A model of management learning for occupational therapists in small business in Australia

This research sought to identify factors that contribute to occupational therapists developing management competencies when they become small business owners providing professional clinical services. This is an important for several reasons and precipitated by the Australian government’s introduction of incentives that encourage health professions to move from employment in public hospitals into the private sector, coupled with a recognition that occupational therapists receive no formal business training in their professional education, and the reported high levels of business failure in the small business sector. A review of the literature established the value of small business to the Australian economy, growth in the health sector generally, and increasing opportunities for allied health professionals to consider starting their own small business. Such a move requires occupational therapists to gain mastery as business managers in addition to their existing professional clinical knowledge and skills. The context of the research was set with a review of the literature on management development in small businesses, which indicates that professionals starting their own small business often have poorly developed management skills, and some experience high rates of failure. Theories on management development in small business were reviewed, and the conclusion drawn that a gap in knowledge on how occupational therapists develop their management skills existed. These gaps in the literature gave rise to the principal research question, that being ‘what factors contribute to the success of occupational therapists as small business owners providing professional services?’ Four related questions focused on motivations for starting a business, the management competencies needed, learning management competencies, and perceptions of business success. The study used a qualitative exploratory approach. Twenty-six female occupational therapists, who were small business owners were interviewed on their experiences of becoming a business manager. Purposive sampling ensured diversity across backgrounds, prior experience, clinical specialisations, and the age of the business. A thematic analysis of data built an understanding about why and how occupational therapists develop their management capabilities in small business. The principal factors affecting the development of the participants’ business and management skills were the interactions between their initial motivations for start-up, career aspirations, and engagement with external business environments. The participants learnt their business skills through a combination of formal learning prior to starting their businesses, and informal learning once they started their businesses. Lower-level learning occurred in the more routine and operational processes, the ‘know-how’ aspects of the business. However, most of their higher level learning was through discontinuous events that had serious consequences for their businesses if not addressed. These higher-level learning events resulted in participants understanding that ‘know-why’ change was needed, and a transformation in their understanding about themselves as business managers. The participants were central in determining the level of interaction between the resources and capabilities in their internal environments, and engagement with external environments that enable the development of their business and management capabilities. The findings led to a theoretical proposition on how occupational therapists make the transition to develop their management capabilities and become successful small business owners. A model of business starts with the nascent business owner assessing their business capabilities, learning to identify environmental opportunities and risks, and finally learning to identify and respond to new opportunities and changing circumstances in the external environment, was developed

In search of wellness: Allied health professionals\u27 understandings of wellness in childhood disability services

Purpose. Wellness approaches are not routine in childhood disability services, despite theoretical and empirical support and an increasing demand for them from health consumers and disability activists. We aimed to investigate how health professionals define or understand wellness and its practice in the context of childhood disability. Method. A qualitative, interpretive approach was taken. Semi-structured interviews were conducted with 23 health professionals (allied health therapists and managers) providing early intervention and ongoing therapy within four Australian childhood health and disability services. Years of experience providing services to children with disabilities and their families ranged from 6 months to 30 years (M = 9.41, SD = 9.04). Results.  The data revealed a noteworthy impediment to incorporating wellness into practice – the difficulties in the allied health professionals reaching consensus in defining wellness. There appeared to be distinct differences between the four services, while there appeared to be no appreciable difference based on the individual professional\u27s years of experience or allied health discipline. Conclusions.  The effect of organisational culture should be considered in efforts to embed wellness in childhood health and disability services in order to address client well-being, empowerment, choice, independence and rights to meaningful and productive lives

In search of wellness: Allied health professionals\u27 understandings of wellness in childhood disability services

