Abstract
Artifacts are “any objects made by human beings” (“Artifact,” n.d.). Artifacts of professions include their “tools of the trade” and “technologies of practice,” meaning any skill, process, tool, or vocabulary created to enact the field’s practices (Lave & Wenger, 2002, p. 117). Sample artifacts of occupational therapy practice include
Skills, such as interviewing, observing performance, analyzing a task, teaching a client, and using professional reasoning;
Tools, such as the Occupational Therapy Practice Framework: Domain and Process (3rd ed.; OTPF–3; American Occupational Therapy Association [AOTA], 2014), the occupational profile template (AOTA, 2017), and the Assessment of Motor and Process Skills (Fisher & Jones, 2012); and
Conceptual understandings, such as how skills and tools relate to enabling occupation (Townsend & Polatajko, 2007).
A field’s skills, tools, and concepts are embedded in its artifacts, although the concepts are seldom recognized by artifact users, especially novice users. One role of education is to engage students with the profession’s practice artifacts and help them unpack the conceptual understandings embedded within those artifacts (Quennerstedt et al., 2011). Especially critical for occupational therapy education is for students to unpack the field’s skills and tools to discover linkages to occupation and how to enable occupation with clients across practice settings.
To help students with this conceptual unpacking, educators create a trove of artifacts of their own, including course syllabi, lectures, assignments, learning activities, feedback, and rubrics. Through these materials, educators teach the artifacts of practice—ideally, in relation to the concept of occupation. Therefore, education artifacts can serve as a window into how educators help students synthesize practice skills and tools with occupation.
Artifacts make up a substantial portion of the learning environment, but they receive little attention in education research (Yanow, 2005). Hooper et al. (2013) found that the learning environment, inclusive of the artifactual environment, was rarely studied in occupational therapy education. This omission is significant, given that up to 93% of meaning is communicated “through acts and objects, the physical artifacts we create . . . and through which we communicate collective values, beliefs and feelings” (Yanow, 2005, p. 42). Without studies of education artifacts, an important dimension of teaching and learning remains unexamined.
This article presents an analysis of education artifacts collected as part of a larger study on how occupation is addressed in occupational therapy education (Krishnagiri et al., 2017). The aim of the analysis was to describe the skills and tools that education artifacts required students to use as well as the broader concepts, especially related to occupation, that students were to gain through these skills and tools. Among many possibilities, learning broader concepts related to occupation could include learning about the human drive to engage in occupation; how a skill or tool relates to the therapeutic competency of enabling occupation (Townsend & Polatajko, 2007); and how occupation works as a mechanism in human survival, culture building, environmental change, social connections, meaning, health, and transformation, among other dynamics of health and well-being (Hooper & Wood, 2014).
Method
Because the larger project (Krishnagiri et al., 2017) from which this study’s data were drawn has been reported in detail elsewhere (Hooper et al., 2018; Price et al., 2017), only a summary of the method is provided here. The project used a basic, or generic, qualitative methodology (Percy et al., 2015) and an exploratory sequential design (Creswell & Clark, 2017). For the basic qualitative phase, 15 occupational therapy and 10 occupational therapy assistant programs in the United States were selected through stratified random sampling that targeted representation from multiple types of institutes of higher education (see Carnegie Classification of Institutions of Higher Education, 2018) across geographic regions.
Each participating program selected key informants who were knowledgeable about the program’s curriculum and approaches to addressing occupation. Those informants were interviewed and were also asked to submit classroom videos and education artifacts that they believed reflected how they or their program addressed occupation. Through post and electronic mail, participants submitted 243 artifacts that included course syllabi; lectures; lecture notes; slide presentations; assignments; grading rubrics; sample student work; lab activities; and self-study documents such as philosophy statements, mission and vision statements, and curriculum graphics.
Data Selection for This Study
We reasoned that students likely pay more attention to, and acquire more information through, assignments than the other artifacts collected. Therefore, for this study, we examined a subset of the education artifacts—assignments—that programs used to convey information about the concept of occupation and its use in practice. However, we found that most assignment artifacts submitted were not solely or even primarily about learning the concept of occupation. Instead, they represented a wide array of skills and tools of practice into which occupation was sometimes infused. Therefore, examining assignment artifacts offered a unique opportunity to explore how conceptual understandings of occupation were embedded within practice skills and tools.
