The mission of the Doctor of Occupational Therapy (OTD) Program at the University of Findlay is to prepare occupational therapists who value clinical and professional reasoning, implement evidence-based, community-focused, and occupation-based approaches to practice grounded in the tenets of humans as occupational beings; are ethical, reflective, autonomous practitioners and leaders in a variety of meaningful professional roles for service with diverse populations.
OTD Philosophy Statement
The Doctor of Occupational Therapy Program is organized around the concepts of humans as occupational beings, the daily performance of occupations, and an understanding of the contextual complexities that are necessary for meaningful occupational performance. Meyer (1922) suggests that the essence of human functioning includes being active and that active engagement serves to ground humans in reality. Kielhofner (1995) has defined human occupation as “doing culturally meaningful work, play or daily living tasks in the stream of time and in the contexts of one's physical and social world" (p.3). These occupations are the foundation for productive living. Dunn, Brown, and McGuigan (1994) extend this concept by suggesting that occupational performance may be understood by examining the phenomenology of the interactions between the person, the task, and the environmental experiences of the individual who is engaged in occupations. Engagement in occupation as a therapeutic change agent and as the ultimate goal of therapy is grounded in the historical and theoretical foundations of the profession and is consistent with the current American Occupational Therapy Association philosophical basis of the profession (AOTA, 2017).
An individual may combine and learn occupations in a variety of ways to support and satisfy the occupational demands of their unique life roles and occupations including: activities of daily living, instrumental activities of daily living, rest and sleep, education, work, play, leisure, and social participation (AOTA, 2014). Occupational therapists are concerned with the ability of clients across the lifespan to learn and perform occupations that allow them to be healthy, satisfied, and productive while striving to attain a desirable quality of life. In addition, occupational therapists ensure client-centered practice by involving individuals in the direction of determining the therapeutic process. Occupational therapists believe that occupational performance is enhanced through a holistic approach that includes attending to and respecting the physical, mental, social, cultural, and spiritual dimensions of the client. The occupational therapy process also includes cooperation and collaboration among clients, caregivers, family members, and other professionals. The practice of occupational therapy requires ongoing learning to develop a base for clinical reasoning and technical competencies for effective interaction, evaluation, and implementation of intervention strategies.
There are many diverse direct and indirect service delivery contexts in which occupational therapists practice. These settings and areas of practice may include: school systems, long-term care facilities, acute care settings, physical rehabilitation settings, mental health programs, home care opportunities, early intervention programs, industrial rehabilitation programs, case management, community-based programs, consultation, education, research, disease prevention and health promotion. It is essential that occupational therapists understand, internalize, and live the ethical principles and values of the profession. Occupational therapists must recognize society and health care are dynamic institutions impacted by individual, local, national, and global growth and change. The practice of occupational therapy also includes innovative, creative thinking necessary for the advancement of the individual and the profession to meet the ever-changing demands of occupational therapy, health care, and society.
The theories described in the Doctor of Occupational Therapy Curriculum Design are considered an integral part of the instructional design and also support the views of the faculty regarding how learning experiences are constructed in professional graduate education to facilitate student understanding of the fundamentals, integration of knowledge and eventual transformation to the role of practitioner. Faculty use a variety of pedagogies in both teaching and evaluation methods to accommodate the needs of various learning styles throughout the curriculum. The occupational therapy faculty view the process of a professional doctoral education in occupational therapy as a collaborative effort between students and faculty. Faculty support a collaborative learning environment and expect students to assume responsibility for their own learning, participate actively in the learning process and contribute to an environment of shared scholarship. The University of Findlay OTD program complies with the Standards for an Accredited Educational Program for the Occupational Therapist (Standards) by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association, Inc. (AOTA).
Our educational philosophy and program objectives serve as the keystone of courses, fieldwork experiences, research, and outreach activities in the department and throughout students' learning experiences. Emphasis on the importance of occupation in human life and occupational engagement link our faculty's respective areas of interest in research and community outreach and service. The philosophy and objectives are infused throughout courses in the doctoral program to prepare future practitioners who are:
- Culturally competent & contextually aware
- Evidence-based, occupation-based & client-centered
- Aware of systems & trends
- Critical thinkers
- Moral and ethical practitioners
The Griffith Memorial Arch has been chosen as a graphic representation of the OTD program curriculum design. All of the concepts of the theories that guide the program are reflected in the various parts of the arch. Refer to the curriculum graphic model. The curriculum design is essentially a plan for selecting and sequencing the program content. This curriculum design also reflects the program's philosophy regarding occupational therapy as a profession and the ACOTE Standards of a professional education for an occupational therapist. In addition, this curriculum design describes a process and does not intend to limit the scope of theories and models of occupational therapy practice addressed and included in the program.
