Entry-Level O.T.D. 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 of 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 four principles: 1) client-centered practice; 2) occupation-based practice; 3) evidence-based practice; and 4) culturally relevant practice (Boyt Schell, et al., 2019).

Client-centered practice reflects the occupational therapist’s desire to understand the uniqueness of each individual and developing 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-based practice is firmly centered on the individual’s desire for satisfactory occupational performance. The occupational therapist seeks to address the personally valued occupations of the individual in contexts most closely approximating the natural environment(s) of the individual (Boyt Schell & Gillen, 2019).

Evidence-based practice involves incorporating research evidence into the professional reasoning process to develop rationales supporting occupational therapy evaluation and intervention practices. The therapist evaluates relevant research, synthesizes the evidence to support intervention, and communicates the predicted outcomes to the individual who is encouraged to be a part of the decision-making in therapy (Law & MacDermid, 2008).

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 in order to remain open to new understandings present in other cultures.

We believe the therapist whose practice reflects client-centered, occupation-based, evidence-based, and culturally competent objectives is able to 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 methods that facilitate connection 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 in order to prepare students for self-authorship (Brookfield 1987; Fink, 2003; Hooper, 2010; Merriam et al., 2007b). Therefore, we complement our 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, educator, context, and process of learning.

Learners will come with previous experiences which are used to connect to new learning about the occupational therapy profession (Merriam et al., 2007a; Hooper et al., 2014). Learners are motivated by the perceived necessity to learn the information (Merriam et al., 2007a). Learners are invested in their learning. 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. Initially, learning requires an individual to have some underlying foundational concepts (Fink, 2003; Sell, 2008), with attention being 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 within (Hooper et al., 2014). Once the learner has an understanding of 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; Schön, 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, evaluation, and synthesis. 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 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 authentic experiences to promote active engagement in higher order thinking and problem solving to prepare students for self-authorship (Boyt Schell & Schell, 2008; 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 positive climate for learning. 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 (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74 (Supplement 2).

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

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.

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

Boyt Schell, B. A., Gillen, G., & Coppola. (2019). Contemporary occupational therapy practice. In Boyt Schell, B. A. &Gillen, G. (Eds), Willard and Spackman’s Occupational Therapy, 13th ed. (pp. 56-70). Lippincott, Williams & Wilkins.

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

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 Boyt Schell, B.A. & Gillen, G. (Eds). Willard and Spackman’s Occupational Therapy, 13th ed. (pp.43-55). Lippincott, Williams & Wilkins.

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

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

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 Boyt Schell, B. A. & Gillen, G. (Eds), Willard and Spackman’s Occupational Therapy, 13th 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, emphasizes understanding culture and its influence on occupational performance.
• OT 501: OT Process & Practice Contexts, provides students with an understanding of the OT process, strategies for professional reasoning, and an understanding of practice contexts.
• OT 502: Research Foundations in OT 1, students understand qualitative and quantitative research methodology as used in the occupational therapy profession and apply principles of evidenced-based practice investigation, critiques and the process of presentation and publication of research projects.
• OT 504: Occupation & Analysis, emphasizes understanding the occupational nature of humans, theories of practice, and analysis of occupation.
• OT 505: Forming Your Professional Identity, addresses the history of OT, values and ethics, and the distinct value of occupational therapy along with the beginning of professional development.
• OT 506: Integration & Fieldwork, emphasizes safety in occupational therapy practice and provides hands-on opportunities in Level I fieldwork to apply concepts learned across courses in the semester.

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 Occupational Therapy 2, students design qualitative and quantitative methodology and engage in analysis. In addition, students learn to apply evidence to practical clinical scenarios and develop further their identity as occupational therapy clinician-researchers.
• OT 539: Health and Disease affecting Occupational Performance, students understand normal development and disruptions of occupational performance by analyzing impacts on occupational performance.
• OT 540: Evaluation of Occupational Performance, where they begin to analyze occupational performance in the evaluation process across the lifespan and across practice contexts.
• OT 541: Developing Leadership skills in OT, students apply leadership theories and models, understand OT leaders in the fieldwork, and analyze their own leadership skills in regard to professional development in preparation for Level II Fieldwork and the Doctoral Experiential Placement.
• OT 542: Integration & Fieldwork 2, provides opportunity to bring together concepts across courses in problem-based cases, hands-on learning in Level I fieldwork and through exposure to consumers.

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 study human anatomy and kinesiology in order to gain competence in the evaluation of and intervention planning for the occupational performance of human beings. Included are human body dissection, theory and techniques of musculoskeletal evaluation with analysis of normal and pathological human motion. The emphasis of this semester is completing the evaluation process and beginning to engage in intervention; thus students are enrolled in OT 544

OT 544: Introduction to OT Intervention, where students are applying intervention approaches and types, health literacy concepts, client/teaching/learning process approaches, and group process with opportunities to function as a group facilitator.

