The Use of Hermeneutics in a Mixed Methods Design

Combining methods in a single study is becoming a more common practice because of the limitations of using only one approach to fully address all aspects of a research question. Hermeneutics in this paper is discussed in relation to a large national study that investigated issues influencing the ability of international graduates to work as occupational therapists in Canada. Using methods that reflect different ontological and epistemological beliefs was necessary to attain a comprehensive view of enablers and barriers that influence workforce integration. Hermeneutics proved to be a credible and flexible strategy for combining methods to create a deep understanding of acculturation issues for international occupational therapy graduates wishing to work in Canada

Using Hermeneutics to Understand Burnout and Coping Strategies Utilized by Occupational Therapists

This research article explores the use of the hermeneutic approach in understanding practice challenges for occupational therapists in the contemporary health care arena. It provides insights into factors that lead to therapist burnout and the strategies they utilize to maintain competent practice. In this mixed methods study, hermeneutics was chosen as the qualitative approach to help understand the meanings occupational therapists ascribe to stressful situations at work and how they cope with those situations. Data was collected by conducting focus groups and semi-structured interviews with seven participants. Demands on time, conflict, lack of respect and autonomy emerged as the main practice issues. Maintaining healthy boundaries, importance of workplace and home community, monitoring self for signs of burnout and focusing on satisfying aspects of work emerged as the major coping strategies employed by the participants

Development of a quality indicator framework for occupational therapy

Occupational therapists are increasingly expected to implement and monitor indicators of occupational therapy quality performance. Goals of quality measurement and improvement include enhancing satisfaction of the end-user, optimising the efficient use of resources and improving health outcomes. A Quality Indicator (QI) Framework with 56 generic indicators was developed for occupational therapy by the World Federation of Occupational Therapists for selecting, organising and reporting on quality indicators in a structured and meaningful way. A consultation involving 46 occupational therapists from 21 countries indicated the QI Framework shows promise to help occupational therapists select relevant and useful measures to evaluate their occupational therapy services. Work will, therefore, continue to further evaluate and refine the QI Framework, as well as develop resources to support the implementation and use of the tool

The Occupational Therapy Examination and Practice Preparation (OTepp) Program: Development, Implementation and Evaluation of an Educational Program for Internationally-Educated Occupational Therapists

This paper provides a chronological overview of the development, implementation, and evaluation of an educational initiative aimed at ensuring internationally-educated occupational therapists are prepared to enter practice in their new country, Canada. The three major phases of the program’s 12-year evolution are described, to distill the key lessons learned at each phase. Data related to the demographics of participants, program content, results of the national examination, registration, and employment outcomes are included. An enhanced understanding of the transition experience of internationally educated occupational therapists provides a strong foundation from which to support internationally-educated colleagues and strengthen the occupational therapy profession

Type of Findings Generated by the Occupational Therapy Workforce Research Worldwide: Scoping Review and Content Analysis

Occupational therapists are needed to meet the health and occupational needs of the global population, but we know little about the type of findings generated by occupational therapy workforce research conducted worldwide. We aim to synthesize these findings and their range of content to inform future investigations. A scoping review with content analysis was used. Six scientific databases, websites of official institutions, snowballing, and key informants were used for searches. Two independent reviewers took selection decisions against the eligibility criteria published a priori in the review protocol. Of the 1246 unique references detected, 57 papers were included for the last 25 years. A total of 18 papers addressed issues of attractiveness and retention, often in Australia, and 14 addressed the issues of supply, demand, and distribution, often in the US. Only these two categories generated subtopics. Many workforce issues were rarely addressed as a main topic (e.g., race/ethnic representation). Cross-national, cross-regional, or cross-professional studies generated more actionable findings. Overall, we found few discernable trends, minimal evidence of research programs, and various gaps in content coverage or in the use of contemporary research approaches. There is a need for a coordinated strengthening of the occupational therapy workforce research worldwide

Limitations and Recommendations for Advancing the Occupational Therapy Workforce Research Worldwide: Scoping Review and Content Analysis of the Literature

Occupational therapy workforce research can help determine whether occupational therapists exist in sufficient supply, are equitably distributed, and meet competency standards. Advancing the value of occupational therapy workforce research requires an understanding of the limitations and recommendations identified by these investigations. This scoping review and content analysis synthesizes the study limitations and recommendations reported by the occupational therapy research worldwide. Two independent reviews included 57 papers from the past 25 years. Stated limitations included: focus on cross-sectional studies with small and convenience samples; participants from single settings or regions; local markets or preferences not specified; focus on self-reported data and intentions (rather than behaviors or occurrences); challenges in aggregating or synthesizing findings from descriptive data; lack of statistical adjustment for testing multiple associations; and the lack of detailed, up-to-date, and accessible workforce data for continuous monitoring and secondary research. Stated recommendations included: strengthening routine workforce data collection; developing longitudinal studies that include interventions (e.g., recruitment or retention packages); developing context-sensitive comparisons; studying the impact on ultimate outcomes; promoting nation-wide, coordinated workforce plans and requirements; and fostering international coalitions for workforce research and developments at scale. These study limitations and recommendations reported by the literature must be considered in the design of a local and global occupational therapy workforce research agenda

