Report - 2007
School of Occupational Therapy
The School of Occupational Therapy at La Trobe University is one of three schools providing occupational therapy education in Victoria, there are 11 Schools nationally. In 2007, the School continued to deliver high quality Bachelor and higher degree courses and research supervision to a large number of students. Academic staff are to be congratulated for their strong commitment to refining course content and delivery and engaging with the development of the new double degree course, the Bachelor of Health Sciences/Master of Occupational Therapy Practice, which will commence in 2009.
As one of the two largest Schools of Occupational Therapy in Australia, staff in the School further developed strategies to improve student learning and engagement with academic and other aspects of University life in 2007. We continue to be impressed with the high standard of students’ work as demonstrated by their professional presentations at the annual Graduating Students’ Conference and pleased with student representation on School committees and support of many School activities particularly on University Open Day.
Professorial Appointments, significant retirements, other staff recognitions
It is pleasing to report that two senior staff in the School completed their doctoral studies in 2007.
Marilyn Di Stefano’s PhD thesis was titled ‘The Occupational Therapy On-Road Driver Evaluation of Functionally Impaired Drivers: Development of an Improved Assessment Protocol’.
This thesis reported on seven related studies leading to development of an improved Occupational Therapy (OT) on-road assessment procedure for use with functionally impaired drivers. These studies included analyses of reports from previously conducted driver performance assessments, which identified key relationships between driver characteristics, documented driving errors and test outcomes. The views of Australian OT driver assessors regarding assessment content, procedures and scoring were investigated via questionnaire and focus groups. Results were used to formulate revisions to the existing OT assessment procedure, aiming to optimise its validity, reliability, and usability which was then trialled in three urban locations. A final study entailed interviews with a large group of OT driver assessors and associated audits of their case files and assessment routes.
The revised procedure was found to discriminate well between drivers with and without functional limitations. Safety-critical errors, errors during the performance of complex manoeuvres, and the occurrence of multiple errors per location were important discriminators; findings also suggested that a flexible approach to standardised scoring, to allow for contextual variables, is important. Results were discussed in relation both to OT professional practice issues and driver licensing practices.
Mary Kennedy-Jones completed a Doctor of Public Health, her thesis was titled ‘Skills and abilities for contemporary occupational therapy practice: Implications for education’.
This qualitative study examined the perspectives of six employers of occupational therapists, nine experienced occupational therapists and eight new graduates concerning the skills and abilities required for contemporary occupational therapy practice were sought. Participants were drawn from both long-standing occupational therapy roles and new, role-emerging settings.
The study findings revealed the need for beginning occupational therapists to have advanced professional competencies such as high level communication skills, skills in time management, planning and organization, and self-management strategies. The new graduates also reported considerable challenges in coping with the demands of their roles. The implications for professional preparation programmes of these findings included the use of a process-oriented approach to learning, for example problem based learning, and the alignment of curricula elements such as curricula content, instructional design, learner tasks and instructor roles and assessment activities to support graduates to meet the demands of an ever-changing health environment.
It is also pleasing to report that Christine Imms, who is completing her PhD thesis titled ‘Participation of Australian children with cerebral palsy: The middle years’, was invited to give one of two inaugural PhD plenary platform presentations at the Australasian Academy of Cerebral Palsy and Developmental Medicine Meeting in Brisbane in April 2007.
Key developments in Teaching and Clinical Education
In 2007 the School of Occupational Therapy participated in the development of two exciting interdisciplinary units to be introduced into the new course commencing 2009. Mary Kennedy-Jones who coordinates entry level courses in the School is providing the leadership for this initiative. The opportunity to work with colleagues from all clinical schools in the Division of Allied Health on important areas of interdisciplinary practice and working in teams has been stimulating. The inclusion of interdisciplinary studies for occupational therapy students is an important development and will position graduates well for the wide variety of roles in a range of healthcare settings.
On November 8th and 9th the School once again held the annual 2 day conference for graduating students which was convened by Carol Mc Kinstry, Dr Primrose Lentin and Christine Imms. This conference provided an opportunity for final year students from entry level courses (undergraduate and entry level master’s degrees) to present their reviews of the research evidence to answer questions which arise from clinical practice. In addition, those students enrolled in the honour’s program also presented their research. Other presentations included students’ work associated with the planning, implementation and evaluation of innovative projects with non government agencies. The conference once again proved most successful in showcasing the ability of our new graduates to evaluate research and incorporate the best available evidence into clinical practice.
With respect to professional practice or fieldwork in 2007, the Student Placement Evaluation Form (SPEF) was introduced as a common fieldwork assessment tool by the four Occupational Therapy Programs placing students in Victoria (Charles Sturt, Deakin, Monash, and La Trobe). All Australian Occupational Therapy programs in Australia now use the SPEF to assess students’ fieldwork performance. To inform supervisors about the SPEF, the School conducted 4 information sessions across Melbourne, and offered in-services to larger departments. This program is proving popular and is ongoing. The transition to SPEF has proceeded smoothly with responses from occupational therapists in the field overwhelmingly positive. Lieve de Clercq, who coordinates professional practice in the School is to be congratulated for expediting this process and developing the School’s collaborations with a wide range of agencies offering fieldwork placements.
