Occupational Therapy Doctorate

Permanent URI for this collectionhttps://hdl.handle.net/2152.3/11352

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Handwriting Lab: An Occupational Therapy-Led Program to Foster Teacher Readiness Toward Evidence-Based Practices
(2023) Nunez, Elizabeth
Background. The gap between evidence-based recommendations for handwriting instruction and current classroom practices demands attention to the context of teachers as primary stakeholders in successful translation of the vast knowledge on handwriting. Existing handwriting programs are not feasible without consideration of the teacher implementing the program. Methods. Kindergarten teachers participated in an 8-week handwriting lab aimed at improving handwriting intervention. The teachers engaged with the occupational therapist (OT) on campus in pre- and post- intervention knowledge- and perspective-sharing, including coaching on ready-made materials. The teachers were then monitored weekly across the implementation of a motor learning-based and a structured set of systematic daily steps for teaching the lowercase letters. Data was also collected on changes in students’ letter writing. Results. Two consenting kindergarten teachers completed the program. Teacher outcomes indicated favorable results toward the success and feasibility of the program’s methods. Teachers experienced positive changes in their commitment to evidence-based handwriting instruction. Quantitative data on student outcomes also revealed positive changes in students’ ability to write lowercase letters. Discussion. As seen through this program, the lack of application of evidence-based knowledge on handwriting can be feasibly addressed by supporting teacher readiness throughout the intervention. Conclusion. The specific teacher-focused methods of the Handwriting Lab translated to positive changes for teachers and students. Translation of knowledge on handwriting into the complex clinical arena of the school setting is a critical area for the ongoing application of the holistic lens of occupational therapy.
Psychological Safety and Inclusive Teaching Practices: Occupational Therapy Faculty's Perception for Student Success
(2023) Farooqui, Sheina
Introduction: Psychological safety (PS) is the belief that it is safe to freely voice concerns and ideas, with little or no fear of reprimand, or belittlement. Currently, there is a gap in the literature about the construct of PS within U.S. Occupational Therapy (OT) educational programs related to faculty leadership and student engagement. Objectives: This capstone explored faculty's perception of PS within their program and highlighted the need to 1) introduce the concept of PS in OT education 2) call to action the use of PS practices in OT academics to support diversity, equity, and inclusion (DEI) initiatives in OT education and 3) utilize inclusive instructional design in OT curriculum to foster PS. Methods: An exploratory, cross-sectional online survey design consisting of 44 closed-ended questions was distributed through virtual platforms and email Listserves to OT/OTA faculty in the U.S. Questions explored PS on a Likert scale ranking and inclusive teaching practices (ITP) through dichotomous yes/no responses. By the response deadline, 85 valid responses were received. Results: Descriptive statistics results of this capstone indicated faculty report a perception of PS when working in teams. On average, participants fell between “sometimes” and “often” for overall PS (M= 3.61) and ITP (M=3.86). For ITP practices, transparency (M= 4.11) and academic belonging (M= 4.04) were the most used strategies. Correlational statistics results indicated no significant association between PS and ITP strategies (r=.091), program cohort size to PS (r= .050), and faculty team size to PS (r= .050). There was a significant association observed between overall PS and ITP subscale critical engagement (CE) (r= .235). Discussion: The findings indicated that there is no strong association between the overall PS and ITP within OT education; however, the results do indicate the presence of both constructs within OTA/OTA programs. Faculty team size and program cohort size are not mediating factors affecting PS or ITP use. Therefore, all OT/ OTA programs could consider utilizing PS and ITP strategies in their program curriculum. Faculty who perceive greater overall PS in their teams are also more likely to use specific critical engagement strategies in their courses. Conclusion: This capstone adds to the body of OT literature to introduce the construct of PS in OT education and highlights faculty’s use of ITP strategies in OT education. Additionally, OT/OTA faculty could benefit from continuing education regarding PS leadership practices, utilization of ITP strategies in the classroom to support DEI in OT curriculum and continuing ongoing research toward trauma-informed approaches as an educational framework in OT education to support critical student engagement.
