402 research outputs found

    Toolbox Talks: Insights for Improvement

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    Tool box talks (TBTs) have the potential to improve communication, empower workers, reduce injuries and improve safety; however, they can also be “missed opportunities” for providing important safety messages in construction. The goal of this paper is to share the results from two research projects designed to improve the frequency, delivery, participation, and outcomes of TBTs. The results of these projects provide suggestions for planning and delivering TBTs in construction. METHODS: In the first project, 86 residential carpentry foremen from 8 different residential contractors in the St. Louis region participated in training for delivering TBTs as part of an 8-hour fall prevention and safety communication intervention. We compared baseline measures of safety behavior and fall prevention knowledge items to follow-up between participating foremen and their crewmembers. Concurrently, surveys of 300 apprentice carpenters were collected to describe the frequency and delivery methods of TBT and to serve as a comparison group for the TBT intervention. In the second project, we evaluated the utility of ergonomics TBTs delivered by a safety representative to 36 carpenters and laborers. Workers rated their perceptions of topic relevance, delivery method, similarities to traditional TBTs, and intent to change behaviors. The safety representative provided feedback regarding the TBTs and reported their observations of improved worker use of ergonomics in work tasks post-training. DISCUSSION / CONCLUSIONS: Both interventions described in this paper improved workplace safety. The interventions demonstrate how to simply shift from non-collaborative TBTs to participatory, context-driven TBTs by using a pre-printed TBT template, modified to address the hazards present at the worksite. Delivery suggestions relate the information to the workers, and include workers in the identification of problems and safety-related solutions. These participatory methods for preparing and delivering TBTs have the potential to improve construction workplace safety practices

    Use of a Logic Model to Develop an Innovative Hand Therapy Clinic to Provide Experiential Learning for Occupational Therapy Students

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    Occupational therapy (OT) students seek experiential learning opportunities to help them construct knowledge and meaning. Student clinics are increasing in prevalence as an effective means to engage in experiential learning. The student experiential learning clinic for hand therapy (SELC-HT) is a newly opened student clinic providing OT to under-insured individuals with upper extremity impairments. The SELC-HT used the student run free clinic (SRFC) logic model to systematically plan, implement, and evaluate its effectiveness. Planning started with evaluating the need and the context of the SELC-HT, allowing developers to state the long-term impacts of preparing students for future clinical practice, reintegrating patients without healthcare back to their roles, and contributing to the OT body of knowledge. Planning then progressed in a backward manner by first identifying measurable outcomes leading to these impacts. The output is data on the SELC-HT’s reach, indicating the clinic is moving toward these outcomes. Development of the activities followed, which will produce the output and outcome data. Lastly inputs were identified to carry out the activities. Following this careful planning, the clinic opened by moving forward through the SRFC logic model. At the conclusion of the first semester, evaluation of the SELC-HT occurred by examining the output data and measurable outcomes. Program evaluation occurred throughout the semester to assess whether the planned components were carried out effectively. As outlined in the SRFC logic model, iterative changes were made to the SELC-HT, with new outcomes, outputs, activities, and inputs implemented in the following semester to continue moving toward the impacts

    Evaluation of a Student Experiential Learning Clinic for Hand Therapy Using a Logic Model

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    Student clinics (SC) provide experiential learning opportunities in occupational therapy (OT) education that develop clinical reasoning, while providing much needed rehabilitation to under and un-insured patients in the community. The Student Experiential Learning Clinic for Hand Therapy (SELC-HT) is a SC that used a logic model for planning, implementing, and evaluating the SELC-HT. The purpose of this study is to report on outcome data on students and patients, as outlined in the evaluation phase of the logic model. The 13 OT master/doctorate students, who delivered care in the SELC-HT, demonstrated growth in self-reported hand therapy knowledge (p=0.002) measured with the Hand Therapy Certification Commission Self-Assessment Tool. Nine of the 12 students responding to alumni survey were employed in hand therapy positions shortly after graduation. Five students authored six manuscripts published in peer-reviewed journals or practice journals about their work in the SELC-HT. Of the 57 patients with baseline data, fractures were the most common diagnosis, and most patients were Black and males. One-third of injuries were due to violence, primarily gunshot wounds. At discharge (n=25) mean disability, measured with the Disability Arm Shoulder Hand, decreased 14.8 points (p=.001), which exceeds minimal clinical difference of 10.83. Statistically significant improvements in work disability (n=18) and work ability (n=21) also occurred. Most importantly, five patients who were not able to work at baseline had returned to work at discharge. These positive student and patient outcomes are due in part to the systematic planning and implementation of procedures defined in the SELC-HT logic model

    Occupation-Centered Anatomy and Applied Biomechanics Courses: Design and Outcomes

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    Occupation-centered course design allows occupational therapy (OT) educators to differentiate ourselves from other professions while communicating the distinct value of occupation to our students. While there have been numerous calls to action for centering occupation in the OT classroom and proposed models to approach course design, there is limited literature on occupation-centered course design in specific courses, notably foundational science courses like anatomy and applied biomechanics. In this study, we outline our course design process in two courses taught concurrently, as well as our prospective study to determine if an occupation-centered course design allowed students to meet objectives and the effect of undergraduate preparation on objective achievement. We also explored students’ agreement with importance of occupation-centered instruction, and our ability to stay occupation-centered. Fifty-five students completed pre and post course surveys rating their ability to perform the five objectives for each course and their level of agreement about the role of occupation in these courses. We found statistically significant increases in all objective ratings, with some ratings more than doubling. Post-course ratings among students with different undergraduate backgrounds were similar despite being statistically different at baseline. Students placed high value in occupation-centered course design at both time points. Students rated the ability to stay occupation-centered lowest in the first few weeks, with Anatomy rated lower than Applied Biomechanics in all weeks. This suggests that the incremental improvements made in the course delivery were effective; however, it was more challenging to create an occupation-centered course in Anatomy

    Needs Assessment, Program Development, and Pilot Testing: Training for Occupational Therapy Students Working with Survivors of Gun Violence

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    After the first year of operation, members of a student-staffed occupational therapy (OT) clinic found that 36% of their patients’ injuries were violence-related, mostly due to gun violence. The purposes of this project were to identify unmet needs of survivors of violence seen in a clinic setting, identify treating professionals’ preparedness to meet these needs, and develop and pilot test a program within the scope of OT to address these needs. A literature review and key informant interviews, surveys, and focus groups identified potential solutions to address gaps between patients’ needs and professionals’ preparedness to meet those needs. The need for student training was prioritized and a one-hour electronic module was developed using peer-reviewed literature, content matter expert input, and evidence-based teaching and learning strategies. The training utilized interactive activities to help learners reflect on personal beliefs and biases, recognize relevant person and environment factors, understand underlying causes of gun violence, gain trauma-informed communication skills, and identify referral options. To pilot test the training, eight first-year OT students completed the training and pre- and post-surveys measuring knowledge and attitude changes. The mean knowledge score improved from 78% correct pre-training to 97% correct post-training, with improvement in one item statistically significant at p=0.025. Four items measuring attitudes also demonstrated statistically significant improvements post-training. Participation in this training program can help OT students develop the knowledge, attitudes, and skills to work with patients who have experienced trauma from community gun violence

    Fall prevention on residential construction sites

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    Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

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    PURPOSE: Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. METHODS: A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: 1) UE symptoms, 2) UE musculoskeletal disorders (MSD), 3) carpal tunnel syndrome (CTS), and 4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. RESULTS: All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. CONCLUSIONS: Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work
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