The mission of the Doctor of Occupational Therapy (OTD) program is to develop clinician-scholars who translate evidence to inform occupational therapy practice, affect health care systems, and meet the occupational needs of people, organizations and populations consistent to emerging 21st century demands.
Occupational therapy is “the therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of enhancing or enabling participation in roles, habits, and routines in home, school, workplace, community and other settings” (AOTA, 2014). Occupational therapists focus on improving performance in all areas of occupation to facilitate health and promote growth, change, and/or adaptation to achieve health, well-being, and participation in life through engagement in occupation (AOTA, 2014).
A view of humanity.
The University at Florida’s OTD program is based on the philosophical belief that people have a need and right to participate in occupations that they choose, need, or desire. Occupations are activities that have meaning and value for the daily lives of individuals, families, groups, communities and populations. Participation in meaningful occupations is viewed as a determinant of health and wellbeing (AOTA, 2017a; AOTA, 2014).
Occupational performance evolves in response to the interaction of the clients (e.g. individuals, communities, and populations), occupation and context or environment (Christiansen, Baum & Bass, 2015). Occupations vary according to life roles, which have a developmental perspective, and may change over the course of a lifetime. Each role has its associated developmentally appropriate and role-appropriate tasks that influence the nature of one’s occupations. Human learning occurs via the dynamic interaction between a person and a task in the context of the relevant environment. Occupational therapists strive to facilitate this process through active collaboration between the client and the therapist.
Occupation is used to prevent or mediate the effects of disability and to facilitate independence and maximum adaptation (AOTA, 2017a). When individuals feel threatened by stress, deprivation, disease, illness or injury, occupational therapy interventions address (1) the individual’s physical, psychological, and social capacities to achieve occupational competence, (2) the skills and habits of effective role performance and (3) environmental modification to support participation.
The professional program fosters culturally sensitive and evidence-based clinical competence through the learner’s active engagement in a collaborative process between student, client and educator, that builds on prior knowledge and experience. Learners integrate academic knowledge, active learning, clinical reasoning, and self-reflection through experiences in and beyond the classroom (AOTA, 2018; Schaber, 2014). Engagement in advanced practice opportunities in health systems and communities supports professional development, opportunities for leadership and advocacy for clients and the profession. The promotion of lifelong learning, collaboration and professional judgment reinforces continual contributions to critical inquiry in evidence-based practice. Completion of a culminating capstone project and an in-depth doctoral capstone experience integrates learner understanding of advanced theory with practice and scholarship. The program facilitates understanding of the connections between philosophical, theoretical and practical knowledge, values, beliefs, ethics, and technical skills for broad application toward engagement in occupation to improve health, participation and quality of life.
The doctoral program in Occupational Therapy provides professional training as a discipline within the College to optimize occupational performance of individuals, communities and populations within dynamic contexts and specific environments. The program builds upon a background in the liberal arts and sciences to foster culturally sensitive, reflective, evidence-based and clinically competent scholarly practitioners, who we refer to as clinician-scholars.
Definition of the clinician-scholar.
The clinician-scholar graduate of the University of Florida’s OTD program has developed entry-level practice and scholarly skills, integrated to support clinical decision-making for optimal client outcomes. The clinician-scholar critically, systematically, and reflectively appraises, applies, and implements best practices and best evidence within the client’s context and culture. The clinician-scholar articulates the core occupational therapy values, as related to advocacy, education, policy, leadership, or service provision meeting the occupational needs of individuals, organizations, and populations.
Overarching curricular goal of the OTD program.
The program is guided by an overarching curricular goal: Graduates of the OTD program will be uniquely prepared, by their experiences as part of a large academic health science center and a college of public health and health professions, to practice as clinician-scholars who will meet the complex demands of current and emerging occupational therapy practice settings, advocate for the profession and populations, communities and individuals served, and provide leadership for the implementation of evidence-based occupational therapy.
Curriculum Content and Scope
The curriculum framework of the OTD program is embedded in a broader institutional and societal context and perspective. Our curriculum framework and educational perspective embraces principles of occupational therapy, public health, health science and rehabilitation science. The curriculum is aligned within the Vision 2025 of the American Occupational Therapy Association (AOTA, 2013) and the models of health, disability and rehabilitation of the World Health Organization (World Health Organization, 2013) and National Institutes of Health. Within this professional perspective lie the activities of our Department as they relate to the university’s tripartite mission of teaching, research, and service.
Consistent with the AOTA philosophical basis for OT education, the curriculum of the OTD program provides the student with a broad-based foundation for entry-level clinical practice (AOTA, 2018). The program’s educational goals include preparation of students in the basic social and biomedical sciences and development of their skills and clinical competencies for practicing ethical evidence-based occupational therapy with individuals, families, groups, communities or populations. The program is structured to facilitate the student’s personal and professional development, to encourage change and adaptation, and to ensure the mastery of the discipline with courses to develop leaders and scholarly practitioners in occupational therapy. Coursework is organized to prepare students to identify potential or actual occupational needs and to intervene with an occupation-centered approach (AOTA, 2017a). Students progress to higher level coursework designed to strengthen the integration of evidence and practice.
Classroom activities emphasize the contributions of multi-disciplinary healthcare teams, as well as the unique contributions of occupational therapists within the team context to promote health. The curriculum focuses on screening, assessments and interventions that address occupational performance and participation, as well as promote health and wellness for individuals, communities and populations. Experiential and active learning ensure development of occupational therapists with advanced knowledge, who are engaged in professional advocacy and who are prepared for leadership roles. Faculty utilize best practices in teaching and learning in higher education, such as: learning by doing, employing educational technology, engaging students in social interaction, implementing blended learning approaches, and facilitating student-centric learning.
The attached graphic illustrates the overall organization of the curriculum. This graphic depicts how students form their identity as a clinician-scholar within the six curricular themes: Human Occupation and Health, Critical Thinking for Practice and Scholarship, Professionalism, Valuing of Diversity, Collaborative Practice, and Psychomotor Skills. This creates a foundation for student to learn to view individuals, communities and populations through an occupational therapy lens. This lens is strengthened as students acquire discipline-specific knowledge and competencies, professional identity and effective communication skills; they become critical thinkers and evidence-based occupational therapists. After demonstrating entry-level competence, students attain advanced practice knowledge and skills through increasing their understanding and application of theory, interprofessional practice, advocacy, and research. The following narrative illustrates how collaboration and active learning are used to engage the student. A phased approach is used to enhance students’ understanding and engagement in professional development, and to develop student proficiency in translating knowledge to practice, with a final capstone experience and culminating project in which students apply advanced knowledge and evaluate outcomes.
Foundation of basic social and applied sciences.
Preceding their professional preparation, students receive a liberal arts education in their undergraduate studies. In year one of the OTD program, all students will have acquired a basic knowledge about body systems and structure, as well as human function and development. They will also have been introduced to the effects of illness, disability or impairment, and their effects on function and participation, within the context and environment.
Core occupational therapy knowledge.
In year one and year two, students focus and filter their basic social and science knowledge through the occupational therapy lens. Students become aware of themselves as occupational beings and begin to apply that understanding to others (AOTA, 2018). Students start the OTD program by studying OT philosophy and theory, and participate in courses that introduce them to the profession’s values, beliefs and ethics. With core knowledge obtained in the prerequisite basic science courses, students continue to apply such knowledge to activity analysis, and to the therapeutic processes. The concepts of critical thinking, evidence-based practice and derivation of new knowledge are introduced in an OT evidence-based practice course and systematically reinforced throughout the curriculum.
The program continues with an increased emphasis on the specific application of the previously acquired knowledge now applied to more complex activities and issues of participation. In our integrated learning model, students engage in a dynamic transaction with the learning context and the teaching-learning process (AOTA, 2018). Our students learn to develop occupation-based interventions embedded in the analysis and application of screening and evaluation results and the use of relevant therapeutic skills. Students are engaged in active learning activities that build clinical competencies in the core knowledge of OT, critical thinking, clinical reasoning, interpersonal and communication skills, performance skills and roles, and ethical practice (AOTA, 2018). Classroom activities are built to develop and evaluate individual student competencies throughout the curriculum. Students complete three Level 1 fieldwork experiences. Through these placements, students apply learning activities into the clinical setting. Students complete these required experiences in three core areas of OT: adult disability, pediatric disability, and psychosocial disability.
Entry-level competencies to address intervention with individual, community and populations.
As they prepare for fieldwork, students continually broaden their professional perspective and strengthen their occupational therapy lens. Students demonstrate a commitment to society as well as to the promotion of the health of individuals in communities. Students learn how to advocate for clients and the profession, while influencing public health policy. Throughout the duration of the program students maintain a portfolio to reflect their professional engagement in community service, scholarly endeavors, educational activities, and exposure to policy evaluation. The portfolio project starts the professional student on a path of self-reflection and lifelong learning, long, intermediate and short term professional goal setting, professional responsibility, continuing competence, and scholarly activity (AOTA, 2015). The portfolio provides a competency assessment following the completion of Level II fieldwork.
Level II fieldwork experiences provide opportunities for students to engage in the professional responsibilities consistent to those expected from practicing occupational therapists, yet still under supervision of a licensed occupational therapist. Through directed practice and role modeling, fieldwork educators engage students in all aspects of the occupational therapy process. To assist with the integration of the didactic and practice experiences, students engage in online discussions, facilitated by the academic fieldwork coordinator, during their fieldwork placements. This assists with bridging coursework with clinical applications and in so doing promotes competence, clinical reasoning, professional identity, and effective communication.
In-depth experiences reinforce advanced knowledge.
In the final year, the program fosters culturally sensitive and evidence based clinical competence by actively engaging the student in a collaborative process with other students, clients and educators. This process builds on prior knowledge and experience by combining professional academic knowledge, experiential learning, clinical reasoning, and self-reflection. Courses in leadership, interprofessional teaming, advanced theory and research, program evaluation and development, and professional advocacy expand their professional identity. A doctoral mentorship series spans year three, aligning students with faculty mentors, to guide them in developing and implementing an evidence-informed capstone project. The project is linked to a capstone experience in the final semester which supports student attainment of in-depth knowledge and skill in an area of interest, or emerging practice area. Throughout the program, the philosophy of OT is integrated with theoretical, practice and empirical knowledge, principles of ethical conduct, technical skills, and critical reflective thinking to improve the client’s (person, organization, population) engagement in occupations (AOTA, 2017a; Meyer, 1977; Christiansen, Baum, & Bass, 2015). This program promotes lifelong learning, collaboration, and professional development to support continual contributions to critical inquiry in evidence-based practice.
The following themes are interwoven throughout the curriculum:
Human Occupation and Health
The founders of occupational therapy espoused the idea of occupation as healing and therapeutic (Meyer, 1977). Research supports these early assertions and practitioners now have the evidence to support the use of occupation as an intervention and engagement in meaningful occupation an outcome of intervention (Gillen, 2013). This theme includes the teaching of occupational therapy theories and models, the use of occupation and to support participation, and the role of occupation in improving quality of life.
Critical Thinking for Practice and Scholarship
Critical thinking involves asking questions, trying to answer those questions through reasoning, and believing the results of that reasoning (Nosich, 2005). In practice, students are taught to be reflective practitioners who use clinical and professional reasoning (Schell & Schell, 2018) and a data-driven approach (Schaaf, 2015) to make evidence-based decisions. We also emphasize critical thinking for safety. In scholarship, we teach students to critically examine the evidence behind practice and encourage inquiry-based learning, in which students are encouraged to ask questions and find the answers.
