Reflection on Professionalism: Retrospective Review of Health Professional Student Reflections

Professionalism is one of the core competencies for occupational and physical therapists. However, difficulty in providing clear definitions of core professional values and behaviours makes professionalism a complex concept to teach. Most proposed frameworks for defining the concept are theoretical or have focused on the academics’ and clinicians’ perspectives; evidence from students’ experiences is lacking. The purpose of this study was to develop a framework to define the concept of professionalism from occupational therapy (OT) and physical therapy (PT) students’ perspectives through analysis of their reflections. The study was a retrospective content analysis of OT and PT students’ reflections completed during clinical placements from 2014-2015 academic years. Sixty students (30 PT and 30 OT) were randomly sampled and one anonymized reflection of each of these students was selected. The qualitative content analysis was initiated by applying a deductive approach using previously presented frameworks to define professionalism. Four themes emerged which resulted in a new framework to define professionalism from students’ perspectives. The emergent themes included the effect of context, the relational dimension, personal dimension, and societal dimension. Students considered context an overarching factor influencing all dimensions of professionalism. Although their perceptions of professionalism were comparable to other presented frameworks, they primarily focused on the relational and personal dimensions of professionalism. The results of this study indicate that OT and PT students consider professionalism as a multi-dimensional and context-specific concept. Despite understanding contextual barriers, at this stage of their professional identity development, students tried to adhere to ethics, and professional values and responsibilities.&nbsp

Comparing Occupational Therapy Students' Competency Scores: 2:1 versus 1:1 Fieldwork

Fieldwork is essential to occupational therapy students’ development of professional competencies. Fieldwork models using student-to-fieldwork educator ratios of 1:1 and 2:1 are widely used, however, quantitative research exploring differences in student competencies between these two models is scarce. The objective of this study was to determine if development of student competencies differ between 2:1 and 1:1 fieldwork models during an occupational therapy educational program. A retrospective study using two years of occupational therapy students’ competency ratings by fieldwork supervisors (N = 95 students; N = 355 fieldwork events) was performed. The Competency Based Fieldwork Evaluation for Occupational Therapists tool was used to assess student competencies at each fieldwork rotation (n = 5 placements). Independent samples t-tests were used to compare students’ scores during 1:1 and 2:1 placements. No significant differences were noted in student competencies following participation in 2:1 and 1:1 placements. It was concluded that students are equally well prepared for practice if they have 1:1 or 2:1 fieldwork experiences

Evaluation of the Quality of Occupational Therapy Fieldwork Experiences

Practice education, or fieldwork as it is referred to in occupational therapy, is a fundamental feature of occupational therapy education, priming students to become competent entry-level practitioners. Factors reported as contributing to poor quality fieldwork experiences include: students not receiving enough feedback; lack of opportunity to develop skills; and not being made to feel welcome in the environment. These are significant contributors to the overall development of competence so it is important to understand the current context of fieldwork experiences being offered in relation to the notion of quality in those learning environments. The purpose of this study was to evaluate the quality of the fieldwork learning environment from the perspective of occupational therapists’ working in one region of Canada. A validated survey, the Quality of Occupational Therapy Fieldwork Experience (QOTFE) tool, was used to identify features of what might constitute quality fieldwork education, and to determine whether there was a difference in quality of fieldwork experience between practice settings or types of practice areas. However, there was minimal variability in scores based on practice setting and practice area variables. These findings indicate a consistent quality of fieldwork experience across practice settings and practice areas. This research presents a picture of the current quality of fieldwork experiences available to occupational therapy students. This may be a starting place for further investigation into the factors that contribute to the quality of practice education learning experience

Patient perspectives: Four pillars of professionalism

Professionalism is a core component of healthcare practice and education; however, there is often not a consistent description of professionalism, and current definitions lack a key perspective: that of the patient. This study aimed to deepen understandings of patients’ perspectives on how professionalism should be enacted by healthcare providers. Using a phenomenological approach informed by constructivist theory, the study team conducted semi-structured interviews and focus groups with 21 patients to ascertain their views on professionalism. Data analysis was conducted using a constant comparative approach wherein initial analysis informed subsequent data collection. Participant themes fell into four pillars of professionalism: taking a collaborative human-first approach; communicating with heart and mind; behaving with integrity; and practicing competently. This study highlights patient perspectives on professionalism and examines consistencies and differences between those perspectives and those of healthcare providers, which are extensively described in the literature. While published literature highlights competence and communication as main aspects of professionalism which our participants also focused on, participants in this study emphasized integrating patients into care teams, employing empathy, and demonstrating integrity. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

A Case Study of Organizational and Curricular Attributes for Interprofessional Education: A Model for Sustainable Curriculum Delivery

Background: In health and social care (HASC) professional education, interprofessional competencies are optimally developed by engaging in interprofessional education (IPE) activities that are delivered sustainably along a continuum. Ultimately, active engagement in IPE is meant to prepare future practitioners for interprofessional collaborative practice (IPCP), which leads to improved patient/client and community-oriented outcomes. Methods and Findings: This qualitative case study explores how four Canadian post-secondary institutions deliver IPE within their HASC professional education programmatic structures. Data were collected from institutional websites, publicly available IPE relevant records and documents, and interviews with coordinators and faculty/facilitators of IPE curriculum. Data were inductively analyzed to generate relevant themes, followed by a deductive analysis guided by the five accreditation standards domains identified in the Accreditation of Interprofessional Health Education (AIPHE) projects. Analyses of the data resulted in five attributes: 1) central administrative unit, 2) longitudinal and integrative program, 3) theoretically informed curriculum design, 4) student-centred pedagogy, and 5) patient/client-oriented approach. Conclusions: Using these attributes and guided by AIPHE’s accreditation standards domains, an organizational-curricular model for sustainable IPE is proposed, through which we assert that IPE reinforced through these organizational and curricular supports reflects successful programming, leading to patient/client-oriented outcomes

Introducing the individual teamwork observation and feedback tool (iTOFT): Development and description of a new interprofessional teamwork measure

The individual Teamwork Observation and Feedback Tool (iTOFT) was devised by a consortium of seven universities in recognition of the need for a means of observing and giving feedback to individual learners undertaking an interprofessional teamwork task. It was developed through a literature review of the existing teamwork assessment tools, a discussion of accreditation standards for the health professions, Delphi consultation and field-testing with an emphasis on its feasibility and acceptability for formative assessment. There are two versions: the Basic tool is for use with students who have little clinical teamwork experience and lists 11 observable behaviours under two headings: ‘shared decision making’ and ‘working in a team’. The Advanced version is for senior students and junior health professionals and has 10 observable behaviours under four headings: ‘shared decision making’, ‘working in a team’, ‘leadership’, and ‘patient safety’. Both versions include a comprehensive scale and item descriptors. Further testing is required to focus on its validity and educational impact.Australia Office of Teaching and Learnin