The Effects of an Occupational Therapy Program on the Overall Well-Being of Older Adults with Intellectual and Developmental Disorders in a Nontraditional Residential Setting
(2023) Joseph, Christine
Background: Life expectancy for older adults with intellectual and developmental disorders (IDD) has increased significantly over the years. As longevity increases for adults with IDD, the number of Americans needing long-term services and support, such as residential facilities, is projected to increase as well. This shift has led to an increased need for external services in residential facilities, such as occupational therapy (OT), to address the psychosocial needs of older adults with IDD. Methods: A non-experimental, pre and post-test one-group design was used to assess the effects of a four-week OT program on the overall well-being and QOL of residents (n=8) over 65 with a diagnosis of IDD at a selected community site. Participants engaged in a four-week OT program every week, focusing on social participation, emotional regulation, and volition with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The Model of Human Occupational Screening Tool (MOHOST) and the Volitional Questionnaire (VQ) were used to assess changes in self-perception of occupational performance and volition with occupational performance. Results: The data collected via the MOHOST showed that participant’s MOHOST scores increased from the pretest (M = 55.50, SD = 6.39) to the post-test (M = 69.00, SD = 11.03) t (7) = -5.26, p <.001). A significant difference (Z = -2.395, p <.05) was noted between scores given for the pre- and post-MOHOST scores. Analysis of the VQ demonstrated mean scores related to volition differed significantly across three time points (F (1, 7) = 23.6, p < .05). Conclusion: These results indicate that OT can have a positive impact on the overall well-being and quality of Life (QOL) of older adults with IDD living in a residential facility. The positive results highlight the importance of expanding OT services on the overall well-being and QOL of the community, especially for underserved populations.
An Educational Intervention to Promote IEP Collaboration with Elementary Students
(2023) Vo, Lien
Aims: This study aimed to explore the occupational therapists' perceptions of collaborating with elementary students when developing Individualized Education Program (IEP) goals in the education plan. Methods: Sixteen occupational therapists (n = 16) participated in a mixed method pre- and post-experimental study using a one-module educational intervention based on adult learning theories. Results were analyzed descriptively and quantitatively using the Sign Test. Results: The educational intervention significantly changed the occupational therapists' perceptions (Mdn = 1.0) from not collaborating to collaborating with elementary students. However, the participants reported that the organization and team support, time, confidence, and student's functional ability negatively impact their practice to collaborating inclusively. The participants found that group learning activities, literature about collaboration, and paper resources were effective during the educational intervention. Discussion: Outcome measures revealed the educational intervention was effective to inform the occupational therapists about inclusive practices to include elementary students when developing IEP goals. The educational intervention contained evidence-based content and was designed based on blending adult learning principles to construct and apply new knowledge. The pilot study had limitations that can help refine future trainings to include other IEP team members. Conclusion: The educational intervention helped the occupational therapists reflect their perceptions to practice inclusively and equitably in giving elementary students a voice in choice of desired IEP goals. Through collaboration, occupational therapists can shape the elementary student's goals in accordance with the IEP plan. As a client-centered profession, occupational therapists must remain grounded and include elementary students as part of the IEP team.
Early Caregiver Training in Stroke
(2021) Koerner, Stephanie
Cerebrovascular accidents (strokes) have a widespread and profound impact on survivors and caregivers, their quality of life and their ability to engage in occupations. Shortened hospital stays, limited access to post-acute rehabilitation, and often drastic changes in an individual’s functioning, can leave caregivers untrained and unprepared at discharge. The focus of acute care is limited to medical stabilization and discharge of the patient, resulting in a missed, and sometimes sole, opportunity to support and prepare caregivers through education and training. The current healthcare climate and review of the literature support the need for an early, standardized education program for caregivers that is clear, systematic, and readily accessible to clinicians and caregivers. The establishment of a formalized program in the acute care setting provides an opportunity for improved outcomes in functioning and quality of life and health for caregivers and survivors of stroke. Benefiting stakeholders, this program serves as a template for other settings. In addition, this program contributes to the scholarship of occupational therapy (OT), positioning the profession as a visible leader in hospital discharge planning and preparation.
Occupational Therapists’ Role in Reducing the Risk of Breast Cancer Related Lymphedema Prior to Diagnosis
(2021) Asfoor, Lina
Breast cancer related lymphedema (BCRL) is a common complication that occur among breast cancer survivors after surgical or radiation interventions. Nearly 40% of breast cancer survivors develop BCRL, though the International Society of Lymphology (ISL) classifies all those with a compromised lymphatic system as having stage 0 lymphedema. Breast cancer related lymphedema can be debilitating for breast cancer survivors, affecting them physically, mentally, emotionally, socially, and financially. Nevertheless, current literature offers no evidence to support a standard approach to improve management at stage 0 lymphedema. Occupational therapists (OTs) can help breast cancer survivors address BCRL at its early stages in order to improve performance outcomes and survivors' quality of life. A high demand is currently present to educate breast cancer survivors on BCRL and its prevention. This article thus aims to identify best practice in minimizing the risk of developing BCRL beyond stage 0 and distinguish the role of OTs in this practice.
