523- Qualitative Paper

Running head: WHAT MAKES A NOVICE OCCUPATIONAL THERAPIST 1

What Makes a Novice Occupational Therapist Successful: A Narrative Account of Four

Occupational Therapy Instructors

Tracie Dunton, Stephanie Perry-Brideau, Nikki Baumgartner, Shanna Leavitt, and Casey Walker

Touro University Nevada

WHAT MAKES A NOVICE OCCUPATIONAL THERAPIST 2

Literature Review

The process of transforming from Occupational Therapy Student to Occupational

Therapy Practitioner has been examined over the years. Studies have focused on efforts to

evaluate and refine school curriculums in order to most effectively impart in students clinical

reasoning skills and to prepare them for the professional and personal challenges that they will

face in their first years of clinical practice.

In a phenomenological examination of the experiences of rehabilitation graduates during

their first year of practice, Tryssenaar and Perkins (2001) found that novice practitioners

experienced constant stress and professional growth during their transition from student to

practitioner. In a study of occupational therapy student’s perceptions and experiences during

their first year of practice, Doherty, Stagnitti and Schoo (2009) found that feeling confident in

one’s clinical decision-making abilities as well as possessing an understanding of technical or

practical occupational therapy skills are both important assets for novice practitioners to feel

competent in providing therapy. However, many studies have found that novice practitioners in

their first year after graduation often experience feelings of incompetence, inadequacy and self-

doubt (Tryssenaar & Perkins, 2001; Nordholm & Westbrook, 1981).

The faculty of the Occupational Therapy School of Allied Health Sciences of the

University of Texas has integrated a plan for student professional development within their

curriculum. The objective of the student professional development process is to enhance the

professional competence of graduates by not only providing them with knowledge and skill, but

also attitudes, values and traits that lead to professional behaviors and competence (Ledet,

Esparza, & Peloquin, 2005). Some of the behavioral outcomes associated with successful

professional development that were identified included: initiative to direct own


learning/competence, seeking guidance when needed, seeking and obtaining relevant

information, cooperating with others effectively, altering behavior in response to feedback,

analyzing, synthesizing and interpreting information, demonstrating flexibility, posessing

empathy and confidence (Ledet, Esparaza & Peloquin, 2005).

The purpose of this investigation was to further the understanding of the expectations for

novice occupational therapy practitioners by asking the question, “What are the important traits

of a novice occupational therapist?” The need for occupational therapists continues to rise, yet

the influx of new practitioners into the field remains relatively low; there were only 15,000

graduates from MOT programs in 2010 (Waite, 2011). Novice therapists are at the greatest risk

for leaving the profession (Doherty, Stagnitti and Schoo, 2009) due to the challenges and stress

of transitioning from the student role to practitioner role. We believe that if students have a good

understanding of the traits and attributes that are valuable to novice occupational therapists,

students can improve their educational experience and enhance their professional development

resulting in an easier, less stressful transition from student to practitioner during their first year of

practice.

Methods

Participants

The participants of this study were occupational therapy instructors at an accredited

masters level occupational therapy institution in the Southwest part of the United States.

Purposive and convenience sampling was used due to the nature of the research question and the

allotted time frame for completion. The faculty was chosen based on whether they were

presently teaching classes in which the researchers were enrolled. Those who were current

instructors of the researchers were not recruited due to conflict of interest. This left four


instructors to be included in the study, one of which was both an instructor and the director of the

occupational therapy program. In order to maintain the confidentiality of the participants, they

will, from now on, be referred to as M., F., R., & W. Their years of experience as occupational

therapists ranged from six to 26 years. They represented a wide range of practice areas in the

field including; adult physical disability rehabilitation in both inpatient and outpatient settings,

long-term and acute care, school based therapy, child-based rehab, neonatal intensive care, and

early intervention services. One of them had also worked in management at one time in his or her

career.

Design

The study design is within the narrative research tradition. The study was conducted

through interviews to gather the stories of these experienced occupational therapists and to hear

what they consider to be necessary traits of novice occupational therapists. Interviews were best

suited for this effort due to the nature of the research question. The question is based on personal

opinion, which is also intertwined with experience, whether it is personal or observed from

working with others in the field.

Procedures

The first step of the process involved developing a list of interview questions that would

best help gather the information needed to complete the study. These questions were geared

toward developing an understanding of what the participants thought was important for novice

occupational therapists during the transition into the field of occupational therapy. Before

continuing with the interviews, informed consent to participate in the study was secured. Also,

before beginning each interview, informed consent was obtained to videotape the interview

session (See Appendix A for a list of the interview questions).


The interviews were set up as semi-structured; eight questions were asked to all four of

the participants. However, during the different interviews as topics emerged, other follow-

up/probing questions were developed and asked. For example while interviewing R., the topic of

mentorship was established so R. was asked “What do you think about mentorship? Do you think

it’s vital for a novice OT?”, and, “What are some ways a novice OT could establish a mentor

when they first get into their career?” in order to gain further information. During M.’s

interview, the topic of a journal club came about and therefore M. was asked, “Can you elaborate

on what is a journal club?” Finally, while interviewing W., it was said that during the first year

of work, novice OT’s tend to follow suit and do what everyone else in their workplace is doing.

The researchers probed for more clarification on this by asking, “What would be a great

recommendation or method of not following suit?”

This semi-structured design allowed the researchers to obtain the information necessary

from each participant in order to begin the coding process. It also gave them further insight into

important topics that were not foreseen to arise. Each interview lasted approximately one hour

and was videotaped so that it could later be transcribed verbatim. After the completion of the

interviews, the researchers transcribed word for word and also completed a separate transcription

of the body language of each participant throughout the entire interview process.

Data Analysis

The researchers began by reading through the transcriptions several times to familiarize

themselves with the interviews and to start identifying themes. A spreadsheet was made so that

themes could be highlighted and identified more easily. (See Table 1) During this coding process

the four major themes that emerged were as follows:

1. Being open and willing to learn.


2. Develop mentorship relationships.

3. Maintaining a continued membership with the national organization, AOTA.

4. Starting and participating in a journal club.

From these themes, the researchers began to combine the information in order to answer the

research question. Once this information was pooled, member checking was done by sending it

out to the participants for verification. Triangulation, a “technique used to increase the accuracy

(trustworthiness) of data gathered” (Kielhofner, 2006, p. 353), although is most commonly done

with methods (Kielhofner), was done among the data gatherers. In doing this, several of the

researchers in this study took notes during the interviews and compared them afterwards.

Multiple persons were used in the data analysis which “strengthens the legitimacy of the final

version of study findings” (Kielhofner, p. 353).

Results

After reviewing the transcriptions of each interview and coding the data, four topics were

discussed by all of the participants (See Table 1 for the index of magnitude table). These

included the concept of being open and willing to learn, mentorship, continued membership in

the national organization (AOTA) and forming a journal club at the workplace. It was made

apparent that there is congruency amongst the participants in what they find to be important

factors for a novice occupational therapist.

Willingness to Learn

The first, and most prevalent, theme that was derived from this qualitative study was the

important trait of a novice occupational therapist is remaining open and having an overall

willingness to learn. This concept was described by all four of the participants in comments such

as, “self-directed learning”, “asking questions”, “continuing to learn”, “willingness to learn” and


“remaining teachable”. These themes were present when asked what important traits of a novice

occupational therapist were and how to synthesize evidence based practice in the first year.

Mentorship

The second theme was mentorship and it was found that the faculty felt these

relationships were of great importance and value to a novice occupational therapist. M. describes

this as the ability to “be open to constructive feedback, willing to have that kind of mentorship

relationship in practice”, and F. suggests to “seek out mentorship.” Also, W. suggests utilizing

the “mentoring aspect” when approaching evidence-based practice. The concept of formalized

and informal mentorship relationship was explained in detail by R. and F.; whereas, W. and M.

mentioned to the differences.

National Organization Membership

The importance of maintaining membership in the national organization, American

Occupational Therapy Association (AOTA) was the third theme found. This was of primary

importance when utilizing evidence-based practice was discussed. M. stated, “Staying a member

of AOTA, getting your journals and your OT practice is a good way to flip through and kind of

know what’s going on.” In addition, F. suggests that “you can attend training through AOTA”

which would enhance the individual’s knowledge. In response to our inquiries about methods of

application of a novice occupational therapist’s ability to synthesize evidence based practice in

their first year of practice, R. strongly proposed, “Starting with continuing to be an AOTA

member so that you have access to that information.”

Journal Clubs

Journal clubs were mentioned and suggested by all participants. Journal clubs were

offered as advice to novice occupational therapists that are trying to make their workplace more


evidence-based, how to try to be the agent of change as the new generation integrates in with the

previous generation, and how to best set an example as a good evidence-based therapist. F. tied

some themes together by elaborating, “develop a journal group within work, again the self-

directed learning” and “disseminate that information.” Furthermore, F. said later that “a journal

group would be part of seeking out mentorship.”

