1

Semester 1 Reflection

The way my primary education approached the scientific method didn’t allow the idea of

the consent change that occurs in science. What they know is correct and there is no room for

change. There is little creativity being allowed in these classes and science needs to be

approached with the foundation that what we know can change and expand. The fluidity of

knowledge is important to note because just like in practice there needs to be adaptability. While

in practice there may be limited opportunities to conduct scientific inquiry, we practice

occupational inquiry daily. Great practitioners stay current on the new literature to dictate their

practice and to comprehend the knowledge from researchers to best educate their clients. These

practitioners redefine their knowledge to meet the person’s level of understanding regarding the

most up-to-date data. We read current articles, go to conferneces, etc. because its our job to be the

“middleman” for clients and researchers. Inquiry is the foundation of occupational therapy.

Intro to Occupational Therapy

Starting the Intro to Occupational Therapy course, we learned on the first day that

evidence-based practice is one of our principles as occupational therapists (American

Occupational Therapy Association, 2020). We value the scientific evidence produced by

researchers to implement into practice because that is the highest level of knowing something is

true. This is why it’s so interesting to me that some researchers believe qualitative studies are

less valuable than quantitative studies. Looking at it through a healthcare lens questions how

societal constructs impact an individual’s health. In daily practice, we identify both quantitative

and qualitative information about a client to best inform the intervention. Learning about

documentation cemented that occupational inquiry is just a smaller form of scientific inquiry.
 2
When I say smaller, I don’t mean lesser, just more on a smaller scale with non-generalizable

information.

As a class, we did presentations detailing a specific area of opportunity in our profession

that we found interesting and was a great way to recognize gaps in knowledge in research. My

group focused on the forced displacement of refugees and we discovered various gaps in

identifying the best intervention plan, culturally appropriate assessments, and targeting older

adults. A lot of research focuses on the mental impact on children who have PTSD from their

experiences but little info on adults which was surprising to me, for example, Simó-Algado et

al., (2002) study. Identifying gaps in knowledge allows for the progress of inquiring about new

information that needs to be produced. I think there’s a need for a scoping review to put all the

knowledge on forced displacement so future OTs can be more impactful in this new upcoming

area.

Psychosocial Process Across Life

In the Psychosocial Process Across Life course we were able to interact with different

assessments and critically examine four: Allen’s Cognitive Level Screen (ACLS), Activity Card

Sort (ACS), Kohlman Evaluation of Living Skills (KELS), and the Kettle Test. The process of

identifying and producing an assessment is so interesting to me. There are a lot of components

that make up a great assessment. It puts into perspective the importance of using an assessment

that has been tested to as both reliable and valid. As a practitioner, the goal is to get the most

accurate assessment to best identify the person’s barriers. Reliability is important to have a for

assessments because that means there is less chance of producing errors. A great example of this

is when you use an assessment during the evaluation, then continue throughout the intervention
 3
to assess their progress rediscovering whether the intervention is working. If an assessment

doesn’t have good test-retest reliability, it reduces the value of scores. A study by Taylor et al.

(2022) tested to see if an already established assessment Wrist Position Sense Test would be

valid, reliable, and responsive to children with hemiplegic cerebral palsy showing that the

populations can be expanded.

There is so little time that is spent with a client and you want to use the time you have

wisely to understand while knowing what you are trying to measure. For example, if you were to

use a self-assessment on an individual who has narcissistic personality disorder it's possible that

the results don't reflect the truth due to the lying nature that is commonly seen. It would be a

waste of time and valuable information gathered.

Human Capacities

In human capacities, the discussion of assessment that stuck with me more was the

thought that it can be the reason someone receives services. It’s very interesting to me that

assessments of the standard deviation scoring dictate an individual’s ability to receive

occupational therapy services. Specifically, someone who is slightly above the first two

deviations is needed to qualify. It's an observed dictation for identifying if someone needs help.

If there are clear statements that someone is experiencing an imbalance in occupations due to a

limitation but they are slightly above the second deviation therefore cannot receive services.

Personally, it's an immoral concept to rely on statistics rather than someone else's experience.

During every Article Report, I always gravitated towards studies that applied to what we

were learning in Human Capacities. Toward the first half of the semester, we learned proper

biomechanical movements as it related to bed mobility and bed-to-wheelchair transfers. Then I

 4
found an article discussing the impact on occupational and physical therapists who had

work-related musculoskeletal injuries. Articles like Darragh et al. (2009) were an important step

that established change in state policies like Washington being a no-lift state, protecting clients

and practitioners from work-related injuries. Every article should be valuable and try to fill the

gap of knowledge and when more and more articles prove therapists are getting hurt, it could

produce legislative change.

Professional Seminar

In a professional seminar, we talked a lot about being culturally responsive and I think an

important way to be culturally responsive is to keep up to date on the data. Knowing what are the

common trends that are happening in various communities and identifying the barriers to social

determinants of health for different populations. This study by Synovec and Aceituno (2020)

identifies epidemiological information about the impact of unhoused individuals of refugees. It

highlights the cultural barriers for refugees to acclimate into new communities, highlighting how

access to healthcare, literacy, unemployment, food and nutrition, and transportation are being

identified as determinants to result in them being unhoused. Knowing where the problems are

being talked about for different populations and then implementing them when you work with

them.

Conclusion

I wanted to focus on the principle of being evidence-based and how important that is for

practice. Knowing how and why to critically assess information and come up with our inference.

No matter what, I’m being trained to be a generalized occupational therapist and I wanted my

practice to be up to date for the betterment of my future clients.

 5
References

American Occupational Therapy Association. (2020). Occupational Therapy Practice

Framework: Domain and Process—Fourth Edition. American Journal of Occupational

Therapy 74(Supplement_2), 7412410010p1–7412410010p87.

https://doi.org/10.5014/ajot.2020.74S2001

Darragh, A. R., Huddleston, W., & King, P. (2009). Work-related musculoskeletal injuries and

disorders among occupational and physical therapists. American Journal of Occupational

Therapy, 63(3), 351–362. https://doi.org/10.5014/ajot.63.3.351

Simó-Algado, S., Mehta, N., Kronenberg, F., Cockburn, L., & Kirsh, B. (2002). Occupational

therapy intervention with children survivors of war. Canadian Journal of Occupational

Therapy / Revue Canadienne D’Ergothérapie, 69(4), 205–217.

https://doi.org/10.1177/000841740206900405

Synovec, C. E., & Aceituno, L. (2020). Social justice considerations for occupational therapy:

The role of addressing social determinants of health in unstably housed populations.

Work: Journal of Prevention, Assessment & Rehabilitation, 65(2), 235–246.

https://doi.org/10.3233/WOR-203074

Taylor, S., Elliott, C., McLean, B., Parsons, R., Falkmer, T., Carey, L. M., Blair, E., & Girdler, S.

(2022). Construct validity, reliability, and responsiveness of the Wrist Position Sense Test

for use in children with hemiplegic cerebral palsy. Australian Occupational Therapy

Journal, 69(5), 637–646. https://doi.org/10.1111/1440-1630.12825