Title

Standardized clients in case-based simulation: Student Perceptions and Relevance of an Occupation-based Curriculum

Location

Room A

Start Time

19-10-2013 9:35 AM

End Time

19-10-2013 10:05 AM

Session Type

Research Paper

Abstract

Occupational science and occupational therapy scholars encourage the adoption of occupation-based content in curricula yet few programs have formal outcome measures from instructional strategies. The University of Utah Division of Occupational Therapy curriculum was designed from an occupational science foundation, with occupation as the focus of each course. Our program adopted the Occupational Therapy Student Performance Assessment (OTSPA) (McNulty et al., 2003), a professional simulation test method using client actors. We administer three OTSPAs that build in complexity over three semesters. For this study, we focused on the third OTSPA, given just prior to the first Level II Fieldwork. This culminating assessment provides an opportunity for students to integrate curricular content with information they obtain in situ with a “real client”.

This study aimed to answer the following questions:

1) What is the student response to clinical simulation as an occupation-based instructional strategy? 2) Is occupation represented in students’ documentation as a result of occupation-based curriculum?

We used a mixed method design to examine data from 156 students that completed the OTSPA between 2007 and 2013. To answer the first question, we used questions from a survey and two qualitative open-ended questions: What elements of the OTSPA facilitated your learning? What elements would you recommend changing to increase its educational value? Students’ documentation in the OTSPA was used as data for the second question.

Survey results revealed that 90% of the students agreed or strongly agreed that the OTSPA enabled them to demonstrate skills that they could not do on a strictly paper-and-pencil test. In addition, 74% of students agreed or strongly agreed that participating in the OTSPA significantly contributed to the development of their professional competencies.

Qualitative results: Analysis of student responses to the first question yielded four themes: 1) putting it all together, 2) interacting with a real “client” boosted confidence, 3) hard to think on the spot-gave me insight into where I am currently; and 4) time management. Analysis of responses to the second question yielded three themes: 1) focus on learning rather than passing; 2) more time for documentation; 3) more practice with test administration and interpretation, and writing evaluations and intervention plans.

Analysis of Documentation: The evaluation documentation was examined to determine how often the client’s occupational priorities were reflected. Out of 849 goals, 84.3% had an occupation focus. Of those not considered occupation based, the most common errors were a) no clear link to the results of the COPM (70.6%) and b) focusing on performance skills with no link to occupation (20.3%).

Integrative learning, a national priority for higher education, affords opportunities to apply knowledge in real-world situations (Huber & Hutchings, 2004). Case-based simulation is one instructional strategy to facilitate integration of occupation into occupational therapy. Given the increased emphasis on clients’ occupational priorities for practice (AOTA, 2008), an occupation-based curriculum can provide standardized student competencies that include eliciting an occupational profile to identify occupational priorities and establishing goals and intervention based on an understanding of the person as an occupational being and measure outcomes of occupation-based curriculum.

Discussion Questions:

  1. How have other educators evaluated the effectiveness of their case-based curriculum?
  2. How can we design cases to increase integrative learning of students and the wholism of occupation?
  3. What is the solution to differences in defining occupation-based intervention among faculty and how does this impact student learning?

References

AOTA. ( 2008). Occupational Therapy Framework: Domain and process. American Journal of Occupational Therapy, 62, 625-688.

Huber, M. T. & Hutchings, P. (2004). Integrative learning: Mapping the Terrain. Washington, D. C.: Association of American Colleges and Universities. Linstrom-Hazel, D., & West-Frasier, J. (2004). Preparing students to hit the ground running with problem-based learning standardized simulations. American Journal of Occupational Therapy, 58, 236- 239.

McNulty, T. C., Poole, J. L., Burtner, P., Crowe, T. K., & VanLeit, B. (2003). The Occupational

Therapy Student Performance Assessment. Short course accepted and presented at the American Occupational Therapy 2003 Annual Conference; Washington, DC.

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Oct 19th, 9:35 AM Oct 19th, 10:05 AM

Standardized clients in case-based simulation: Student Perceptions and Relevance of an Occupation-based Curriculum

Room A

Occupational science and occupational therapy scholars encourage the adoption of occupation-based content in curricula yet few programs have formal outcome measures from instructional strategies. The University of Utah Division of Occupational Therapy curriculum was designed from an occupational science foundation, with occupation as the focus of each course. Our program adopted the Occupational Therapy Student Performance Assessment (OTSPA) (McNulty et al., 2003), a professional simulation test method using client actors. We administer three OTSPAs that build in complexity over three semesters. For this study, we focused on the third OTSPA, given just prior to the first Level II Fieldwork. This culminating assessment provides an opportunity for students to integrate curricular content with information they obtain in situ with a “real client”.

This study aimed to answer the following questions:

1) What is the student response to clinical simulation as an occupation-based instructional strategy? 2) Is occupation represented in students’ documentation as a result of occupation-based curriculum?

We used a mixed method design to examine data from 156 students that completed the OTSPA between 2007 and 2013. To answer the first question, we used questions from a survey and two qualitative open-ended questions: What elements of the OTSPA facilitated your learning? What elements would you recommend changing to increase its educational value? Students’ documentation in the OTSPA was used as data for the second question.

Survey results revealed that 90% of the students agreed or strongly agreed that the OTSPA enabled them to demonstrate skills that they could not do on a strictly paper-and-pencil test. In addition, 74% of students agreed or strongly agreed that participating in the OTSPA significantly contributed to the development of their professional competencies.

Qualitative results: Analysis of student responses to the first question yielded four themes: 1) putting it all together, 2) interacting with a real “client” boosted confidence, 3) hard to think on the spot-gave me insight into where I am currently; and 4) time management. Analysis of responses to the second question yielded three themes: 1) focus on learning rather than passing; 2) more time for documentation; 3) more practice with test administration and interpretation, and writing evaluations and intervention plans.

Analysis of Documentation: The evaluation documentation was examined to determine how often the client’s occupational priorities were reflected. Out of 849 goals, 84.3% had an occupation focus. Of those not considered occupation based, the most common errors were a) no clear link to the results of the COPM (70.6%) and b) focusing on performance skills with no link to occupation (20.3%).

Integrative learning, a national priority for higher education, affords opportunities to apply knowledge in real-world situations (Huber & Hutchings, 2004). Case-based simulation is one instructional strategy to facilitate integration of occupation into occupational therapy. Given the increased emphasis on clients’ occupational priorities for practice (AOTA, 2008), an occupation-based curriculum can provide standardized student competencies that include eliciting an occupational profile to identify occupational priorities and establishing goals and intervention based on an understanding of the person as an occupational being and measure outcomes of occupation-based curriculum.

Discussion Questions:

  1. How have other educators evaluated the effectiveness of their case-based curriculum?
  2. How can we design cases to increase integrative learning of students and the wholism of occupation?
  3. What is the solution to differences in defining occupation-based intervention among faculty and how does this impact student learning?