Reflections on Education and Learning in Occupational Therapy for the 21st Century

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<ul><li><p>COMMENTARY ON EDUCATION</p><p>Reflections on Education and Learningin Occupational Therapy</p><p>for the 21st Century</p><p>Charlotte Brasic Royeen, PhD, OTR, FAOTA</p><p>Because working with clients and their families has an educational component</p><p>embedded within it, education has always been a focus of occupational therapy.</p><p>And, just as occupational therapy has changed over the years, so, too, education</p><p>has changed. The purpose of this essay is to reflect upon what some of these</p><p>changes in education have been, relate them to occupational therapy education</p><p>and, based upon this reflection, set priorities needing to be addressed in occupa-</p><p>tional therapy education for the 21st century. This article reveals many more dif-</p><p>ferent issues in education than identified by Grant just 10 years ago (Grant, 1991)!</p><p>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).</p><p>[Haworth co-indexing entry note]: Reflections on Education and Learning in Occupational Therapy for</p><p>the 21st Century. Royeen, Charlotte Brasic. Co-published simultaneously in Occupational Therapy in Health Care</p><p>(The Haworth Press, Inc.) Vol. 15, No. 1/2, 2001, pp. 209-213; and: Education for Occupational Therapy in Health</p><p>Care: Strategies for the New Millennium (eds: Patricia Crist, and Marjorie Scaffa) The Haworth Press, Inc., 2001,</p><p>pp. 209-213. Single or multiple copies of this article are available for a fee from The Haworth Document Delivery</p><p>Service [1-800-HAWORTH, 9:00 a.m. - 5:00 p.m. (EST). E-mail address: getinfo@haworthpressinc.com].</p><p> 2001 by The Haworth Press, Inc. All rights reserved. 209</p><p>Occ</p><p>up T</p><p>her </p><p>Hea</p><p>lth D</p><p>ownl</p><p>oade</p><p>d fr</p><p>om in</p><p>form</p><p>ahea</p><p>lthca</p><p>re.c</p><p>om b</p><p>y U</p><p>nive</p><p>rsity</p><p> of </p><p>Nor</p><p>th D</p><p>akot</p><p>a on</p><p> 10/</p><p>26/1</p><p>4Fo</p><p>r pe</p><p>rson</p><p>al u</p><p>se o</p><p>nly.</p></li><li><p>CHANGES IN EDUCATION</p><p>In the past twenty years, education overall has been revolutionized due to a</p><p>variety of factors. The most important of these factors are:</p><p> Instructional technology,</p><p> A shift in focus from education to learning, and</p><p> An increased recognition of the need for interdisciplinary collaboration.</p><p>Each of these will be discussed in turn.</p><p>Instructional Technology. The advent of the Internet, Internet 2, cheaper and</p><p>more portable computers, and the maturation of Generation X, the first generation</p><p>to have been raised in a multimedia stream of consciousness, has created a Brave</p><p>New World in education. In spite of whatever attitudes, values, and beliefs any of</p><p>us hold about technology in education, educational change is here (Baldwin,</p><p>1998)! Not only is it here, but also technology in education is forcing a change in</p><p>the usual and customary ways of operating universities, businesses, and just about</p><p>every aspect of our lives. Nontraditional education used to mean night school.</p><p>Now it means taking courses, entire programs in a content area, and even PhD</p><p>study online or via distance using the World Wide Web.</p><p>Shift from Teaching to Learning. The teacher-centered focus of education</p><p>has given way to a student-centered focus upon learning (Barr &amp; Tagg, 1995).</p><p>The traditional method of content delivery, lecture, is no longer regarded as the</p><p>way to impart knowledge and understanding. Rather, active learning, wherein</p><p>knowledge and understanding are constructed by the learner based upon previ-</p><p>ous learning and experience, and which, concomitantly, transforms the learner</p><p>in some meaningful way, is the current focus of educational innovation and is</p><p>the new standard for education (Cranton, 1994). Excellence in education is now</p><p>defined as assisting the student to learn knowledge, skills, or attitudes that allow</p><p>them to accomplish some outcome objective. This is in marked contrast to past</p><p>models of excellence wherein knowledge was presented to the student in dense</p><p>and relentless ways (e.g., recall how you probably were taught neuroanatomy or</p><p>physiology, or drop in on a traditional medical school lecture).</p><p>Recognition of the Need for Interdisciplinary Collaboration. The 20th cen-</p><p>turys focus upon specialization as initiated by the industrial revolution has</p><p>rendered great knowledge gains, but also condemned us to insularity, segmen-</p><p>tation, and related individualism. Given the explosion of knowledge in single</p><p>fields, it is rare to find individuals who cross disciplines, fields, or areas of</p><p>study. Thus, wheels are reinvented, research is unwittingly replicated, and re-</p><p>sources are not allotted to best serve society.</p><p>These three factors will be specifically related to occupational therapy.