Irene Ilott

2001 College of Occupational Therapists' Research and Development Strategic Vision and Action Plan

The Research and Development Strategic Vision and Action Plan proposes a flexible approach for the next 5 years, being responsive to changes in the policy context and reflecting the needs of members, consumers and carers. Equal importance is attached both to research and to development. This strategic shift will support action to produce quality outcomes from all occupational therapy personnel, together with the production of the national research agenda by the College of Occupational Therapists.

Valuing Occupational Therapy as a Complex Intervention

This opinion piece introduces a framework for understanding and valuing occupational therapy as a complex intervention. The nature of complexity, particularly non-linearity and unpredictability, is summarised. The factors that characterise occupational therapy as a complex intervention are then presented. These include the visible actions that constitute the occupational therapy process; the centrality of activities and occupation in the therapists thinking and actions; the shifts of perspectives in occupational therapy intervention; the client-centred nature of practice; and the importance of the therapists thinking skills. All these factors elucidate why we should be proud of the complexity of occupational therapy and why a simple definition is unattainable.

Feelings and Failing in Professional Training: the assessor's dilemma

Abstract Assessing individuals as failures in education and training is rarely something that is done lightly or without misgivings. Related to this, the challenges of setting clear threshold or passing standards, are considerable. Assessors’ affective responses during fail scenarios in professional training were explored during focused interviews with 30 academic and practice staff. The pattern of feelings reported at each stage of the decision‐making process, factors which influence judgements and the reactions of others are described. The strength and spread of feelings stand out as an important sources of evidence. Understanding more about these affective responses may assist assessors as they make critical judgements at the margins of professional competence.

Evidence-Based Occupational Therapy: it's Time to Take a Global Approach

This opinion piece advocates that the time is right to adopt a worldwide strategic approach to evidence-based occupational therapy (EBOT). This means globalising the evidence and localising decision making in a context-sensitive way. The main barriers to and needs for collaborative action over the next 10 years are identified. The analysis is based on our experience and on reflections upon an international meeting on EBOT held in Washington DC in 2004. We hope to challenge readers to think about what they can do to make EBOT a reality for everyone everywhere.

Occupational science: A journey of discovery in the United Kingdom

Abstract A travel metaphor is used to describe the development of occupational science within the United Kingdom over the last decade. The authors’ personal perspective is supported by a literature review and survey of occupational science within occupational therapy education. The result is an archive of the subtle, incremental changes in thinking about humans as occupational beings. Increased understanding has revived pride in occupation amongst occupational therapy educators, practitioners, and researchers. A strategic, inter‐disciplinary approach to future directions is recommended.

Occupational Science: An Impossible Dream or an Agenda for Action?

This special issue celebrates the first decade of occupational science in the United Kingdom. The proposal by Yerxa et al (1989) that there should be a formalised academic discipline named occupational science underpinning the practice of occupational therapy inspired a revival of pride in occupation that has spread throughout the world. British occupational therapists were equally hopeful. In a special issue of the Journal of Occupational Science: Australia, a description was given of how occupational science has permeated occupational therapy within the United Kingdom in an incremental, opportunistic and accumulative way (Mounter and Ilott 1997). Yet is this sufficient for the dream to become a reality? The metaphor of a journey of discovery has been used to describe this process; it is now suggested that a crossroads has been reached whereby a proactive stance is necessary if occupational science is to continue its journey as an agenda for action and not become an impossible dream (Mounter and Ilott 2000). Since the 1980s, there has been a revival of interest in the concept of occupation. This was initially associated with the theoretical frameworks being developed to explain the art, science and practice of occupational therapy. Occupational science seemed a timely concept because its proponents suggested that the profession needed to review its dependence on a knowledge base embedded in the traditional medical sciences (Yerxa et al 1989). Other academic disciplines, such as human geography, sociology and anthropology, were seen as having greater potential to add to our knowledge of occupation and there could possibly be the emergence of a ‘new’ interdisciplinary science of occupation, with occupational therapy playing a major role in its development. During the past decade, the international occupational therapy literature has contained many articles rooted firmly in the study of occupation, which show that the profession is contributing to a better understanding of this complex topic. What does not appear to be so clear (certainly in the United Kingdom) is the contribution occupational therapy is making to a new, broader, interdisciplinary subject called occupational science, as originally envisaged by Yerxa et al (1989). Occupational Science: an Impossible Dream or an Agenda for Action?

