Entry-Level OTD Curriculum Design

Occupational therapy helps people of all ages engage in day-to-day activities through therapeutic use of occupations (AOTA, 2020). The word occupation refers to all the activities that occupy the individual’s time, meet personal needs, enable participation in family and community life, and sustain health and well-being (AOTA, 2017; Wilcock, 2006). Occupational therapists believe that humans need occupation to grow and thrive; as humans participate in occupation, the union of the mind, body, and spirit is expressed. Occupations are embedded in the everyday life of each person and are best understood in the context of the environment(s) in which they occur (Hooper & Wood, 2019). Occupational therapists believe that occupations, and especially occupational participation, have the power to impact humans’ state of personal health. Restricted opportunity for participation in personally valued occupations is believed to result in states of dysfunction, dissatisfaction, and an overall diminished well-being (Hasselkus, 2011). Occupational therapists believe in occupational justice – the right to access occupational participation and meet basic occupational needs regardless of life circumstances and/or disability (Wilcock & Townsend, 2019).

The primary goal of occupational therapy is to promote engagement and participation in personally valued occupations to improve health and well-being. To meet this goal, contemporary occupational therapy practice is characterized by five principles:

• Client-centered and relational practice reflects the occupational therapist’s desire to understand the uniqueness of each individual and develop a profile descriptive of the individual’s occupations. The client-centered therapist fosters development of a therapeutic relationship where the responsibility for decision-making, including goals and objectives of therapy, is shared with the individual (Law, 1998). The client is recognized as either a person, group, or population (AOTA, 2020).
• At the core of client-centered practice is occupation. Occupation-centered practice is firmly based on the individual’s desire for satisfactory occupational engagement in their typical contexts. The goals in occupational therapy are related to the person’s occupational concerns (Copolla, Gillen, & Boyt Schell, 2024).
• Evidence-based practice and practice-based evidence suggests that professional reasoning is grounded in research evidence and client preferences while also using practice outcomes data for decision-making. The therapist reflects upon research and practice evidence to determine more effective approaches for ongoing quality improvement of services (Copolla, Gillen, & Boyt Schell, 2024).
• Culturally relevant practice recognizes that occupations are shaped by culture and that effective occupational therapy must attend to the social, political, and cultural milieu of the individual served (WFOT, 2010). Occupational therapists are challenged to reflect upon the assumptions embedded in their own culture to remain open to new understandings present in other cultures.
• Occupational justice in practice ensures that all individuals have the right to experience occupational participation with equal opportunities and access. Occupational justice upholds inclusion with services that mitigate disparities such as race, economics, gender identity, or other identities that place an individual at risk for marginalization. Occupational therapists engage in advocacy to promote occupational justice in practice (Copolla, Gillen, & Boyt Schell, 2024).

We believe the therapist whose practice reflects these five principles can facilitate engagement and participation in occupations to meet personal and societal needs.

Reflecting our beliefs about the value of occupation to human beings, our philosophy of teaching and learning begins with the core subject of occupation. Subject-centered learning enables educators and their students to keep the profession’s core subject at the center of learning (Hooper et al., 2014; Palmer, 1998). We believe maintaining occupation as our central focus is fundamental to students’ development of sound professional reasoning and ultimately, professional identity (Bilics, 2014; Hooper et al., 2014).

Keeping occupation at the center, experiential learning philosophy guides our conceptualization of the learner, the educator, and methods utilized to facilitate learning. We believe that learning occurs when practical experiences are paired with multimodal methods that facilitate integration between these experiences and understanding occupation (Hooper et al, 2014; Merriam et al., 2007a). As students come to understand occupation, we intentionally provide opportunities for critical reflection to prepare students for self-authorship (Brookfield 1987; Fink, 2003; Hooper, 2010; Merriam et al., 2007b). Therefore, we complement experiential learning philosophy with transformational learning methods. The outcome is students are capable of self-authorship where they can use their internalized understanding of occupation and their identity as an occupational therapist to solve novel problems and aspire to become agents of change in the profession (Hooper, 2010). With this in mind, we set forth our view of the learner, learning process, educator, and learning context.

Diverse learning styles exist among groups of learners due to various inherent and experiential determinants of learning (Kitchie & Arnaud, 2020). Learners will come with previous experiences which are integrated into new learning to create new understanding about the occupational therapy profession (Anderson, Krathwohl, et al. 2001; Hooper et al., 2014; Merriam et al., 2007a). Learners are motivated by the perceived necessity to learn information (Merriam et al., 2007a). With this motivation comes the ability to initiate and engage in self-directed inquiry. The learner takes responsibility for being an active participant—able to transfer knowledge and skills into both the professional and personal arenas of his or her life (Sell, 2008). The learner is curious and tolerates ambiguity as they engage in the learning process. The learner collaborates with others in an array of dynamic learning strategies as implored by environmental and situational demands (Merriam, et al., 2007a, 2007b).

We believe learning how to reason like an occupational therapist is critical to the learning process and evolves along a developmental continuum from basic understanding to more advanced analysis, integration, and creation. Initially, learning requires an individual to have some underlying foundational concepts (Fink, 2003; Sell, 2008), with attention given to the learner being self-directed in acquiring foundational knowledge. Foundational concepts include an understanding and knowing of the profession’s core, human occupation, in which all additional concepts and knowledge should be situated (Hooper, et al., 2014). Once the learner understands the conceptual foundation, the next stage in the progression of learning is “learning how to think like an OT,” where emphasis is given to mastering critical thinking within the domain of occupational therapy. Rather than an emphasis on content alone, learning involves mastering more complex ways of knowing through critical thinking processes (Boyt Schell & Schell, 2008; Schon, 1987). To facilitate the process of learning, it is believed that learning occurs when learners are provided opportunities to readily engage with knowledge through application, analysis, evaluation, and creation (Anderson, Krathwohl, et al. 2001). The final stage is the ability to synthesize learning or engage in self-authorship (Fink, 2003; Hooper, 2010). The ultimate outcome is when the learner has acquired the skills and attitude to be a life-long learner and change agent.

Educators establish a classroom culture that facilitates development of the inquisitive nature of the student to further enable them to ask the critical questions of themselves, of the occupational therapy profession and of the society in the future (Merriam et al., 2007a; Hooper et al., 2014). This includes understanding current practice, posing missing elements, and developing solutions for future practice (Hooper, 2010). The educator fosters positive relationships among the community of learners (student, educator, practitioner, researchers, and consumers). Educators carefully construct learning experiences from a repertoire of contextualized instructional methods based on where students are in the learning process (Merriam et al., 2007a, 2007b). The educator integrates multiple teaching theories and multimodal methods to address all domains of learning [cognitive, affective, & kinesthetic] (Bloom, 1956) that align with diverse learning styles among groups of learners.

Educators assure that the social context for learning incorporates the OT Department’s core values with the OT Code of Ethics (AOTA, 2020) to intentionally create a welcoming, inclusive, and safe learning space. The context of learning should encompass a variety of learning activities to address both the needs of the learner and the learning outcomes. The best learning opportunities are those that provide experiences in authentic physical contexts (e.g. classroom, laboratories, community) to promote active engagement in higher order thinking and problem solving to prepare students for self-authorship (Boyt Schell & Schell, 2008; Dewey, 1938; Hooper 2010; Merriam et al., 2007a). Students are likely to learn more when they learn in collaboration with a community of learners (Boyt Schell & Schell, 2008). Collaborative learning enhances cooperation, discourse, teamwork, and heightens the individual’s learning through self-reflection (Boyt Schell & Schell, 2008). The community of learners takes equal responsibility to create a safe, yet challenging, climate for learning (Maslow, 1962). Assessment and feedback are fostered through a supportive environment and enable understanding of what learners bring to the classroom and aid in adjusting the context to promote effective learning (Angelo & Cross, 1993).

American Occupational Therapy Association [AOTA] (2020a). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74 (Supplement 2).

AOTA. (2020b). AOTA 2020 occupational therapy code of ethics. American Journal of Occupational Therapy, 74(Supplement_3), 7413410005p1–7413410005p13.

American Occupational Therapy Association Commission on Education (2017). Philosophical base of occupational therapy. American Journal of Occupational Therapy, 71(Suppl.2), 7112410045. https://doi.org/10.5014/ajot.2017.716S06

Anderson, L.W. (Ed.), Krathwohl, D.R. (Ed.), Airasian, P.W., Cruikshank, K.A., Mayer, R.E., Pintrich, P.R., Raths, J., & Wittrock, M.C. (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom’s taxonomy of educational objectives (Complete edition). New York: Longman.

Angelo, T. A., & Cross, K. P. (1993). Classroom assessment techniques: A handbook for college teachers (2^nd ed.). Jossey-Bass.

Bilics, A. (2014). Philosophy of occupational therapy education. AOTA: Commission on Education.

Bloom, B. S. (1956). Taxonomy of educational objectives: Cognitive and affective domains. New York: David McKay.

Boyt Schell, B. A., & Schell, J. W. (2008). Clinical and professional reasoning in occupational therapy. Lippincott & Williams & Wilkins.

Brookfield, S. D. (1987). Developing critical thinkers: Challenging adults to explore alternative ways of thinking and acting. Jossey-Bass.

Copolla, S., Gillen, G., & Boyt Schell, B.A. (2024). Contemporary occupational therapy practice and future directions. In G. Gillen & C. Brown (Eds.) Occupational therapy (14^th ed.). Lippincott

Dewey, J. (1938). Experience & education. Simon & Schuster

Fink, L. D. (2003). Creating significant learning experiences. Jossey-Bass.

Hasselkus, B. R. (2011). The meaning of everyday occupation. SLACK, Inc.

Hooper, B. (2010). On arriving at the destination of the centennial vision: Navigational landmarks to guide occupational therapy education. Occupational Therapy in Health Care, 24(1), 97-106.

Hooper, B., Krishnagiri, S., Price, M. P., Bilics, A. R., Taff, S. D., & Mitcham, M. (2014). Value and challenges of research on health professions’ core subjects in education. Journal of Allied Health, 43(4), 187-193.

Hooper, B., & Wood, W. (2019). The philosophy of occupational therapy: A framework for practice. In B.A. Boyt Schell & G. Gillen (Eds). Willard and Spackman’s Occupational Therapy, (13^th ed., pp.43-55). Lippincott, Williams & Wilkins.

Kitchie, S. & Arnaud, L.M. (2020). Determinants of learning. In S.B. Bastable, P.R. Gramet, D.L. Sopczyk, K. Jacobs, & M.M. Braungart (Eds.), Health professional as educator: Principles of teaching and learning (2^nd ed.), (pp.129-184). Jones & Bartlett.

Law, M. (Ed.). (1998). Client-centered occupational therapy. SLACK, Inc.

Law, M. & MacDermid, J. (2008). Evidenced-based rehabilitation. SLACK, Inc.

Maslow, A. H. (1962). Toward a psychology of being. Princeton: D. Van Nostrand Company.

Merriam, S. B., Caffarella, R. S., & Baumgartner, L. M. (2007a). Experience and learning (pp. 159-186). Learning in adulthood. Jossey-Bass.

Merriam, S. B., Caffarella, R. S., & Baumgartner, L. M. (2007b). Transformational learning (pp. 130-158). Learning in adulthood. Jossey-Bass.

Palmer, P. J. (1998). The courage to teach: Exploring the inner landscape of a teacher’s life. Jossey-Bass.

