how to teach students to be client-centred practitioners while engaged in counselling. PURPOSE: The purpose of this study was to examine the impact of the use of a client-completed rating scale on student occupational therapists' client-centred counselling skills. METHOD: A time-series design was used to measure the changes in students' counselling skills over time. Demographic information was collected prior to time one. An online questionnaire was administered after study completion to explore students' experiences of using the Session Rating Scale. FINDINGS: The impact of using the Session Rating Scale as a measure of students' client-centred counselling skills performance significantly improved over time. Most students valued using the rating scale and would recommend its use for future students. IMPLICATIONS: The process of supporting students to learn how to engage clients in providing timely feedback and using this feedback to design treatment sets the stage for integration and application of client-centred practice.

A mixed methods study of student perceptions of using standardized patients for learning and evaluation.

BACKGROUND: Educators recognize the value of using standardized patients (SPs) when teaching and evaluating clinical skills in rehabilitation entry-to-practice education programs but have published little supporting evidence and have yet to evaluate programmatic SP use from a student perspective. This study explored occupational and physical therapy students' perceptions of SP use in their professional education. METHODS: Recruiting current and graduated students, we conducted a two-phase mixed-methods sequential-explanatory study integrating data from a quantitative survey (phase 1) and qualitative focus groups with representative students (phase 2). Quantitative data were used to direct the second phase and informed selection of a purposive sample to participate in four focus groups (N=12). RESULTS: The 24-item online survey obtained a 32% response rate (N=167). Mean ratings were high, but significant differences were found between the four subsections of Teaching, SP Experience, Feedback, and Evaluation (P=0.000). Secondary analyses revealed significant differences based on sex, program, and age. Qualitative analysis revealed that students found SP use especially helpful earlier in their program to bridge classroom teaching and clinical practice. Students in the occupational and physical therapy programs approached SP interactions differently in terms of the authenticity, personal investment, and value of SP feedback. Educator feedback was perceived as reflective of technical skill, and SP feedback reflective of therapeutic value, which students prioritized differently. Students identified a preferential continuum of options for learning and practicing skills, ranging from peers and instructors through SPs to actual patients. CONCLUSION: SPs were perceived as most useful early on in the professional education program, serving to bolster self-confidence and prepare students for clinical fieldwork. Discipline-specific differences impact the perception of SP use and value. Educators need to be aware of pragmatic and contextual issues when using SPs for examination purposes, including repeated exposure to the same actor.

Advancing the use of theory in occupational therapy: a collaborative process.

BACKGROUND: Theory is important to the growth and evolution of occupational therapy. However, use of theory remains challenging for many therapists. PURPOSE: The aim was to develop a process that occupational therapists could apply to advance theory in practice. METHOD: Based on a review of the literature and using a qualitative instrumental case study design, 18 student occupational therapists and eight fieldwork educators completed online modules on the theory advancement concepts generated from the literature, wrote journals, and/or participated in online discussions during fieldwork. Following fieldwork, educators were interviewed and students participated in focus groups exploring their experiences. Directed content analysis was used to analyze the data. FINDINGS: Based on the data collected, we developed the Theory Advancement Process (TAP). The TAP is composed of four primary contexts, a climate of collaborative relationships with four key elements, and four essential processes. IMPLICATIONS: The TAP presents a collaborative process for students, faculty, and therapists to work together to advance the use of theory in practice.