Our program strives to develop students into professionals who recognize the importance of their work for themselves and for society (Wood, 2004). The development process includes training in professional behaviors, ethical reasoning, professional development, and lifelong learning for continuing competence. As students gain professional skills though fieldwork experiences, the emphasis moves to enhancing leadership and engaging in advocacy.
Valuing of Diversity
We consider diversity in broad terms, including, but not limited to, differences in ability, religion, political beliefs, gender, ethnicity, education, socioeconomic background, sexual orientation and geographic location. We emphasize a commitment to valuing differences and similarities among groups. Students learn to recognize health, social, and economic disparities that impact the occupational needs of individuals, communities, and populations across contexts from an occupational justice perspective (Gupta, 2016). Students participate in learning activities designed to imbue cultural humility and improve cultural competence in order to develop culturally-responsive practitioners who value diversity.
Client-centered care is emphasized throughout the curriculum, with students taught to embrace client autonomy and choice-making throughout the occupational therapy process (Law, Baptiste & Mills, 1995). Students learn strategies for interprofessional communication and teaming, as well as engage in experiential learning with students from other health care disciplines to address competencies for interprofessional practice (Interprofessional Education Collaborative, 2016).
Psychomotor skills are complex motor actions informed by cognitive functions. Occupational therapists use psychomotor skills to analyze body functions during assessment and to facilitate client engagement in a variety of interventions (Jay & Owen, 2016). Students engage in psychomotor learning through repetitive practice with feedback from instructors and fieldwork educators. Once mastery is achieved, students are able to safely and comptetently perform psychomotor tasks and begin adapting task performance across a variety of contexts.
Each program outcome links to a curricular theme and supports the overarching curricular goal. Upon completion of the program, graduates of the University of Florida OTD program will:
- develop and implement theoretically-sound, evidence-based occupational therapy programs and practices that incorporate an ecological perspective of human health (Human Occupation and Health)
- integrate rigorous critical thinking for sound clinical reasoning that leads to implementation of best practices for optimal client outcomes (Critical Thinking for Practice and Scholarship)
- commit to ethical reasoning that represents the highest ethical standards, values, and attitudes of the profession (Professionalism)
- champion the diverse occupational needs of individuals, communities, and populations to support participation in valued occupations across contexts (Valuing of Diversity)
- practice with an interprofessional, collaborative perspective of client care (Collaborative Practice)
- conduct occupation-based assessments and implement occupation-based interventions to increase participation across contexts for individuals, communities, and populations (Psychomotor Skills)
Evaluation of student learning and program outcomes occurs through portfolio review, competence assessment, fieldwork evaluation, completion of a capstone/culminating project, and the capstone experience /doctoral experiential component. See Table 1 for the program outcomes across the curriculum.
American Occupational Therapy Association.(2014).Occupational therapy practice framework: Domain and process (3rd ed.).American Journal of Occupational Therapy, 68 (Suppl.1), S1–S48. doi:10.5014/ajot.2014.682006
American Occupational Therapy Association. (2015). Standards for continuing competence. American Journal of Occupational Therapy, 69 (Suppl. 3), 6913410055. doi:10.5014/ajot.2015.696S16
American Occupational Therapy Association. (2017a). Philosophical base of occupational therapy. American Journal of Occupational Therapy, 65 (Suppl.), S65. doi: 10.5014/ajot.2011.65S65
American Occupational Therapy Association. (2017b). Vision 2025. American Journal of Occupational Therapy, 71, 7103420010. https://doi.org/10.5014/ajot.2017.713002
American Occupational Therapy Association. (2018). Philosophy of occupational therapy education. American Journal of Occupational Therapy, 69, 6913410052p1-6913410052p2. doi:10.5014/ajot.2015.696S17
Christainsen, C. H., Baum, C. M., and Bass, J. B. (2015). Health, occupational performance, and occupational therapy. In C. H. Christiansen, C. M. Baum & J. B. Bass (Eds.), Occupational therapy: Performance, participation and well-being (pp. 7-21). Thorofare, NJ: SLACK Incorporated.
Gillen, G. (2013). A fork in the road: An occupational hazard? (Eleanor Clarke Slagle Lecture). American merican Journal of Occupational Therapy, 67, 641–652. doi:10.5014/ajot.2013.676002
Gupta, J. (2016). Sociopolitical dimensions of participation: Occupational justice. In S. A. Wells, R. M. Black, & Gupta, J. (Eds.), Culture and occupation (pp. 35-61). Bethesda, MD: AOTA Press.
Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update. Washington, DC: Interprofessional Education Collaborative.
Jay, J. & Owen, A. (2016). Providing opportunities for student self-assessment: The impact on the acquisition of psychomotor skills in occupational therapy students. Assessment & Evaluation in Higher Education, 41(8), 1176-1192. doi:10.02602938.2015.10713173
Law, M., Baptiste, S., & Mills, J. (1995). Client-centered practice: What does it mean and does it make a difference? Canadian Journal of Occupational Therapy, 62, 250-257.
Meyer, A. (1977 [reprinted from 1922]). The philosophy of occupation therapy. American Journal of Occupational Therapy, 31, 639-642.
Nosich, G. M. (2005). Learning to think things through: A guide to critical thinking across the curriculum, 2nd ed. Upper Saddle River, NJ: Pearson Prentice Hall.
Schaaf, R. C. (2015). The Issue Is—Creating evidence for practice using Data-Driven Decision Making. American Journal of Occupational Therapy, 69, 6902360010. doi:10.5014/ajot.2015.010561
Schaber, P. (2014). Conference Proceedings—Keynote address: Searching for and identifying signature pedagogies in occupational therapy education. American Journal of Occupational Therapy, 68, S40–S44. doi:10.5014/ajot.2014.685S08
Schell, B. A. B. & Schell, J. W. (2018). Clinical and professional reasoning in occupational therapy, 2nd ed. Philadelphia: Wolters Kluwer.
World Health Organization. How to use the ICF: A practical manual for using the International Classification of Functioning, Disability and Health (ICF). Exposure draft for comment. October 2013. Geneva: WHO
Table 1: Themes and Instructional Outcomes
|Theme||Instructional Outcomes- Phase 1||Level II Fieldwork Outcomes||Instructional Outcomes- Phase 2||Capstone Outcomes||Program Outcomes (Graduation)|
|Human Occupation and Health||Utilize theoretical and scientific concepts to guide the occupational therapy process for support of performance, participation and well-being of individuals across the lifespan.||Apply theoretical and scientific concepts across a variety of real-world contexts for individuals across the lifespan.||Integrate advanced theoretical and scientific concepts with practical experiences to prioritize client quality of life. Appraise the role of advanced theoretical and scientific concepts to support human occupation and health in practice.||Synthesize knowledge about human occupation and health and as it relates to a focused area of study in a clinical or community setting.||Develop and implement scientifically and theoretically-sound, evidence-based occupational therapy programs and practices that incorporate an ecological perspective of human health.|
|Critical Thinking for Practice and Scholarship||Incorporate scientific and theoretical foundations to critically analyze the relationships between client factors, performance patterns, performance skills, activity or task, environment, and context to support occupational performance. Anticipate and distinguish unsafe situations in various settings. Modify behavior, task and/or environment to enforce safe practices.||Demonstrate clinical competence through conducting screening, comprehensive assessment, hypothesis generation, goal development, and implementation of evidence-based practices. Discriminate safety risks and violations in a real-world setting and respond appropriately.||Use clinical reasoning to identify appropriate outcome measures for occupational therapy interventions provided to individuals, communities, and populations. Appraise the safety practices of entry-level students in order to guide and instruct in safe behaviors.||Evaluate outcomes of a capstone project to identify implications for occupational therapy.||Integrate rigorous critical thinking and sound clinical reasoning when implementing best practices for optimal outcomes for individuals, communities, and populations.|
