Occupational Therapy Impact on Developing Competent Skills

This research study was designed to explore the perspectives and experiences of occupational therapy students in a role emerging practice. The occupational therapy profession is in evolving state in health and social care; emphasis on health promotion has given rise to opportunities to expand their practice into unconventional settings. College of Occupational therapists (COT) has emphasised the relevance of role emerging placement in practice and its use in the pre-registration curriculum (College of Occupational Therapists, 2006). Research studies have identified how COT has challenged Occupational therapist educators to prepare students for the ever-changing health and social care contexts (Clarke et al., 2014). This has led to the provision of role-emerging placement to help students explore new-work-based learning opportunities and allow them to gain the professional identity and confidence required as an upcoming occupational therapists.

Evidence has shown that role-emerging placement (REP) is increasing. However, most reviewed literature is either descriptive, based on professionals’ perspectives on its necessity and value, or practically directed to placement evaluation (Thomas et al., 2007). There has been limited research explored specific to students’ experiences and opinions on the influence and effectiveness of this role. These researches are mainly practice educator’s opinions done in the mid-1990s or expressed by authors without students’ direct contribution (Overton, Clark and Thomas, 2009), which is likely to lead to bias in their findings. Although the literature on a role emerging placement is not extensive as other traditional placement practices, research shows that it is being practised. There is literature reviewed in countries like Canada, Australia, and America, where role emerging placement has been in use for than in the UK (Bossers et al., 1997; Thew, Hargreaves and Davis, 2008). Therefore, the gap around student perspective of role emerging placement and pursuit of updated evidence initiated the need for this topic and research.

This study hopes to provide and conduct recent qualitative research from/ for the United Kingdom (UK) that includes allied health student perspectives before, during, and after Role emerging placement. It will consist of the growing evidence of student experience, increase awareness and discuss views on how it contributes to developing knowledge and facilitate learning. These findings will provide information and an opportunity to consider if role emerging placement will empower students to prepare themselves better to become confident and competent professionals. It will also encourage inclusive support from the Universities and occupational therapy departments for students learning and overall well-being. The study will include all proposed steps, aims, methodology justification, appropriate participants, data collections, critically appraised literature review, and the role of a researcher.

Research Question

What is the perspective of occupational therapy students regarding role emerging placement in developing competent skills?

Literature Review

Appendix 1 displays a table that outlines the research articles (A1 to A3) which will be used in the literature review. The validity of this research is evaluated by the Critical Appraisal Skills Programme Tools (CASP). The literature reviews the materials published in the United Kingdom, Canada, USA, and Australia.

A1 investigates students’ learning experience from the role emerging placement, student’s perspective, and the supervisor. This process is significant in enhancing theory-to-practice learning. With the increased use of role emerging placement, there is a significant tension between implementing the program in occupational therapy and taking the necessary steps to understand the outcome. Dancza, Copley, and Moran’s (2019) study show that role emerging placement is critical in promoting students learning. However, the program faces serious challenges in structured guidance and negotiation.

A2 investigates the views, expectations, level of satisfaction, and perception of occupation therapy regarding the role emerging placement before and after. Role emerging placement plays a significant role in developing the professional identity of occupational therapy students. This is because various placement models can be used to promote student participation in multiple community-based services. Golos and Tekuzener (2019) show that students prefer given roles to supervision. Role emerging placement is significant in expanding and developing occupational therapy areas of practice.

A3 evaluates the role of emerging placement that the higher education institution uses to enhance the learning experience in areas that lack occupational therapy services. Fieldhouse and Fedden (2009) show that self-negotiated contract learning is a significant process. This is because it enables the students to develop a sense of appreciation as occupational beings. The program enables the students to interpret their experiences leading to knowledge construction instead of acquiring information which creates a pool of deep learning. Despite contract learning requiring great responsibility from the students, it enables them to become problem solvers by identifying their learning style (Thew, Hargreaves, and Cronin-Davis, 2008). Furthermore, it allows learners to have lifelong learning habits.

The literature review portrays a gap in the UK role emerging placement in that most of the findings are not based on the views of the students regarding the effectiveness of the role emerging placement. The resources show the significance of varying learning methods, such as formative assessments and collaborative learning. The gap is identified based on materials that may have varying variables. UK literature would have been significant in the identification of the gap.

Aims

1. To investigate a deeper understanding of occupational therapist students’ experience and view with role emerging placement in the UK and how such placement has influenced therapist quality of practice and development.
2. To consider possible implications for practice, education, and future research.
3. To identify the need for inclusive support in learning for University of Worcester occupational therapist students on a role emerging placement to prepare them for a range of opportunities for future direction.

Objective

To increase awareness in the United Kingdom of role emerging placement and gain a deeper understanding of how it has influenced occupational therapist students to experience the quality of practice.

Study Design and Methods

The research will use a qualitative methodology using semi-structured interviews to collect data. This method is essential to the current study as it focuses on presenting the views of occupational therapy students.

Justification of the Selected Research Methodology

There are two main research methodologies that can be used in this research study, which include quantitative and qualitative research methodology. The quantitative method collects numerical data, which are then analysed to identify the relationship between variables (Taguchi, 2018). Various strengths are associated with this data, such as being easy to analyse and the findings being objective in that they can be applied to the rest of the population. However, its main weakness is that it does not provide an explanation behind the phenomenon. The qualitative research method involves collecting non-numerical data based on the respondents’ feelings, attitudes, and experiences (Yilmaz, 2013). The strength of the qualitative method is that it enables the researcher to understand the views and attitudes of the respondent regarding a certain issue. Furthermore, the collected data is based on people’s experiences (Taguchi, 2018). The weakness of this methodology lies with replication, where it is difficult to replicate the data. Furthermore, data analysis is time-consuming since it is analysed in stages. However, the research used qualitative research methodology because of the above strengths and flexibility in data involving personal experience, which could not be collected using quantitative.

Methods

Participants

The participant will be recruited using purposeful sampling. Though there are other sampling methods, this method is appropriate for this qualitative study because it will allow the researcher to choose a specified population that will be willing to participate and share information expressively and, therefore, eradicates every form of doubt and scepticism (Chandra and Sharma, 2013). It will include a group of individuals knowledgeable and experienced in the research topic.

Eligibility Criteria

The inclusion criteria involve English-speaking occupational therapy undergraduate students in Worcester University within their 2nd year and 3rd year and recently graduated occupational therapy students. The exclusion criteria exclude students from other professions in 2nd year, 3rd year, and 1st-year occupational therapist students.

Qualitative Outcome

The following are areas that the researcher will explore with the participants. First, occupation therapy students’ interviews will provide the interview outline and the definitions of the effects. Second, role emerging placement awareness where the participants will clearly describe the current program. Third, personal experiences concerning role emerging placement; the participants will highlight their experiences with role emerging placement. Lastly, the perception of role emerging placement, where the participants will describe their views and initial thoughts concerning the program. The topic guide in the appendix highlights the areas that the researcher will explore with the participants.

Measures and Data Collection Tools

A flexible semi-structured interview and an in-depth one-to-one approach will be used to collect data. An interview sheet with a guide on how the questions will be asked will be provided to help the researcher stay on track and be cautious of the choice of words (DeJonckheere and Vaughn, 2019). The interview questionnaire will be an open and closed question format to encourage participants to give flexible responses to experiences unique to them, which the researcher did not anticipate (Braun and Clarke, 2013; Hollway and Jefferson, 2013). The flexibility of this semi-structured interview is appropriate for this study and enables participants to elaborate on information from their views since deeper understanding is required (Gill et al., 2008). However, while collecting data, the researcher should be cautious about gathering superfluous feedback.

The semi-structured interview has multiple uses, from clinical research to educational settings, because it can be used even when the resources are few. This method can be conducted on any setup as it can be accomplished with few participants, such as eight to twelve (DeJonckheere and Vaughn, 2019). The researcher using this method for data collection requires relational focus and practice interviewing skills. Relational skills include curiosity and active engagement, which the researcher will employ during the interviewing stage (DeJonckheere and Vaughn, 2019). Practical interviewing skills involve the relationship between the researcher and the respondent. Retrieving quality data requires interactions rather than a transactional method that implements a question-answer approach (DeJonckheere and Vaughn, 2019). The advantage of this method is that interviewing method does not require excellent skills since one can learn and practice.

Another helpful method that the researcher can employ is a focus group. This method requires careful selection of the participants, which is done by purposive sampling in this research. A Focus group is helpful in uncovering collective views together with the meaning behind them (Buijs et al., 2008). However, the method is not appropriate when there is a challenge of raising the required number of participants (Harrison et al., 2015). The participants will be interviewed once, and each participant 50mins to one hour time to be interviewed. There will be 25 to 30 minutes of added time flexibility to sort out technicalities and introduction, negotiating consent, clarifications, and conclusion. Furthermore, the additional minutes will also be used for feedback.

