Alison Wicks

New Ways for Occupational Scientists to Tackle “Wicked Problems” Impacting Population Health

It is time for more occupational scientists to begin addressing complex socio-environmental problems, such as climate change and obesity. Such daunting problems are considered wicked as they have been defying the traditional research methods used to solve them. Therefore, occupational scientists who choose to focus on population health problems need to adopt new ways of doing research. Effective contributions to and imaginative solutions for population health require occupational scientists to develop transdisciplinary partnerships, align themselves with public healths fifth wave and new integrative model of health, and think more creatively about the future.

Occupational therapists' perceptions of occupation in practice: An exploratory study.

BACKGROUND/AIMnThe World Federation of Occupational Therapists minimum standards state occupation and its relationship with health must be concepts covered in occupational therapy education. Therefore, it is assumed that Australian graduates have sound knowledge of the principles of occupation-based practice. In some practice settings, the link to occupation may not be explicit and graduates could face challenges to being occupation-based. The aims of this pilot study were to explore graduates perceptions of occupation in their practice and to investigate whether graduates felt sufficiently prepared for occupation-based practice.nnnMETHODSnTwo focus groups with eight therapists in total were employed to uncover experiences and perceptions of occupation. Themes were synthesised using Braun and Clarkes method of thematic analysis, where line by line coding was employed to inductively build themes.nnnRESULTSnParticipants believed that occupation-based practice was important but did not necessarily need to be implemented as a means of intervention. From the participants perspective, simply striving for occupation as the end goal of therapy was acceptable. A strong focus on impairment-based practice hindered some therapists from exploring the use of occupation-based practice. For recent graduates, workplace culture was pervasive and inhibited the use of occupation. In addition, participants felt university educators did not provide an integrated or consistent approach when teaching how to apply occupation in practice.nnnCONCLUSIONnWorkplace expectations and limited power to influence practice are impeding graduates from authentically applying occupation in practice. Insights from recently graduated therapists about occupation have the potential to inform future directions of occupation-based practice.

Interprofessional education in practice: Evaluation of a work integrated aged care program

Health professional clinical education is commonly conducted in single discipline modes, thus limiting student collaboration skills. Aged care residential facilities, due to the chronic and complex health care needs of residents, provide an ideal placement to provide a collaborative experience. Interprofessional education is widely acknowledged as the pedagogical framework through which to facilitate collaboration. The aim of the evaluation was to assess student attitudes towards collaboration after active involvement in an interprofessional education program. Students studying nursing, occupational therapy, and aged care were invited to complete a version of the Readiness for Interprofessional Learning Scale before and after participating in a three-week pilot interprofessional program. A positive change in student attitudes towards other health professionals and the importance of working in interprofessional teams was reported with significant differences between two statements indicated: Learning with health-care students before qualifications would improve relationships after qualifications; and I learned a lot from the students from the other disciplines. The innovative pilot project was found to enhance student learning in interprofessional teams and the aged care environment. Further development of this and similar interprofessional programs is required to develop sustainable student projects that have health benefits for residents in aged care residential facilities.

Occupational engagement among community dwelling older people: A time-geographic perspective

How older people spend their time in different occupations could contribute to our understanding of everyday life in healthy ageing. This study adopted a time-geographic method and occupational perspective to explore the occupational engagement of community dwelling older people. The term occupational engagement encompasses what people do, where and with whom they spend their time and the perceived level of competence and meaningfulness of their time use. Nineteen volunteers born between 1932 and 1933, living alone in an urban area in northern Sweden and receiving no home care services, completed open time-geographic diaries for 5 days in May 2010. The diary data were analyzed using Daily Life software program. The study revealed the complexity and the diversity of the older peoples occupational engagement and that most of their time was spent alone in their home. The older people reported they were very good at doing almost half of the occupations in which they engaged and that their occupations were primarily either very meaningful or meaningful. While some methodological limitations were identified, time-geographic studies of community dwelling older people living independently are considered to have potential to contribute to community and social planning for older people as they can provide interesting insights to older persons time use and occupational needs.

Editorial: Special Issue on Population Health

Occupation for Population Health, the theme of the 6 Australasian Occupational Science Symposium, held in Canberra in December 2012, is woven through this special issue. The theme combines a population health approach with an occupational perspective, acknowledging occupation as a determinant of health. Population health approaches aim to improve health and reduce health inequities between various population groups by examining the factors that influence health. Design of cities, landscape of public spaces and options for travel are some factors that determine what people can and cannot do. Such factors shape people’s occupations, the health of populations and ultimately the health of the planet.

