The Kawa Model: A Self-Reflection Tool for Occupational Therapy Student Development in Practice Placements in Australia.

Introduction: The Kawa Model is a conceptual occupational therapy model of practice that uses the metaphor of a river as a medium to support the exploration of self, life events, and environment. In this study, the Kawa Model was used by occupational therapy students during a practice placement in a remote community setting as a tool to support learning, build self-awareness, and promote reflection on personal and professional development. Method: The study used an exploratory qualitative research design. Six student participants were purposively recruited and orientated to the use of the Kawa Model at the beginning and throughout their remote community practice placement. Semistructured interviews were used to collect data which were analysed thematically using interpretative phenomenological analysis (IPA). Findings. Analysis of the student transcripts revealed three overarching themes: self-awareness, the development of personal and professional skills, and working with metaphor. All students identified the model as a reflective tool that enhanced their understanding of their student selves in a remote setting. The students described the growth of various professional skills including communication, goal planning, and confidence. Whilst initially students found the metaphor challenging to fathom, throughout their placement, they found it impactful for comprehending their development of self. Conclusion: This study revealed that the students' self-awareness and personal and professional development were influenced by their engagement with and application of the Kawa Model. Repeated engagement with the Kawa Model enhanced the students' journey of personal and professional skill development.

Preparing students for the future through developing evaluative judgement.

In today's environment, health students need to be prepared for an ever changing workplace and workforce. They need to understand what demonstrates good quality work and how to assess their standard of work. Evaluative judgement can contribute to student and graduate self-regulation and autonomy in their learning. This toolbox article describes how to implement strategies for developing evaluative judgement in allied health placements. These strategies were developed as part of an occupational therapy program in rural Western Australia, where experiential education is provided through service-learning with both direct and indirect supervision. Practical advice is provided on the use of peer-assisted learning, rubrics, self-assessment and feedback. Challenges and opportunities in implementing strategies to develop evaluative judgement, such as how to achieve effective feedback, are also discussed. The suggested toolbox may be adapted to various clinical placement contexts. Developing evaluative judgement can help to prepare our students to be lifelong learners. This article empowers educators to promote this capability in their students to create work ready graduates, who are able to operate independently and in rapidly evolving, technologically enabled environments.

Hospital discharge processes involving older adults living with dementia: An integrated literature review.

AIMS AND OBJECTIVES: To identify barriers and facilitators to engagement of people with dementia and family carers in planning for discharge from hospital. BACKGROUND: Hospital discharge can be particularly challenging for older people with dementia. To assist in the development of bespoke discharge processes that address the unique needs of older people with dementia, an integrated review of the literature was undertaken. DESIGN AND METHODS: A four-stage integrative review framework guided the review. Three search strategies were employed: a computerised database search, a hand search of reference lists and forward citation searching. Paired members of the research team reviewed eligible full-text papers. The methodological quality of each paper was assessed using the Mixed-Methods Assessment Tool, followed by data extraction and completion of summary tables. Within and across study analysis and synthesis of study findings was undertaken using thematic synthesis. RESULTS: Fifteen papers were included in the review. Most identified barriers to collaborative discharge processes related to distributed responsibility for discharge, risk averse approaches to discharge, limited family carer confidence, and limited validation of assumptions about family competency to manage at home. Facilitators included supported clinician and family carer engagement, and maintaining independence for activities of daily living. RELEVANCE TO CLINICAL PRACTICE: Reflective analysis of discharge decisions, focused on risk and possible risk aversion, can assist teams to evaluate the quality of their discharge decisions. The use of formal communication strategies such as a patient/family-held journal of the hospital experience and a structured family meeting early in the hospital admission can enhance family engagement in discharge planning. Prevention of functional and cognitive decline is emerging as critical to improving hospital discharge outcomes.