Purpose. Wellness approaches are not routine in childhood disability services, despite theoretical and empirical support and an increasing demand for them from health consumers and disability activists. We aimed to investigate how health professionals define or understand wellness and its practice in the context of childhood disability. Method. A qualitative, interpretive approach was taken. Semi-structured interviews were conducted with 23 health professionals (allied health therapists and managers) providing early intervention and ongoing therapy within four Australian childhood health and disability services. Years of experience providing services to children with disabilities and their families ranged from 6 months to 30 years (M = 9.41, SD = 9.04). Results.  The data revealed a noteworthy impediment to incorporating wellness into practice – the difficulties in the allied health professionals reaching consensus in defining wellness. There appeared to be distinct differences between the four services, while there appeared to be no appreciable difference based on the individual professional\u27s years of experience or allied health discipline. Conclusions.  The effect of organisational culture should be considered in efforts to embed wellness in childhood health and disability services in order to address client well-being, empowerment, choice, independence and rights to meaningful and productive lives

A systematic review of the impact of powered mobility devices on older adults\u27 activity engagement

Purpose: To systematically review the impact powered mobility devices have on engagement in independent occupations for adults with acquired mobility limitations. Method: Electronic search of CINAHL Plus, Medline, PsychInfo, OT Seeker, Joanna Briggs Institute, and Physiotherapy Evidence Database. Search terms included combinations of words to encompass all terms most likely used for powered mobility. Results: Eleven studies were eligible for inclusion. One study was a true experimental design; four studies were pre-experimental, and six were nonexperimental. Studies indicated positive improvements to occupational engagement and independence while environmental barriers were identified as negatively impacting occupation and increasing risk of injury or accident. Conclusions: Drawing conclusions from this research are problematic due to varying methodological quality. This review suggested two distinct themes: environmental barriers generate difficulties and challenges, which can subsequently result in accident or injury, and access to powered mobility impacts positively on areas of independence, quality of life, mobility and engagement

Factors affecting job enrichment and professional competence in occupational therapy

This exploratory study was in response to a number of issues which occupational therapists have raised about themselves as professionals and the profession generally. A recurring issue relates to their claims that universities do not equip graduates with the "right" knowledge and skills for practice. This is interpreted to mean that universities emphasise the learning of academic, rather than practical knowledge and skills. However, it is not clear what constitutes useful and relevant knowledge and skills for practice, where these are best learnt , and in what contexts. This study sought to establish some insights and understandings about why occupational therapists are disenchanted with the education they receive at university and their apparent reluctance to further their education beyond the basic degree level. This was done by identifying and analysing the range of dilemmas occupational therapists encounter in professional practice. Participants were occupational therapists from a number of different work settings; with a wide range of professional experience; and who live in either Perth or a regional town of Western Australia. The principles and processes of grounded theory guided the systematic analysis of the dilemmas therapists experienced in practice. Six factors which affect job enrichment and professional performance were identified - meaningfulness of work; responsibility for outcomes of work; knowledge of the results of work activities; balance in roles; self image; and autonomy. Further to these six factors the study found that most occupational therapists feel isolated in practice, regardless of whether they work alone or with others, in a large traditional organisation or for a geographically isolated service. The study concludes, if educators acknowledge the factors which affect job enrichment and professional competence they will be better positioned to develop alternative ways to meet the learning needs of undergraduate and graduate students. This includes an adoption of relevant philosophies and approaches for student learning to appropriately equip them with knowledge and skills for self-directed and life-long learning

Evaluating Baccalaureate Occupational Therapy education in evidence-based practice

Purpose: This study investigated whether graduates had implemented the evidence-based practice skills learnt in their baccalaureate course in their workplace. It clarifies our understanding of factors that influence delivering evidence-based practice in the workplace and the efficacy of evidence based practice courses introduced in higher education. It indicates whether education by itself solves the implementation riddle or if workplace factors also limit implementation. Design: Quasi-experimental post-test only design based on postal questionnaire and focus groups. Method: Graduate occupational therapists from 1998-2001 (N = 220) were surveyed (n = 71) then focus groups representing control and experimental groups were used to gather additional data. Descriptive and non-parametric analyses (chi square) were made of the data. Findings: Significant differences between experimental and control groups were found in the ability to implement evidence-based practice. Workplace factors had an effect on implementation. Conclusions: Baccalaureate education of occupational therapists does increase knowledge of, and skills in, implementing evidence-based practice