Evidence‐based Practice: A Critical Appraisal

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Did Elvis Presley Die of Boredom

During August, the media marked the 30th anniversary of the death of Elvis Presley, ‘The King of Rock ‘n’ Roll’. One radio programme particularly caught my attention. This was the special, hour-long edition of Great Lives, broadcast on BBC Radio 4 on 14 August, in which Lord Trimble and others reflected on Elvis’s life and music. The record producer, Bones Howe, who produced the hit, If I can dream, made some telling observations about the demise of Elvis Presley. He said that Elvis was pulled down by inactivity and that he was bored with what he was doing – performing to unappreciative, inattentive audiences in Las Vegas. His conclusion was that ‘Elvis died of boredom’. Bones Howe’s choice of the words inactivity, doing and boredom struck an occupational chord. His diagnosis triggered questions and thoughts, such as: is it possible to die of boredom? What do we know about boredom? Is boredom contributing to the current epidemic of lifestyle diseases? Bones Howe’s language was reminiscent of an article entitled ‘Doing, being and boredom’, which noted that ‘Boredom is a little understood concept which is intimately linked with human occupation and meaning’ (Farnworth 1998, p140). To discover what advances in understanding had occurred over the last decade, I did a quick search of four online resources using the term ‘boredom’. I was hoping to find a concept analysis or a systematic literature review, those trusty stalwarts for getting to grips with a subject. Unfortunately, neither was found, but there were some intriguing studies and commentaries from a range of disciplinary perspectives. The search produced 21 records on the Cochrane Central Register of Controlled Trials, 943 records on the ISI Web of Knowledge, 803 records on PubMed and 3 records on the Library Catalogue of the College of Occupational Therapists. A scan of some of their titles and abstracts revealed a kaleidoscope of knowledge. Boredom has been investigated in many cultural contexts, in relation to work and leisure, for youth and older people, and for problems like trichotillomania (hair pulling), substance abuse, depression and cancer, using a social-constructivist approach right through to self-report scales of boredom. If you are interested, repeat this search and drill down into the wealth of information. I doubt that you will be bored. Boredom is such a salient topic for occupational therapists that there is a pressing need to synthesise what is known so that we can begin to explore the impact on lifestyle diseases. This could be done by clarifying ambiguities and interrelationships with similar concepts, such as anti-flow (Allison and Duncan 1988), boreout (Boyes 2007) and rust-out (Moniz-Cook et al 1997); and by doing a critical, interpretative literature review (Dixon-Woods et al 2006) to combine the diverse perspectives and research into a coherent whole. In this way, we would learn from the death of Elvis Presley, at the tender age of 42 years. Postscript: No, Elvis died of heart failure, but was boredom a contributory factor?

JOS Comment: A Special Occupation: Commissioning an Heirloom

Objects are intrinsic to many occupations and heirlooms, or inherited keepsakes, are a special category of objects that give tangible evidence of continuity across generations. This paper contains a retlexive account of commissioning a textile artist to change everyday, handcrafted objects into heirlooms. The aim was to transform individual, cherished possessions into the inalienable wealth of my family. Each stage of the commissioning process is described to convey the multiple meanings of this consumer behaviour that produced a memorial that embodies the essence of a working c1ass woman. Commissioning also proved to be an adaptive coping strategy because it added a creative purpose to life whilst dealing with bereavement.

Short Communication: Junior doctors: an exemplar of integrated competency

Integrated competency provided an appropriate model for identifying the competencies of Senior House Officers. A range of consultative and survey methods highlighted the commitment, integrated competency of this most junior grade of registered medical practitioners. The specification of the constituents of their clinical, managerial, supervisory and developmental roles is intended to support quality health care by establishing processes whereby all SHOs receive appropriate education to work within, and extend the limits of their competence.