Meaning and Impact of Interprofessional Simulation Participation for Occupational Therapy Students: A Qualitative Descriptive Study

Occupational therapy programs are incorporating simulation experiences more regularly into their curricula. However, there continues to be a need for more evidence demonstrating simulation benefits, particularly when various client populations, standardized actors, interpersonal skill practice, and multiple disciplines are incorporated into scenarios. The purpose of this qualitative descriptive study was to describe the meaning and impact of participating in an interprofessional simulation for occupational therapy students as part of their current academic preparation and future clinical practice in the hopes of increasing the participants’ interpersonal and clinical reasoning skills. Study participants were entry-level occupational therapy doctoral students (N=64) and their written reflections represented the collected data. The interprofessional simulation involved standardized actors and challenged students’ interpersonal skills as they responded to an unexpected and emotionally charged situation. Data were analyzed line by line and incident-to-incident, and ultimately organized into a categorical structure. There were four major categories: Simulation experience, Student meaning, Future clinical impact, and Multifactorial impact. Study results suggest: 1) occupational therapy students appreciate and benefit from simulation experiences; 2) standardized actors decrease familiarity for students and adds realism; and 3) interprofessional education opportunities contribute to students’ understanding of their own role and the roles of other disciplines. When designing simulation experiences, faculty should consider incorporating unexpected circumstances to challenge the student’s interpersonal skills, using a combination of high fidelity simulations with standardized actors, and including as many disciplines as possible to fully reflect the diversity and extensive skills of the interdisciplinary team

Educational Impact on Therapists’ Knowledge, Beliefs, and Actions: A Pilot Study

ABSTRACT Purpose: Collaborative goal setting has been shown to be an effective way to promote client engagement leading to improved outcomes; however, healthcare professionals face challenges when implementing collaborative goal setting into their clinical practice. The purpose of this study was to evaluate the effectiveness of educational workshops to 1) increase a therapist’s knowledge of motivational interviewing and action planning, 2) promote collaboration between therapists and their patients/clients, 3) promote collaboration between therapists and their interdisciplinary team and 4) increase the ease of implementation of motivational interviewing and action planning skills into a therapist’s clinical practice. Method: A mixed-methods design was utilized. Occupational therapists and physical therapists were recruited via email to participate. Data were collected via online surveys at three different times (before the first educational workshop, after the second workshop, and three months after the second workshop) consisting of quantitative related survey questions assessing the participants’ knowledge, beliefs, actions, and perceived self-efficacy related to motivational interviewing and action planning and qualitative questions focused on typical goal development processes, level of collaboration and challenges associated with developing goals with clients and interdisciplinary team members and anticipated/resultant impact and meaning of participation in the educational workshops. Results: The sample included 19 participants. Quantitative data demonstrated a statistically significant increase in self-scoring related to knowledge, beliefs, and actions when comparing all the pre-education to the post-education scores, except for one (collaboration with interdisciplinary team members). A follow-up analysis on this criterion demonstrated no statistically significant changes over the three-month period, potentially indicative of retention of the material covered. The qualitative data provided further insight into the challenges faced by participants and the perceived benefits of participating in the educational workshops. Conclusion: The educational workshops appeared to be effective in addressing some of the barriers to collaborative goal setting (e.g. lack of time, knowledge/skills, appropriate patients, concern for duplication of services) found in the literature, most notably providing the participants with the knowledge and skills needed, which is the first step when implementing collaborative goal setting into clinical practice. Further research in this area is recommended

Recommendations for Academic Programs to Best Support Occupational Therapy Students: Student Perspectives

Declining occupational therapy student mental health and well-being is well described in the literature. However, there is a lack of literature describing recommendations from the student perspective that could help academic programs as they develop and implement support programming. Involving students in the process can be beneficial as they are experts in their experiences. The purpose of this qualitative descriptive study was to describe recommendations current occupational therapy students had for their academic programs to best support them during their educational experience. The study sample consisted of 628 entry-level masters and doctoral occupational therapy students from 31 states. Participant responses to one open-ended question compromised the raw data. Data was analyzed line by line using a multi-tiered coding process. Five themes emerged from the data related to faculty/student interactions, in-classroom learning, out of classroom support, programmatic recommendations, and no recommendations. Many of the participants’ recommendations were consistent with the general recommendations found in the literature. However, occupational therapy academic programs could incorporate the participants’ recommendations into their local level programming while also highlighting occupational therapy’s distinct values. To promote student well-being, consider all contexts and factors that impact their students’ occupational performance and incorporating meaningful, occupation-based activities inside and outside of the classroom. As occupational therapy programs are successful in supporting their students, they could contribute to their university systems’ wider campus efforts highlighting the profession’s unique role in promoting health and well-being

Predictors of General Well-Being in Postprofessional Students of Occupational Science and Occupational Therapy