In addition to these in-services and information sessions, the School offered 6 one-day Supervision Skills Workshops to clinicians. Over the last two years, 400 clinicians from across Victoria have attended the workshops, resulting in greater consistency and quality of supervision, and a significant reduction in the number of students failing placements. In 2007 the School also trialled an Evidence-based practice workshop which can be offered to all departments taking students.
Finding sufficient placements was an ongoing problem in 2007. All students were able to go on placement in a timely manner due to a combination of the following strategies:
- Offering more flexible arrangements in scheduling of placements (i.e. part-time)
- Using more non-government agencies & expanding fieldwork in emerging areas of practice
- Developing alternative placement in traditional areas (i.e. projects)
- Education sessions for supervisor (i.e. on alternative fieldwork models)
Kidney Australia and the Muscular Dystrophy Association are two examples of non-government organisations that offered a considerable number of student placements (28 second year placements). Students participated in camps offered by these organisations and this provided students with hands on experience in assisting people with disabilities in their self-care, transfer/ mobility, and leisure and work activities.
Key Developments in Research
There is currently significant national and international interest in the area of driver assessment and rehabilitation/ transport and mobility (in general) for older and functionally impaired adults.
A major aspect of research activity during 2007 involved four staff (Associate Professors Carolyn Unsworth and Linsey Howie, Dr. Marilyn DiStefano and Ms Robin Lovell) who continued to contribute to research developments in OT-DRIVe which auspices the School’s mobility and driving-related research and education activities. Several grant applications were submitted from this group during the year and Associate Professor Carolyn Unsworth was successful in obtaining funding for her research on the “Development of a standardised assessment battery to be used in licensing recommendations for older and functionally impaired drivers” from the Royal Automobile Club of Victoria - RACV ($25,000) and the Faculty of Health Sciences, La Trobe University ($10,000). Our group also formed a network of Australian occupational therapy researchers who take an occupational focus in the area of driver assessment and rehabilitation/ transport and mobility for older and functionally impaired adults. The aim of this network is to promote research collaboration in this field.
Marilyn Di Stefano and Robin Lovell received funding from the Transport Accident Commission (TAC) to further develop and continue to present the TAC “Community Mobility for Older People” program which was initially funded in 2006. This has involved the training of occupational therapy driver assessors to conduct presentations to groups of interested older people in both the Melbourne area and in some parts of country Victoria. Twenty-five sessions were conducted in 2007 with funding received for a further 30 to be presented in 2008. The Driver Education and Rehabilitation Course remains very popular with interest in participating coming from interstate as well as local occupational therapists. In order to address the demand an additional course will be run in 2008.
Over the Christmas period (2006-7) Associate Professor Carolyn Unsworth travelled to Sweden as a visiting professor, her activities were reported in the 2006 Annual Report. Subsequent to this visit, Carolyn was appointed an adjunct professor of Jönköping University in June 2007. The School also appointed Torbjörn Falkmer from Jönköping University as an adjunct professor and visited the School in October to further collaborations in the field of driving.
It is gratifying to report that Adjunct Professor Carey was involved in two NHMRC grants that were completed in 2007. She was chief investigator of the study titled Brain adaptation associated with spontaneous and training-induced recovery of touch sensation post stroke. This study was conducted at the National Stroke Research Institute in collaboration with the School of Occupational Therapy. Professor Carey was also an associate investigator for the NHMRC Centre of Clinical Research Excellence program titled Neurosciences: Cross-discipline enhancement of clinical research and education. This collaboration, based at NSRI, provided enormous opportunity for cross fertilization of ideas and excellence in research output and training for staff and students.
An affiliation, headed by Adjunct Prof Carey, has also been formalised between the National Stroke Research Institute and La Trobe University. The partnership has facilitated: joint academic/research positions; research supervision across sites; has involved collaborations between staff across sites and departments; and has facilitated support of international scholars such as the Institute of Advance Studies Distinguished Fellow, Professor Rudiger Seitz. A special initiative has been to produce a special issue on Stroke Rehabilitation for the journal Brain Impairment. The special issue will be published mid 2008.
With respect to course work, Ellie Fossey, who is the coordinator of Higher degrees coursework programs in the School guided the introduction of two postgraduate certificates in 2007 - a Postgraduate Certificate in Occupational Therapy and a Postgraduate Certificate in Paediatric Occupational Therapy. These programs are designed to provide pathways into continuing postgraduate study for occupational therapists wishing to pursue professional development through higher education.