Initial and Secondary Data Analyses of Artifacts
During the basic qualitative phase of the larger study, we first inductively analyzed the interview data. To explore triangulation among data sources, the codes generated from the inductive analysis of interviews were applied deductively to all video and artifact data, although with modifications as dictated by the data. All artifact data were categorized by type of document and uploaded into the data analysis software Atlas.ti (Version 6.2; Scientific Software Development, Berlin, Germany). Three pairs of researchers then coded all artifacts. These findings triangulated the interview data.
Because of the pivotal role assignments play in learning, we conducted a deeper, secondary analysis of assignment artifacts, the focus of this study. For this secondary analysis, we adopted a sociocultural learning paradigm, meaning that we viewed artifacts as shaped by social processes and thus as conveyors of values in the social context (Lave & Wenger, 2002). A sociocultural perspective views artifacts as “shaping action and agents in essential ways” (Quennerstedt et al., 2011, p. 291). We accordingly selected a social constructionist approach to analyze artifact data, as recommended by Yanow (2005). In this approach, artifacts are accessed “through identifying, locating and closely reading or viewing research-relevant documents” (p. 47). Artifacts are then examined for their tangible aspects, that is, skills and tools, and for their intangible aspects, that is, underlying concepts.
The first, second, and third authors (Hooper, Krishnagiri, and Price) independently categorized assignments by the tangible skills students were required to perform. The first author further coded for the tangible tools that students were required to use. For example, students conducted observations (skill) and processed the observations using the OTPF–3 (tool). The first author next coded the less tangible aspects of the assignment, meaning the underlying concepts related to occupation. The research team critiqued and refined the skills, tools, and concepts. Interviews were consulted to create context for assignments.
Results
Each artifact typically included the specific skill that students were to perform and a tool that they were to use in relation to the skill. For example, assignments required students to conduct an interview (a skill) and categorize it using the domain of the OTPF–3 (a tool). Collectively, assignments required these skills: observe, interview, teach, consider impairments, analyze activities, and work with case studies. The OTPF–3 was the primary tool included in the artifacts. Broader, underlying concepts associated with occupation were less evident in the artifacts, such as how skills and tools related to occupation in people’s lives or how to enable occupation. We organized the findings by the skills that assignments required students to use. The sections that follow describe, within each skill category, the skill, tool, and conceptual understandings apparent in that group of artifacts.
Primary Skills Required by Assignments
Observe or Engage in Experiences
Assignments that required students to observe or engage in experiences included several formats, such as learning an activity that a student had always wanted to try, observing people doing something that a student had never seen before, attending exhibits and festivals, observing classmates’ activities, watching videos of people doing something, and observing students’ own typical occupations. Regardless of the format, these assignments commonly required students to observe or participate in and then analyze an experience using the categories of the OTPF–3 domain. The learning outcomes often included how well students understood each category. Assignments usually incorporated a practice-related component, such as having students grade the observed or experienced activity for someone with a disability or imagine the challenges someone with a disability would face doing the activity. Students then typically reflected on the assignment.
One example required taking the train to “experience public transportation . . . and understand the various activities associated with using public transportation.” After taking the train, students were directed to write about the performance components they used and how they used them and to refer to the OTPF–3 for terminology. Students then considered what taking the train would be like for people living with particular health conditions.
These artifacts made clear that students were to use the skills of observation and activity analysis and the tool of the OTPF–3. The artifacts did not commonly require that students also demonstrate the broader conceptual understandings beyond an accurate application of the domain categories of the OTPF–3. In other words, most artifacts did not require students to connect interviewing, analyzing, or using the OTPF–3 to the dynamics of occupation in people’s lives or to the competencies associated with enabling occupation. However, the few artifacts that did encourage the link to conceptual understandings about occupation’s role in life did so with additional prompts, such as “reflect on what you learned about yourself and how you changed through doing this occupation.” In one assignment, for example, students tracked their time use, analyzed their occupational patterns, and explained how the patterns contributed to their health, well-being, and meaning in life. Another assignment asked students to identify how much control, support, focus, and mastery they experienced and developed through occupation. Although these assignments asked students to learn about the impact of occupation in their lives, they rarely looped back to the relevance of these insights for working with clients.
Conduct Interviews
Conducting interviews included several learning formats, such as interviewing classmates, family members, friends, people with disabilities, and community members. Regardless of format, the assignments had a common structure: interview someone; summarize the interview; analyze the interview content according to predetermined criteria, often the OTPF–3 domain categories; and reflect on their performance of the interview. In completing these assignments, students used the skill of interviewing, informed by the tools of the OTPF–3 and the Occupational Questionnaire (Scanlan & Bundy, 2011), which is a formal interview.