Procedure

1. The participants will be recruited using a non-probability sampling technique; in this case, it is a purposive sampling method (Palinkas et al., 2013). The researcher uses professional networks to recruit qualified participants and ensure they have the necessary information regarding the research study, such as the consent form and information pack.
2. Setting up the interview through physical meetings or virtual. However, because of the COVID-19 pandemic measures, virtual interviews will be considered suitable for this study. The researcher will ensure that the necessary materials, such as recording equipment, are available (McGrath, Palmgren, and Liljedahl, 2018). Furthermore, privacy will be maintained because of the nature of the study and the ethics in conducting research.
3. Actual interview and recording
4. The researcher will use the thematic analysis steps to generate themes from the data (Kallio et al., 2016).
5. A conclusion will be drawn from the findings of the thematic analysis and check whether it addresses the aims and objective of the research.

Ethical Considerations

This involves a significant issue for the researcher to ensure that all data is fairly collected. Furthermore, the data should be unbiased in selecting sources and accurately analysed following ethical considerations (Farrimond, 2013). The University of Worcester’s ethical checklist will give all information required for ethical guidance in this research. In the initial process, relevant knowledge/ information about the research should be given to participants explaining the purpose of the study, the sensitivity and confidentiality of the information (DeJonckheere and Vaughn, 2019). The researcher should protect and clarify how data will be used to allow participants to make informed decisions, willingly sign the consent form, and give full consent before the study. Participants should understand that participation is voluntary, and they have the right to autonomy to decide to continue or withdraw from the study and retrieve their information (Khandhar, Barrow, and Brannan, 2021). To ensure ethical consideration, participants should be respected and given the right to ask questions throughout the study (Goddard and Melville, 2011). All information in the questionnaire should remain confidential and anonymous.

Public Involvement

Including the public in health research has become a common practice in the UK and other parts of the world. The need for public involvement and the need to evaluate its impact has significantly increased. Its usage has expanded on areas such as systematic reviews, research that evaluate stakeholders’ views, and realistic evaluations (Barber et al., 2011; Boivin et al., 2018). Various studies have guided how to include public members in the research (Carter et al., 2013). Their findings suggest that their participation increases the number of people recruited to participate in the research, making the study appropriate and relevant (Wykes, 2014). This also helps formulate the research question, evaluate the study design and provide significant insights into the analysis.

Most of the research studies on the public’s involvement in the research focus on their effect on the research process, such as the rates of retention and recruitment, the relevance of the research, validity, and quality of the study. This concept has been conceptualised as a means of attaining better research (Crocker et al., 2018). It is in line with the norms that guide medical research, which is perceived as the gold standard in assessing the effectiveness of health research (Edelman and Barron, 2015). However, there are negativities associated with the involvement of the public. This involves the norms of bureaucracy where certain groups are encouraged to participate in the research study, especially those comfortable with the research (Cowden and Singh, 2007). For instance, retired individuals, whites, and middle income. The most significant criticism of public involvement is associated with the opposite effect (Komporozos-Athanasiou et al., 2016). However, in this study, public involvement will not be incorporated because of the specific target that the research is based on and also the extra costs associated with their involvement.

Data Collection Methods and Analysis Plan

The data that will be collected using the semi-structured interviews will be analysed using thematic analysis. This method entails identifying patterns within the data, which are then used to generate themes (Kiger and Varpio, 2020). This method has six steps which include researcher familiarisation with the data, generation of codes, searching of themes, reviewing of themes, identification and naming of themes, and production of the report. The researcher can quickly learn this method and then use it for analysis (Nowell et al., 2017). This method is powerful as the researcher can analyse various data through summarisation, identification of key features, and interpretation of various data sets.

Role of Researcher

The researcher’s position is relevant and influences the entire research process. Their leading role shapes how the research questions are raised and formed, how data is collected and analysed, and how findings are revealed. They also observe the participants, create awareness of the world and sometimes directly participate in some cases (Austin and Sutton, 2014); they also educate people and make sense of different perspectives people bring to them (Creswell et al., 2007). A qualitative researcher should understand the emotional nature, personal and the private nature of the topic (Dickson-Swift et al., 2008). Therefore, be mindful of the potential exposure of an individual’s sensitive information.

