Steven D. Taff

Explicit or Hidden? Exploring How Occupation Is Taught in Occupational Therapy Curricula in the United States

OBJECTIVE. Occupation is considered core and threshold knowledge for occupational therapy, yet how it is conveyed through education is not well understood. This study examined how the concept of occupation was taught in occupational therapy and occupational therapy assistant curricula in the United States. METHOD. Using a qualitative descriptive research design, in-depth interviews, video recordings, and artifacts of teaching occupation were collected from 25 programs, chosen using stratified random sampling. Interview data were analyzed using an inductive, constant comparative approach; video and artifact data were analyzed deductively using findings from the interviews. RESULTS. Instructional methods were innovative and ranged from didactic to experiential. The degree to which occupation was present in instruction ranged from explicit to implicit to absent. CONCLUSION. Although educators valued teaching occupation, the concept was still elusive in some instructional methods and materials. Occupation knowledge and pedagogical content knowledge may have influenced how explicitly occupation was taught.

The illusion of client-centred practice

Abstract Aim: A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession’s philosophical basis and espoused commitment to client-centred practice. Findings: The current practice of occupational therapy in the reimbursement-driven practice arena in the United States is incongruent with the profession’s espoused philosophy and values of client-centred practice. Occupational therapy differentiates itself from medicine’s expert model aimed at curing disease and remediating impairment, by its claim to client-centred practice focused on restoring health through occupational enablement. Practice focused on impairment and function is at odds with the profession’s core tenet, occupation, and minimizes the lasting impact of interventions on health and well-being. The profession cannot unleash the therapeutic power of human occupation in settings where body systems and body functions are not occupation-ready at the requisite levels for occupational participation. Conclusion: Client-centred practice is best embodied by occupation-focused interventions in the natural environment of everyday living. Providing services that are impairment-focused in unfamiliar settings is not a good fit for client-centred practice, which is the unique, authentic, and sustainable orientation for the profession.

Childhood Toxic Stress: A Community Role in Health Promotion for Occupational Therapists

People who experience the toxic stress of recurrent traumatic events in childhood have a higher risk for mental and physical health problems throughout life. Occupational therapy practitioners have a remarkable opportunity to be involved in addressing this significant public health problem. As health care practitioners already situated in the community, we have a responsibility to lead and assist in establishing and implementing occupation-based programs and to nurture the links between the child welfare system and existing intervention systems. In this article, we review the current research on toxic stress and recommendations made by other health care disciplines and offer strategies for occupational therapy practitioners to begin a dialogue on this critical, emerging issue.

A Way of Seeing: How Occupation Is Portrayed to Students When Taught as a Concept Beyond Its Use in Therapy

OBJECTIVE. The concept of occupation is core to learning occupational therapy, yet how occupation is taught has not been widely studied. We explored how occupation is addressed in 25 U.S. occupational therapist and occupational therapy assistant programs. METHOD. We used a basic qualitative research design, collecting data through interviews, artifacts, and video recordings of teaching. We secondarily analyzed 8 programs in which occupation was taught beyond its application in practice. RESULTS. Educators portrayed occupation as (1) a way of seeing self (students learn about themselves as occupational beings), (2) a way of seeing others (students learn about others as occupational beings), and (3) a way of seeing the profession (students learn occupation as the central focus of occupational therapy). Varied learning experiences promoted these perspectives. CONCLUSION. Three concepts—subject‐centered learning, threshold concepts, and transformative learning—formed the theoretical foundation for teaching occupation as a way of seeing. Price, P., Hooper, B., Krishnagiri, S., Taff, S. D., & Bilics, A. (2017). A way of seeing: How occupation is portrayed to students when taught as a concept beyond its use in therapy.

Balancing Efficacy and Effectiveness with Philosophy, History, and Theory-Building in Occupational Therapy Education Research

The preferred focus for education research in occupational therapy increasingly rests on studies that investigate efficacy and effectiveness in the teaching-learning context. While important, the almost exclusive promotion of outcomes-focused studies can come at the expense of other forms of inquiry, including philosophy, history, and theory-building. To fully inform education and enhance practice, outcomes-focused research needs the conceptual foundation provided by philosophical, historical, and theory-building studies. In this paper, the authors suggest that the research enterprise in occupational therapy education is in its infancy and, therefore, quite susceptible to shortcuts that head straight to outcomes. To address this issue, the authors promote an approach where theory-building studies and philosophical explorations both precede and enrich all research endeavors, including those aimed at identifying “what works” in professional education.