Five postgraduate students from the School completed Master of Occupational Therapy theses in 2007, their thesis titles were: Sensory Processing Abilities Of Children Who Have Sustained Traumatic Brain Injuries (Jane Galvin); The Performance Of Drivers With Normal Cognition On The Occupational Therapy Onroad Assessment And How They Compare With Drivers With Dementia (Robin Lovell); An Evaluation Of The Effectiveness Of The Nofalls Exercise Program As An Intervention To Increase Physical Activity Levels And Falls Efficacy In Previously Sedentary Older Adults (Sue Morgan); Occuptional History And Time Use Of A Tasmanian Forensic Psychiatric Population (Marita O’Connell) and Individual Characteristics That Predict Favourable Outcomes Following A Generalised Somatosensory Discrimination Training Program In The Hand After Stroke (Johanne Walker).
Key Developments in Community Service
The National Stroke Foundation (NSF) is the consumer group for stroke survivors. Through this organisation Prof Carey has contributed to raising the awareness of stroke to the wider community as well as contributed to educating clinicians in best clinical practice. This has involved:
- review and revising the NHMRC Guidelines for Stroke Rehabilitation and Recovery,
- contributing to organisation of audit of Post-acute stroke guidelines (NHMRC endorsed guidelines)
- presenting clinical guidelines for occupational therapy at the Stroke Rehabilitation and Recovery Conference; and
- presenting for the online training program that is provided on the NSF webpage and supplements the manual of the guidelines.
Key Developments in International Activities
A number of developments in international activities took place in 2007. Associate Professor Carolyn Unsworth was invited by the Ministry of Health, Singapore to travel to Singapore as a Visiting Expert in Neurological Rehabilitation in 2008.
Professor Carey travelled to Washington University in St. Louis, USA to visit and discuss collaborative opportunities with Prof Carolyn Baum, Director of Occupational Therapy and Neurology, and the Cognitive Rehabilitation Research Group. It is planned that Prof Baum will visit in August 2008 for ongoing discussions and collaboration. Prof Carey was also supported by the James S. McDonnell Foundation to attend and chair the rehabilitation section of a workshop on Touch, Space and Body Awareness held in Boston, USA. Experts from the fields of basic sciences, cognitive neuroscience, neurology and rehabilitation were involved, with the outcome a textbook for clinicians on the Cognitive Neuroscience of Rehabilitation.
In 2007 Prof Carey also commenced as an expert consultant (in the area of somatosensory testing) on the National Institutes of Health Toolbox collaborative initiative to develop an Assessment of Neurological and Behavioural Function. The project is part of the NIH Blueprint for Neuroscience Research and is supported by a US $21million NIH grant. It aims to provides investigators with a brief, but comprehensive, measurement tool for assessment of cognitive, emotional, motor and sensory function. This collaboration will be ongoing over the next 5 years.
In 2007 the School again enrolled a number of graduates from Singapore’s Nanyang Polytechnic into the twelve month advanced standing Bachelor of Occupational Therapy program at Bundoora. In addition, the inaugural Singapore based program for diplomates from Nanyang Polytechnic began in July 2007. This program was mounted in collaboration with the Singapore General Hospital Post Graduate Allied
Health Institute (SGH: PGAHI)and is coordinated by Janet Fricke. It is an 18 month course with two core units on evidence based practice and occupational therapy theory being undertaken prior to the teaching of a variety of specialist elective studies. Lecturers from the School have developed the units to be taught with one or two face to face block modules which are supported by Learning Management System (LMS) or web based tutorials. The Singapore based course has been popular with graduates who are unable to come to Australia because of family or financial considerations. All the students undertaking this format of the course are also practising as occupational therapists. A second cohort of students will begin the course in July 2008.
The School was pleased to welcome several visiting scholars to the School in 2007. During 2007 Professor Seitz, a neurologist from Germany visited as a LaTrobe University Distinguished International Fellow for 4 months. This provided a great opportunity for intensive collaboration, discussion with students, dissemination of results and development of new projects. Prof Seitz will return to Australia in June 2008 to present at the Human Brain Mapping Conference and continue ongoing collaborations with Prof Carey at the National Stroke Research Institute and LaTrobe University.
Professor Helene Polatajko who visited in May is the FCAOT Professor and Chair of the Department of Occupational Science and Occupational Therapy and Graduate Department of Rehabilitation Science University of Toronto. Professor Polatajko conducted a two day CO-OP workshop which was attended by therapists from Australia, LaTrobe University post graduate and undergraduate students. During her visit she also met with several staff to discuss her research and developments in education and practice in Canada and the USA.
List of all PhDs and Professional Doctorates completed in 2007
Dr Jannette Blennerhassett completed her PhD studies in 2007 for the thesis titled: The contribution of Somatosensory Impairment to Pinch Grip after Stroke. Dr Blennerhassett was supervised by Prof Carey (School of Occupational Therapy) and Prof Thomas Matyas (School of Psychological Sciences). She has co-authored 3 publications on this topic in peer review international journals to date and given a number of conference presentations. Dr Blennerhassett is a senior research physiotherapist, Royal Talbot Rehabilitation Hospital and is now co-supervising an honours student in the School of Occupational Therapy.
Over the past 5 years, the number of occupational therapists seeking to enrol in a higher degree has steadily increased. Of particular note are increasing enrolments in the professional doctorate course. During 2007 we supervised 4 clinical doctorate students with another 5 students expected to enrol in 2008.