Donna Drynan

1000 fieldwork hours: : Analysis of multi-site evidence

Background. Internationally, the World Federation of Occupational Therapists has established a minimum of 1,000 hours as the fieldwork standard. Purpose. To examine student development in fieldwork across placements to determine if students achieve entry-level competence after completion of 1,000 hours of fieldwork. Methods. Archival data (N=400) from six occupational therapy programs were analyzed to examine the acquisition of fieldwork competency over time as measured by the Competency Based Fieldwork Evaluation Scale. Findings. Competency scores increased with each fieldwork placement, the majority of students achieved entry-level scores upon completion of their final fieldwork placement. While, on average, some competency scores exceeded entry level by 1,000 hours, Practice Knowledge, Clinical Reasoning, and Facilitating Change fell just short. Implications. The identification of a plan for addressing the lower ratings in these three competencies should be considered.

Getting it “right”: how collaborative relationships between people with disabilities and professionals can lead to the acquisition of needed assistive technology

Abstract Purpose: The purpose of this study was to examine the impact of a consumer-led equipment and device program [Equipment and Assistive Technology Initiative (EATI) in British Columbia, Canada] from the perspective of program participants. The importance of collaborative assessments for obtaining the right assistive technology (AT) for meeting an individual’s needs is discussed in light of the program’s participant-centered “Participation Model”, or philosophy by which the program is structured. Method: A cross-sectional survey with participants and semi-structured interviews were conducted with participants (≥18 years) who held a range of disabilities. The survey asked participants to rank their AT and to identify the method by which they obtained the technology [by self, prescribed by a health professional or collaborative (self and professional)]. Interviews addressed participants’ opinions about obtaining and using AT. Results: In total, 357 people responded to the survey (17% response rate) and 16 people participated in the interviews. The highest ranking AT was assigned to devices assessed via a collaborative method (self = 31%, practitioner = 26%, collaborative = 43%; χ2 (16, 180) = 39.604, p < 0.001). Conclusions: Shared decision-making between health professionals and people with disabilities within the assessment process for assistive technology leads to what participants perceive as the right AT. Implications for Rehabilitation Collaborative decision-making can lead to the selection of assistive technology that is considered needed and right for the individual. Person-centered philosophy associated with assistive technology assessment is contributing to attaining “the right” AT.

Introducing the individual Teamwork Observation and Feedback Tool (iTOFT): Development and description of a new interprofessional teamwork measure

ABSTRACT 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.

Evaluation of methods for teaching electronic visual scanning to children with cerebral palsy: two series of case studies

Purpose: To evaluate the effectiveness of two instructional techniques in teaching electronic row–column scanning to children with cerebral palsy. Method: Two case series involving four participants each. Eight children, four boys and four girls (ages 3–13 years), were assigned to one of two intervention groups and completed three baseline and five intervention sessions. One intervention (n = 4) consisted of computer-based activities alone, while the other intervention (n = 4) consisted of a sequential approach starting with paper-based activities and then shifting to computer-based activities. Results: Participants within both groups demonstrated varying degrees of skill mastery (80% accuracy or better) of linear and, for some, electronic row–column scanning within the training phases of the intervention sessions. However, there was no clinically important change in test scores between baseline and outcome measures for either group. Conclusions: Significant challenges exist when studying the effectiveness of instructional techniques for teaching electronic row–column scanning to children with cerebral palsy. These case series provide information regarding the importance of selecting the most appropriate scanning technique to ensure reliable switch activation, carefully structuring the teaching environment to optimize learning, and being cognizant of the impact of fatigue and motivation on performance. Implications for Rehabilitation Research and Practice Examining the effectiveness of techniques to teach electronic row–column scanning to children with cerebral palsy (CP) is challenging Using a case-series approach to evaluate instructional techniques for electronic row–column scanning is clinically feasible as a first step, given the limited number of children with CP in any setting Our case-series demonstrated the importance of selecting the most appropriate scanning technique to ensure reliable switch activation, carefully structuring the teaching environment to optimize learning, and being aware of the impact of fatigue and motivation on performance.

Building sustainable fieldwork partnerships between Canada and India: Finding common goals through evaluation

ABSTRACT Initiatives in education and research have taken centre stage to address global health issues. Fieldwork learning in a global context is seen as one strategy to expose students to global health challenges and to collaborate towards viable solutions. Because of the inequities that exist globally, ethical dilemmas can be encountered throughout partnership development and require thoughtful consideration regarding the demands placed on partners in low resourced settings and issues of sustainability. A programme evaluation using the WEIGHT guidelines as a framework for critical reflection discusses the partnership development and future of one collaborative multi-stakeholder programme between Canadian occupational therapy programmes, an Indian partner and a Canadian charity. Collegiality, mentorship and an overall perspective of meeting the WEIGHT guidelines were evident from the reflections. Important considerations of programme equity as it relates to cost, communication and feedback needs, resource gaps and sponsor related issues emerged as areas of future priority.