Background: Doctoral students experience decreased well-being during their educational experience. Self-compassion, engagement in meaningful occupations, and occupational balance positively impact well-being in individuals. This study examined the relationships between these constructs in postprofessional occupational science and occupational therapy students. Method: This quantitative cross-sectional study collected national survey data (N = 113) using the Self-Compassion Scale – Short Form, the Engagement in Meaningful Activities Survey, the Occupational Balance Questionnaire 11, and the 14-item Scales of General Well-Being. Multiple linear regression analysis determined how well each construct predicted general well-being and the strength of each construct’s relationship compared to other constructs. Results: The model of combined variables was significant, F(3, 104) = 36.22, p \u3c .001, accounting for 51.1% of the general well-being variance. All predictors were significant, with the self-compassion standardized coefficient beta being largest (β = .39), followed by engagement in meaningful occupations (β = .38), and occupational balance (β = .16). Conclusion: Self-compassion, engagement in meaningful occupations, and occupational balance predicts well-being in postprofessional students, which is consistent with previously known relationships. The participants’ understanding of foundational tenants of occupational science and occupational therapy may have helped mitigate further decline in their well-being, confirming the power of occupation to positively impact well-being

Short-term Service-Learning: Implications for Preparing Health Science Students for Practice

Purpose: The purpose of this paper is to examine students’ self-reported learning outcomes following participation in collaborative interprofessional service-learning experiences through the qualitative analysis of participants’ written, guided critical reflections. Method: Participants responded to guided reflection questions pre and post trip. The four pre-trip open-ended reflection questions included: what the students expected or hoped to learn, how they expected to learn this, the importance of this learning for their career skill development and how this learning could be used in the future. Upon completion of the service-learning experience, students were asked the same questions with slight variation- What did they learn, how did they learn this, the importance of this learning for career skill development and how this learning could be used in their future practice. Open coding strategies were employed to guide the researchers’ analysis of the student participants’ written responses. Results: There were 145 participants in the study, including 86 students in a comparison group and 59 students who participated in service-learning trips during 2018 and 2019. Service-learning participants majored in nursing (47.4%, n=28) and occupational therapy (33.9%, n=20), with fewer participants in pharmacy (n=5), physical therapy (n=5) and social work (n=2). Comparing pre and post service-learning group responses, researchers noted that the post-trip reflections included more depth, breadth and insight compared to the pretest reflection responses for each theme. Post trip responses also included the additional theme of personal growth. Post-trip participants reported having a greater self-awareness of their own limitations and strengths, having a broadened perspective, experiencing spiritual growth, and developing attitudes of gratefulness, humility, flexibility, patience, and empathy after participating in the trip, reinforcing the idea that immersion created learning is exponential when it is experiential. Conclusions: Service learning coupled with guided critical reflection is an effective tool in enhancing interprofessional collaboration. Qualitative analysis of students’ self-reported learning through written reflections served as a valuable means for capturing learning outcomes related to interprofessional collaboration competencies

Students’ Self-Perceptions of Self-Awareness/Self-Regulation when Experiencing Unexpected Situations in an Interprofessional Clinical Simulation

Background: The healthcare environment is becoming increasingly complex and demanding; therefore, providers need to possess both technical and non-technical skills to respond in unexpected circumstances. Self-awareness and regulation are non-technical skills where an individual becomes aware of personal and others’ emotions and then modulates those emotions to effectively act during a challenging situation. Educational programs need to embed more opportunities for students to develop these skills to enhance patient outcomes. Purpose: The purpose of this research study was to explore student self-perceptions of self-awareness and self-regulation when experiencing unexpected situations in an interprofessional clinical simulation. Methods: Healthcare students (n = 109) from four disciplines participated in this qualitative research study involving an interprofessional small group, face to face simulation with unexpected circumstances. Following the simulation, participants engaged in a semi-structured debriefing. Comments were recorded and analyzed to develop a thematic structure. Results: Participants had varying views about their level of preparedness to handle complex, unexpected situations ranging from feeling not prepared at all to recognizing that they need to be equipped for anything. Students also reported a greater appreciation for the interprofessional team, acknowledging the need for one another as they navigated unexpected circumstances. Some students used their self-awareness and regulation skills in the moment to manage their emotions and move to action in response to the unexpected circumstances, while others benefited from observing and hearing from others during the simulation and debriefing session. Conclusions: The interprofessional simulation helped to prepare students to navigate unexpected challenging patient care circumstances. Students experienced some role and action confusion in response to the emotionally charged scenario; however, they recognized the importance of being self-aware, regulating their own emotions and the skills of the interdisciplinary team to best meet the needs of the patient and family. Additional opportunities for non-technical skill practice should be included in healthcare curriculums to enhance students’ preparedness for the current healthcare environment. Further research is recommended to determine best practices for teaching these non-technical skills

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts