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Occupational therapy programs throughout the United States
are placing an emphasis on designing curriculum to enhance
students cultural competence in order to meet the demands of an
increasingly diverse population. (Kong et al. 1999) Occupational
therapy practitioners need to be aware and educated on how to
interact with people of different cultural backgrounds, including
ways to build rapport, and engage in culturally responsive care
(Humbert, 2012). In alignment with the demand for culturally
relevant practice, the ACOTE requires occupational therapy
programs include both national and international resources in
making assessment and intervention choices, and encourage the
influence of contributions of cultural factors to education,
research, and practice (Sood et al. 2014, p. 13). According to
Horton (2009), one specific way educational programs can enhance
their students cultural awareness is encouraging and offering ways
for students to travel abroad.
The foundation for clinical skills is provided within the
classroom setting, and further developed with level I and level II
fieldwork opportunities throughout the occupational therapy
students education. According to the American Occupational
Therapy Association, the goal of level I fieldwork is to ”introduce
students to the fieldwork experience, and develop a basic comfort
level with an understanding of the needs of clients.” (AOTA, 2013)
In order for international opportunities to be considered part of the
fieldwork experience, placements must comply with the
Accreditation Council for Occupational Therapy Standards. This
requires that the fieldwork placement align with the curricular
themes of the specific university, include a memorandum of
understanding, and ensure qualified personnel supervise the
student (ACOTE, 2007, a,b&c).
Consistency among research regarding international fieldwork
placements (IFPs) highlights the potential for international
placements to foster knowledge in a way that is global and
comprehensive (Haro et al 2014, Barker et al 2010, Humert et al
2012, Whiteford et al, 2007, & Simoenelis et al 2011). Following
an IFP, McAllister et al. (2006), found students reported increased
ability to identify stereotypical patterns of thinking, re-evaluated
their own assumptions, and reconstructed their understanding of
other cultures. Similarly, Humbert et al. (2012) found students
discussed increased cultural awareness, and adaptability by
responding to new challenges. Overall, existing literature supports
the opportunity for the occupational therapy studenst to engage in
the provision of therapy services to diverse populations, as it
exposes students to a unique clientele and fosters the development
of culturally competent practice.
REVIEW OF THE LITERATURE ABSTRACT
Alexandra Groot, OTD/S Faculty Advisor: Elena Espiritu, OTD, OTR/L
Expert Mentors: Janet Braun, Study Abroad Advisor and Operations Director Shelly Jewell, Director of Study Abroad
Residency Project: Exploring International Education Opportunities For Belmont OTD Students
SUMMARY According to the United States Census Bureau, ethnic
minorities will account for 48% of the U.S. population by the year
2050. (United States Census Bureau, 2012). As the health field
pushes for a more global outlook regarding the provision of health
services, educating students on diversity and cultural awareness is a
necessity. Providing the opportunity to participate in international
fieldwork placements can allow future Belmont Occupational
Therapy Students a unique opportunity for both personal and
profession growth.
REFERENCES
The purpose of this residency project was to create a
framework for international experiences (e.g. therapy based
mission trips, and fieldwork experiences) to enrich Belmont
Doctorate of Occupational Therapy student’s education regarding
the distribution of therapeutic services in diverse populations. By
including the opportunity for international involvement within the
curriculum, students can engage in a unique experience for growth
in a way that traditional fieldwork may not.
American Occupational Therapy Association. (2010). Occupational therapy code of
ethics and ethics standards (2010). American Journal of Occupational
Therapy, 64(6 Suppl.), S17-S26. doi:10.5014/ajot.2010.64S17
Barker, A., Kinsella, E.A., Bossers, A. (2010). Learning in international practice
placement education: a grounded theory study. British Journal of
Occupational Therapy, 73(1), 29-37.
Callister, L.C. & Harmer, A.C. (2006). Opening our hearts and minds: The meaning of
international clincal nursing electives in the personal and professional lives of
nurses. Nursing and Health Sciences, 8, 95-102.
Gat, S., & Ratzon, N.Z. (2014). Comparison of occupational therapy students’
perceived skills after traditional and nontraditional fieldwork. American
Journal of Occupational Therapy, 68(2), 47-54. doi:10.5014/ajot2014.007732.
Haro, A.V., Knight, B.P., Cameron, D.L., Nixon, S.A, Ahluwalia, P.A.,Hicks, E.L.
(2014). Becoming an occupational therapist: Perceived influence of
international fieldwork placements on clinical practice. Canadian Journal of
Occupational Therapy, 8(3), 173-182. doi: 10.1177/0008417414534629.
Horton, Ayana. (2009). Internationalizing occupational therapy education. British
Journal of Occupational Therapy, 72(5), 227-233.
