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Entry-Level Occupational Therapy Doctorate (OTD)
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The curriculum is based on a liberal arts foundation, with course work designed to address the cognitive, psychosocial and sensory-motor needs of clients and the impact of cultural, social and physical aspects of the environment on the clients adaptive process. Self-reflection is encouraged as students participate in self-evaluation regarding their strengths and vulnerabilities in various practice environments and share that evaluation with faculty. As students transition into the professional role of the occupational therapist, faculty serve as role models and mentors, encouraging high ethical standards, active participation in community service and creative involvement in scholarly pursuits.
The curriculum design is influenced by a number of factors including the 2011 Standards for an accredited education program for the occupational therapist, and the mission statements of the University of North Dakota, School of Medicine and Health Sciences and the Department of Occupational Therapy, as well as the occupational adaptation model of occupational therapy.
The 2011 Standards are reflected in the guidance provided in the development of the curriculum content, program evaluation and ongoing assessment of program quality.
The curriculum design reflects the mission of the University of North Dakota and the School of Medicine and Health Sciences to serve the public through teaching and preparation of highly skilled entry-level occupational therapists, scholarly and creative activity and service in the development of sequenced learning experiences designed to produce an entry-level occupational therapist who is able to initiate, maintain and manage occupational therapy services to meet the needs of society. The exemplars of self-reflection, client-centeredness and occupation-centered practice driven by research evidence, as well as skills for lifelong learning and ethical and effective leadership, reflect the mission of the Occupational Therapy Program.
The model of occupational adaptation's influence on the curriculum design is presented in the following discussion of occupational adaptation, skill development, and adaptation and role transition. A graphic presentation of the curriculum model follows.
Occupational adaptation is a process that allows each person to master and respond adaptively to the various occupational challenges that are encountered in the course of a lifetime. A developmental process is presumed where occupation readiness skills in the person subsystems (sensory, cognitive, and psychosocial) set the stage for interaction in the environmental contexts of work, play, and leisure (Schkade & McClung, 2001). The intent of the Occupational Therapy Program is to develop students capable of assisting individuals to both assume the roles appropriate to their developmental position and to adapt to the challenges inherently present at each point in the developmental process with the common goal of competence in occupational functioning.
Occupational readiness in the UND OT curriculum begins in the first semester of the program when the students are enrolled in anatomy and group experience. Both courses present foundational information that helps to ground the student's knowledge in occupational therapy. Other examples of courses with occupational readiness components include neuroscience, medical sciences, administration, research, assistive technology and muscle function. The theory and practice courses present occupational readiness in combination with occupational activities where the students are provided opportunity to 'try on' skills related to the role of the therapist, adding the element of therapeutic context (environment) to learning.
The curriculum presents coursework in a sequence addressing occupational development of infants and young children in the second semester of the curriculum, moving to children, adolescents and young adults in the third semester and then to adult and aging populations in the fourth and fifth semesters. Multiple factors influencing the developmental process are simultaneously considered within each course including the physical, emotional, social, cultural and environmental factors that impact individual development.
The Level I/II Fieldworks provide the student ample opportunities to integrate knowledge and actively experience the role of the therapist in the practice setting and further develop occupational competence. Throughout the occupational therapy curriculum, the student is expected to take responsibility for learning. This is particularly evident when the student chooses a graduate track to pursue. As a graduate, the student is expected to integrate clinical experiences with academic knowledge as would be expected of the reflective practitioner.
Adaptation and Role Transition
Students enter the Occupational Therapy Program as active learners with demonstrated academic achievement and through engagement in occupational learning activities are regularly challenged toward personal, academic and professional growth.
The role of the educator is to provide learning activities that are representative of the role expectations of professional practice as an occupational therapist. Adjustments in learning activities may be made by the educator in response to the students' mastery of the subject. Examples include substituting discussion for lecture or using a small group learning activity to reinforce student learning and increase student engagement.
The role of the student is to evaluate engagement, participation level, and mastery of course/subject content. Students are encouraged to take responsibility for learning and become the agent of change in relation to acquisition of professional knowledge. For example, the student may evaluate a preferred method of learning and determine the need for a change in study habits or class participation in order to master course expectations.