Interview assignments were sometimes linked to the occupational therapy process by representing them as the interviewee’s occupational profile. Some assignments asked students to draw conclusions from interviews about interviewees’ “levels of life satisfaction, dissatisfaction and goals” or about what they “need and want to do” and “what interfered with their needs and wants,” followed by asking students what they would do with this information in practice.
These artifacts made clear that students were to use the skills of interviewing and activity analysis and the tool of the OTPF–3; however, the conceptual understandings to be gained through their use remained unclarified in most artifacts. In other words, artifacts did not commonly require students to connect interviewing, analyzing, and using the OTPF–3 to the dynamics of occupation in people’s lives or explain how they related to enabling occupation. However, one assignment emphasized the dynamics of occupation. Students asked interviewees about “childhood, adolescent and adulthood occupations” and about patterns of occupation and occupation’s impact on the interviewee’s “physical, cognitive, emotional and social development” over time.
Teach Peers
For assignments that required teaching peers, students typically selected or were assigned an activity, analyzed the activity, and designed a class presentation that taught the activity and its analysis to peers. These assignments included typical and modified performance of activities for both children and adults. Modified performance, as stipulated in one assignment for example, involved teaching “adaptive methods for [activities of daily living (ADLs)].”
Some assignments required students to develop and submit their teaching strategy beforehand, for example, outlining the “teaching–learning processes, each step that will be followed, time required for each step, teaching strategy, [and] potential problems.” Instructions commonly stated, “Complete and share an activity analysis of the client’s occupation using the [OTPF–3] as your guide.” Learning approaches such as adult learning theories and the Four Quadrant Model (Greber et al., 2007) were sometimes emphasized. Two assignments, in an attempt to simulate practice, required students to teach a peer who role-played someone with a disability. Some assignments asked students to demonstrate practice-related skills alongside their teaching, such as “clinical reasoning and time management.” For example, students were to anticipate difficulties that their peers would have with learning a task and plan accordingly, mirroring the reasoning process when teaching clients.
Students were generally required to reflect on their teaching performance, which sometimes involved considering peer feedback or specific prompts, such as, “What ways of teaching were you most comfortable with and how will you challenge yourself to develop a broader repertoire of teaching styles?” Students were assessed on the “clarity [and] accurate content” of their “activity analysis” and on their “oral presentation skills,” including using “appropriate gestures,” refraining from “use of crutches (um, ah, like),” and remaining “within time limits.”
These artifacts made it clear that students were to use the skills of activity analysis and teaching, sometimes informed by tools such as adult learning theories; at other times, however, no tools were specified in the artifact. One assignment’s rationale was specified as “Activity teaching is a core skill of an [occupational therapist]” and therefore “being a good teacher is important to being a good therapist.” However, this assignment did not require students to explain teaching as a competency for enabling occupation. Another teaching assignment did ask students to examine the dynamics of occupation. In this assignment, students taught the “origins of the occupation” and its “cultural relevance” to a person in a case study and explained how and why the occupation could serve as a medium for improving occupational performance.
Consider Impairments
Assignments that involved considering impairments typically began with students investigating a diagnosis, including etiology, prevalence, associated impairments, precautions, and common medical treatments. They often stipulated that students analyze impairments using two elements of the OTPF–3, musculoskeletal client factors and performance skills. Students next considered the impact of the impairment on areas of occupation from the OTPF–3, usually in relation to typical performance. These assignments often concluded with presentations to peers.
An “injury paper,” for example, was designed to “increase awareness of types of shoulder injuries” and “articulate occupations affected by the injury using the [OTPF–3].” Students were provided an example of what they should report: “[ADLs]—bathing and showering—unable to lift arm past 90° to shampoo hair.” The assignment concluded with a bridge to practice, asking students to “describe one intervention [for the impairment] that is directly [related to occupational therapy] and one intervention that is used universally that you learned from your research.”
Students mainly used the skills of analyzing impaired movement and matching it to an analysis of activity, informed by the tool of the OTPF–3. One artifact communicated the broader conceptual understandings to be gained through using these skills and tools: an “awareness of various conditions,” “the functional implications of a condition,” “occupations that might be affected”—using the OTPF–3—and recognition of “the needs of individuals based on their situations.” Conceptual understandings of occupation beyond an impairment’s impact on performance were not apparent in the artifacts.
Work With Clients or Case Studies
Assignments that involved working with real or simulated clients or with case studies commonly required students to “follow the [occupational therapy] process from evaluation to intervention implementation, as well as documentation utilizing a SOAP [subjective–objective–assessment–plan] note format.” In a lab practical, students completed the occupational therapy process with a simulated client. The assessment began with an “occupational profile, including performance patterns (habits, roles, routines, other).” Students then assessed “client factors, [ADLs], work and [instrumental activities of daily living]” and identified precautions, strengths, problems, goals, and interests. Students categorized their planned interventions as preparatory, purposeful, or occupation based and then summarized the process in a SOAP note.
Other artifacts prompted a similar sequence through the occupational therapy process: “Summarize from the case the occupational profile,” “identify two areas of occupation of most concern,” “identify [three] strengths [and] resources,” “identify five client factors most disruptive to the client’s life roles,” “write [three] occupation-based goals,” and “develop an intervention and implementation plan.” Some assignments included activity in the intervention portion of the process as students identified “how increased occupational performance can be derived from the use of the activity ([e.g.,] motor, process, communication),” described “ways to grade this activity,” and indicated “how the activity can be changed to increase occupational performance.”
Students used skills of assessment, intervention planning, and documentation to complete these assignments. The primary tool was the process portion of the OTPF–3. The broader conceptual understandings to be gained were not commonly specified. Artifacts led students through the occupational therapy process but did not prompt them to explain how the process facilitates health through occupation.
Assignments That Excluded Occupation
Assignments designed to teach or assess occupation did not always explicitly include occupation in the physical artifact. Students used skills such as leading groups, designing programs, and conducting and documenting standardized assessments. For example, students evaluated an assessment tool on the basis of population, client factors measured, scoring, psychometrics, and research. Another assignment required students to “develop at least 10 activities that can become part of a [half] hour activity program for children with developmental disabilities.” Students compiled activities that provided deep pressure, bilateral integration, spatial awareness, and fine and gross motor skills. Similarly, an intervention planning and clinical reasoning assignment asked only that students discuss the client’s condition and developmental stage. The intervention included prompts such as “Describe one of your treatment sessions” and questions such as “What are the possible outcomes from this intervention?” “What would you do if the intervention wasn’t working?” and “How will the setting impact your intervention?” No prompts in these examples asked students to relate the intervention to occupation or to the competency of enabling occupation.
Other assignments asked students to evaluate practice in various settings or countries. Students were often asked to reflect on the role of occupational therapy but without specific guidance to examine whether or how occupation was addressed in these settings. A few assignments in this category did include, among many criteria, an instruction such as “Identify domains of concern (performance areas of occupation) and examples of purposeful activities,” making occupation seemingly present. The actual grading rubrics, however, assessed more procedural skills such as organization of the required paper and quality of the writing. In other words, the elements that were reinforced through grading did not include occupation, rendering it absent in what ultimately counted about the assignment.
Discussion
This study analyzed education artifacts, specifically assignments, used in occupational therapy education to assess and convey the concept of occupation. The study asked, “What skills and tools did assignment artifacts ask students to use?” and “What broader conceptual understandings, primarily about occupation and enabling occupation, were students to gain through the skill or tool?” Assignments required students to interview, observe, analyze activity, teach, and implement the occupational therapy process. Thus, the data overwhelmingly reflected active and experiential learning approaches, or learning through doing, which scholars have long proclaimed reflects basic principles of occupational therapy (Schaber, 2014). Two key points from the findings are explored: (1) Learning across assignments was similar regardless of the skill or tool performed, and (2) artifacts made learning the skills and tools more apparent than learning the concepts supporting the skills and tools.
Focus of Learning Across Artifacts
The majority of artifacts examined in this study emphasized learning about activity analysis using the OTPF–3 and about the occupational therapy process. Most also included transferring knowledge to practice.
Activity Analysis
Most assignments required students to analyze their observations, experiences, interviews, and instruction topics by breaking them into facets. Assignments varied in the specific facets that students were to analyze; how many facets they were to consider; and whether they were to consider the transactions, or interactions, among facets. Analyses predominantly used one or several of the OTPF–3 domain categories. Thus, the skill of activity analysis was almost exclusively defined by the tool of the OTPF–3.
Most assignments asked students to analyze activities by multiple factors, but not by the transactions among factors. For example, assignments requiring students to consider impairments required analysis of client factors isolated from their transaction with clients’ environments, motivation, habit, meaning, or resilience, all of which may change the impairment’s effects (World Health Organization, 2002). A few artifacts did, however, include transactions among two or three factors, such as “Discuss how changes in the physical and social context affected the occupation” and “Explain how the occupation changed based on the environment.” One asked students to link culture to the meaning of an occupation.
