The numbers of occupational therapists in community practice are not yet large enough to provide fieldwork placements to accommodate all students. This article describes a project designed to educate community agencies that do not employ occupational therapists, about our service while at the same time securing new fieldwork placements. We used on-site different discipline and offsite same discipline supervision to provide students to selected agencies without cost. Funding for one year from the Ontario Ministry of Health to the Ontario University Programs in Rehabilitation Science enabled us to initiate and evaluate the project. Students in the project developed their ability to work independently and to see their potential role in health promotion and prevention. Despite the lack of ongoing government funding, four years later, community sites are not only being maintained, but the number of sites has increased from 28 to 39, providing a total of 75 student placements. By educating a growing number of community agencies about the work of occupational therapists, the project has also expanded the boundaries of practice.
The construct of perceived self-efficacy, proposed to explain the discrepancy between skill and actual performance, has received widespread attention in the psychological and medical literature. This paper describes the construct in detail, including the difference between self-esteem and perceived self-efficacy, and proposes a goodness of fit with occupational therapy practice. It is postulated that attention to the assessment and monitoring of perceived self-efficacy, along with the use of activities that closely approximate the actual activities to be performed in the community, will result in improved occupational performance and thus, better occupational therapy outcomes. Occupational therapists are challenged to identify and incorporate this construct into their day-to-day clinical programs to enhance treatment outcomes.
The health care system is responding to a paradigm shift from the industrial era to the knowledge society. The rapidly changing administrative structures of some hospitals and increasing numbers of proposals for new models of care are disconcerting for therapists who are used to working in traditional organizational structures and models of care. However, with a broader understanding of the shift that is occurring, it becomes apparent that this paradigm shift is pushing the system toward care practices that are more consistent with occupational therapy practices than those of the traditional medical model. This paper describes the factors influencing the direction of the paradigm shift, the major emerging models of care and organizational structures associated with the paradigm shift, and then discusses the issue of whether the paradigm shift presents a threat or a challenge to occupational therapists.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.