Cognitive Evaluation: Is It Time to Require Standardized Assessments?

Mounting evidence from across the medical community supports standardized cognitive assessment and intervention. This manuscript presents a clinical perspective on the benefits of utilization of standardized assessments to inform clinical practice. Today’s value-based care initiatives demand standardized testing to support evidence-based practice. Standardized cognitive assessment would wisely be adopted into practice to help practitioners fully identify impairments preventing patients from achieving successful outcomes

Exploration of Occupational Therapy Practice for Children with Autism Spectrum Disorders in the Dominican Republic

Background: To better understand the current practice trends of ASD treatment globally and promote practitioner collaboration, it is important to complete studies in countries where little is known about the diagnosis and treatment of ASD through an occupational lens. The aim of this study was to gain an insight into how occupational therapists in the Dominican Republic evaluate and treat children diagnosed with ASD. Method: This qualitative descriptive study explored the perception of occupational therapists (n = 6) and caregivers of children with ASD (n = 28) through a questionnaire and focus group. Interview transcripts and questionnaire text were analyzed using thematic analysis. Trustworthiness was established through member checking, an audit trail, triangulation, reflexivity, and a thick description. Results: Three themes emerged: caregiver ability to access quality services, importance of caregiver involvement in the treatment process, and value of client-centered care. Conclusion: Promoting cultural humility, which focuses on continuous critical self-reflection and lifelong learning, can lead to improved outcomes for this population from initial diagnosis to the overall treatment process

Promoting Student Understanding of Occupation-Centered Practice and Updated Inter-Rater Reliability of the Occupation-Centered Intervention Assessment

The Occupation-Centered Intervention Assessment (OCIA) was developed as a reflective tool for students to improve their comprehension of occupation-centered practice. Finding new and innovative ways to incorporate occupation-centered assignments can serve as a strategy to develop student integration of occupation-centered practice and allow educators to appraise student comprehension. The purpose of this study was to evaluate student understanding of occupation-centered practice by utilizing various statistical analyses, including updated inter-rater reliability, of the OCIA using student assignments. Utilizing a methodological approach, 121 first-year students analyzed 10 physical rehabilitation videos utilizing the OCIA to rate the interventions for their level of occupation-centeredness. Overall, the students demonstrated good agreement (α =.864), indicating the OCIA has good inter-rater reliability with first year students. Individual and aggregate student OCIA scores and standard deviations provided valuable information to the course instructors for threshold concepts to reinforce throughout the course and program. The use of the OCIA facilitates student comprehension and application of occupation-centered reasoning and can be woven into didactic curricula as a learning tool

A Comparison of Modified Team-Based Learning and Lecture-Based Instruction in Occupational Therapy Education

This study explored the comparative effectiveness of team-based learning and lecture-based instruction in consecutive cohorts of occupational therapy students. Further, the study explored student perceptions of team-based learning. The mixed method study employed a two-group, quasi-experimental design and a broad qualitative design using thematic analysis with a convenience sample of consecutive occupational therapy student cohorts (N=70, N=62) in a human movement class. Cohort A (N=70) received instruction using a lecture-based instruction (LBI) approach and individual assessment. Cohort B (N=62) received modified team-based learning (TBL). Mid-term, final examination, and final course grades were compared. Thematic analysis was employed to assess student perceptions of TBL as an instructional method. Students receiving LBI had higher mid-term scores than those receiving TBL (p=.000). Final examination scores were also higher for LBI when compared to TBL (p=.000). However, the final course grade score showed no significant difference between LBI and TBL (p=.562). Thematic analysis revealed that students felt positive about the TBL instructional method. Further, students who participated in the TBL class perceived less academic stress, and believed testing and competency assessments were effective reflections of their learning. Both TBL and LBI are viable methods for occupational therapy educators to use in human movement/kinesiology-based courses

Supporting the Professional Reasoning of Students from Fieldwork to Practice

The Occupation-Centered Intervention Assessment (OCIA) was created to assist occupational therapy practitioners and students to apply knowledge of the core theoretical constructs of occupation from didactic education to clinical practice. This study investigated how the OCIA influenced students’ professional reasoning and supported students’ transition from academic education to clinical practice during fieldwork. Using an inductive qualitative approach, researchers analyzed master’s level students’ (n=61) reflection on using the OCIA to analyze an intervention they had reported providing during fieldwork. Collaborative data analysis produced 48 initial codes. Ongoing peer briefing led to grouping of coded data into three themes and 15 subthemes, and subsequently into four subthemes. Trustworthiness was established through use of multiple researchers, reflexivity, an audit trail, thick description, and peer briefing. Three major themes emerged: (1) promotion of reflection on practice; (2) support of the student’s developing professional identity; and (3) ease of use of the OCIA. The OCIA serves as a tool to facilitate development of students’ professional reasoning while promoting occupation-centered practice

Mixed-Method Study of the Experiences and Routines of Caregivers of Children with Type 1 Diabetes