Effects of Reflex Integration in Autism: An Occupational Therapy Case Report
(2019) Padilla Melendez, Jennifer
Introduction: Primitive reflexes play a role in motor development by preparing an infant to move against gravity and develop sensory organs and receptors. The Masgutova Neurosensorimotor Reflex Integration (MNRI) is a non-invasive, natural, and replicable neuromodulation technique that creates mature neurological pathways in the reflex circuit to aid in the development of mature motor patterns. Autism Spectrum Disorder (ASD) is a term used to describe a group of neurodevelopmental conditions characterized by social communication deficits and repetitive sensory-motor behaviors. Objective: To describe the effects of the MNRI intervention on bilateral coordination, auditory-visual integration, and crossing midline motor patterns of a child diagnosed with ASD who presents with a persistent asymmetrical tonic neck reflex (ATNR) and to discuss the implications of MNRI as it relates to occupational therapy (OT) practice. Methods: The child (10 years old) with a diagnosis of ASD with significant motor delays, persistent ATNR, and lack of independence for activities of daily living (ADL) was randomly selected from a purposive sample and participated in an 8-week MNRI intervention protocol to integrate the ATNR. The child was assessed pre and post intervention using the Schilder test, Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2), Sensory Profile 2, and a crossing midline observation form. Results: The case study results suggest that the MNRI intervention was successful at integrating the ATNR and improving bilateral coordination and crossing midline skills. The MNRI was not successful at improving upper-limb coordination. No effects were identified in regards to auditory-visual integration.
Occupational Therapy Practice Guidelines for Post-Surgical Breast Cancer Survivors
(2020) Sitabkhan, Shamima
Cancer continues to grow at an alarming rate globally and in the United States. Breast cancer is one of the leading cancer diagnoses in women, and surgery is a common treatment option for breast cancer. Breast surgery leads to numerous challenges with a unique set of complications affecting breast cancer survivors’ functional abilities and quality of life (QoL). To effectively address these unique set of complications, cancer rehabilitation professionals, including occupational therapy (OT) practitioners, need to have specific training, advanced skills, and clinical judgment in the field of oncology rehabilitation. This paper addresses the need for population-specific OT clinical practice guidelines (CPGs), as a resource to OT practitioners, with recommendations on evidence-based assessments and interventions to holistically address the physical, psychosocial, spiritual, and functional needs of this population. The Occupational Therapy Practice Guidelines for Post-Surgical Breast Cancer Survivors were developed after completing a thorough needs assessment, communication with the interdisciplinary oncology team, an intensive review of current research on the efficacy of assessments and interventions within the scope of OT, and the application of OT theory to practice guidelines. The CPGs provide recommendations on completing a comprehensive assessment, guidance on interventions to address symptom management, and a list of recommended upper extremity exercises for the OT practitioner while working with this population. The CPGs were implemented with a one-person case study with outcomes indicating that the CPGs may be effective at increasing functional abilities and maximizing QoL for individuals after surgical intervention for breast cancer.
Bioimpedance Spectroscopy for the Health Care Professional
(2020) Underwood, Melinda
Purpose: The capstone project aimed to develop a continuing education module to educate health care providers and staff on the purpose and use of the bioimpedance spectroscopy (BIS) unit. The researcher also conducted a one-month clinical utility survey with the outpatient wound care team to determine if using the BIS measurement tool changed patient intervention plans. Methods: The researcher developed a continuing education training module with pre-and post-testing to assess the participants learning. A course evaluation was developed to evaluate the effectiveness of the learning module. A mixed-methods clinical utility survey was performed with the outpatient wound care center where participants completed a systems usability scale (SUS) questionnaire and participated in a one–month follow-up interview. Results: Seven subjects participated in education and demonstration training during the clinical utility survey. Four of seven participants completed the SUS questionnaire. The data revealed an above average SUS score and good learnability and usability scores. Conclusions: The module and clinical survey confirmed that health care providers found the unit easy to operate and could potentially implement BIS into their daily workload. Reported barriers to using the device include unit location, short staffing, infection control, and patient load. Despite these barriers, the wound care staff have been trained on the device's use and found BIS beneficial for lymphedema patients, chronic venous insufficiency, congestive heart failure, kidney failure, peripheral vascular disease, and post-operative wound care needs.

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