Humbert, T. K., Burket, A., Deveney, R., & Kennedy, K. (2012). Occupational therapy
students’ perspectives regarding international cross-cultural experiences.
Australian Occupational Therapy Journal, 59(3), 225–34.
Kong, H., Hom, H., & Kong, H. (1999). Cross-cultural awareness and occupational
therapy education. Occupational Therapy International, 6(1), 24–34.
Knecht-Sabres, L. J. (2013). Experiential learning in occupational therapy: Can it
enhance readiness for clinical practice? Journal of Experiential Education,
36(1), 22–36.
McAllister, L., Whiteford, G., Hill, B., Thomas, N., Fitzgerald, M. (2006). Reflection
in intercultural learning: examining the international experience through a
critical incident approach. Reflective Practice, 7(3), 367-381.
Overton, A., Clark, M., & Yvonne, T. (2009). A review of non-traditional occupational
therapy practice placement education: a focus on role-emerging and project
placements. British Journal of Occupational Therapy, 72(7), 294-301.
Simonelis, J., Njelesani, J., Novak, L., Kuzma, C., & Cameron, D. (2011).
International fieldwork placements and occupational therapy: lived
experiences of the major stakeholders. Australian occupational therapy
journal, 58(5), 370–377.
Whiteford, G. E., & McAllister, L. (2007). Politics and complexity in intercultural
fieldwork: The Vietnam experience. Australian Occupational Therapy Journal,
54, 74-83.
Whiteford, G., & St-clair, V. W. (2002). Being prepared for diversity in practice:
occupational therapy students ’ perceptions of valuable intercultural learning
experiences. Australian Occupational Therapy Journal, 65(3),129-137.
CURRICULAR THEMES
Faith-Based
Advocacy
Clinical Excellence
Entrepreneurial Leadership
Phase 1
• Exploration of existing literature
• Identify ACOTE standards regarding international fieldwork opportunities
Phase 2
• Collaborate with Study Abroad department
• Identify international opportunities
• Gain an in-depth understanding of cultural competence
Phase 3
• Experiential Component in Guatemala
• Create Student Pre-travel Manual
Phase 4
• Create potential student activities
• Dissemination of project with academic fieldwork coordinator
MISSION
My mission is to demonstrate faith-based advocacy by exploring
international educational opportunities for future Belmont OTD
students. This will provide client-centered, occupation-based
services to a population in need, as well as allow future students
the potential to develop a deeper sense of cultural awareness and
understanding.
Barker et al (2010)
Personal and professional
development
Thinking outside the
box/Confidence
Adaptability
Cultural sensivity
Haro et al (2014)
Active Ingredients: confidence
•Creativity
•Cultural Sensitivity
•Problem Solving
OT roles:
•Communication
•Client-centered practice
Competitive Edge
Simonelis et al (2011)
Collaborative Learning
Cultural Negotiations
Thinking on my own
Humbert et al (2012)
Connectedness
Cultural awarness
Complexity
Whiteford et al (2007)
Client-Centered practice
Learning through doing
Doing
Callister & Harmer (2006)
Cultural competence
Interpersonal connections
Commitment to making a difference
Personal and professional
development
McAllister et al (2006)
Aspirations and expectations of the intercultural
experience
Culture Shock
Awareness and overcoming stereotypes
Intercultural communication
issues and strategies
Figure 3. Common themes within existing literature discussing the perceived benefits of international fieldwork placements.
Figure 2. Residency Timeline
Figure 1
GUATEMALA MISSION TRIP 2015
Belmont occupational and physical therapy students were
given the opportunity to participate in a therapy based
mission trip to Guatemala over the 2015 Spring Break.
Four clinicians and 21 students collaborated together
while working with children with various complex medical
conditions. The team was able to immerse themselves
within the Guatemalan culture while visiting a variety of
different settings including schools, orphanages, homes,
an adaptive tennis center, and a Church. Students
creativity soared by utilizing limited resources in various
ways to meet the specific needs of the individual.
The experience challenged students to think outside of
the box, and put the foundational skills learned in the
classroom to work in a diverse environment.
Interprofessional development also occurred due to the
occupational and physical therapy students need to use
each others skillsets to provide optimal care. Students
groups always had a representation from both disciplines
to ensure all needs were met. The team provided
donations including clothing, therapy supplies, toys, and
candy to a variety of schools, homes and orphanages. The
trip was an unbelievable experience which resulted in my
personal and professional development.
CONTENT WITHIN MANUAL
AOTA Guide for planning IFP
ACOTE Standards for Fieldwork
Memorandum of understanding
Going Global, Live Beyond, and World Relief overview
Passport 101
Travelers Insurance options
Recommended Packing List
Spanish to English cheat sheet
Recommended Vaccinations
Mission trips available through Belmont
Optional culturally relevant assignments
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