It is the researcher’s responsibility to protect participants from harm from the onset of the study. Their ability to manage participants’ intense emotions and their own is vital throughout the study process (Sullivan and Sargeant, 2011). However, researchers observing and engaging in personal and distressing responses of participants can be physically and psychologically daunting (Dickson-Swift et al., 2009). It has also been argued that researchers handling sensitive information are psychologically at risk, and such topics can arouse emotional responses, making defining research problematic (Johnson and Clarke, 2003). Concerns have been expressed about researchers’ vulnerability and how researchers’ well-being should be acknowledged and recognised as they carry out their studies (Dickson-Swift et al., 2008). A researcher needs to take a step back and be cautious of underlying biases and assumptions throughout the research process. This can be difficult as most researchers are passionate and have a great interest in the study. The role of the researcher using a qualitative method involves asking participants about what events they experienced to gain a deep understanding of what it feels like from their point of view. It is the researcher’s responsibility to be honest, and ethical throughout the research.

Reference List

Austin, Z. and Sutton, J. (2014) ‘Qualitative research: getting started’, The Canadian Journal of Hospital Pharmacy, 67(6), pp. 1-9.

Barber, R. et al. (2011) ‘Can the impact of public involvement on research be evaluated? A mixed methods study’, Health Expectations, 15(3), pp. 229-241.

Boivin, A. et al. (2018) ‘Evaluating patient and public involvement in research’, BMJ, pp. 1-9.

Bossers, A. et al. (1997) ‘Understanding the role-emerging fieldwork placement’, Canadian Journal of Occupational Therapy, 64(1), pp. 70-81.

Braun, V. and Clarke, V., 2013. Successful qualitative research. 1st edn. Sage.

Buijs, A. et al. (2008) ‘Looking beyond superficial knowledge gaps: Understanding public representations of biodiversity’, International Journal of Biodiversity Science & Management, 4(2), pp. 65-80.

Carter, P. et al. (2013) ‘Mobilising the experiential knowledge of clinicians, patients and carers for applied health-care research’, Contemporary Social Science, 8(3), pp. 307-320.

Chandra, S. and Sharma, M., 2013. Research methodology. Oxford: Oxford publisher.

Clarke, C. et al. (2014) ‘The development of an authentic professional identity on role-emerging placements’, British Journal of Occupational Therapy, 77(5), pp. 222-229.

College of Occupational Therapists (2006). Recovering ordinary lives: the strategy for occupational therapy in mental health services 2007–2017, results from service user and carer focus groups. Web.

Cowden, S. and Singh, G. (2007) ‘The ‘user’: friend, foe or fetish? A critical exploration of user involvement in health and social care’, Critical Social Policy, 27(1), pp. 5-23.

Creswell, J. et al. (2007) ‘Qualitative research designs’, The Counseling Psychologist, 35(2), pp.236-264.

Crocker, J. et al. (2018) ‘Impact of patient and public involvement on enrolment and retention in clinical trials: systematic review and meta-analysis’, BMJ, pp. 1-12.

Dancza, K., Copley, J. and Moran, M. (2019) ‘Occupational therapy student learning on role-emerging placements in schools’, British Journal of Occupational Therapy, 82(9), pp. 567-577.

DeJonckheere, M. and Vaughn, L. (2019) ‘Semistructured interviewing in primary care research: a balance of relationship and rigour’, Family Medicine and Community Health, 7(2), pp. 1-8.

Dickson-Swift, V. et al. (2008) ‘Risk to researchers in qualitative research on sensitive topics: issues and strategies’, Qualitative Health Research, 18(1), pp.133-144.

Dickson-Swift, V. et al. (2009) ‘Researching sensitive topics: qualitative research as emotion work’, Qualitative Research, 9(1), pp. 61-79.

Edelman, N. and Barron, D. (2015) ‘Evaluation of public involvement in research: time for a major re-think?’ Journal of Health Services Research & Policy, 21(3), pp. 209-211.

Farrimond, H. (2013). Doing ethical research. Houndmills, Basingstoke, Hampshire: Palgrave Macmillan.

Fieldhouse, J. and Fedden, T. (2009) ‘Exploring the learning process on a role-emerging practice placement: a qualitative study’, British Journal of Occupational Therapy, 72(7), pp. 302-307.

Gill, P. et al. (2008) ‘Methods of data collection in qualitative research: interviews and focus groups’, British Dental Journal, 204(6), pp. 291-295.

Goddard, W. and Melville, S. (2011). Research methodology. 2nd edn. Kenwyn, South Africa: Juta & Co.

Golos, A. and Tekuzener, E., (2019) ‘Perceptions, expectations and satisfaction levels of occupational therapy students prior to and after practice placement and comparison of practice placement models’, BMC Medical Education, 19(1), pp. 1-9.