The courses in this curriculum serve to build the knowledge and skills of a student in a developmental manner as they progress through the program. Higher level courses are based upon content introduced previously in prerequisites and other professional phase coursework. Strategic recursion is built into the curriculum to revisit ideas and provide integrated experiences explored earlier in the curriculum. As the student moves from the academic setting to fieldwork, skills and techniques become more familiar and integrated as the student continues to develop toward his or her future role as an occupational therapist. As the student nears the completion of the doctoral experience, they will obtain entry-level competence and function at a level that incorporates motivation and an understanding of the role of the occupational therapist.
This development parallels the subsystems outlined by the Model of Human Occupation and emphasizes the importance of contextual learning experiences outlined by the Ecology of Human Performance framework and identified in the OTD Program Philosophy Statement. The entire sequence of a student's pre-professional and professional education is based on learning the skills, roles, motivations, and values of the profession through a carefully considered curriculum outline, particularly emphasized in the Professional and Contextual Issues sequence of coursework. In addition, students learn to use clinical reasoning to guide their professional decisions and practice occupational therapy in a client-centered manner using occupation-based methods, skills particularly emphasized in the Essentials and Clinical Practice coursework. Students synthesize the concepts identified in the program objectives to become self-directed, life-long learners; agents for change; and leaders in the profession through Level II fieldwork and the Doctoral capstone identified in the Experiential Learning components of the program.
OTD Curriculum Design
The curriculum design for the Doctor of Occupational Therapy Program at the University of Findlay is primarily based upon concepts of the Model of Human Occupation (Kielhofner, 2007) and the application of Clinical and Professional Reasoning (Schell & Schell, 2008). Kielhofner uses the term 'environment' to describe the multiple dimensions of context that impact the motivation, organization and performance of occupation. The program also draws heavily on ecological models to expand Kielhofner's concept of environment and further describe the contextual complexity that affects an individual's life. Ecological models, such as the Ecology of Human Performance (Dunn & McGuigan, 1994), support the concept that context is important to human performance. Personal factors, environmental influences, and occupation-related characteristics impact participation, health, and well-being. Together these theories provide a background that faculty use to assist students in better understanding the factors that enable and constrain occupational performance.
The program strongly supports community-based practice and works with organizations and populations. To understand and work in the community, the importance of cultural responsiveness is key and the program has intentionally threaded an emphasis on developing cultural competency throughout the curriculum. The use of the Kawa Model (2006) provides a theoretical approach that supports a view of culture as a dynamic process. It affirms the inseparability of the individual from context and nicely parallels Kielhofner's description of the physical and social environment while also describing cultural complexities.
The ability to recognize the contextual implications and understand an individual's occupational performance needs is the essence of clinical reasoning for occupational therapists. Clinical reasoning is “the process used by practitioners to plan, direct, perform and reflect on client care" (Schell, 2003, p. 131). Schön (1983) first described how effective professional practice requires a blend of technical knowing combined with reflection during the actual process of practice. Mattingly and Fleming (1994) incorporated Schön's work into a research project that came to be known as the Clinical Reasoning Study. This study found that the process of critical thinking goes beyond an accumulation of professional skills and knowledge, and requires individual practitioners to respond critically to uncertainty, instability, uniqueness, and values conflicts. Even when a professional consciously uses evidence-based theories and techniques, the practitioner is dependent on implicit recognitions, judgments, and skillful performances that require critical thinking. Clinical reasoning recognizes and values the individual strengths, judgment, and levels of competence of the occupational therapy practitioner.
