The development of a needs assessment of pediatric occupational therapists: learning needs for competency in mainland China

The growth and learning needs of pediatric occupational therapists working in the People’s Republic of China (PRC) have not been fully researched or documented at this time. Without a formal occupational therapy association, the communication and planning to identify these professional development needs can be challenging. WFOT resources available for non-member countries combine with some of the traditional occupational therapy resources and initiatives from neighboring member associations. Hong Kong and Taiwan provide practices and materials that reflect Chinese culture and assist in promoting the profession (Lin, 2014; Sinclair, 2015). Language nuances, historical and political issues can make direct transference to the mainland of China problematic. These activities help support occupational therapy as a distinct healthcare profession within these regions of the PRC but may have barriers to direct application in mainland China. A formal needs assessment of the occupational therapists has not yet been undertaken. The steps to develop a pediatric needs assessment are presented in this paper. Research confirms a facilitated needs assessment can assist in determining and understanding learning needs, preferences, patterns, and future topics (Newcomer, Hatry, & Wholey, 2015) for occupational therapists and the groups that provide them professional development training in mainland China. There are three distinct stakeholder groups identified for this research project: pediatric occupational therapists, professional development producers, and families of children receiving therapy services in mainland China. The research team works collaboratively with identified stakeholder partners to identify the training and growth needs of the pediatric occupational therapist to provide the required educational recommendations that will foster competency in practice. Both the occupational therapists and the providers of professional development activities gain a better understanding through participation in the program evaluation processes of surveying learning needs in the context of international evidence-based competency content. The implementation and dissemination of the program verifies, validates and provides a synthesis of perspectives and establishes a connection for the client’s input to the therapy services. The program evaluation summary recommendations are hypothesized to have an impact on improving the perception of the quality of pediatric occupational therapy services received by caregivers and families in mainland China

An evaluation of the development of clinical reasoning skills in a cohort of occupational therapy students in Hong Kong : implications for curriculum design

The aim of the study was to evaluate how Hong Kong Occupational Therapy students develop their clinical reasoning abilities and progress through the stages of their undergraduate curriculum. The study examines a range of factors that may affect their development of clinical reasoning. The student cohort was composed of a class of 80 BSc (Honours) occupational therapy students at the Hong Kong Polytechnic University. The study was predominantly quantitative; however, focus group interviews were included among a range of methodologies. Validated test instruments were administered during the four instances of pre- and post-clinical education intervention. The Study Process Questionnaire (Biggs, 1987c) assessed approaches to learning. The Moore & Fitch Inventory of Leaming Preferences (cited in Woods, 1994) was administered to determine whether or not changes in students' learning preferences and attitudes affected clinical reasoning skills. The Self-Assessment of Clinical Reflection and Reasoning (Royeen et al, 1994) was administered as a pre- and post-clinical education intervention to evaluate students' level of clinical reflection and reasoning skills. A focus group interview was designed to probe students' understanding and application of clinical reasoning processes. The study's findings enhance our understanding of the progressive development of students' clinical reasoning skills through novice to expert continuum. Extrapolating into the undergraduate domain, this study highlighted the difficulties students face when trying to reason through, integrate and synthesize their theoretical learning in both academic and clinical education settings. An outcome of this study identified that clinical reasoning is multifaceted and complex in its application. The major conclusions suggest ways in which the development of Hong Kong students' clinical reasoning skills could be enhanced by taking account of their culturally influenced learning styles. As clinical reasoning does not occur in isolation, students need to develop these skills, establish the connection between theory and practice, and apply these skills in client intervention

An evaluation of the development of clinical reasoning skills in a cohort of occupational therapy students in Hong Kong : implications for curriculum design

The aim of the study was to evaluate how Hong Kong Occupational Therapy students develop their clinical reasoning abilities and progress through the stages of their undergraduate curriculum. The study examines a range of factors that may affect their development of clinical reasoning.The student cohort was composed of a class of 80 BSc (Honours) occupational therapy students at the Hong Kong Polytechnic University. The study was predominantly quantitative; however, focus group interviews were included among a range of methodologies. Validated test instruments were administered during the four instances of pre- and post-clinical education intervention. The Study Process Questionnaire (Biggs, 1987c) assessed approaches to learning. The Moore & Fitch Inventory of Leaming Preferences (cited in Woods, 1994) was administered to determine whether or not changes in students' learning preferences and attitudes affected clinical reasoning skills. The Self-Assessment of Clinical Reflection and Reasoning (Royeen et al, 1994) was administered as a pre- and post-clinical education intervention to evaluate students' level of clinical reflection and reasoning skills. A focus group interview was designed to probe students' understanding and application of clinical reasoning processes.The study's findings enhance our understanding of the progressive development of students' clinical reasoning skills through novice to expert continuum. Extrapolating into the undergraduate domain, this study highlighted the difficulties students face when trying to reason through, integrate and synthesize their theoretical learning in both academic and clinical education settings. An outcome of this study identified that clinical reasoning is multifaceted and complex in its application.The major conclusions suggest ways in which the development of Hong Kong students' clinical reasoning skills could be enhanced by taking account of their culturally influenced learning styles. As clinical reasoning does not occur in isolation, students need to develop these skills, establish the connection between theory and practice, and apply these skills in client intervention

HAND THERAPY OUTCOMES: THERAPISTS’ PERCEPTIONS OF OCCUPATION-BASED INTERVENTIONS IN PRACTICE

Purpose: It is well known that hand therapists frequently use biomechanical-based interventions in their treatment of upper extremity injuries and pathologies. There is a push to return to the occupational therapy profession’s roots of occupation-based practice, which has recently been further reinforced with the introduction of the American Occupational Therapy’s (AOTA) Choosing WiselyⓇ Initiative (Gillen et al., 2019). Hand therapy is one area in which occupation-based practice could become more prevalent. This study will enhance the existing research on occupation-based hand therapy through the use of focus group interviews with occupational therapists who have a majority of their caseload classified as hand therapy. The purpose of this study is to examine hand therapists’ perceptions of occupation-based hand therapy to develop an improved understanding of the connection between hand therapy and the overarching field of occupational therapy. Methodology: This study was approved by the Institutional Review Board (IRB) at the University of North Dakota in Grand Forks, ND. A phenomenological approach was used to guide this study. Convenience and snowball sampling were used to gather participants. Participants were primarily recruited through the use of the University of North Dakota Occupational Therapy Fieldwork Database. Participants received an email invitation and then were asked to attend one of two focus group sessions. Data was audio recorded and then transcribed verbatim. Results: Data from the two focus groups was used to create a total of four categories and 13 themes. The data was analyzed using a phenomenological theoretical framework. Three assertions were developed. Results suggest that hand therapists have a tendency of using a top-to-bottom-up approach (Fisher & Jones, 2017) throughout the therapeutic process; however, the end goal of occupational performance drives intervention. It was found that hand therapists do keep occupation at the forefront of practice, despite the misconceptions that exist. The participants did not feel that the benefits of maintaining an AOTA membership justified that annual cost; thus, there is potential for a disconnect and lack of communication between hand therapists and the profession of occupational therapy. Conclusion: The lack of hand therapist membership in AOTA creates challenges for the entire profession because there is potential for a disconnect between occupational therapists practicing as hand therapists and the field of occupational therapy as a whole. It serves as a barrier for dissemination of information crucial to occupational therapy practice, such as research, best practice standards, and mandates from legislation or third-party payers. It also contributes to the lack of understanding of hand therapists’ use of occupation-based practice

Nursing Instructors Preparing Nursing Students to Cope with Distractions When Administering Medications: A Phenomenological Qualitative Study

The purpose of this hermeneutic qualitative study was to discover and describe how nursing instructors teach nursing students to cope with interruptions and distractions while administering medication. The hermeneutic phenomenology approach is appropriate for discovering what nursing instructors teach their students about distraction in the classroom, simulation laboratory, and clinical setting. The study’s guiding theory was Kolb’s experiential learning theory. Nursing instructors from associate and bachelor’s degree programs from across the United States were recruited to participate in this study. The participants completed questionnaires about medication administration instruction, expanding on their answers in semi-structured, one-on-one interviews. All participants had the opportunity to participate in a focus group. Document analysis entailed reviewing each schools’ curricula on medication administration for common themes and trends. The data underwent researcher and coresearcher analysis through a qualitative data analysis system for themes and trends. Four themes emerged from the data. First students would encounter distractions. Second, instructors felt the students did not get enough simulated practice. Third, students did not get enough practice drawing medications from the dispensing station and administering medications. Fourth, the participants stressed safety and focus while administering medications

Racial Trauma: The Silent Killer Among High School Students of Color

Racial trauma is deeply institutionalized within our educational system because of the primary focus on the dominant Western society ideology of culture, language, literacy, and academic standards. Due to minimum recognition in the mental health field or the education arena, the effects of such trauma are profound. They can account for social and behavioral dysfunctions seen in high school adolescent students of color as well as low academic achievement. The phenomenon of racial trauma in society is deeply tragic, with historical roots that pervade public high school campuses and classrooms. The premise of this research was founded on White dominance and privilege. Today, the effects of racial trauma have become dominantly prevalent and still trickle into the personal and academic lives of high school students of color. This study aims to understand the problem through the eyes and lived experiences of high school students of color. The overarching research question is: How does racial trauma impact the mental health of high school students of color? Individual interviews and narrative inquiry were used to encapsulate and validate the issues of racial trauma and its impact on students of color’s mental health. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu)

Teaching Social Determinants of Health in Physical Therapist Professional Education Programs: Exploring Curricular Approaches and Examining an Assessment Tool

There is a growing emphasis and need for physical therapists (PTs) to serve not only as clinicians but also as advocates to pursue health equity. Clinical practice for preventing and rehabilitating injuries and promoting physical activity will not eliminate health disparities resulting from the social determinants of health (SDH). Leaders in the field of physical therapy have charged physical therapist professional education programs to teach future PTs to address SDH, however, as of August 2023, the Standards and Required Elements for Accreditation of Physical Therapist Education Programs does not specifically require curricular content regarding SDH. The purposes of this dissertation were to explore what is known about teaching SDH in physical therapist professional education programs and examine an assessment tool that programs could use to evaluate student outcomes regarding SDH training. A scoping review of 91 articles describing how SDH is taught in health professional training programs in the United States revealed the only published articles addressing physical therapy were through interprofessional education (IPE). The review demonstrated variability in content, educational methods, assessment methods, and curricular logistics across health professional training programs. Consensual qualitative research methodology was used to explore the phenomenon of teaching SDH content as experienced by core faculty in physical therapist professional education programs. Five themes and associated categories emerged regarding the 14 faculty members’ educational approaches, preparedness, and resources for incorporating SDH into curricula at their respective programs. Finally, pilot testing of the Physical Therapy Social Determinants of Health Scale (PTSDHS) was conducted to assess structural validity and internal consistency of the tool. Exploratory factor analysis suggested a 4-factor model of a 27-item instrument, with 3 of the factors having acceptable internal consistency as subscales. Findings suggest that faculty must look to other health professional training programs to determine how to incorporate SDH content into a physical therapist professional education program’s curriculum and will need to decide what topics and educational approaches are most appropriate for their program and context. Faculty already teaching this content should pursue dissemination to share knowledge and resources. Further development of the PT-SDHS is warranted to provide a robust, validated tool

Development and evaluation of a haptic framework supporting telerehabilitation robotics and group interaction