Harrison, M. et al.(2015) ‘Profiling unauthorised natural resource users for better targeting of conservation interventions’, Conservation Biology, 29(6), pp. 1636-1646.

Hollway, W. and Jefferson, T. (2013) Doing qualitative research differently. London: SAGE.

Johnson, B. and Clarke, J. (2003) ‘collecting sensitive data: the impact on researchers’, Qualitative Health Research, 13(3), pp. 421-434.

Kallio, H. et al. (2016) ‘Systematic methodological review: developing a framework for a qualitative semi-structured interview guide’, Journal of Advanced Nursing, 72(12), pp.2954-2965.

Khandhar, P., Barrow, J. and Brannan, G. (2021). Research ethics. Treasure Island, FL: StatPearls Publishing.

Kiger, M. and Varpio, L. (2020) ‘Thematic analysis of qualitative data: AMEE Guide No. 131’, Medical Teacher, 42(8), pp. 846-854.

Komporozos-Athanasiou, A. et al. (2016) ‘Citizen participation as political ritual: towards a sociological theorising of ‘health citizenship’’, Sociology, 52(4), pp. 744-761.

McGrath, C., Palmgren, P. and Liljedahl, M. (2018) ‘Twelve tips for conducting qualitative research interviews’, Medical Teacher, 41(9), pp. 1002-1006.

Nowell, L. et al. (2017) ‘Thematic analysis’, International Journal of Qualitative Methods, 16(1), pp. 1-12.

Overton, A., Clark, M. and Thomas, Y. (2009) ‘A review of non-traditional occupational therapy practice placement education: a focus on role-emerging and project placements’, British Journal of Occupational Therapy, 72(7), pp. 294-301.

Palinkas, L. et al. (2013) ‘Purposeful sampling for qualitative data collection and analysis in mixed method implementation research’, Administration and Policy in Mental Health and Mental Health Services Research, 42(5), pp. 533-544.

Sullivan, G. and Sargeant, J. (2011) ‘Qualities of qualitative research: part I’, Journal of Graduate Medical Education, 3(4), pp. 449-452.

Taguchi, N. (2018) ‘Description and explanation of pragmatic development: quantitative, qualitative, and mixed methods research’, System, 75, pp. 23-32.

Thew, M., Hargreaves, A. and Cronin-Davis, J. (2008) ‘An evaluation of a role-emerging practice placement model for a full cohort of occupational therapy students’, British Journal of Occupational Therapy, 71(8), pp. 348-353.

Thomas, Y. et al. (2007) ‘Benefits and challenges of supervising occupational therapy fieldwork students: Supervisors’ perspectives’, Australian Occupational Therapy Journal, 54, pp. S2-S12.

Wykes, T. (2014) ‘Great expectations for participatory research: what have we achieved in the last ten years?’ World Psychiatry, 13(1), pp. 24-27.

Yilmaz, K. (2013) ‘Comparison of quantitative and qualitative research traditions: epistemological, theoretical, and methodological differences’, European Journal of Education, 48(2), pp. 311-325.

Appendices

Appendix 1

Appendix 2

Role Emerging Placement? Occupational Therapy Student’s Perspectives on the Impact on Developing Competent Skills

Question Sheet

Disclaimer: the participant has read and understood the ethical requirements for this research and has the necessary information to continue with the research interview and give informed consent. Remind the researcher that they are free not to decide whether to answer the question or not and can end the interview at any time. They can also remove their data and themselves at any time.

Remind the participants that some questions might be upsetting and that the information is attached to the consent form provided for further support if required

Check whether they are happy and request confirmation to continue with the study.

1. What is the area of practice of your role emerging placement?
2. What are the roles that you develop during role emerging placement?
3. Were they significant?
4. Why?
5. What are the skills that you developed during your role emerging placement?
6. Have the skills influenced your area of expertise?
7. Which skill do you believe will help you in your future career?
8. Why?
9. Is role emerging placement influencing your career?
10. Are there other factors?

Appendix 3

Topic Guide

Occupational Therapy Students’ Interview

Provision of the interview outline, including definitions

Role Emerging Placement Awareness

• Can you describe what role emerging placement is?
• What does it mean to you?

Role Emerging Placement Personal Experiences

• How do you feel about it?
• What do you want to achieve through it?
• What factors affect this approach?
• Can you provide your experience?
• Were you prepared for it?
• What were the challenges you experienced?

Perception of Role Emerging Placement

• What are your initial thoughts regarding this program?
• What are the areas you feel concerned about?

Appendix 4

Checklist