Discussion

Novice OT’s often struggle with integrating the knowledge they received in school and

using that knowledge in the field. We were curious to know if having certain traits as a new

graduate makes that transition smoother. When we were coming up with the original research

question we asked “What traits do OT instructors expect from a novice OT?” As we gave it more

thought, that changed to asking which traits our participants felt were important for an OT in

their first year of practice. Through the interviews we did get a sense that certain themes were

showing up and after the transcription was done we realized that the answers we received did not

really fall into what we thought of as specific traits. We thought we would get answers that had

more to do with personality, however the topics that turned into our themes went further than a

person’s personality and into what novice OT’s can do in their first year of practice.

Through our interviews we found the participants had some of the same ideas pertaining

to what novice OT’s can do once in the field. The main ideas that were repeated were the

importance of being open and having an overall willingness to learn, mentorship, AOTA

membership and participation in a journal club.

One aspect that is evident through all these themes is the idea of continuing education.

Whether specifically stated or implied through the other themes, it is apparent that once an OT is

out of school his or her education is not over. Occupational Therapy is always growing and


evolving, and this happens when therapists make the commitment to continue to learn and

research.

Limitations to our study included our lack of multiple data collection methods and

sample size. In order to reach saturation you must exhaust all possible sources of data collection.

Futures studies may want to use field observations and/or focus groups, along with interviews as

methods of collecting data. Due to time constraints and the scope of our study we were only able

to recruit four subjects for our research. In narrative research the optimal sample size is 10

participants.

This study can be used to help prepare new graduates as they make the transition to

taking on their own clients. The ideas our participants had for novice OT’s can be used in

conjunction with the curriculum that professors are teaching. It would also be beneficial for

professors in this field to come up with their own ideas on what they feel are important aspects

for novice OT’s. By identifying these thoughts on their own, each professor can incorporate

different ways to emphasize the themes they believe to be the most important.


Appendix A

Interview Questions

1. What are the important traits of a notice occupational therapist?

2. What do these traits entail and how would you see these in the workplace?

3. Why do you consider these traits to be important?

4. Are the valuable traits of a notice occupational therapist generalizable across all

patient populations?

5. Are there specific traits that are more applicable to certain populations?

6. Do you think it is important for a novice occupational therapist to use evidence-

based practice? Why or why not?

7. How can a notice occupational therapist apply their ability to synthesize evidence-

based practice in their first year of practice?


Table 1

NOVICE OT EXPERIENCE QUALITATIVE RESEARCH STUDY INDEX OF MAGNITUDE

THEMES W F R M

OPEN & WILLING TO LEARN X X X X

MENTORSHIP X X X X

AOTA MEMBERSHIP/ AJOT X X X X

JOURNAL CLUB X X X X

EFFICACY/ CREDIBILITY X

X

REIMBURSEMENT X X

X

CONTINUING EDUCATION X

X

CONFERENCES X X

X

CLIENT-CENTERED/ HOLISTIC X

X

THERAPEUTIC RAPPORT X

X


References

Doherty, G., Stagnitti, K. and Schoo, A.M.(2009). From student to therapist: Follow up of a first

cohort of Bachelor of Occupational Therapy students. Australian Therapy Journal, 56,

341-349. doi: 10.1111/j.1440-1630.2008.00751.

Kielhofner, G. (2006). Research in occupational therapy: Methods of inquiry for enhancing

practice. Philadelphia, PA: F.A. Davis Company.

Ledet, L., Esparaza, C.K. & Peloquin, S. M. (2005). The conceptualization, formative evaluation,

and design of a process for student professional development. American Journal of

Occupational Therapy, 59, 457-466. doi: 10.5014/ajot.59.4.457.

Tryssenaar, J. & Perkins, J. (2001). From student to therapist: Exploring the first year of practice.

American Journal of Occupational Therapy, 55, 19-27. doi: 10.5014/ajot.55.1.19.

Stube, J.E., & Jedlicka, J.S. (2007). The acquisition and intergration of evidence-based practice

concepts by occupational therapy students. American Journal of Occupational Therapy,

61, 53-61. doi: 10.5014/ajot.61.1.53.

Waite, A. (2011, September 12). The new occupational therapy jobs boom: A profession in two

acts. OT Practice, 16, 10-14.

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523- Qualitative Paper