Self-Management Program Participation and Social Support in Parkinson's Disease: Mixed Methods Evaluation

ABSTRACT Aims: To explore the potential influence of the Stanford Chronic Disease Self-Management Program (CDSMP) on social support in Parkinsons disease (PD). Methods: This was a quasi-experimental mixed methods design. Volunteers with PD (n = 27) and care partners (n = 6) completed the CDSMP, questionnaires of social support and self-management outcomes, and an interview about social support in relation to CDSMP participation. PD participants (n = 19) who did not participate in the CDSMP completed the questionnaires for quantitative comparison purposes. Results: Regarding the quantitative data, there were no significant effects of CDSMP participation on social support questionnaire scores; however, there were some positive correlations between changes in social support and changes in self-management outcomes from pre- to post-CDSMP participation. Three qualitative themes emerged from the interviews: lack of perceived change in amount and quality of social support, positive impact on existing social networks, and benefit from participating in a supportive PD community. Conclusions: Although participants did not acknowledge major changes in social support, there were some social support-related benefits of CDSMP participation for PD participants and care partners. These findings provide a starting point for more in-depth studies of social support and self-management in this population.

Curriculum-Level Strategies That U.S. Occupational Therapy Programs Use to Address Occupation: A Qualitative Study

OBJECTIVE. This studys objective was to describe curriculum‐level strategies used to convey occupation to occupational therapy students. METHOD. The study used a descriptive qualitative research design. Fifteen occupational therapy and 10 occupational therapy assistant programs participated in interviews, submitted curriculum artifacts such as syllabi and assignments, and recorded teaching sessions. Data were coded both inductively and deductively and then categorized into themes. RESULTS. Occupational therapy programs designed strategies on two levels of the curriculum, infrastructure and implementation, to convey knowledge of occupation to students. The degree to which strategies explicitly highlighted occupation and steered instruction fluctuated depending on how differentiated occupation was from other concepts and skills. CONCLUSION. Two arguments are presented about the degree to which occupation needs to be infused in all curricular elements. To guide curriculum design, it is critical for educators to discuss beliefs about how ubiquitous occupation is in a curriculum and whether curricular elements portray occupation to the extent preferred.

Teaching knowledge generated through occupational science and teaching the science itself

ABSTRACT This paper reviewed data that were collected for a study on teaching occupation in the context of occupational therapy programs, in order to explore if and how teaching occupational science was represented. Data that referenced occupational science were sparse but the available instances allowed observations to be made about teaching occupational science. Teaching the concepts and research findings of occupational science was more prevalent than teaching the science itself, raising questions about the implications of dispersing concepts from occupational science across a curriculum detached from their origins. Implications related to curricula, professional identity and translational science are explored. Suggestions are made for teaching concepts in explicit connection to occupational science, as well as stand-alone education about the science.

Traversing hills and valleys: Exploring doing, being, becoming and belonging experiences in teaching and studying occupation

ABSTRACT Research findings in occupational science and occupational therapy education can be mutually informing, yet this mutual benefit is seldom explored. A secondary analysis of data from a study of how occupation is addressed in US occupational therapy curricula explored this question: what latent meanings within education research data are pertinent to occupational science? Data were selected that richly described the tandem occupations of teaching and learning where the focus was occupation-related content. Three processes adopted from Ricœurian hermeneutic interpretive analysis—explanation, understanding, and appropriation—revealed the occupational experiences of doing, being, becoming and belonging as a dynamic web among instructors and students who participated in the study and the researchers. Further, the analytic process united the occupational experiences of research participants and researchers, and prompted researchers to reflect on and engage emotionally with their teaching and other occupations, facilitating appropriation of the research for their classroom practices.

Diversity and Inclusion in Occupational Therapy: Where We Are, Where We Must Go

ABSTRACT Diversity is a fundamental element of the AOTA Centennial Vision and a critical aspect for the visibility, growth, and sustainability of the occupational therapy profession. In this article, the authors suggest that, while the profession has been aware of the need for a diverse workforce and has taken steps to increase diversity and cultural competency, a more structured, comprehensive, and action-oriented approach must be considered to address an issue which impacts professional roles and client engagement, satisfaction, and well-being. Informed by the value-added and mutual accommodation models of cultural diversity, the authors provide specific strategies and actions which promote diversity and inclusion at the personal, institutional/organizational, and professional levels.