Occupational Therapy Education Research: Results of a National Survey

Research in Occupational Therapy Education

Research in occupational therapy education has an extensive history in Canada and the United States. Between 2003 and 2013 the Canadian Journal of Occupational Therapy (CJOT) and the American Journal of Occupational Therapy (AJOT) published almost 50 articles on topics related to education scholarship in occupational therapy, such as fieldwork education (Haro et al., 2014; Holmes et al., 2010; Klinger & Bossers, 2009), simulation (Bethea, Castillo, & Harvison, 2014), development of evidence-based practice competencies (Cohn, Coster, & Kramer, 2014; Thomas, Saroyan, & Snider, 2012), and clinical reasoning (Lysaght & Bent, 2005; Mitchell & Xu, 2011). Research has also addressed novel areas of occupational therapy education such as student epistemologies (Mitchell, 2015), online learning methods (McAlister, 2014; Perlman, Weston, & Gisel, 2005), and student diversity and disability studies (Block, Skeels, Keys, & Rimmer, 2005). According to the tables of contents of AJOT, CJOT, the British Journal of Occupational Therapy, and the Australian Occupational Therapy Journal, between 4% and 10% of all articles published between 2009 and early 2015 reported results of education research. This list of areas of education scholarship for occupational therapy researchers is not exhaustive but demonstrates the scope and breadth of research endeavors in this area.

Education research within the profession appears to be increasingly necessary, visible, and valued. In the “Occupational Therapy Education Research Agenda” published in an AJOT supplemental issue on education, the American Occupational Therapy Association (2014) noted that

The 2014 AJOT supplemental issue contained articles on education research on topics such as curriculum mapping, reflection, simulation, instructional technology, and doctoral entry-level education. Twelve articles reported results of contemporary research in education, emphasizing the need to conduct high-quality research to advance occupational therapy education practices. As the guest editors Burke and Harvison (2014) eloquently stated,

To our knowledge, only two studies published in North America have reported results of environmental scans of education research activity in occupational therapy. In the first, a survey by the American Occupational Therapy Foundation of 73 (86% of total N) accredited professional and postprofessional programs in the United States undertook to identify the full range of research activities conducted by faculty in occupational therapy professional and postprofessional education programs with the aim of identifying trends across 1 yr (Parham & Zemke, 1997). The survey collected data on topics related to the scholarly activities and productivity of faculty and students, and results were compared with those of previous studies to provide a longitudinal view of trends over the 12 yr that preceded the survey. Although the results were useful for identifying trends in U.S. research activities, they did not differentiate between the types of research (e.g., education, rehabilitation, basic sciences) being conducted. Moreover, the study has limited relevance to current practice because the survey was conducted almost 20 yr ago.

The second, more recent study sought to identify a baseline for faculty engagement and productivity in occupational therapy education research in the United States (Gupta & Bilics, 2014). The authors surveyed 520 (23% of total N) faculty members nationally on their use of evidence to inform teaching and the frequency and nature of involvement in education scholarship. Although almost all respondents (90%) engaged in teaching and about one-third (34%) identified education as an area of content expertise, only 16% reported frequent involvement with education scholarship. The authors emphasized the need to build capacity for education research and to promote diversification of education research topics. U.S. researchers thus have taken steps to understand the profile of education research, but no research has explored how relevant such studies are to developments in the field or how research findings are being disseminated and adopted.

The purpose of this study was to identify the breadth and scope of education-related research activities conducted by occupational therapy faculty in Canada and factors that encourage or detract from advancement of such work. The questions guiding the study were as follows:

Method

In this descriptive study, we used an online survey (see Supplemental Appendix A, available online at http://otjournal.net; navigate to this article, and click on “Supplemental”) to collect information on practices of Canadian occupational therapy faculty participating in education research. Ethics approval was obtained from the institutional review board of McGill University, Montreal, Canada.

Results

Forty-seven faculty members at 14 Canadian occupational therapy programs completed the survey, representing approximately 24% of all full-time-equivalent faculty across Canada. The academic rank of respondents ranged from clinical professor to full professor. Overall, 68% (n = 32) indicated that they were in a tenured or tenure track position. Seventy-nine percent (n = 37) reported that research was an expectation of their position. The portion of time assigned to research varied greatly, ranging from 0% to 80% of the workload (mean = 29.7%, standard deviation = 19.6). For almost half of respondents (n = 23, 49%), research constituted 31%–40% of their workload. However, a third (34%) of the sample reported that research formed less than 10% of their workload.

Nature of Education Research in Occupational Therapy

The focus of education research among respondents in terms of past, present (as of 2013), and future projects (i.e., planned projects or projects in development) is depicted in Figure 1. Data are based on responses to categories provided on the survey instrument. Respondents were asked to provide the titles of their projects.

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Figure 1.

Participants’ involvement in distinct areas of education research inquiry (N = 47).

Respondents could list up to five additional projects beyond those included in our named survey categories. Project titles that related to the 10 survey categories were added to the counts in those categories, and the rest were grouped into an “other” category. Topics in the “other” category reported by two or more respondents included program evaluations, student health, distinct topics in occupational therapy curricula (e.g., ethics education, professionalism, enabling healthy lifestyles), clinical reasoning, knowledge translation, student writing skills, use of simulation in occupational therapy education, international education (fieldwork, academic), online or distance education approaches, and theory development related to education (e.g., complexity theory, transformative learning, professional identity).

Discussion

This study was conducted with the goal of gathering data on the breadth and scope of Canadian research on occupational therapy education in an effort to provide a fuller picture of issues related to education research in the occupational therapy profession. A fundamental goal was to stimulate discussion regarding the development of a robust program of education scholarship in occupational therapy in North America and beyond.

Our results indicate that approximately 24% of Canadian occupational therapy faculty members were conducting education-focused research. Most research seemed to be driven by personal and professional interest rather than being systematically driven by needs in the field. Many participants indicated that research in education was a “passion” and something that they engaged in above and beyond their other work. For the majority of respondents, education research was not the main focus of their research activities. The exception was faculty members engaged in fieldwork education or coordination, for whom the main areas of scholarship were related to education, often with very limited allotted research time and resources. These respondents made greater use of collaboration through networking groups related to academic fieldwork. This finding mirrors the prevalence of research on fieldwork topics in recent issues of AJOT and CJOT.

Barriers to education research in occupational therapy are noteworthy. Respondents identified challenges such as lack of funding opportunities for education research, low value placed on education research in some academic institutions, limited training or support in research, and lack of time for this type of research for faculty who were not in a tenure track position or whose research program was not focused primarily on education research.

With respect to funding, participants had sought a broad range of sources or proceeded with limited or nonexistent budgets. In Canada, funding sources for HPE research are limited, and this appears to be the case in the United States as well (Gupta & Bilics, 2014). The primary funding sources identified by respondents appear to reflect current trends in education in Canada, given the current emphasis on interprofessional education (Ateah et al., 2011; Hammick, Freeth, Koppel, Reeves, & Barr, 2007) and health force development and retention in particular (e.g., Health Force Ontario, 2015; Tran et al., 2008). Other grants from major federal funding agencies are extremely competitive and may not be a good match for the nature and scope of the research conducted by occupational therapy education researchers. Given the difficult financial climate and the mandates of major funding agencies in Canada, proposals will likely need to be of broader scope, to have the potential to make significant contributions to health and society, and to be of larger scale than many of the education research studies typically undertaken in our field.

The nature of respondents’ academic appointments was frequently described as a barrier to research productivity. For example, some who were limited-term faculty or had fieldwork portfolios identified a passion for education research but had little allotted research time and a limited capacity to apply for and obtain research funding. The expectations of academic rank represented a further barrier for many respondents. For those in contract academic or non–tenure track positions, research forms only a small portion of their academic duties because of limited time for research, grant preparation, and manuscript writing.

