Occupational Therapy Students’ Experiences of Team-Based Learning: A Multi-year Study

Many health sciences disciplines have adopted team-based learning (TBL) as part of their education pedagogy, with studies showing increased classroom participation and learner satisfaction. However, it will be beneficial to explore the learning experiences of occupational therapy students in TBL using a mixed methods approach. In an undergraduate occupational therapy program, students undertook three clinical modules using TBL in years two and three. This study explored their perceptions and experiences of TBL. This was a mixed methods prospective cohort study, during which two cohorts of students from Academic Year (AY) 2016 and AY2017 completed the Team-Based Learning Student Assessment Instrument (TBL-SAI) at the end of their first (midway evaluation) and third clinical module (final evaluation). In addition, they completed a semi-structured survey to share their learning experience. One-hundred twenty-seven occupational therapy students from both cohorts had full data and their results showed higher than neutral for Accountability, Preference for TBL, and Student Satisfaction sub-scales and composite scores at midway and final survey. Collectively, there were no significant changes in TBL perceptions, and no significant relationships were found between TBL-SAI scores and module results. Within the AY2017 cohort, there was positive moderate association between Accountability sub-scale midway score and module results. Qualitative analysis produced four themes: 1) power of discussion; 2) time use; 3) changed learning process and outcome; and 4) tailoring aspects of TBL to enhance learning. Occupational therapy students’ scores in the TBL-SAI domains were higher than neutral at midway and final evaluation. TBL may be a suitable method to aid learning of clinical occupational therapy knowledge

The use of virtual reality and augmented reality in psychosocial rehabilitation for adults with neurodevelopmental disorders: A systematic review

ObjectivesVirtual reality and augmented reality have been used in psychosocial rehabilitation for adults with neurodevelopmental disorders in recent years, to provide functional training in a scaffolded and appealing manner. This systematic review attempted to evaluate (1) how virtual reality or augmented reality technology was deployed, when used as an intervention for adults with neurodevelopmental disorders; and (2) how virtual or augmented reality-assisted psychosocial rehabilitation programs impacted on the functional domains of community living, employment and social participation.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was adopted and a search of publications between June 2012 and June 2022 was carried out. The target groups were adults with schizophrenia/schizoaffective disorders, autism spectrum disorder, intellectual disabilities and attention deficit hyperactivity disorder. Interventions that targeted at least one functional domain were included.ResultsThe database search generated 1,267 records and 38 studies met the inclusion criteria. Three studies utilized augmented reality while the rest utilized virtual reality. The virtual scenarios were displayed in various ways, such as head-mounted displays, computer screens, mobile devices and cave rooms. A few studies also used features such as speech recognition, eye tracking and motion-capture device to provide real-time feedback to participants during rehabilitation. Eleven studies reported interventions that addressed community living, 15 studies addressed vocational skills and nine studies trained participants in social skills or social cognition. Three studies sought to improve quality of life using virtual scenarios to expose participants to various situations. Majority of these studies reported preliminary promising results, with improvement in the functional domains addressed. However, several studies had small sample sizes and many single-arm pretest-posttest studies were assessed to be of serious or critical risk of bias.ConclusionVirtual reality and augmented reality are deployed in various ways to augment psychosocial rehabilitation for adults with neurodevelopmental disorders. Most interventions target skills training or strategy learning in the areas of community living, work and social participation. Preliminary positive findings of their effects on functional performance were reported. Larger and robust studies using ecologically valid outcome measures will be needed to establish their effects on real-world functional outcomes.Systematic review registrationidentifier: CRD42022335443

Special Libraries, January 1930

Volume 21, Issue 1https://scholarworks.sjsu.edu/sla_sl_1930/1000/thumbnail.jp

The effects of cognitive remediation on functional outcomes among people with schizophrenia: A randomised controlled study

Objective: Cognitive remediation is an intervention to overcome cognitive deficits through drills and use of strategies. Previous studies have reported positive effects for cognitive remediation on neurocognition, but researchers allegiance effects are not always adequately controlled. Furthermore, its efficacy amongst the Asian population has not been established. Hence, this study aimed to determine if cognitive remediation would have positive effects on neurocognition and functioning within an English-speaking Asian population, when compared against the effects of a credible and balanced control provided by therapists blinded to the study hypothesis. Method: A total of 70 participants with schizophrenia who attended vocational training or day rehabilitation programmes were randomised to receive a 60-hour programme of either cognitive remediation or physical exercise. Neurocognition and functional outcomes were measured at baseline, upon completion of treatment, 6 months after treatment and 1 year after treatment. Results: Participants who received cognitive remediation had significantly greater improvement in all neurocognitive domains. Furthermore, the cognitive remediation group achieved greater attainment of vocational or independent living skills and better functional outcomes at post-intervention and at the end of the 1-year follow-up. Conclusions: When compared against a credible intervention such as physical exercise, cognitive remediation was able to show significant positive effects on both neurocognition and functional outcomes among the Asian population of schizophrenia patients

The effect of therapeutic alliance on attitudes toward psychiatric medications in schizophrenia

Purpose/Background: The differential influence of therapeutic alliance with different health care professionals on patients' medication adherence has never been examined. Methods/Procedures: Ninety-five stable outpatients (91 patients with schizophrenia and 4 patients with schizoaffective disorder) were recruited. Individual, clinical, and medication factors were assessed, along with drug attitude (10-item Drug Attitude Inventory). Comparison on these factors was made between outpatients who identified psychiatrists as the health care professional most involved in their care, as compared with other health care professionals. Findings/Results: Older age, longer duration of illness, presence of medical comorbidities, lower levels of internalized stigma, higher levels of insight, higher levels of functioning, lesser severity of depressive symptoms, and positive symptoms were found to be significantly associated with greater levels of drug attitude (small to moderate associations). Only therapeutic alliance had a large correlation with drug attitude (ρ = 0.503, P < 0.001). The therapeutic alliance scores between the 2 health care professionals groups are not significantly different. However, participants who have identified psychiatrists as the health care professional that contributed the most to their recovery reported a significantly more positive attitude (μ = 6.18, SD = 3.42) toward psychiatric medication as compared with the other health care professionals group (μ = 3.11, SD = 5.32, P = 0.004). Only 2 factors, the Revised Helping Alliance Questionnaire (β = 0.424, P < 0.001) and Personal and Social Performance scale (β = 0.272, P = 0.006), were statistically significant predictors of drug attitude. Implications/Conclusions: Therapeutic alliance is found to be the lead factor associated with drug attitude in patients with schizophrenia. Identifying psychiatrists as the health care professional most involved in the patients' recovery can greatly increase patients' drug attitudes. Maintaining individuals' functioning also contributes to drug attitude.Ministry of Health (MOH)National Medical Research Council (NMRC)This work was supported by the National Medical Research Council, Ministry of Health, Singapore (grant no. NMRC/CG/004/ 2013). J.L. is further supported by the National Healthcare Group's Clinician Scientist Career Scheme (grant no. NHG- CSCS/15007) and the Singapore Ministry of Health's National Medical Research Council under its Clinician Scientist Award (NMRC/CSAINV17nov005)

An Asian study on clinical and psychological factors associated with personal recovery in people with psychosis

Background: Despite the rising recognition of personal recovery, there is a lack of research on personal recovery in individuals with psychosis in Singapore. This study aims to evaluate the psychometric properties of the QPR-15 using the CHIME personal recovery framework and to examine its associations with clinical recovery factors. Methods: Sixty-six stable outpatients were recruited and assessed at two time points approximately 2 weeks apart. Convergent validity was examined through Spearman correlations with scores on CHIME-related psychological factors: connectedness (Ryff subscale- positive relations with others), hope (Herth Hope Index- abbreviated), identity (Ryff subscale- self-acceptance, Internalized Stigma of Mental Illness- Brief), meaning (World Health Organization Quality of Life Assessment-Brief Form), empowerment (Empowerment Scale). Pearson’s correlation was used to examine the test-retest reliability, while Cronbach’s alpha was used to examine internal consistency. The initial factor structure was evaluated via principal component analysis, Velicer’s minimum average partial (MAP) criteria, parallel analysis, and a scree plot. Spearman correlations and hierarchical multiple linear regression (controlling for age and gender) were employed to examine the association of clinical (symptoms and functioning) and psychological factors with the QPR-15. Results: The QPR-15 demonstrated convergent validity with all CHIME-related psychological factors (rs ranged from 0.472 to 0.687). Internal consistency was excellent (Cronbach’s alpha = 0.934), and test-retest reliability was adequate (r = 0.708). Initial factor structure evaluations revealed a one-factor model. Correlations of clinical factors with the QPR-15 were mostly low (rs ranged from − 0.105 to − 0.544) but significant, except for depressive symptoms (CDSS: rs = − 0.529 to − 0.544), while correlations were moderate for psychological factors. Clinical factors significantly explained 28.3–31.8% of the variance of the QPR-15. Adding psychological factors significantly increased the model variance at baseline (∆ adjusted R2 = 0.369, F change < 0.001) and at time point 2 (∆ adjusted R2 = 0.208, F change < 0.001). Conclusion: Our results provide preliminary evidence that the QPR-15 has adequate psychometric properties in Singapore and encompasses the CHIME personal recovery framework. In addition, our results suggest that clinical recovery and personal recovery are not substitutes for each other but rather are complementary, thereby promoting a more holistic evaluation of recovery in people with psychosis. Implications are discussed.NMRC (Natl Medical Research Council, S’pore)MOH (Min. of Health, S’pore)Published versio

