Occupation-Based Practice: A Three-Year Study of the Impact of an Occupational Science Curriculum on Level II Fieldwork Students’ Perceptions of Occupational-based Practice

Introduction Occupation-based practice is viewed as focusing on clients’ meaningful engagement in valued occupations to promote health and well being. Occupational therapy students are educated to evaluate clients in situations that jeopardize their performance of occupations. Ideally, the practitioner, and client will collaborativey design an intervention program that has specific relevance to the client (American Occupational Therapy Association, 2008). While preparatory methods are a legitimate intervention strategy, preparing a client for participation in occupation is not the same as fostering actual participation in that occupation (Rogers, 2007). Incorporating occupations into intervention is a challenge in many practice settings. Healthcare settings, in particular, present challenges to occupation-based practice through an emphasis on productivity and reimbursement. The demands of working in such environments interfere with therapists designing interventions that foster clients’ participation in valued occupations (Rogers, 2007). When designing a new occupational science baccalaureate curriculum, faculty embraced the discipline of occupational science as a body of knowledge pivotal to the support of occupational therapy education. Pierce et al. (2010) found that one of the functions of this discipline is to disseminate knowledge about occupation to inform the practice of occupational therapy. After implementation of the occupational science curriculum, faculty redesigned the occupational therapy entry-level program to focus on occupation-based practice. Occupational therapy students were educated to offer clients opportunities and resources to engage in meaningful occupations for improved health and quality of life (Stack & Barker, 2011). The purpose of this research is to determine if students on Level II Fieldwork placements were encountering and engaging in occupation-based practice. This study focuses on Level II Fieldwork students’ perceptions of current occupational therapy practice and its congruency with the philosophy of occupational science in supporting occupation-based practice. Methods This research paper reports a retrospective cohort of Level II Fieldwork occupational therapy students for three consecutive years. A total of 156 students completed the master’s level entry program during this time. Data sources include: student blogs written over 24 weeks, fieldwork educator comments at midterm and final evaluation periods, student comments on the fieldwork experience and their responses to an exit questionnaire. Grounded theory methodology was employed during data analysis. Results Preliminary results of the study found that students valued occupation-based practice as conveyed in their academic work in the occupational science program and the occupational therapy program. Students’ perceptions of practicing therapists’ use of occupation-based practice was that its implementation was much lower than what students had anticipated. Level II Fieldwork students found that emphasizing the psychosocial aspect of occupation with clients could encourage a return to, and engagement in, valued occupations. Conclusions Implications for occupational therapy education and research are that students need education about the value of occupation and occupation-based practice but also need preparation in practical ways to integrate this practice in settings that rely heavily on preparatory methods and purposeful activities. The data support that students’ knowledge of occupation and occupation-based practice can assist in changing current occupational therapy practice at facilities that participate in Level II Fieldwork education. KEYWORDS: occupation, occupation-based practice, occupational therapy educatio