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The McMaster Occupational Therapy Program is based on conceptual frameworks grounded in the professional practice of occupational therapists (professional conceptual frameworks), and educational preparation of health professionals (educational conceptual frameworks). The conceptual frameworks are integrated into a single model, fondly referred to as the Steps and Pillars.
Steps: Professional Conceptual Framework
The steps of the conceptual frameworks illustrate the major foci of the program in terms of professional conceptual models. These include theories, models, frameworks and bodies of knowledge that students need to understand and be able to apply upon graduation. The foundational step is a focus on philosophy of health which includes definitions and determinants of health. It also includes foundational information about factors that contribute to health, including biological sciences (anatomy, physiology) and social sciences (psychology, sociology). The second step focuses on concepts of occupation, which refer to the theories and approaches to practice to help us understand the occupational issues experienced by clients. Occupation is a central concept in occupational therapy that “…refers to groups of activities and tasks of everyday life, named, organized and given value and meaning by individuals and a culture. The third step further assists students to consider how to view or consider occupation and occupational issues through various lenses. The McMaster Lens for Occupational Therapy is introduced early in the program, and helps students consider the many layers through which we can consider a client or population to understand occupation and how occupational therapists can provide services. For example, clients can be viewed through a developmental lens by asking questions about what are typical occupations for someone at that age and stage of life. The top step is called Process frameworks and refers to the models that help guide occupational therapists in their interactions with clients from referral to discharge. The most common process frameworks are the Occupational Performance Process Model (OPPM), and the Canadian Practice Process Framework (CPPF).
The final aspect of the Steps to consider is the carpet which lays across the top of the steps. The design on the carpet represents the Profile of Occupational Therapy Practice in Canada (“OT Profile”) (CAOT, 2012). Within the OT Profile, a model of essential competencies for the occupational therapy profession is depicted (see image below). The seven key areas of competency have been identified within our educational program as key learning outcomes.
The Pillars: Educational Conceptual Frameworks
The pillars of the Steps and Pillars model are reflections of the educational philosophies, theories and approaches that are drawn upon in the Occupational Therapy Program. There are five distinct pillars, although they are highly inter-connected. Each is described briefly here:
1. Self-directed learning (SDL), as outlined by Knowles (1975), clearly assigns the major responsibility for learning to the student. Within the framework provided by the goals and objectives of the program, students should be able to determine their own learning goals, how best to achieve their objectives, how to select learning resources, and how to measure their own progress. Faculty facilitate learning by asking questions, stimulating critical thinking, challenging the students' point of view, providing feedback, and evaluating student performance. Students are encouraged to think and discover during the process of gaining new knowledge, and not simply memorize facts. Self-directed learning is a component of life-long learning, which is now a clear expectation for all occupational therapists as practitioners within a regulated health profession. Self-directed learning provides students with the essential skills needed to work within changing practice contexts.
2. Problem-based learning (PBL), as a conceptual framework, contends that knowledge is best remembered in the context in which it is learned, and that acquisition and integration of new knowledge requires activation of prior knowledge. In contrast to the common approach of using a problem for application after learning has taken place, problem-based learning requires that the learner encounter a problem first as the initial stimulus for learning. The learner thus becomes actively involved in the learning process, can shape it to meet personal needs based on prior knowledge and experience, can engage in independent study appropriate to his/her unique learning style, and can integrate information from many sources, including student peers, into a conceptual framework for use in dealing with future problems.
Small group learning is a natural extension of problem-based learning. To maximize small group learning, we believe it is important to bring students from various educational and work experience backgrounds together so that the heterogeneity of the group itself becomes a valuable learning resource. The transfer of knowledge is enhanced through the use of problems that encourage students to not only learn content, but also to develop strategies to recognize the ‘analogy' or ‘principle' that can then be transferred to new problems and contexts.
3. Inter-Professional Education is an emerging approach to professional preparation of health professional students. IPE is defined as “occasions when two or more professions learn with, from and about each other to improve collaboration and quality of care” (The Center for Advancement of Interprofessional Education (CAIPE), 1997). The occupational therapy program offers opportunities for students to achieve inter-professional competencies through the formal curriculum. Student occupational therapists are also encouraged to further their development of these competencies through offerings within the Faculty of Health Sciences. The Faculty of Health Sciences at McMaster University has developed PIPER (Program of Interprofessional Education and Research) to encourage students to develop strong collaborative and team skills for future practice. Our occupational therapy program has firmly placed interprofessional education as a mandated activity for all students. The PIPER model provides students with four IPE competencies and three levels of activities from which they may choose to meet the mandatory requirements.
4. Experiential Learning is another important pillar of the McMaster Occupational Therapy Program. Students are engaged in numerous “hands on” learning experiences throughout their education. This includes classroom and community-based sessions that are part of university-based terms; in addition, clinical education offers rich experiential learning opportunities over 28 weeks of practica experience in four different settings. An important component of experiential learning is reflection; it is only through reflection on what was done, accomplished, observed or learned that a student can more readily generalize and build on the learning. Throughout university-based and practica courses, students are expected to engage in reflections which support them to consolidate and generalize their development as professionals.
5. The final pillar of the educational conceptual framework is Inquiry Based Learning, which is a student-centred, active learning approach focusing on questioning, critical thinking and problem solving. Although it shares features with problem-based learning, the approach is most often used in the McMaster Occupational Therapy Program in large-group classes. Students are engaged in learning that may begin with lecture or presentation by faculty, but readily moves into group discussions, team-based learning, or student presentations to support competency development.
Courses offered in the McMaster Occupational Therapy program frequently draw on many of the principles and approaches of the pillars simultaneously. Therefore, in the Steps and Pillars Model, the threads that spiral around the pillars represent each of the various courses in which students enrol. The courses bring together the competencies from the OT Profile and the other components of the Professional Conceptual Framework, draw on the educational conceptual frameworks of the pillars, to ensure that by the time they graduate, students have become competent entry-level occupational therapists. The arrow at the top of the model indicates that graduates are ready to take the competencies and strategies as life long learners with them as they graduate and enter practice.
Click here to view the Process Frameworks Presentation; an overview of the Occupational Performance Process Model (OPPM) and the Canadian Practice Process Framework (CPPF).
If you would like transcripts of the videos found within the process frameworks presentation, please contact firstname.lastname@example.org.