Background: Type 1 diabetes is one of the most prevalent chronic childhood conditions that affects family roles, routines, and the ability to participate in meaningful occupations after a child’s diagnosis. Because of the complex health management routines required to ensure the safety and well-being of a child with type 1 diabetes, caregivers may experience decreased overall health and well-being. Method: This sequential mixed-method study used a cross-sectional survey (n = 37) and phenomenological interviews (n = 6) to explore burden (the Burden Scale for Family Caregivers), quality of life (the WHO Quality of Life-BREF), and role engagement (a questionnaire) for caregivers of children living with type 1 diabetes. Results: The findings suggest that as caregiver burden increased, quality of life decreased (r = -.73, p \u3c 0.05). The caregivers described how caring for their children affected relationship maintenance with spouses, family, and friends; impacted their productive occupations involving work, home responsibilities, self-care, and finances; and revealed a pressing need for education and advocacy. Conclusions: The findings highlight the importance of supporting caregivers in their roles in providing diabetes management care to children with type 1 diabetes. Future research is needed to develop and test novel occupational therapy interventions aimed to simultaneously improve family-centered participation goals that support the medical management of diabetes care and the caregiver’s psychosocial well-being

Journey Interrupted: A Phenomenological Exploration of Miscarriage

Background: Miscarriage is a significant life event that impacts occupational performance, identity, and competence and that influences perceptions of motherhood. Because of the lack of social rituals often attributed to the death of a loved one, miscarriages may result in disenfranchised grief, which impedes coping. Methods: This phenomenological study explored the impact of miscarriage on relationships, perceptions of motherhood, and the meaning of occupation in the context of grief. Data was collected through semi-structured interviews (N = 4) and completion of a brief demographic questionnaire. The interviews were digitally recorded, transcribed verbatim, and reviewed to ensure accuracy. Using inductive thematic analysis, the first author identified initial codes, collated the codes into preliminary themes, and then reviewed, further analyzed, and refined the themes. Results: Three overarching themes were identified: (a) the journey: ambiguity, vulnerability, and the trauma of a miscarriage; (b) seeking acknowledgement and validation of loss: impact on relationships; and (c) occupational engagement: evolving roles and perspectives. Conclusion: The findings of this study illustrated the complexity of the lived experience of miscarriage and highlighted the significant impact of miscarriage on self-identify, relationships, and the complex role of occupation in the context of bereavement

Establishing Inter-Rater Reliability of the Occupation-Centered Intervention Assessment for Student Observation of Rehabilitation Interventions

The Occupation-Centered Intervention Assessment (OCIA) is a tool designed to capture and rank occupational therapy interventions through an occupational lens to improve occupational therapy students’ professional reasoning skills. The purpose of this study was to determine the inter-rater reliability of the OCIA for occupational therapy interventions provided to adults with physical rehabilitation needs as observed by occupational therapy students. Utilizing a methodological research approach, 111 students completed training for application of the OCIA and independently scored five standardized videos of occupational therapy interventions. Results indicated an overall agreement of α=0.856 using Krippendorff’s alpha. Student raters demonstrated good agreement for rating adult physical rehabilitation interventions, indicating that the OCIA may be a beneficial learning tool for didactic coursework prior to experiential learning

Education and Perceptions of Post-Therapy Maintenance Programs in Long-Term Care: A mixed Methods Exploratory Study

Background: Occupational therapists develop maintenance programs (MPs) for long-term care (LTC) residents to optimize participation in everyday activities. The purpose of this study was to examine nursing professional attitudes and knowledge of MPs and to evaluate the effectiveness of an occupational therapist-led in-service. Method: Nursing staff (n = 20) attended the in-service, completed a pre and posttest, and completed interviews (n = 5). We used an exploratory sequential mixed methods design with a one-group quasi-experimental design for the quantitative portion and a descriptive qualitative approach for the interviews. Results: The results indicated significantly increased knowledge regarding MPs, use of the MPs, and overall perception of nursing management support (p \u3c 0.05). Qualitative analysis of the interviews revealed four themes: MPs promote resident independence, perceived multiple barriers prevent implementation, the need for increased staff training and communication, and positive interdisciplinary MP communication. Conclusion: Preliminary data indicated that therapists-led educational sessions may have a positive impact on nursing staff knowledge and perceptions of MPs. However, future programming to develop training to overcome barriers of MP implementation is needed

Bundling Payment Initiatives for Total Hip and Knee Arthroplasties: Perspectives of Health Care Professionals

Background: A broad qualitative research study explored the perceptions of rehabilitation health care professionals and administrative leadership on coordination of care for rehabilitation patients who received hip or knee arthroplasties under the bundling initiative. Method: Data was collected through the conduction of a focus group, email communication, and individual phone interviews. Researchers analyzed data collected from five administrative personnel and eight rehabilitation health care professionals who work in a facility that participates in a bundling initiative payment model. Results: Four major themes were identified: importance of care coordination, increased efficiency and effectiveness, establishing protocols, and challenges of bundling payment. Conclusion: These findings indicate the significance of interprofessional collaboration and communication, establishment of patient autonomy, and adherence to rehabilitation protocols with hip or knee arthroplasties