The Clinical Reasoning Behind Occupational Therapy Practitioners’ Use of iPads

PURPOSE: The field of occupational therapy is continuing to grow and improve treatment techniques and strategies through the use of assistive technology. Previous research has shown that iPad use in occupational therapy is a growing trend. However, there are still questions about how effective iPads are during therapy sessions and how they benefit a client’s ability to engage in everyday occupations. The purpose of this study was to gain insight into the clinical reasoning behind occupational therapy practitioners’ use of iPads during treatment.

DESIGN: Nineteen occupational therapy practitioners participated in this qualitative, phenomenological research study through the use of a private Facebook group and an online survey. Participants were recruited through convenience sampling using contacts of an occupational therapy department.

METHOD: In the Facebook group, participants were asked to answer questions posted on the group page. This format was used to encourage dialogue among participants as it allowed participants to see one another’s answers and respond to them. The anonymous online survey, which contained the same questions asked of the Facebook group, was for those who did not participate in the Facebook group. The survey was sent to participants through email. They answered questions aimed at better understanding their use of iPads with clients, such as “How do you decide when to use an iPad with a client?” and “How do you know whether the iPad is effective in helping your client achieve his/her therapy goals?” Inductive content data analysis was used to analyze data.

RESULTS: While information was gained on how participants used iPads with clients, the participants were not able to fully explain their clinical reasoning or evidence that guided their use of iPads. The three themes that emerged were the benefits of iPad use, disadvantages of iPad use, and decision making behind iPad use. Benefits noted by participants included the following: iPads are an engaging activity to build rapport and motivate clients, there are a variety of apps to work on motor and cognitive skills, and iPads can increase practitioner efficiency with documentation of clients’ improvement, progress, and goals.

Disadvantages included the following: iPads are expensive and difficult to clean, some facilities limit Internet searches and what apps are allowed to be downloaded, there is concern about transfer of learning from the app to real life, a potential decrease may occur in a client’s social participation, and clients may have difficulty switching to a different task. Factors in the decision to use iPads included the following: the need to work on specific skills such as cognitive, fine motor, visual–perceptual, communication, handwriting, auditory processing, and storytelling skills; the fact that iPads can be used with all populations; and the idea that they can be used as one type of activity to reach client goals. In fact, participants were found to use iPads less than 50% of treatment time.

CONCLUSION: Overall, participants’ use of iPads was based on their own perceptions of benefits. Results reinforce that it is important for occupational therapy practitioners to remain goal oriented and to use iPads only when appropriate and that there is the potential for iPads to help certain populations obtain skills they can carry over to functional activities. The purpose of the study was to gain insight into occupational therapy practitioners’ clinical reasoning in using iPads during treatment; however, participants were not able to clarify their clinical reasoning related to iPad use. More research needs to be done to fully understand the clinical reasoning behind iPad use in occupational therapy and to better ensure that iPad use is appropriate based on evidence-based practice and research.

References

Des Roches, C. A., Balachandran, I., Ascenso, E. M., Tripodis, Y., & Kiran, S. (2014). Effectiveness of an impairment-based individualized rehabilitation program using an iPad-based software platform. Frontiers in Human Neuroscience, 8, 1015. https://doi.org/10.3389/fnhum.2014.01015

Hoesterey, C., & Chappelle, C. (2012). Touch the future: Using iPads as a therapeutic tool. OT Practice, 17(13), 7–9.

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Verdonck, M., & Maye, F. (2015). Enhancing occupational performance in the virtual context using smart technology. British Journal of Occupational Therapy, 79, 385–390. https://doi.org/10.1177/0308022615591172