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  • COMMENTARY ON EDUCATION

    Reflections on Education and Learningin Occupational Therapy

    for the 21st Century

    Charlotte Brasic Royeen, PhD, OTR, FAOTA

    Because working with clients and their families has an educational component

    embedded within it, education has always been a focus of occupational therapy.

    And, just as occupational therapy has changed over the years, so, too, education

    has changed. The purpose of this essay is to reflect upon what some of these

    changes in education have been, relate them to occupational therapy education

    and, based upon this reflection, set priorities needing to be addressed in occupa-

    tional therapy education for the 21st century. This article reveals many more dif-

    ferent issues in education than identified by Grant just 10 years ago (Grant, 1991)!

    Charlotte Brasic Royeen is Chairperson, Education Special Interest Section, and re-cent Chair, Commission on Education, American Occupational Therapy Association.She is also Associate Dean for Research, and Professor in Occupational Therapy,School of Pharmacy and Allied Health Professions, Creighton University, 2500 Cali-fornia Plaza, Omaha, NE 68178 (E-mail: croyeen@creighton.edu).

    [Haworth co-indexing entry note]: Reflections on Education and Learning in Occupational Therapy for

    the 21st Century. Royeen, Charlotte Brasic. Co-published simultaneously in Occupational Therapy in Health Care

    (The Haworth Press, Inc.) Vol. 15, No. 1/2, 2001, pp. 209-213; and: Education for Occupational Therapy in Health

    Care: Strategies for the New Millennium (eds: Patricia Crist, and Marjorie Scaffa) The Haworth Press, Inc., 2001,

    pp. 209-213. Single or multiple copies of this article are available for a fee from The Haworth Document Delivery

    Service [1-800-HAWORTH, 9:00 a.m. - 5:00 p.m. (EST). E-mail address: getinfo@haworthpressinc.com].

    2001 by The Haworth Press, Inc. All rights reserved. 209

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  • CHANGES IN EDUCATION

    In the past twenty years, education overall has been revolutionized due to a

    variety of factors. The most important of these factors are:

    Instructional technology,

    A shift in focus from education to learning, and

    An increased recognition of the need for interdisciplinary collaboration.

    Each of these will be discussed in turn.

    Instructional Technology. The advent of the Internet, Internet 2, cheaper and

    more portable computers, and the maturation of Generation X, the first generation

    to have been raised in a multimedia stream of consciousness, has created a Brave

    New World in education. In spite of whatever attitudes, values, and beliefs any of

    us hold about technology in education, educational change is here (Baldwin,

    1998)! Not only is it here, but also technology in education is forcing a change in

    the usual and customary ways of operating universities, businesses, and just about

    every aspect of our lives. Nontraditional education used to mean night school.

    Now it means taking courses, entire programs in a content area, and even PhD

    study online or via distance using the World Wide Web.

    Shift from Teaching to Learning. The teacher-centered focus of education

    has given way to a student-centered focus upon learning (Barr & Tagg, 1995).

    The traditional method of content delivery, lecture, is no longer regarded as the

    way to impart knowledge and understanding. Rather, active learning, wherein

    knowledge and understanding are constructed by the learner based upon previ-

    ous learning and experience, and which, concomitantly, transforms the learner

    in some meaningful way, is the current focus of educational innovation and is

    the new standard for education (Cranton, 1994). Excellence in education is now

    defined as assisting the student to learn knowledge, skills, or attitudes that allow

    them to accomplish some outcome objective. This is in marked contrast to past

    models of excellence wherein knowledge was presented to the student in dense

    and relentless ways (e.g., recall how you probably were taught neuroanatomy or

    physiology, or drop in on a traditional medical school lecture).

    Recognition of the Need for Interdisciplinary Collaboration. The 20th cen-

    turys focus upon specialization as initiated by the industrial revolution has

    rendered great knowledge gains, but also condemned us to insularity, segmen-

    tation, and related individualism. Given the explosion of knowledge in single

    fields, it is rare to find individuals who cross disciplines, fields, or areas of

    study. Thus, wheels are reinvented, research is unwittingly replicated, and re-

    sources are not allotted to best serve society.

    These three factors will be specifically related to occupational therapy.

    210 EDUCATION FOR OCCUPATIONAL THERAPY IN HEALTH CARE

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  • RELATIONSHIP TO OCCUPATIONAL THERAPY EDUCATION

    Instructional Technology. Steven Gilbert (Gilbert, 2001) is a nationallyrecognized expert in technology as well as teaching and learning. I recentlyhad the opportunity to hear him speak, and a key concept he imparted wasabout hybrids. That is, he believes that hybrid courses of study, or those thatcombine some aspect of live, classroom interaction coupled with some as-pect of distance learning using the World Wide Web, are going to become thestandard for education, just as lecture has been the standard of education forpast centuries. This suggests that for occupational therapy education, hybridforms of learning incorporating face-to-face interactions with instructors andstudents will be linked with or merged with other forms of educational in-struction available through the World Wide Web or related technologies suchas CD-ROM, streaming videos, or teleconferencing classrooms.

    Shift from Teaching to Learning. Many of you may recall the movementof occupational therapy away from the term patient to client or familycentered care. Similarly, occupational therapy education is now challengedto move from a teacher-centered focus to a learner-centered focus. In fact, ithas been my experience that occupational therapy is way ahead of the curveon this one, since active learning has always been a tenet of occupationaltherapy and easily generalizes to occupational therapy education.

    Recognition of the Need for Interdisciplinary Collaboration. There is consid-erable literature in our field about the recognized need to collaborate across dis-ciplines in order to provide better and more effective care to clients and theirfamilies (Conner-Kerr, Wittman, & Muzzarelli, 1998; MacKinnon & MacRae,1996; Touchard & Berthelot, 1999; Tryssenaar, Perkins, & Brett, 1996). Yet,most occupational therapy educational programs, just like every other profes-sional course of study, have the majority of classes in isolation from other disci-plines or professions. Education as it currently operates is reinforcingindividuality when teamwork and interdisciplinary education and practice arewhat society really needs. The need for interdisciplinary collaboration speaks tothe need to evaluate and revise how we implement fieldwork education.

    Considering these reflections about education and learning in occupational ther-apy, priorities emerge which need our attention, deliberation and action for occupa-tional therapy education in the 21st century. They are summarized as follows:

    CONSEQUENT PRIORITIES NEEDING TO BE ADDRESSEDIN OCCUPATIONAL THERAPY EDUCATION

    FOR THE 21st CENTURY

    1. Technology in teaching and learning. Consideration of how best to in-corporate instructional technology in occupational therapy education is

    Commentary on Education 211

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  • critically needed. Guidelines for a variety of ways to accomplish effec-tive use of technology in education, as well as ways to assist educators inadopting technology in education, are warranted.

    2. Assume leadership role in the demonstration of active learning. It is myexperience that the majority of occupational therapy educators use ac-tive learning in an effective manner without necessarily knowing thatthey are doing so. Increasing the level of understanding of educationaltherapy and practice, as well as understanding how occupational therapyeducation often epitomizes this, is appropriate.

    3. Fieldwork education: Delineation and measurement. Fieldwork has al-ways been an educational experience directly focusing upon studentlearning. Clearer articulation of how student learning in the form offieldwork can and should occur in occupational therapy outside of medi-cal model practice is needed. And, valid and reliable ways to measurestudent learning in fieldwork education are urgently needed. Ask anyfieldwork educator.

    4. Interdisciplinary learning.