Occupational Therapy Process
Assignments commonly required students to engage in the occupational therapy process—sometimes incorporating occupation in a single phase of the process, sometimes in multiple but stand-alone phases, and occasionally as the phases transacted across the process. In other words, most assignments featured occupation only in the occupational profile and in the subjective component of SOAP notes, without a clear description of how the profile and subjective elements transacted with the whole process. Other assignments included occupation elsewhere in the occupational therapy process but again without requiring students to address transactions among elements of the occupational therapy process. For example, areas of occupation were included in assessment alongside of, rather than in direct transaction with, client factors and performance skills.
Transferring Learning to Practice
Most assignments included some bridge to practice, even if a bit forced. Assignments commonly asked students to imagine an observation or experience from the perspective of a person with a disability and to adapt or grade it to increase or decrease the demands in motor, sensory–perceptual, emotional regulation, cognitive, social, or strength or endurance skills. Still other assignments, attempting to bridge learning to practice, asked students to imagine how performance of the activity would change given an acquired disability and what they would consider as practitioners to help clients be successful in that activity. Students completed the occupational therapy process as they would do in practice.
Transparency of Artifacts: Black Box and Glass Box Learning
Considering the results from a sociocultural perspective, we viewed artifacts as containing a procedural dimension, including skills and tools, and a conceptual dimension that included broader conceptual understandings that guide the use of skills and tools. Lave and Wenger (2002) reported that the conceptual understandings embedded in artifacts may not be apparent to users. Findings from this study were consistent with that report.
The skills and tools that students used in assignments were evident and thus transparent. However, the underlying concepts supporting the skills and tools used in assignments were not transparent, reflecting what Wenger (2014) referred to as black box learning. Artifacts become “black boxes” when users complete procedures without comprehending the concepts at the heart of the procedures. Some artifacts in this study made the procedural dimension of skills and tools visible yet did not ask students to make explicit or substantive links to the concepts of occupation or enabling occupation, concepts that shape how the skills and tools are used and what they affect. One such example was an assignment that asked students to analyze upper extremity movement using the OTPF–3 as the tool of analysis but did not make the conceptual understandings encoded in the skill and tool transparent. In other words, embedded in the OTPF–3, yet omitted from assignments, is the concept that upper extremity impairments affect occupation on the basis of the transactions among the impairment, contexts, performance skills and patterns, and other client factors, not of the impairment alone. Thus, the conceptual dimension of some assignments was not transparent or differentiated from the procedural dimension. This black box phenomenon was further evidenced when rubrics held students accountable to the procedures of skills and tools but not to the conceptual understandings embedded within them.
When artifacts are black boxes, learners focus largely on skills or tools because the conceptual understandings embedded within the skills and tools are invisible. This approach is problematic in occupational therapy because understandings of occupation are often housed in the conceptual dimension of the field’s artifacts. When the conceptual dimension is not transparent, occupation may be “seen but not noticed” (Hasselkus, 2006) while students complete assignments. Thus, Lave and Wenger (2002) underscored that “understanding the technology of practice is more than learning to use tools” (p. 117).
Take, for example, the prominent use of the OTPF–3 domain as a common tool in artifacts analyzed for this study. The domain is what Lave and Wenger (1991/2003, p. 117) referred to as “a mediating technology” for a larger concept. The OTPF–3 is a tool that embeds the concept that occupation arises or fails to arise depending on the transactions of multiple domain categories. This broader conceptual understanding, however, can be invisible when the tool is used to categorize observations or interviews into different domain categories. If assignments require categorization and omit transactions, students use the tool separately from the conceptual understanding it embeds. This approach exemplifies black box learning, in which the internal conceptual understanding that justifies why the tool is important is not understood by those who use it.
Reed (1986) elucidated this phenomenon when, in her Eleanor Clark Slagle Lecture, she claimed that occupational therapy tools and methods are imbued with and communicate conceptual, historical, and sociocultural meanings. She reasoned that the profession’s tools and methods make sense when used consistently with the deeper conceptual understandings that they carry; however, divorced from these deeper understandings, practitioners and students may use a method in ways that make little sense or that mimic other professions’ use of the same method.
It is also possible, however, that even the skills and tools in the assignments remained partially invisible to students because they were seemingly common sense—talking to people, watching people, and analyzing how people do things. The assignments in this study engaged students in these procedures of the field yet rarely identified them as procedures of the field. It therefore becomes possible that students interview, teach, observe, and analyze without fully grasping that they are using occupational therapy’s hands-on skills for enabling occupation. