Investigating the impact of curriculum on attitudes by first year occupational therapy students towards people with a disability

Are attitudes important?

Investigating the impact of curriculum on attitudes by first year

occupational therapy students towards people with a disability

Photo used with permission: Tamer / World Health Organization (WHO)

Photograph used with permission from the World Health Organisation (WHO). The photo "Shadow of Disability" by Tamer is one of 33 awarded photographs from the WHO photo contest "Images of Health and Disability 2005". The contest has been organized in order to promote the understanding and use of the International Classification of Functioning, Disability and Health (ICF)

Visit http://www3.who.int/icf/icftemplate.cfm to view more photos.

Photo on title slide

http://www3.who.int/icf/icftemplate.cfm

yes sometimes yes often no

limitation

0

10

20

30

40

50

60

70

Pe

rce

nt

limitation

Direct experience by OT students with persons with a disability

Survey adapted from: Human Resources and Social Development Canada. (2001). Canadian Attitudes Towards Disability Issues.

wheelchair f/t hearing aid walks with a cane

limited vision wheelchair p/t

0.00

0.50

1.00

1.50

2.00

2.50

3.00

Me

an

Conceptions of disability: person using a visible aid


Closer to 1 means student view person with this aid as having a “disability”

depression

chronic pain

mem

ory

verbal comm

unication

obese

HIV/AIDS

poor social skills

homeless

0.00

1.00

2.00

3.00

4.00

Me

an

Conceptions of disability:person without visible aid


Closer to 0 means student view person with this limitation as having a “disability”

find out about disab

afraid of sorry for indifferent towards

awkward admiration

0.00

1.00

2.00

3.00M

ea

n

Students’ level of comfort being with a person with a disability


1 = Often and

4 = Never

fully included 1.50 somwhat included 2.50 not very included

participation

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

Pe

rce

nt

Perception of how included people with a disability in participating in society

Survey adapted from: Human Resources and Social Development Canada. (2001). Canadian Attitudes Towards Disability Issues .

Perception of barriers to participation in society


employment education transport health care

0.00

0.50

1.00

1.50

2.00

2.50

3.00

Me

anThe higher

the bar = the more difficulty a person with a disability has participating in this aspect of society.

(Range 1-4)

recreation financial security social life raise a family

0.00

0.50

1.00

1.50

2.00

2.50

3.00

Me

an


The higher the bar = the more difficulty a person with a disability has participating in this aspect of society.

(Range 1-4)

Perception of barriers to participation in society

.50 a great deal of discrimination

1.50 some discrimination a little discrimination

discrimination

0.0%

20.0%

40.0%

60.0%

80.0%

Pe

rce

nt

Do people with a disability face discrimination?


yes no

witnessed discrimination

0

10

20

30

40

50

60P

erc

en

t

witnessed discrimination

Witnessed discrimination


Using models to explain how attitudes affect participation

A World Health Organization model–The ICF

An occupational therapy model–PEOP

What is the ICF?

ICF is WHO's framework for health and disability.

It provides a standard language and framework for the description of health and health-related states

Its focus is on health and functioning NOT disability (an important attitudinal shift)

Model of ICF

http://www3.who.int/icf/beginners/bg.pdf

What is the PEOP model?

An occupational therapy model

Describes the interaction between person, environment, occupation and performance

Describes how these factors can support/enable or restrict performance of activities, roles of the individual/organization/community.

(Baum & Christiansen, 2005)

The Person-Environment-Occupation-Performance (PEOP) model

The Person-Environment-Occupation-Performance (PEOP) model

ATTITUDES

ATTITUDES

ATTITUDES

ATTITUDES

Where do “attitudes” fit in the PEOP?








Putting it together

How does the ICF model work with

the PEOP model?

Putting it together

Putting it together

Putting it together

Putting it together

YEAR1

SEM 1Foundations of

Occupational Science and Therapy: A

Human Structure& Function

HBS109

Communication & DiversityHDS101

UnderstandingHealth

HBS107

SEM 2Foundations of

Occupational Science and Therapy: B

HealthBehaviour

HBS110

Functional Human AnatomyHSE102

Integrated Human Physiology

HSE208

YEAR2

SEM 1Neuroscience

HSO207Elective Elective

Occupational Development, Disability and Adaptation: A

HSO205

SEM 2Health Information

& DataHBS108

Occupational Dysfunction

HSO202

Sociology of HealthASC206

Occupational Development, Disability and Adaptation: B

HSO206

YEAR3

SEM 1 Researching Occupational

PerformanceHSO302

Occupational Performance Evaluation & Intervention: 1

HSO305Elective Elective

SEM 2OT Evaluation

& EvidenceHSO303

Occupational Performance: Evaluation & Intervention: 2

HSO306

OST Practicum: AHSO304

(2 credit points)

YEAR4

SEM 1

Occupational Therapy Practice, Knowledge &

ReasoningHSO401 (Pass stream) Occupational Environments

and Technology HSO403

(Pass and Honours streams)

OST Practicum: BHSO405

(2 credit points)(Pass and Honours streams)

OR

Occupational Therapy Practice, Knowledge &

ReasoningHSO411 (Honours stream)

SEM 2

Occupation: Enabling Action & Outcomes

HSO402 (Pass stream)

Critical Analysis of Occupational Issues

HSO404 (Pass stream)

Elective(Pass stream)

Elective(Pass stream)

OR ORHonours Research Project

HSO410(Honours stream)

Occupation: Enabling Action & Outcomes

HSO412 (Honours stream)

Critical Analysis of Occupational Issues

HSO414 (Honours stream)

First year, First Semester Curriculum strategy 2006Snakes and Ladders

Facilitated by two people who have a visible physical disability, the disability has no impact on their ability to perform their role as facilitator

OT: what a great job!Students are taught by a man who has spastic quadriplegic cerebral palsy about OT’s in his life and their role in helping him to be as independent as possible.

Student playing Snakes and Ladders

Initial interviewing• Students will see therapists in action, undertaking initial

interviews, building rapport and designing OT treatment plans from a person-centered, strengths based perspective

Independent Living Centre Visit• Students will visit the ILC and learn about environmental

adaptations and equipment that allow people with a disability to complete tasks more independently

A range of field visits:• Seeing OT and other health professionals in action,

asking the “patient/client” what makes a good therapist?

First year, First Semester Curriculum strategy 2007

Research Proposal

This research aims to measure student attitudes towards people with a disability at the commencement of their studies in occupational therapy. Comparative data will then be used to measure if change in attitudes occurred and qualitative data collection will analyse where changes occurred or did not occur.

Timeline for research project

Honours project in 2007• Ethics application submitted November 6 2006• Baseline data on attitudes to be collected using The

Measurement of Attitudes toward people with disabilities (Antonak & Livneh, 1988) in Febrauary 2007

• In-depth interviews with randomly selected participants from the first year cohort in July 2007

• Comparative data to be collected using The Measurement of Attitudes toward people with disabilities (Antonak & Livneh) in August 2007

• Data analysis and thesis writing September/October• Completion by November 2007

Antonak, R.F. & Livneh, H. (1988). The measurement of attitudes towards people with disabilities: Methods, psychometrics and scales. Springfield, Illinois: Charles Thomas Publisher.

Baum, C. M, & Christiansen, C. H. (2005). Person-environment-occupation-performance: An occupation-based framework for practice. In C. H. Christiansen, C. M. Baum, and J. Bass-Haugen (Eds.), Occupational therapy: Performance, participation, and well-being (3rd ed.). Thorofare, NJ: SLACK Incorporated.

Bhattacharya, M. & Sidebotham, P. (2000). Parental and professional perceptions of the levels of disability in children with Down's syndrome. Ambulatory Child Health 6, 153-163.

Bruhn, J. G. (1991). Nouns that cut: The negative effects of labelling by allied health professionals. Journal of Allied Health (Fall), 229-231.

Byron, M., Cockshott, Z., Brownett, H. & Ramkalawan, T. (2005). What does 'disability' mean for medical students? An exploration of the words medical students associate with the term 'disability'. Medical Education 39, 176-183.

Crepeau, E. B., Cohn, E. S., & Schell, B. A. B. (2003). Willard and Spackman's occupational therapy (10th ed.). Baltimore, Md.: Lippincott.

Gething, L. (1993). Attitudes toward people with disabilities of physiotherapists and members of the general population. Australian Journal of Physiotherapy 39(4), 291-296

References

Gething, L. (ND). Interactions with disabled persons scale: Scale and manual. Sydney: University of Sydney.

Human Resources and Social Development Canada. (2001). Canadian Attitudes Towards Disability Issues. http://www.sdc.gc.ca/en/hip/odi/documents/attitudesPoll/qualitativeStudy/qualitativeStudy.pdf#search=%22Canadian%20Attitudes%20Towards%20Disability%20Issues%20Environics%20Research%20Group%22. Accessed 3 February 2006.

Nosek, M.A., Howland, B.A., Rintala, D.H., Young, M.E. Chanpong, G.F. (2001). National Study of Women with Physical Disabilities: Final Report. Sexuality and Disability 19(1), 5-39.

Tervo, R.C., Azuma, S. Palmer, G. & Redinius, P. (2002). Medical students' attitudes toward persons with a disability: a comparative study. Archives of Physical Medicine and Rehabilitation 83(11), 1537-1542.

Thistlethwaite, J.E. & Ewart, B.R. (2003). Valuing diversity: Helping medical students explore their attitudes and beliefs. Medical Teacher 25(3), 227-281.

World Health Organization. ICF Photo contest winners 2005. Accessed November 1 2006. http://www3.who.int/icf/photocontest2005/index.htm

World Health Organization. (2002). Towards a common language for functioning, disability and health ICF. Geneva: Author.

References