An occupational perspective of poverty and poverty reduction

ABSTRACT Poverty is a complex problem with diverse interdependencies. Effective poverty reduction requires new ways of thinking about poverty and innovative programs to reduce its impact on people, communities and the environment. To date, a mix of economic, social structural, capabilities and learning perspectives have been applied to understanding poverty and planning strategies to expedite its reduction. We propose that inclusion of an occupational perspective will foster deeper understanding of the causes of poverty and its impact on people and communities. To that end, we introduce the SEED-SCALE, a novel theoretical framework designed to bring about social change. We argue that it is inherently occupation-focused and highly appropriate for poverty reduction programs, as it uses human energy (i.e. what humans do) to generate community and global solutions.

A Transactional View of Shedding at the Berry Men’s Shed

Shedding refers to the whole experience that occurs within a men’s shed program. A transactional view of shedding at the Berry Men’s Shed reveals the human and material transformations that occur as well as the resultant individual and community benefits. Understanding shedding from a transactional perspective highlights the complexity and multidimensional nature of shedding. Shedding involves more than just doing. It involves doing with others and doing for others. Moreover, a transactional view of the Berry Men’s Shed demonstrates the valuable contributions of community-based, occupation-focused programs and the importance of opportunities for such programs to be developed organically. Such understandings are not gained when a view of occupation is too individualistic or when interrelations between person and context rather than their holistic transactions are studied.

Imagining occupational therapy

‘Imagining occupational therapy’ expresses the opinions of four occupational therapists from Canada, Europe, Australia and New Zealand whose combined experience spans 152 years, an average of 38 years. Meeting serendipitously in March 2011, they reflected on the question: Why do we continue to practise and call ourselves occupational therapists when many colleagues have left the profession well before retirement? Igniting conversations were questions and vignettes about their professional lives and their profession. The aim of this opinion piece is to kindle other occupational therapists in imagining a future world for themselves and their profession, just as kindling grass and sticks may fuel a fire.

Solutions for strengthening the occupational therapy academic workforce

Dear Editor, Cusick, Froude, Bye and Zakrzewski’s (2014) editorial in the Australian Occupational Therapy Journal is a timely reminder of the need to consider current and future occupational therapy academic workforce demands, including student and university expectations for training and investment respectively. Their comments highlighted for us the importance of innovative solutions within education programs. As the number of undergraduate and graduate entry programs increase in Australia, it is necessary to harness the right mix of occupational therapy educators to meet future graduates’ expectations for quality education, work readiness and employability. Cusick et al.’s (2014) suggestion of ‘grow your own’ (p. 131) has its merits due to the increased need for appropriately qualified academic staff. However, as they acknowledge, there are benefits and risks to ‘growing your own’ staff. Benefits include prior knowledge of overall teaching philosophies and course content, reduced time spent on orientation to specific university systems, policies and facilities, possible familiarity with local practitioners and knowledge of the local health-care context. Nevertheless, some risks when home grown teachers are employed include loss of diverse perspectives and a possible lack of touch with the realities of practice if graduates enter academia immediately post-graduation. At the University of Canberra, the Field of Occupational Therapy in the School of Public Health and Nutrition has introduced two solutions for addressing workforce demands: providing a teaching fellowship for someone enrolled in a PhD; and appointing adjunct and honorary positions. The introduction of a teaching fellow into the Masters of Occupational Therapy programme means an additional staff member, who does not yet have a doctoral qualification but who is currently enrolled in a PhD programme, can join the academic workforce. This strategy can increase research outputs as well as the number of teaching staff. On the basis of an apprenticeship model, the teaching fellow can build teaching skills under supervision and guidance of experienced academic staff and gain valuable experience for the future. At the completion of a teaching fellowship period, the staff member will have completed a PhD, and have adequate teaching experience to potentially gain a full-time academic position. The Adjunct Professor and Adjunct Associate Professor appointments strengthen the occupational therapy programme’s teaching, research and professional activities as well as foster cooperative arrangements between the programme and international, national, academic, business, professional and cultural communities. Other honorary appointments such as Professional Associate have been created for experienced occupational therapists with postgraduate qualifications (masters and doctoral level) who are currently working in traditional, role-emerging or other practice areas ‘on the ground’. The blended academic and practice-oriented position of the Professional Associate leads to benefits which include: expanded opportunities for students’ learning potential; maintenance of curriculum currency with practice-based evidence; a formal university affiliation for occupational therapy practitioners, and opportunity for programme design and active research and scholarship. Together with exploring innovative solutions, we encourage and challenge the profession to lobby for and create opportunities that encourage occupational therapists to partner with universities and be able to participate in formal blended positions in academia, programme design and student education. At present, such opportunities are more the exception than the rule.

Becoming environmentally sustainable in healthcare: an overview

This paper provides an overview of environmental sustainability in healthcare and highlights the need for a policy framework for action. Examples from overseas demonstrate what has effectively enabled mitigation of and adaptation to the threat of climate change. The need to overcome perceived limits and barriers to health professionals engagement in sustainable practice is noted. The scientific evidence recommends immediate action.