DMU OTD Philosophy

What view of occupational therapy informs the DMU OTD curriculum?

Occupation is the basic tenet upon which occupational therapy is based. “In occupational therapy, occupations refer to the everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to, and are expected to do” (World Federation of Occupational Therapy [WFOT], 2021, para. 2). The American Occupational Therapy Association’s (2020) Practice Framework categorizes occupations as activities of daily living (ADLs), instrumental activities of daily living (IADLs), health management, rest and sleep, education, work, play, leisure, and social participation. Participation in occupation fosters health and well-being, contributes to competence and self-worth, and provides the context in which we form social relationships. Occupations are ever evolving and changing based upon development, interests, skills, and contexts at each phase and stage of life. In addition, occupations occur within diverse contexts which encompass environmental and personal factors, such as physical, social, and cultural surroundings.

It is through occupations that people perform, develop, accomplish, self-maintain, form identity, connect, and derive purpose. Thus, occupations are central to life meaning and fulfillment and are a critical component of health. Health, from an occupational therapy perspective, is more than simply the absence of disease. Instead, health includes physical, social, and mental wellbeing; quality of life; and life satisfaction as a result of occupational engagement. This means that the health and wellbeing of individuals, groups, communities, and populations are influenced by the ability to perform the activities that they need and want to do. Examples include the ability to dress, care for children, utilize public transportation, prepare healthy meals, engage in restful sleep, participate in an online class, play during recess, or take part in a book club.

Just as participation in meaningful occupations improves and supports health and wellbeing, lack of engagement in occupation, or occupational deprivation, leads to poor health and quality of life. Activity and participation limitations as a result of impairments in body functions and structures or through unsupportive contexts and environments negatively impact physical, social, emotional, and mental health and wellbeing. Simply put, without occupation, people suffer.

As such, the purpose of occupational therapy is to support and promote the mind, body, and spirit health of individuals and populations by enhancing the ability to engage in meaningful occupations that support participation in all aspects of life, which we believe is a fundamental right of all people (AOTA, 2017). Occupational therapists focus on occupations as not only the ultimate goal and outcome of therapy but also the means by which therapeutic interventions are provided. With a rich understanding and expertise, occupational therapists utilize the power of occupation for health promotion and wellness, remediation, health maintenance, disease and injury prevention, and compensation or adaptation. Occupational therapists help others live life to its fullest.

What are our fundamental beliefs about human beings and how they learn?

At Des Moines University, learning is transformative, integrative, active, collaborative, and inclusive; it is a dynamic process that continues to unfold and build. Transformative learning theory focuses on adult education and the idea that learners can adjust their thinking based upon new information through critical thinking and reflection. This means that we provide students opportunities to learn about new perspectives, to question their assumptions, and to engage in critical discussion and reflection. In order to promote this transformation of our students, we understand the importance of creating a learning environment that is safe and positive and that encourages deep learning experiences, learning through errors, purposeful practice, and resilience.

Integrative means that learning happens by making connections and organizing around unifying concepts. We intentionally, iteratively, and spirally integrate coursework, asking students to continually revisit and build upon their prior knowledge in order to enhance and deepen their learning and work toward building their skills and confidence as occupational therapy professionals. This happens through a learning process that is active, meaning that it occurs through doing. The DMU OTD curriculum is set up to promote engagement, reflection, interaction, and collaboration, both intra and inter-professionally. Faculty work to facilitate student learning by creating significant learning experiences, encouraging students to move beyond memorization and instead to integrate, apply, and care about the content. We work to engage students and create lasting change, enhancing and preparing them as occupational therapists who are lifelong learners. In fulfilling the spectrum of student learning, we facilitate students to understand and remember concepts; apply the content; relate the content among and between courses, information, and situations; care about how the content impacts them as occupational therapists; and develop a strategy for continuing to learn after their entry-level education is complete (Fink, 2013).

We understand that each of our students is an individually unique, adult learner. Because of this, we align our curriculum and our courses based upon the principles of andragogy, or adult learning theory. Our students bring their unique educational and life experiences to DMU in order to create a rich and inclusive learning environment. These experiences are tools that enhance learning and will be the basis for some of the learning activities that occur across the curriculum. Our students are encouraged to be self-directed and to bring their personal motivations for learning, using faculty as guides and facilitators during the process. Our curriculum is intentional in connecting learning to real life occupational therapy practice to enhance student motivation and understanding of how learning impacts their future practice. We ask our students to come oriented and ready to learn, think critically, clinically reason, and problem solve.

References
American Occupational Therapy Association. (2020). Occupational Therapy Practice Framework: Domain and Process- Fourth Edition. American Journal of Occupational Therapy, 74(Suppl_2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001
American Occupational Therapy Association. (2017). Philosophical base of occupational therapy. American Journal of Occupational Therapy, 71(Suppl. 2), 7112410045. https://doi.org/10.5014/ajot.2017.716S06
Fink, L. D. (2013). Creating significant learning experiences. Jossey-Bass.
World Federation of Occupational Therapy. (2021). About occupational therapy. https://www.wfot.org/about/about-occupational-therapy

OTD Curriculum Design

The Des Moines University Doctor of Occupational Therapy curriculum has been designed to align with our philosophy of learning and our view of occupational therapy. At DMU, learning is transformative, integrative, active, collaborative, and inclusive; it is a dynamic process that continues to unfold and build. Our curriculum has been intentionally designed to create occupational therapists who are competent, ethical, culturally responsive, evidence-based, and collaborative scholars and leaders, prepared to engage in lifelong learning, advance the profession, and support health for all.

Des Moines University’s OTD curriculum is designed as a spiral. A spiral curriculum promotes deepening of understanding and skills through successive encounters and building of content (Bruner, 1960; Harden & Stamper, 1999). The value of a spiral curriculum is that there is consistent reinforcement, movement from simple to complex, repetitive and progressive development of concepts, and ongoing application and integration. Occupational therapy practice is not compartmentalized nor is it simple and straightforward. Thus, occupational therapy education calls for an innovative and contemporary curriculum which prepares students in a way that is reflective of their future practice.

As guided by spiral curriculum theorists (Bruner, 1960; Harder & Stamper, 1999) features of this curriculum include

  1. Topics are iterative and revisited. Students will continue to revisit, apply, and integrate topics throughout the curriculum in order to deepen their understanding.
  2. Topics increase in levels of difficulty and complexity. The iterative nature of the curriculum is not simply a repeat of information. Rather, learning objectives deepen in order to improve the student’s understanding, skills, and expertise.
  3. Courses are intentionally integrated both horizontally and vertically. This means that the curriculum has been built so that new learning intentionally connects back to old learning and that concurrent courses are linked. This integration allows students to reinforce what is already known while making meaningful connections between content.
  4. Students increase competence. Throughout the journey of the curriculum students are working to achieve program goals. Checkpoints of competence ensure students are successfully progressing toward future practice as an occupational therapy practitioner, scholar, and educator.

Within the DMU OTD curriculum, courses are set up in a logical sequence to promote student learning and success. There are three phases to the curriculum: Knowledge, skills, and experience. In the knowledge phase, students focus on the themes of occupation and professional reasoning. Students build knowledge about functional and foundational sciences such as occupational science, anatomy, behavioral science, kinesiology, and neuroscience as well as conditions which affect occupational engagement. Students begin to employ professional reasoning to build foundations for professional and ethical decision making and to form their professional identity as a future occupational therapist.

In the second phase of the curriculum, students take their foundational knowledge and begin to apply and integrate it in order to develop skills. Two themes guide this phase, professional practice and scholarship. For professional practice, students actively engage in the occupational therapy process of evaluation, intervention, and outcomes. Developing professional practice skills includes five integrated Level 1 fieldwork experiences. Students begin to identify as an OT scholar and engage in evidence-based practice and scholarship through research. This includes understanding and critically appraising research evidence as well as design and implementation of a scholarly project.

The final phase of the curriculum is experience. Themes in this phase include innovation and collaboration. Students experientially engage as a professional in order to meaningfully analyze and evaluate their knowledge and skills as well as to create themselves as leaders and members of interprofessional collaborative teams. Students are pushed to be innovative and creative in their final semester of didactic coursework through learning activities such as program development and advocacy projects. These final didactic experiences successfully propel students into their Level 2 fieldworks and capstone experience and project, ultimately preparing them to successfully practice as an entry-level occupational therapist.

Overall, the OTD curriculum at DMU focuses on equipping our students, future occupational therapists, with the knowledge, skills, and experiences needed to be effective and successful occupational therapists. They will be prepared to serve individuals, communities, and populations across the lifespan and in a variety of settings. The curriculum focuses on what is current in the field of occupational therapy as well as the future of the profession so that DMU OTD graduates are prepared to enter both traditional and emerging areas of practice that fit well with their needs, skills, and interests.

References
Bruner, J. S. (1960). The Process of Education. Harvard University Press.
Harden, R. M., & Stamper, N. (1999). What is a spiral curriculum? Medical Teacher, 21(2), 141-143.

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