Situational analysis for informing the global strengthening of the occupational therapy workforce

Background: Occupational Therapists are needed for meeting the health, rehabilitation, and occupational needs of the population worldwide, but there is no strategy for strengthening the occupational therapy workforce against a backdrop of an insufficient and inequitable supply worldwide. Objective: To perform a situational assessment of occupational therapy workforce development and research toward informing a global human resources strategy for the occupational therapy workforce strengthening. Method: A multi-methods design incorporating Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis based on scoping review findings, workforce development frameworks, and expert feedback. Results: Strengths included identified workforce research trends, gaps, and findings. Weaknesses included a shortage of workforce research, lack of uniform and readily available workforce datasets, absence of workforce research programs, over-reliance on descriptive and non-experimental research, lack of research on workforce topics (e.g., diversity), and lack of labor market or economic analyses. Opportunities are the availability of guidance and tools for strengthening the health and rehabilitation workforce worldwide, and increased membership from low- and middle-income countries (LMICs) in the World Federation funding of occupational therapy workforce research, the lack of occupational therapists data on international datasets and studies, suboptimal educational capacity in LMICs, lack of professional regulation and uniform workforce data collection in many contexts, and a perceived lower priority of this health workforce focused on health and wellbeing rather than medical outcomes. Conclusion: This SWOT analysis identifies strengths and opportunities to be seized and weaknesses and threats to be addressed by development of a strategy for the global strengthening of the occupational therapy workforce

Worldwide Survey on Digital Assistive Technology (DAT) Provision

Occupational therapists have long been involved in assistive technology (AT) provision worldwide. AT is recognized by the World Health Organization (WHO) to enhance functioning, independence, and autonomy and ultimately promote well-being for people living with disabilities. With the digitalisation of societies, the everyday lives and occupations of individuals are changing, becoming more reliant on digital solutions. The development of digital assistive technology (DAT) also offers opportunities for people with disabilities to access, interact, and pilot the digital world. However, we do not know how occupational therapists are involved in DAT provision worldwide. A survey was conducted in the global occupational therapist’s community in June 2022 to describe DAT provision and the factors influencing it. Occupational therapy practitioners were included (n=660) in the analysis. In DAT provision, occupational therapists mostly provide advice to people, assess their needs, provide instruction or training, prescribe DAT, and fit DAT to people and their environment. The clients served through DAT provision are most frequently people with neurological impairments, chronic illnesses, sensory impairments, and older people. The reasons for providing DAT focus on education, work, school, and leisure. It is expected that DAT provision will enhance independence, self-esteem, occupational participation, and social relationships. Issues faced by occupational therapists when providing DAT are costs of product and funding schemes, sufficient knowledge, and access to knowledge sources. Survey respondents are mostly from Western countries with access to the Internet and the digital world, including having digital literacy, highlighting the digital divide that exists between world regions and countries, but also within countries worldwide. There is a need to continue research to better understand the issues related to digitalisation and the digital participation of people living with disabilities

Measuring the quality of occupational therapy students’ interviewing skills.

Introduction: Interviewing is an occupational therapy skill that is rich in dynamic and qualitative detail. However, the teaching and assessment of students’ performance in this key skill is often either left to examiner judgement, or reduced to component skills.Objectives: To develop and evaluate a robust assessment rubric to measure the skilfulness of occupational therapy stu-dents’ interview performance.Method: We reviewed the outcomes of a viva assessment in which students (n=249) interviewed a standardised patient and were scored on a skills checklist and then awarded stand-ard grades (pass, credit, etc.). Based on Rasch analyses of student outcomes, we iteratively re- developed the assessment rubric to focus on the quality of performance. After piloting a revised rubric using modelled data and scoring video re-cordings of student examinations, we used it to assess a new cohort of students (n=235) and repeated the analyses.Results: Checklists alone proved inadequate to evaluate students’ performance directly or to support examiners’ judgements of quality among skilled performance beyond the pass level. The rich detail in the revised rubric proved feasible and resulted in vastly improved statistical measures of both reliability and range of measurement in the examination.Conclusion: We successfully developed a novel examination rubric that, for students and educators, provides an empirically supported yet rich, qualitative description of occupational therapy interviewing skills at a range of levels. This builds directly on prior work in defining interviewing skills to offer a quantifiable hierarchy of qualitative interviewing skills to inform student instruction as well as assessment and feedbac