Collaboration and support appeared to be key for many participants but were lacking because of the structure and culture of the academic workplace. Nontenured faculty may lack strong training and experience in research and thus require mentoring and partnerships to produce high-quality work. Participants highlighted the importance of education research being valued and supported at the departmental and institutional levels. These findings suggest that a cultural shift is needed such that workloads include time devoted to education research, faculties build research teams related to their education programs and practices, and standards for academic progression through the ranks recognize and reward education research. These recommendations are consistent with those proposed to enhance education research in the U.S. context (Gupta & Bilics, 2014).

In terms of dissemination of education research, our results indicate that as a whole, respondents were involved in dissemination through peer-reviewed publications, presentations at conferences, and participation in capacity-building sessions in their universities. Only 44 peer-reviewed articles were published over a 10-yr period, and approximately two-thirds (64%) of this research was published in occupational therapy journals, which suggests that respondents were not disseminating their research in journals with a broader audience. It is unknown whether respondents did not submit more broadly because of concerns about applicability to other disciplines or whether they saw occupational therapy journals as being best positioned to influence occupational therapy education.

Publication in HPE journals is becoming increasingly difficult (Norman, 2014) and may be deterring prospective occupational therapy authors from submitting their work to these publication venues. In a 2014 editorial in Advances in Health Sciences Education, Geoff Norman described the state of current research publications in HPE and listed problems with many submissions to the top journals in the field. Only about 13% of the papers submitted to the journal were accepted; many lacked applicability, relevance, and quality (e.g., poor design, overemphasis on self-assessment, weak outcomes), and of those that were rejected, only about 1 in 3 was published elsewhere. Although our data do not permit us to ascertain why participants published primarily in discipline-specific journals rather than HPE journals, the factors Norman listed could be considered in exploring the issues further using qualitative methodologies.

Participants identified a much higher number of presentations (n = 398) than publications (n = 44) within the same 10-yr period. It would be of interest to explore further whether the presentations-to-publications ratio is higher in occupational therapy education research than in other areas of occupational therapy research. The process of publishing an article is often more challenging and time consuming than for conference presentations; factors such as the nature of one’s academic appointment, insufficient resources (e.g., time, research assistants, financial support), and lack of knowledge of journal options may be creating barriers to dissemination of education research through journal articles.

Some of the issues Norman (2014) highlighted point to the quality of research as a potential concern related to publication and dissemination and may explain the higher volume of knowledge dissemination through presentations and non–peer-reviewed publications. As reported in this study, limited funding may reduce scientific quality, as may the need for research training and mentorship among faculty who are motivated to participate in research but are not tenure track or research faculty.

Finally, the demand by many journal review panels for randomized controlled studies and large sample sizes as evidence of research quality is problematic in a field in which class sizes and curricular standards limit options for creating ideal experimental conditions. It is incumbent on researchers to demonstrate rigor in their research designs regardless of the research methods they use. For example, well-designed and -executed case studies and cohort designs would be feasible and informative relative to education strategies and can be enhanced by replication in multiple sites. Longitudinal designs based on administrative data could also be applicable to some research questions in both the fieldwork and academic domains.

Implications and Directions for Future Research

Occupational therapy has a long tradition of scholarship in education that spans several areas, including admissions, fieldwork, mentorship, interprofessional education, and workforce development. Faculty members across the 14 Canadian occupational therapy programs expressed commitment to education research and cited a need to conduct research in new and innovative areas, many of which are in line with emerging education technologies and new trends within the profession and health care more generally. The following implications were synthesized from the study:

Conclusion

The findings of this study provide an overview of Canadian occupational therapy education research and reveal barriers and constraints to growth and scientific development. The results suggest potential strategies to advance education research in this field at the level of researchers, institutions, journals, and the profession as a whole. Continued development in this important area of inquiry is vital to maintaining a relevant evidence base that supports excellence in research on occupational therapy education.

Supplemental Material