Using the CHIME personal recovery framework to evaluate the validity of the MHRM-10 in individuals with psychosis

The recovery movement has revealed that outcomes which focuses on just symptoms and functioning may not be holistic and that consumer-rated outcomes may contribute to a more holistic and person-centric care model. However, a brief and effective measure is required in clinical settings; hence, the aim of the current study is to evaluate the psychometric properties of the briefest personal recovery measure- Mental Health Recovery Measure-10 items, using the CHIME (Connectedness, Hope and optimism about the future, Identity, Meaning in life, Empowerment) personal recovery framework. 64 outpatients with schizophrenia or schizoaffective disorder were assessed at two time points, 2 weeks apart. Data collected included sociodemographic information, MHRM-10, Psychological factors related to the CHIME framework, in respective order: RYFF subscale positive relations with others; Herth Hope Index (HHI); Internalized Stigma of Mental Illness (ISMI) and RYFF subscale self-acceptance; World Health Organization Quality of Life- BRIEF (WHOQOL-BREF); Empowerment, and Clinical factors- symptoms as measured by Positive and Negative Syndrome Scale, functioning (PSP) and depressive symptoms (CDSS). MHRM-10 demonstrated convergent validity with CHIME personal recovery psychological factors (all ρ > 0.5). MHRM-10 had excellent internal consistency (Cronbach's alpha = 0.904) and adequate test-retest reliability (ρ = 0.742, p < 0.001). Initial factor structure analysis revealed a one factor structure. The MHRM-10 is a valid instrument for use and can serve as a tool to facilitate a more collaborative and person-centric model of care for individuals with psychosis.Ministry of Health (MOH)National Medical Research Council (NMRC)This study was funded by the Singapore Ministry of Health’s National Medical Research Council under the Centre Grant Programme (Grant No.: NMRC/CG/004/2013). The funders had no role in the design and conduct of the study, or in the analysis and interpretation of study data and in writing the manuscrip

Defining occupational competence and occupational identity in the context of recovery in schizophrenia

The Occupational Self Assessment (OSA) measures two constructs from the Model of Human Occupation: occupational competence and occupational identity. In the field of mental health, the recovery movement has sparked discussions about what constitutes personal, clinical, and functional recovery. However, how occupation-based terminologies are related to the recovery framework is unclear

Factors associated with changes in community ability and recovery after psychiatric rehabilitation : a retrospective study

One of the key goals of psychiatric rehabilitation is to return individuals with mental illnesses back into the community via restoration of the necessary skills. This retrospective study seeks to evaluate the factors associated with improvement in community functioning after a period of outpatient rehabilitation. 223 individuals enrolled into three broad rehabilitation groups—clinical, vocational and creative therapies/individual sessions—were included in this study. The Multnomah Community Ability Scale (MCAS) and Milestones of Recovery Scale (MORS) were used to evaluate each individual before and after the rehabilitation programme. Across all three groups, there were significant improvements in MCAS scores and MORS ratings. In multivariate models, clinical rehabilitation group was superior to creative therapies/individual sessions in predicting MORS change. The study also revealed a close relationship between recovery gains and improvement in community ability.NMRC (Natl Medical Research Council, S’pore)MOH (Min. of Health, S’pore)Accepted versio

Assessment of patients with negative symptoms of schizophrenia from movement, and prosodic and conversational speech signals

Negative symptoms of schizophrenia are often characterized by speech and motor impairments. Therefore, in this paper we combine audio (prosody and conversation) and video (body movement) signals to distinguish patients (43) from healthy control (23) subjects. First, we used these different modalities individually as features in machine learning algorithms yielding an accuracy of 67-79%. Next, we combined the different modalities as features, improving the accuracy to 85%.NMRC (Natl Medical Research Council, S’pore)Accepted versio