Vol. 27 • Issue 16
• Page 10
Research in the clinic is constantly converted into teaching and teachable materials within the university setting. Additionally, it is introduced throughout curricula within many areas of occupational therapy practice and the occupational therapy process.
Through research, occupational therapists examine appropriate intervention techniques to consider for cases, the best evaluations to use with clients given their particular conditions or needs, how long interventions should last, the long-term prognoses for clients, and more.
"The current standards for occupational therapy education require that evidence-based practice and active integration of research be part of the educational learning experience for the students," noted Karen Ann Cameron, PhD, OTD, MEd, OTR/L, associate professor of occupational therapy and coordinator of the MSOT program at Alvernia University in Reading, PA.
It is also a legal and ethical responsibility for occupational therapists to provide the best current acceptable interventions for clients, she said. Therefore, it is imperative that all occupational therapists understand and integrate research into their intervention planning process and remain current in the profession.
Bringing Research to Class
Cameron notes that two things are happening: professors are conducting research and researchers are teaching courses.
"With regards to professors teaching, the ratio of teaching to research is generally dependent upon the institution or the position of the faculty member within the institution," she said.
Often, the institution requires that educators perform both activities, teaching and research; it is required as part of the hiring, promotion and tenuring processes for faculty members. However, different institutions place different priorities on research and teaching.
From left: Mike jAmory, MS, OTR/L, network director of inpatient services at St. Luke's Hospital, Bethlehem, PA; Rebecca Sensenig, MS, OTR/L, (seated) and Karen Ann Cameron, PhD, OTD, OT program director at Alvernia University, Reading, PA.
At some larger Carnegie I classified research institutions, professors mainly engage in research, obtain grant funding and supervise graduate research, while at smaller, teaching-based institutions, engaging in scholarship is considered secondary and professors mainly teach. Additionally, in many occupational therapy programs, professors oversee research or mentor the research of students.
The same holds true for clinical researchers, acknowledged Cameron.
"Some facilities actually hire researchers to research full time and then they, in turn, teach within their facilities and often serve as adjuncts and/or guest lecturers within occupational therapy academic programs," she said. "In other facilities, clinicians take it upon themselves to engage in research projects to answer clinical questions-sometimes individually, sometimes it becomes a team, or even a department initiative," she explained. "Again, in many instances these individuals are happy to come into classes to share their experiences with students, or even engage the students in the clinical research process while they are out on fieldwork and clinical experiences."
Cameron, who is both a professor and a researcher, uses research to inform her teaching, so students get the most up-to-date information on occupational therapy intervention. She conducts research in her areas of interest contributing to the development of new knowledge.
She also researches how to teach and how occupational therapy knowledge is developed and understood by students. This year, Cameron hopes to initiate a research study examining the impact (if any) of service learning on the development of occupational therapy professionals.
As a practicing clinician, Cameron uses research to inform her intervention with her clients. For example, she was the consultant for a client with a very rare diagnosis that she and the majority of the medical team assigned to her had not heard of.
"I had to examine the research to see what, if anything, was out there on the disease itself, the prognosis, etc, and then if anything was done in occupational therapy," she said. "There was no research in the OT journals or anywhere on treatment for such a client. As a result, I had to scour the journals to find out what was done in other disciplines, analyze the findings and determine the applicability to this client in occupational therapy.
"I then conducted a case study research project on this client analyzing the intervention and outcomes in occupational therapy."
Cameron presented her research project at the state and national conference and is now working on an article. She has brought this case to the classroom in many ways: students went with her and worked alongside her during the client's treatment sessions; students met with the patient, family and physicians; and students helped with the initial and discharge evaluations of the client and analyzed the results, as well as analyzed her intervention activities. Students also brought the patient's story back as a case study to teach another group of students in the sophomore year of their occupational therapy studies.
"Additionally, I use the data from the treatment of this patient to continue to inform my students now as a case study, and my students are able to see how the lack of information led me to develop a research project and use research skills to problem solve," said Dr. Cameron.
Student Research Projects
Contrary to popular belief, it is not only the big research institutions that foster research and produce research. A good deal of research comes from faculty and students in smaller liberal arts schools as well.
Grace Sheldon Fisher, EdD, OTR/L, associate professor and chair of the occupational therapy department at Misericordia University in Dallas, PA, notes that occupational therapy professors at Misericordia University conduct research in a variety of areas, including lifestyle redesign, senior health and wellness, home safety, gerontology, chronic pain, handwriting, sensory integration, therapeutic use of yoga and video games in children.
All occupational therapy students at Misericordia University are required to complete the research course series and successfully complete all of the courses' requirements, which include research proposal development and research project implementation, analysis, and final report writing. Many student projects are later presented by graduates at state and national research conferences.
At Alvernia University, students are required to complete a master's thesis as the capstone learning activity. Students work with a thesis committee composed of a chair and two committee members who, in turn, mentor the student through the research process. Each student must identify a research question or work with a professor to develop a question, develop the project, submit for approval from the university's institutional research board, carry out the project, write it up and then defend in an oral defense.
As the graduate year for students occurs after they have completed level II fieldwork, Alvernia University faculty encourages the students to consider what questions they had or experienced while in their last level-2 clinical. These real-life questions help to reinforce the use of research or the research process to help answer them. It also helps to strengthen the bond between the clinic and academia.
"This process of actively engaging in research helps the students understand the process of research, gives them actual practice in research, and develops their critical reasoning and analytical skills," said. Cameron. "Students, by going through the process, learn that even the best laid research agenda can be met with unforeseen challenges, obstacles and problems. Students must actively learn how to deal with all of these in order to complete their projects."
She noted that students are encouraged to meet their professional obligation to disseminate research results to others through professional presentations at local, state and even the AOTA annual conference, or to submit for publication.
"It is important to help them overcome their fears that their research is insignificant, or small in the grand scheme of the profession," Cameron emphasized. "All research is important and can help inform the profession."
The Importance of Research
Eva Rodriguez, PhD, OTR/L, chair of the occupational therapy program and clinical assistant professor at Stony Brook University in Stony Brook, NY, believes it's important for occupational therapy students to be exposed to clinical research.
"I think it helps them understand that the two are not separate," she explained. "In the past there has always been a disconnect between the research and the clinic. It's important for us today, given the constantly changing needs of health care and the constantly changing needs of reimbursement, that we do make this connection.
"We need to show students early on in their education that there is a practicality to this-that they can look at a research article and walk away with something from that and apply it to their clinical practice. I think that helps them understand the relationship between research and practice."
She added that as OT moves within the Centennial Vision to become a scientific, research driven, evidence-based profession, and meet many imperatives from third-party payers and legislation, students must learn that evidence is the foundation of the profession in day-to-day clinical settings.
Beth Puliti is a frequent contributor to ADVANCE.