Schell (2008) describes professional reasoning as the reasoning that occurs in non-medical environments such as schools and community settings. Occupational therapy managers, fieldwork educators, and supervisors use professional reasoning as they conceptualize OT practice. Through carefully considered instructional design throughout the OT program, students develop clinical and professional reasoning skills through didactic learning activities, integrated lab practice and experiential learning. The program aims to develop reflective practitioners who can enter the field with the ability to problem solve and think critically with autonomy and creativity. Throughout the OTD program students are increasingly challenged to look beyond the technical aspects of providing occupation-based interventions and consider the current and future needs of an individual within the context of individual life circumstances. By emphasizing the process of both clinical and professional reasoning, students are supported while being encouraged to examine the development of their own reasoning skills and learn about, from and with others throughout the curriculum.
These theories and models, in total, provide a framework for approaching both education and practice. The instructional design facilitates students' ability to connect class topics and experiences to the core of human occupation and its relationship to health and well-being; a student's view of knowledge evolves from absolute to fluid and dynamic. The design supports the development of students who are ready to make contributions to the art and science of occupational therapy, practice competently and become ethical entry-level practitioners who benefit society when they enter the field.
Instructional Design: Professional Curriculum
Six general categories of courses organize the curriculum into sets of courses delivered as explicit “threads" taught longitudinally in a specific sequence to allow for increased levels of depth and intensity. We expect that students in every course actively engage in a collaborative learning environment that provides integrated experiences. Developing the ability to engage in scholarly inquiry and developing the skills necessary for evidence-based practice occurs along the journey as well.
Foundational Courses
This first series of courses focuses on the exploration of the foundations of the profession of occupational therapy and foundational knowledge necessary for clinical practice. Students learn the primary curricular and professional concepts regarding how to be occupation-based, client-centered and culturally responsive practitioners. The history, philosophy, domain and process, theories and practice of occupational therapy are also introduced in these foundational courses. In addition, students also develop an advanced understanding of anatomy, human movement, neuroscience and common health/disease conditions encountered by occupational therapists in clinical practice.
Essentials of Occupational Therapy Practice
Essential elements of occupational therapy necessary in most practice settings are the emphasis of this series of courses. Students learn how to plan and lead therapeutic groups; teach others, advocate for and promote occupational therapy in professional settings; use theories and evidence in a variety of practice contexts; become more familiar with typical community settings and the importance of promoting health and wellness; and demonstrate the ability to apply management techniques and leadership skills required for contemporary occupational therapy practice.
Professional and Contextual Issues in Occupational Therapy Practice
The professional and contextual issues series of courses is an important and distinct element of the OT program at the University of Findlay. Students learn how they may have an impact on both individual clients and the organizations in which they work. In addition, students become more familiar with professional roles and responsibilities, the importance of cultural responsiveness, and specific considerations when addressing the needs of all populations.
Clinical Practice in Occupational Therapy
The clinical practice series of courses provides students with a foundation for applying the Occupational Therapy Practice Framework (OTPF) (AOTA, 2014) to clinical practice across all practice settings and the specifics for assessment, planning and providing interventions in biopsychosocial, pediatric, adult and geriatric practice settings. Students also learn how to apply theoretical information to guide clinical practice decisions and to develop and write effective therapeutic goals using professional language and terminology. These intervention courses provide students with opportunities to learn and apply specific assessment techniques, interpret assessment data, plan appropriate interventions and evaluate the effectiveness of, and measuring client outcomes of occupational therapy services.
Research and Scholarship
This series of courses introduces basic research concepts and methodologies as students learn to access, analyze, interpret, and apply relevant professional evidence. The process is designed for use of evidence to support clinical practice. Emphasis is placed on engagement in hands-on experiences which guide the students through searching the literature and developing skills to critically appraise a specific body of evidence.
The focus of the culminating research project sequence is the identification of an important topic to study, development of an adequate proposal, collecting and analyzing data and effectively writing up the results in a manner acceptable for presentation or dissemination.
Experiential Learning
The program includes both Level I and Level II fieldwork and the doctoral experiences. Level I fieldwork education is an important aspect in the development of professional skills and knowledge. Level I fieldwork experiences provide students with opportunities to synthesize knowledge and develop skills and attitudes that support the role of an entry-level practitioner in occupational therapy. Three Level I fieldwork experiences are scheduled to coincide with specific coursework in both traditional medical model and community based practice settings across the lifespan. Upon completion of the Level I fieldwork experiences, students return to the classroom where there is an opportunity to reflect upon and extend the usefulness of these experiences. Level I fieldwork experiences are scheduled to expose the student to a variety of populations and conditions facilitating the integration and application of the didactic and laboratory learning experiences.