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 Applied to Occupational Performance, students utilize evaluation data to plan interventions, intervention planning, implementation, review, and outcomes with specific emphasis for populations across the lifespan where occupational performance is affect by mental functions.
• OT 601: Interventions for Neuro-Musculoskeletal & Movement Functions Applied to Occupational Performance, students utilize critical thinking skills necessary to understand interventions across the lifespan for neuro-musculoskeletal and movement functions specific to occupational performance.
• OT 602: Management & Advocacy for Occupational Therapy Practice, students will understand the role of the occupational therapy manager and be able to analyze public policy and apply leadership skills through advocacy efforts.
• OT 603: Integration & Fieldwork 3 is an opportunity for synthesis of content covered in this semester and students apply learning through integrated case studies, consumers, and Level I fieldwork.
• OT 610: Experiential 1, students will review expectations of the Doctoral Experiential Placement and process, Independent Study (IS) and Scholarly Project (SP) culminating project guidelines, samples of potential sites, procedures for contacting sites, and the Background/Purpose section of the Doctoral Experiential Memorandum of Understanding.
• Half of the students are enrolled in OT 569 Inter-professional Health Care course.

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

• OT 612: Interventions for Sensory Functions Applied to Occupational Performance
• OT 613: Community-based Practice Interventions.
• OT 614: Innovative Practitioner, where they critically think as they engage in needs assessment and program planning which brings together evaluation and intervention planning for populations or agencies.
• OT 616: Integration & Fieldwork 4, continues to provide an opportunity for integration of concepts learned across the semester as students learn through cases, consumers, and Level I fieldwork.
• OT 617: Education in OT, where the primary emphasis is on understanding the role of OT as a fieldwork educator and as an academic educator.
• Half of the students are also enrolled in OT 569: Inter-professional Health Care.
• OT 611: Experiential 2, students will develop a draft of the Memorandum of Understanding (MOU) for the Doctoral Experiential Placement. The MOU will include an individualized learning plan, a schedule, and documentation of roles and responsibilities of all parties involved with the Doctoral Experiential Placement IS/SP. In addition, the experiential site will be secured with the Doctoral Experiential Placement MOU signed and dated by the student, site, and faculty mentors.

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
• OT 618 Advanced Integration 1
• OT 689: Readings in OT, Readings is focused on literature review and related work for the Doctoral Experiential Placement and IS or SP to be completed in Semester 8.

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

• OT 684: Level II Fieldwork B
• OT 689: Readings in OT. The emphasis becomes focused on transitioning to synthesis where students are independent, innovative, and ready to become agents of change.
• OT 620: Advanced Integration 2, provides opportunities as it challenges students to apply critical thinking in action. Students prepare for and take the department’s competency exam.

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

OT 694: Doctoral Experiential Placement, to develop advanced skills beyond the generalist level in one of the following areas: 1) clinical practice skills, 2) research/theory development, 3) administration/policy development, 4) program development, 5) advocacy, or 6) 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.

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

Giddens, J. F., Caputi, L., & Rodgers, B. (2015). Mastering Concept-Based Teaching: A guide for nurse educators. Elsevier

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.

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 utilize professional reasoning strategies to provide rationale for decisions made during the occupational therapy process.

1.  The student will use professional reasoning strategies to provide
     rationale for decisions made during the occupational therapy process.

2.  The student will demonstrate ability to accurately implement the OT
     process in all potential practice areas including evaluation,
     intervention, and outcomes.

3.  The student will develop and maintain a therapeutic relationship
     with clients in order to collaborate during the OT process that would
     benefit the client’s health and well-being.

4.  The student will act as a research user in planning and modifying
     intervention in light of evidence.

5.  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.

6.  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.  

7.  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

8.  The student will apply occupational based theories and models of
     practice in order to construct, modify, and evaluate occupational
     performance related to the OT process.

9.  The student will actively participate in profession-specific and formal
     educational activities in a variety of context that enhance the role and
     awareness of occupational therapy demonstrating professional
     engagement.

10. 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.

11. The student will evaluate factors influencing public policy and create
      a course of action for improving access to occupational therapy
      services.

12. The student will make use of management skills to create
      occupational therapy services for individuals and organizations.

13. The student will utilize leadership skills and strategies in preparation
      for innovative practic

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

14. The student will develop and practice relevant and culturally sensitive
      strategies and skills when interacting with consumers across
      occupational therapy practice to demonstrate cultural competence.

15. 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.