Schön, D. A. (1987). Educating the reflective practitioner. Jossey-Bass

Sell, R. G. (2008). Meeting the needs of adult learners. In R.M Diamond (Ed). Designing and assessing courses and curricula: A practical guide (pp. 257-270). John Wiley & Sons.

Wilcock, A. A. (2006). An occupational perspective of health. SLACK, Inc.

Wilcock, A. A., & Townsend, E. A. (2019). Occupational Justice. In B. A. Boyt Schell & G. Gillen (Eds), Willard and Spackman’s Occupational Therapy (13^th ed., pp. 643-660). Lippincott, Williams & Wilkins.

World Federation of Occupational Therapists (2009). Position statement on diversity and culture. http://www.wfot.org

The first semester encompasses Stage 1: Foundational Concepts where students are learning those skills foundational to occupational therapy practice regardless of practice context.

• OT 500: Culture & Occupation. Students learn to recognize the influence of culture and diversity across the domains of occupational therapy and begin to develop cultural humility in support of clients as occupational beings. Students investigate, analyze, and apply credible sources that reflect diverse experiences and worldviews in preparation for client collaboration.
• OT 501: OT Process & Practice Contexts. Students develop a foundational understanding of occupational therapy including occupational therapy process, types of professional reasoning, and contexts where occupational therapy occurs.
• OT 502. Research Methods in OT 1: Qualitative to Quantitative Designs. The student engages in the concepts of scientific inquiry through the continuum of qualitative and quantitative research designs and methodology used in the occupational therapy profession. The student applies principles of evidenced- based practice investigation, learns to both critique and design research studies as an ethical clinician-researcher, engages in understanding and interpreting qualitative and quantitative data analyses and outcomes, and is introduced to the process of dissemination of scholarly work.
• OT 504. Occupation & Analysis. Introduction to the concepts of occupation, relation to health and wellness, occupationbased models, and analysis. 
• OT 505. Forming Your Professional Identity. Students are introduced to foundational concepts of the occupational therapy profession and exemplars of personal and professional growth. Topics include historical development of the occupational therapy profession, occupational therapy philosophy, ethics, and distinct value of occupational therapy. The course includes personal application
  of professional exemplars. 
• OT 506. Integration & Fieldwork 1. Integration courses are intended to apply content in the semester. Topics include application of occupational therapy process, professional reasoning, cultural competence, justice, therapeutic relationship, and occupation analysis.

The second semester involves the transition from Stage 1: Foundational Concepts to Stage 2: Critical Thinking. During this semester, the primary emphasis is placed on critically thinking about occupation by applying foundational concepts as students begin to engage in the OT process with the primary emphasis being evaluation.

• OT 503. Research Methods in OT 2: Outcomes to Translation to Practice. The student selects, analyzes, and interprets qualitative and quantitative data, and advances their knowledge of research designs, evidence types, copyright, and publication processes. The student engages in scholarly writing, understanding interprofessional collaboration as well as the diverse roles an occupational therapy practitioner may fulfill, and translating research outcomes for dissemination and implementation for practice.
• OT 539. Health & Disease Affecting Occupational Performance. Students gain foundational understanding of typical development throughout the lifespan. The course addresses the impact of disruptions in typical development on occupational performance.
• OT 540. Evaluation of Occupational Performance. This course engages the student in the critical thinking necessary to understand evaluation concepts and apply the OT process in the art and science of evaluation. Students will encounter diversity of OT practice and professional identity concepts through assessing occupational performance and underlying factors (i.e., client factors and body functions).
• OT 541. Developing Leadership Skills in OT. Students gain knowledge of leadership theories and models, explore their leadership talents, and develop strategies to strengthen their leadership as they progress through the occupational therapy program and prepare for occupational therapy practice.
• OT 542. Integration & Fieldwork 2. Integration courses are intended to apply content in the semester. Topics include application of occupational therapy process with specific emphasis on professional reasoning in the evaluation process. 

During the third semester, students are engaged in Stage 2: Critical Thinking as they continue to critically think about occupational performance.

• OT 543. Movement & Occupational Performance. Students combine the study of human anatomy and kinesiology to allow the student to grow competence in the evaluation of and intervention planning for the occupational performance of human beings. Included are human anatomical structures, theory, and techniques of musculoskeletal evaluation with analysis of normal and pathological human motion as the foundations of intervention planning as an occupational therapy practitioner. 
• OT 544. Introduction to OT Intervention. Students are provided with an introduction to intervention approaches and types, selecting and developing interventions, health literacy, client/teaching/ learning process, and individual and group processes. 

The student continues in Stage 2: Critical Thinking, as the focus of study transitions from evaluation to the intervention component of the OT process.

• OT 600. Interventions for Mental Functions to Support Occupation. Students develop skills for intervention planning, implementation, review, and outcomes with specific emphasis for populations where occupational performance is affected by mental functions.
• OT 601. Interventions for Neuromusculoskeletal Functions to Support Occupation. Students utilize critical thinking skills necessary to understand interventions for neuromusculoskeletal and movement related functions specific to occupational performance. 
• OT 602. Management Principles in Occupational Therapy. Students will understand the role of the occupational therapy manager in developing management skills that promote justice, engagement, and collaboration.
• OT 603. Integration & Fieldwork 3. Integration courses are intended to apply content in the semester. Topics include application of occupational therapy process with specific emphasis on professional reasoning in the intervention process.
• OT 610. Experiential 1. Students begin developing the Doctoral Experience and the capstone (IS/SP).
• OT 569. Interprofessional Health Care. . A process-learning course intended to provide experience in building a team of health professionals from different professions. The focus is on learning to work effectively with an interprofessional health care team. Emphasis is placed on effective teamwork, the unique contributions of different professions, patient or family centered approach in health care delivery, and awareness of potential medical errors. *Students are enrolled in either Fall or Spring.

During fifth semester students continue in Stage 2: Critical Thinking.

• OT 612. Interventions for Sensory Functions to Support Occupation. Students use critical thinking skills necessary to understand interventions for sensory functions specific to occupational performance across the lifespan. Concepts are applied to the occupational therapy process through intervention planning, implementation, review, and outcomes.
• OT 613. Interventions to Support Occupation in Community-Based Practice. Students prepare to engage in occupational therapy intervention in community- based practice settings. Special attention is given to individual, group, and population approaches. 
• OT 614. Innovative Practitioner. Students develop skills to critically assess various factors and policies that impact service delivery, occupational therapy services, and the ability to address societal needs. Students use this information to advocate for and develop innovative programming for groups and populations.
• OT 616. Integration & Fieldwork 4. Integration courses are intended to apply content in the semester. Topics include application of occupational therapy process with specific emphasis on professional reasoning in the intervention process. 
• OT 617: Education in Occupational Therapy. Explores the methods and strategies used to develop, implement, and assess education programs for students in academia and fieldwork settings, for patients/clients, businesses, and professional staff. Information and discussion focus on the theory and research relevant to education in a variety of settings.
• OT 569. Interprofessional Health Care. . A process-learning course intended to provide experience in building a team of health professionals from different professions. The focus is on learning to work effectively with an interprofessional health care team. Emphasis is placed on effective teamwork, the unique contributions of different professions, patient or family centered approach in health care delivery, and awareness of potential medical errors. *Students are enrolled in either Fall or Spring.
• OT 611. Experiential 2. . Students continue developing the Doctoral Experience and the capstone (IS/ SP).

In semester 6, students are at the end of Stage 2: Critical Thinking. They are engaged in the first Level II experience and Advanced Integration 1 provides opportunities for students to apply their learning in an occupational therapy clinical/health setting with emphasis on clinical reasoning, reflective practice, professionalism and competence in developing skills to meet career responsibilities.

• OT 683. Level II Fieldwork A. Students apply occupational therapy concepts and the occupational therapy process including evaluation, intervention, and outcome measurement in varying fieldwork settings.
• OT 618 Advanced Integration 1. Students apply occupational therapy skills in a clinical/health setting with emphasis on clinical reasoning, reflective practice, professionalism, and competence in developing skills to meet career responsibilities.
• OT 689. Readings in Occupational Therapy. Students select and critique readings to support a literature review in the student's area of interest.

During the seventh semester students transition from Stage 2: Critical thinking to Stage 3: Synthesis.

• OT 684. Level II Fieldwork B. Students apply occupational therapy concepts and the occupational therapy process including evaluation, intervention, and outcome measurement in varying fieldwork settings.
• OT 689. Readings in Occupational Therapy. Students select and critique readings to support a literature review in the student's area of interest.

During the final semester students continue to engage in Stage 3: Synthesis.

• OT 694. Doctoral Experience. Students develop in-depth knowledge in one or more of the following areas: advanced
  clinical practice skills, research/theory development, administration/ policy, program development, advocacy, or education. 
• In conjunction with the Doctoral Experiential Placement, students complete a culminating project that relates theory to practice and demonstrates synthesis of advanced knowledge in a practice area as they complete either OT 995: Scholarly Project (SP) or OT 997: Independent Study (IS). The culminating project will be consistent with the student’s individualized learning objectives noted on the Doctoral Experiential Memorandum of Understanding. The IS/SP culminating project can take one of the following forms: 1) case study; 2) program development/modification; 3) course development; 4) advocacy via professional journal or agency level, or 5) research report. The IS/SP culminating projects can be completed in groups, however they must still reflect each student’s individualized goals and objectives indicated on the Doctoral Experiential Memorandum of Understanding.

Emphasis on student’s development of professional reasoning, capacity to engage in the occupational therapy process including the therapeutic relationship and becoming a research user and builder.

• The student will use professional reasoning strategies to provide rationale for decisions made during the occupational therapy process.
• The student will demonstrate the ability to accurately implement the OT process in all potential practice areas including evaluation, intervention, and outcomes.
• The student will develop and maintain a therapeutic relationship with clients to collaborate during the OT process that would benefit the client’s health and well-being.
• The student will act as a research user in planning and modifying intervention in light of evidence.

The student will design, construct, and implement the process for building evidence to act as a research builder.

Emphasis on student understanding of the occupational nature of humans, the Occupational Therapy profession, application, and synthesis of occupation performance theories of practice throughout the OT process, participation and understanding of professional engagement, and understanding in thought and practice of intra-professionalism and interprofessionalism.

• The student will analyze and articulate the role of occupation and its influence on health and wellness in the examination of the occupational nature of humans.
• The student will articulate an understanding of the history, values, and ethics of occupational therapy and advocate with confidence what occupational therapy can offer society.
• The student will apply occupational based theories and models of practice to construct, modify, and evaluate occupational performance related to the OT process.
• The student will actively participate in profession-specific and formal educational activities in a variety of contexts that enhance the role and awareness of occupational therapy demonstrating professional engagement.
• The student will apply skills necessary to effectively take part in intra/interprofessional collaborative practice.

 

Emphasis on student knowledge and understanding of public policy in acting to improve access to OT services, student implementation of effective management skills in creating OT services, and student utilization of leadership skills/strategies for innovative practice.

• The student will evaluate factors influencing public policy and create a course of action for improving access to occupational therapy services.
• The student will make use of management skills to create occupational therapy services for individuals and organizations.
• The student will use leadership skills and strategies in preparation for innovative practice.

Emphasis on student’s ability to engage in culturally relevant practice and to promote justice through advocacy for occupational engagement for all beings.

• The student will develop and practice relevant and culturally sensitive strategies and skills when interacting with consumers through occupational therapy practice to demonstrate cultural competence.
• The student will analyze the effects of health disparities and inequalities and will advocate to increase occupational engagement for all occupational beings to promote justice.