Telerehabilitation robotics has grown remarkably in the past few years. It can provide intensive training to people with special needs remotely while facilitating therapists to observe the whole process. Telerehabilitation robotics is a promising solution supporting routine care which can help to transform face-to-face and one-on-one treatment sessions that require not only intensive human resource but are also restricted to some specialised care centres to treatments that are technology-based (less human involvement) and easy to access remotely from anywhere. However, there are some limitations such as network latency, jitter, and delay of the internet that can affect negatively user experience and quality of the treatment session. Moreover, the lack of social interaction since all treatments are performed over the internet can reduce motivation of the patients. As a result, these limitations are making it very difficult to deliver an efficient recovery plan. This thesis developed and evaluated a new framework designed to facilitate telerehabilitation robotics. The framework integrates multiple cutting-edge technologies to generate playful activities that involve group interaction with binaural audio, visual, and haptic feedback with robot interaction in a variety of environments. The research questions asked were: 1) Can activity mediated by technology motivate and influence the behaviour of users, so that they engage in the activity and sustain a good level of motivation? 2) Will working as a group enhance users’ motivation and interaction? 3) Can we transfer real life activity involving group interaction to virtual domain and deliver it reliably via the internet? There were three goals in this work: first was to compare people’s behaviours and motivations while doing the task in a group and on their own; second was to determine whether group interaction in virtual and reala environments was different from each other in terms of performance, engagement and strategy to complete the task; finally was to test out the effectiveness of the framework based on the benchmarks generated from socially assistive robotics literature. Three studies have been conducted to achieve the first goal, two with healthy participants and one with seven autistic children. The first study observed how people react in a challenging group task while the other two studies compared group and individual interactions. The results obtained from these studies showed that the group interactions were more enjoyable than individual interactions and most likely had more positive effects in terms of user behaviours. This suggests that the group interaction approach has the potential to motivate individuals to make more movements and be more active and could be applied in the future for more serious therapy. Another study has been conducted to measure group interaction’s performance in virtual and real environments and pointed out which aspect influences users’ strategy for dealing with the task. The results from this study helped to form a better understanding to predict a user’s behaviour in a collaborative task. A simulation has been run to compare the results generated from the predictor and the real data. It has shown that, with an appropriate training method, the predictor can perform very well. This thesis has demonstrated the feasibility of group interaction via the internet using robotic technology which could be beneficial for people who require social interaction (e.g. stroke patients and autistic children) in their treatments without regular visits to the clinical centres

Animal-Assisted Interventions in Supervision: A Collective Case Study

Animal-assisted interventions (AAIs) have been discussed in recent conceptual literature as having potential for positive implications when applied in supervision (Chandler, 2017; Jackson, 2020; Owenby, 2017; Stewart et al., 2015). However, there was limited empirical foundation or guidance for the integration of two distinct specializations (AAIs and supervision). The purpose of this qualitative collective case study (Stake, 2006) was to explore and understand the experiences of supervisors who have been implementing AAIs within the context of supervision. Specifically, this study addressed the following overarching research question and two sub-questions were addressed: Q1 Why are supervisors integrating AAIs into supervision? Q1a What are the experiences of supervisors who have been integrating AAIs into supervision? Q1b How are supervisors integrating AAIs into clinical supervision? Three doctoral-level counseling professionals with extensive training and experience in AAIs participated, representing three cases of animal-assisted interventions in supervision (AAI-S). Participants had been practicing AAI-S between 7 and 10 years. Two cases existed within university-based, graduate-level AAI training programs and one case existed in the context of a private-practice. Five sources of data were collected for each participant (demographic questionnaire, professional documents [e.g., informed consent, supervisory disclosure statement], multiple interviews per participant [average of six hours per participant], which included a virtual tour of the AAI-S environment and introductions to animal partners). Data were analyzed using thematic analysis within and across cases (Braun & Clarke, 2009, 2021). Cross-case analysis suggested themes related to need for supportive context for implementation of AAI-S, professionals’ personal experiences associated with AAIs, common guiding frameworks for understanding the process of AAI-S, welfare and competency concerns, and the compelling rationale for AAI-S. The final report presented the findings as a holistic account of AAI-S. Based on the findings of this study, implications recommendations for counselor educators, supervisors, and professionals were provided as well as directions for future research