</p><p>210 EDUCATION FOR OCCUPATIONAL THERAPY IN HEALTH CARE</p><p>Occ</p><p>up T</p><p>her </p><p>Hea</p><p>lth D</p><p>ownl</p><p>oade</p><p>d fr</p><p>om in</p><p>form</p><p>ahea</p><p>lthca</p><p>re.c</p><p>om b</p><p>y U</p><p>nive</p><p>rsity</p><p> of </p><p>Nor</p><p>th D</p><p>akot</p><p>a on</p><p> 10/</p><p>26/1</p><p>4Fo</p><p>r pe</p><p>rson</p><p>al u</p><p>se o</p><p>nly.</p></li><li><p>RELATIONSHIP TO OCCUPATIONAL THERAPY EDUCATION</p><p>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.</p><p>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.</p><p>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, &amp; Muzzarelli, 1998; MacKinnon &amp; MacRae,1996; Touchard &amp; Berthelot, 1999; Tryssenaar, Perkins, &amp; 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.</p><p>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:</p><p>CONSEQUENT PRIORITIES NEEDING TO BE ADDRESSEDIN OCCUPATIONAL THERAPY EDUCATION</p><p>FOR THE 21st CENTURY</p><p>1. Technology in teaching and learning. Consideration of how best to in-corporate instructional technology in occupational therapy education is</p><p>Commentary on Education 211</p><p>Occ</p><p>up T</p><p>her </p><p>Hea</p><p>lth D</p><p>ownl</p><p>oade</p><p>d fr</p><p>om in</p><p>form</p><p>ahea</p><p>lthca</p><p>re.c</p><p>om b</p><p>y U</p><p>nive</p><p>rsity</p><p> of </p><p>Nor</p><p>th D</p><p>akot</p><p>a on</p><p> 10/</p><p>26/1</p><p>4Fo</p><p>r pe</p><p>rson</p><p>al u</p><p>se o</p><p>nly.</p></li><li><p>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.</p><p>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.</p><p>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.</p><p>4. Interdisciplinary learning. Interdisciplinary learning does not mean yet an-other course in the curriculum which is already overburdened. But, it doesmean providing meaningful experiences for students to interact together.Given the nature and intent of the profession, a natural form for this wouldbe service learning. Thus, guidelines for implementation of interdisciplin-ary service learning including occupational therapy are needed.</p><p>5. The dignity of teaching. Lee Shulman suggests that teaching should be ascholarly responsibility of the disciplinary community (Shulman, 1993).Thus the Dignity of Teaching (American Association for Higher Edu-cation, 2000) (a term used in Campus Program Update, 2000) may bebest expressed and revered through the ways of a scholar as applied toteaching. Again, guidelines for occupational therapy education relatedto this are needed.</p><p>These priorities are set forth as a starting point for a concerted effort under</p><p>the general rubric of the scholarship of teaching. This volume is a great exam-</p><p>ple of how to increase the focus of occupational therapy education towards the</p><p>scholarship of teaching. The co-editors are to be commended for this effort!</p><p>REFERENCES</p><p>American Association for Higher Education. (November, 2000). The dignity of teach-ing. Campus Program Update, II, 1.</p><p>Baldwin, R. G. (1998). Technologys impact on faculty life and work. New Directionsfor Teaching and Learning, 76, 7-21.</p><p>212 EDUCATION FOR OCCUPATIONAL THERAPY IN HEALTH CARE</p><p>Occ</p><p>up T</p><p>her </p><p>Hea</p><p>lth D</p><p>ownl</p><p>oade</p><p>d fr</p><p>om in</p><p>form</p><p>ahea</p><p>lthca</p><p>re.c</p><p>om b</p><p>y U</p><p>nive</p><p>rsity</p><p> of </p><p>Nor</p><p>th D</p><p>akot</p><p>a on</p><p> 10/</p><p>26/1</p><p>4Fo</p><p>r pe</p><p>rson</p><p>al u</p><p>se o</p><p>nly.</p></li><li><p>Barr, R. B., &amp; Tagg, J. (1995). From teaching to learninga new paradigm for under-graduate education. Change, 27(6), 12-25.</p><p>Conner-Kerr, T. A., Wittman, P., &amp; Muzzarelli, R. (1998). Analysis of practice-roleperceptions of physical therapy, occupational therapy, and speech-language ther-apy students. J Allied Health, 27(3), 128-131.</p><p>Cranton, P. (1994). Understanding and promoting transformative learning. San Fran-cisco, CA: Jossey-Bass.</p><p>Gilbert, S. (2001). Making on-line education work for students and faculty. Paper pre-sented at the Creighton University, School of Pharmacy and Allied Health Profes-sions Faculty Development Workshop, Omaha, NE.</p><p>Grant, H. K. (1991). Education then and now: 1949 and 1989. American Journal of Oc-cupational Therapy, 45(4), 295-299.</p><p>MacKinnon, J. L., &amp; MacRae, N. (1996). Fostering geriatric interdisciplinary collabo-ration through academic education. Phys Occup Ther Geriatr, 14(3), 41-49.</p><p>Shulman, L. S. (1993). Teaching as a community property: Putting an end to pedagogi-cal solitude. Change, 25(6), 6-7.</p><p>Touchard, B. M., &amp; Berthelot, K. (1999). Collaborative home practice: Nursing andoccupational therapy ensure appropriate medication administration. Home HealthNurse, 17(1), 45-51.</p><p>Tryssenaar, J., Perkins, J., &amp; Brett, L. (1996). Undergraduate interdisciplinary educa-tion: Are we educating for future practice? Can J Occup Ther, 63(4), 245-251.</p><p>Commentary on Education 213</p><p>Occ</p><p>up T</p><p>her </p><p>Hea</p><p>lth D</p><p>ownl</p><p>oade</p><p>d fr</p><p>om in</p><p>form</p><p>ahea</p><p>lthca</p><p>re.c</p><p>om b</p><p>y U</p><p>nive</p><p>rsity</p><p> of </p><p>Nor</p><p>th D</p><p>akot</p><p>a on</p><p> 10/</p><p>26/1</p><p>4Fo</p><p>r pe</p><p>rson</p><p>al u</p><p>se o</p><p>nly.</p></li></ul>

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