The process of student reflection on learning is ongoing and reinforced throughout the curriculum both in required course work and in the student evaluations which occur each semester. Thus, students become reflective practitioners who take responsibility for and actively seek to meet professional learning needs in practice.
The UND Occupational Therapy Program emphasizes occupational skills development across the lifespan with multiple opportunities for students to experience/ appreciate the impact of contextual factors on adaptive processes and role transition. Students are expected to acquire the tools to not only assist clients with adaptive processes across the lifespan but also to enable client participation in valued occupations. Through the course of their education, students are expected to develop the knowledge, skills and adaptive capacity needed to address occupational challenges inherent to the role of occupational therapist and the reflective skills needed to sustain life-long learning.
Figure 1: Curriculum Design
The UND Occupational Therapy Program has identified the following listing of core curricular threads represented throughout the curriculum and recognized as exceptional qualities of the Program as demonstrated by its graduates.
The first set of curricular threads describes three elements of practice recognized as vital to contemporary occupational therapy practice. The graduate is prepared for practice in a wide variety of practice settings including pediatrics, adult rehabilitation, mental health, community and emerging practice areas.
Client-centered practice – The therapist holds "a philosophy of service committed to respect for and partnership with people receiving services, emphasizing the individual recipient of service and a focus on developing, restoring, or adapting the individual's skills and organizing and using assistance available in natural supports from family and friends" (Crepeau, Cohn, & Shell, 2009, p. 1155).
Occupation-based practice – The therapist's intervention planning supports engagement in personal and valued occupations when the occupational therapist and client "collaboratively select and design activities that have specific relevance or meaning to the client and support the client's interests, needs, health and participation in daily life" (Crepeau, Cohn, & Shell, 2009, p. 1162)Evidence-based practice – Therapists are prepared to "use... research study findings, client values and practitioner expertise during clinical reasoning to support the process of making wise practice decisions" (Crepeau, Cohn, & Shell, 2009, p. 1158).
The second set of curricular threads represents unique areas of emphasis specific to the UND Occupational Therapy Program. Graduates recognize the importance of therapeutic relationships and therapeutic use of self in practice, use the reflective process to enhance their practice, and are prepared to assume leadership positions early in their careers.
Therapeutic Relationship – Therapists are well-prepared to use "collaborative and client-centered approaches, emphasize caring and empathy, and demonstrate clinical reasoning and use of narrative" in the course of client-therapist relationships to forward successful interaction in therapy (Taylor, 2008, p.14).Reflective practitioners – The therapist regularly employs the reflective process to benefit everyday practice, as well as to assess continuing competency needs and plans for future learning. Reflection is a "tool in analyzing thoughts and actions that assists practitioners to justify interventions and gives practitioners the ability to learn from experience" (Sladyk, Jacobs, & MacRae, 2010, p. 622); but also a "process of listening to both the verbal and emotional content of a speaker and verbalizing both the feelings and attitudes sensed behind the spoken words to the speaker" (Sladyk, Jacobs, & MacRae, 2010, p. 622).Leadership in practice – The therapist enters occupational therapy practice with confidence and prepared to serve in a leadership capacity including "the ability to engage and influence others to facilitate and embrace meaningful change through careful consideration of individual and societal contexts in the embodiment of a shared vision" (Sladyk, Jacobs, & MacRae, 2010, p. 618).
Figure 2: Curriculum Threads
Figure 3: Curriculum Design with Curriculum Threads
Crepeau, E. B., Cohn, E. S., Schell, B. A. B. (2009). Willard & Spackman's occupational therapy (11th ed.). Philadelphia: Lippincott Williams & Wilkins.
Schkade, J. & McClung, M. (2001). Occupational adaptation in practice: Concepts and cases. Thorofare, NJ: SLACK, Incorporated.
Sladyk, K, Jacobs, K., & MacRae, N. (2010). Occupational therapy essentials for clinical competence. Thorofare, NJ: SLACK, Incorporated.
Taylor, R. R. (2008). The intentional relationship: Occupational therapy and use of self. Bethesda, MD: American Occupational Therapy Association.