|Professionalism||Display professional behaviors consistent with the OT Code of Ethics and state regulatory requirements. Adopt a positive attitude towards constructive feedback on professional behaviors.||Characterize and analyze the behaviors of role models so that those behaviors can be incorporated into students’ own practices. Apply and demonstrate effective professional behaviors on a day-to-day basis when working with clients/ patients, multi-disciplinary team members and peers. Embrace constructive feedback to improve or further develop professional behaviors. Participate in a self-reflection activity to gain insight in competencies, areas for growth and areas of challenge related to professional behaviors.||Integrate and display professional behaviors, code of ethics, and behaviors consistent with those expected by regulatory bodies in day-to-day interactions with professors/ professional staff and peers. Demonstrate and perform professional behaviors to advocate for causes consistent with occupational justice, equity, inclusion, and tolerance.||Synthesize the core components (i.e., ethical conduct of scientific/evaluative/developmental/clinical project, confidentiality, privacy, justice, autonomy of client [person or organization], respect for others) to successfully obtain approval for implementation of a capstone project. Engage in behaviors that encompass professionalism, ethical practice, and continuing competence throughout the capstone experience.||Commit to ethical reasoning that intrinsically represents the highest ethical standards, values, and attitudes of the profession.|
|Valuing of Diversity||Demonstrate cultural knowledge and awareness and articulate understanding of the process of lifelong learning and self-reflection for improving cultural humility.||Provide culturally appropriate, ethical, and client-centered assessment and intervention services.||Synthesize cultural humility knowledge, skills, and values within practice, research, leadership, and advocacy.||Integrate cultural diversity components to design and/or implement projects for diverse populations across contexts.||Champion the occupational performance of individuals, communities, and populations to support health and well-being within culturally diverse contexts.|
|Collaborative Practice||Distinguish the traditional roles of various healthcare and community providers (PT, Primary Physician, Specialty Physician, Community Organizations, Government Agencies, Audiologist, etc.) so that their contributions to client needs can be identified. Characterize the scope of OT practice so that contributions from other healthcare providers and community collaborators can be integrated to fulfill unmet needs and improve participation. Differentiate the role of OTR and OTA and the importance of cultivating said relationship.||Differentiate the skills, knowledge, responsibilities, and roles of other healthcare providers on a client’s team. Initiate interprofessional referrals to address clients’ needs that are outside of OT scope of practice Assess individual strengths and weaknesses in skillsets and knowledge for the purpose of integrating skills and knowledge from others on the healthcare team to meet client needs. Utilize models and frameworks (Ecological Model, ICF Model, etc.) to gather information that informs a holistic understanding of client needs. Advocate for the contributions of other healthcare and community providers on the team.||Conduct a community assessment so that gaps in services, knowledge, infrastructure, healthcare access, and healthcare quality are identified. Develop a proposal for community stakeholders that integrates identified needs and evidence based recommendations for improving services, allocating resources, and effecting policy change that positively impacts human occupation.||Demonstrate leadership and advocacy skills in order to establish outcomes in collaboration with mentors and other stakeholders that can be fulfilled through the completion of a capstone experience and project.||Practice with an interprofessional and collaborative perspective of client care.|
|Psychomotor Skills||Demonstrate the ability to safely set up and direct interventions using purposeful activities and preparatory methods that support client remediation and/or compensation.||Conduct a comprehensive client evaluation and carry out occupation-based interventions efficiently and safely.||Teach and model assessment and /or intervention skills to others.||Implement focused assessments and/or interventions with a specific population (as applicable). Implement a project and disseminate findings to a diverse audience.||Conduct occupation-based assessments and implement occupation-based interventions to increase participation across contexts for individuals, communities, and populations.|