Level II fieldwork provides students with an extended opportunity to further develop and apply clinical reasoning and requisite entry-level practice skills through supervised, hands-on learning experiences. Each student must complete two twelve-week fieldwork experiences. An important consideration in scheduling Level II fieldwork experiences is a close examination of an individual student's Level I fieldwork experiences. The Academic Fieldwork Coordinator and the OT faculty strive to ensure that each student's overall fieldwork experiences provide the student with the opportunity to work with clients across the life span, with a variety of conditions, and in different service delivery models and/or practice settings.
The Doctoral Capstone and Project are designed to advance student knowledge through experiential learning opportunities in a variety of possible practice settings. Students may pursue in-depth experiences in specific clinical practice settings; advanced research opportunities; administration in various possible practice settings; leadership or management experiences in a variety of possible settings; program and policy development at the state and/or national levels; or pursue academic opportunities such as teaching or theory development. The Doctoral Capstone and Project are intended to equip students for meaningful opportunities and productive careers that allow students to maximize potential and enhance contributions to the profession.
Summary
The University of Findlay's Doctor of Occupational Therapy curriculum is based on the importance of successful and productive living supported by the performance of daily occupations. Our graduates emphasize the importance of engagement in and balance of meaningful occupations throughout the life span. Additionally, graduates recognize the importance of considering the contextual implications required to support occupational performance.
Throughout the OTD program students develop and are evaluated on, clinical reasoning skills through didactic learning activities and experiential learning opportunities. The occupational therapy faculty evaluate students on the ability to critically analyze the clinical decisions they make based on experience, evaluation data, observations, client and family reports, and other contextual considerations. Students develop critical thinking beyond the technical aspects of providing occupation-based interventions and consider the current and future needs of a client within the context of individual life circumstances. By emphasizing the process of clinical reasoning, students have an opportunity to examine the development of their own reasoning skills and learn from others throughout the curriculum.
It is an enormous undertaking to successfully prepare students for every possible clinical situation that they may encounter in practice. In recognition of this, the curriculum promotes holistic, client-centered, evidence and occupation based practice; fosters the development of clinical reasoning, problem-solving, and scholarship; and emphasizes the importance of self-directed, life-long learning to promote change in the profession and encourage effective leadership within the professional community. We believe that graduates of the Doctor of Occupational Therapy Program at the University of Findlay have the interest, skills, and motivation required to support their own development, and the needs of the profession, in an ever-changing health care environment and global community.
Program Outcomes
Upon completion of the OTD Program at the University of Findlay, graduates will:
- Practice occupational therapy in a holistic and client-centered manner that ensures a critical awareness of and sensitivity to contextual and cultural issues that impact occupational performance.
- Articulate and apply diverse evidence-based, community-focused, occupation-based approaches to interventions relevant to goals, outcomes, and resources for people, populations, and communities across the life span.
- Evaluate sociopolitical and economic systems and trends that impact the ever-changing administration and provision of occupational therapy services with all people, populations, and communities.
- Employ theoretical foundations, professional and clinical reasoning, and current research for effective evidence-based practice.
- Be moral and ethical occupational therapy practitioners who demonstrate leadership and an understanding of and commitment to the values of the profession by being self-directed practitioners, life-long learners, and agents of change through effective solutions.
References
Dunn, W. & McGuigan, A. (1994). The ecology of human performance: A framework for considering the effect of context. American Journal of Occupational Therapy, 48(7), 595-607.
Iwama, M. (2006). The Kawa model: Culturally relevant occupational therapy. New York: Elsevier, Churchill Livingstone.
Kielhofner, G. (2007). A model of human occupation: Theory and application (4th Ed.). Baltimore: Williams & Wilkins
Mattingly, C. & Fleming, M. H. (1994). Clinical reasoning: Forms of inquiry in a therapeutic practice. Philadelphia: F.A. Davis Company.
Shell, B. & Schell, J.W. (2008). Clinical and Professional Reasoning in Occupational Therapy. Baltimore: Williams & Wilkins.
Schon, D. (1983). The reflective practitioner: How professionals think in action. New York: Basic Books.