The history of occupational therapy may be understood as a continual transaction between two cultural discourses: pragmatism and structuralism. Pragmatism is a way of thinking that presupposes humans are agentic by nature and knowledge is tentative and created within particular contexts. Structuralism is a way of thinking that assumes humans are composites of recurring general frameworks and that knowledge is objective and can be generalized to multiple contexts. Early in the field's history, both pragmatist and structuralist assumptions about the human and knowledge produced different readings, or interpretations, of what constituted the appropriate tools, methods, and outcomes for occupational therapy. Consequently, occupational therapy adopted an interesting mix of pragmatist language regarding the human and structuralist approaches to knowledge, resulting in professional identity problems still experienced today. However, recent developments offer an opportunity for occupational therapists to correct old identity problems through critically evaluating incompatible assumptions and carefully reading the prevailing cultural ethos.
Although educators valued teaching occupation, the concept was still elusive in some instructional methods and materials. Occupation knowledge and pedagogical content knowledge may have influenced how explicitly occupation was taught.
Three concepts-subject-centered learning, threshold concepts, and transformative learning-formed the theoretical foundation for teaching occupation as a way of seeing.
Two arguments are presented about the degree to which occupation needs to be infused in all curricular elements. To guide curriculum design, it is critical for educators to discuss beliefs about how ubiquitous occupation is in a curriculum and whether curricular elements portray occupation to the extent preferred.
This single-case study explored what internal beliefs or commitments one therapist holds about the nature of reality and how those beliefs influence her delivery of occupational therapy services. Data were collected through three in-depth interviews and through observation of the therapist conducting treatment sessions. Results suggest that the therapist's view of reality can be categorized into four areas: (a) what she believes about ultimate reality; (b) what she believes about life, death, and eternity; (c) what she believes about human nature; and (d) what she believes about the nature of knowing. The findings also suggest that this core worldview informs how the therapist frames clinical practice and how she delivers occupational therapy services. Further, both the therapist's view of reality and her clinical practice are deeply rooted in her sociocultural experiences. This case study provides a rich description of the interrelatedness of sociocultural context, worldview, and clinical reasoning.
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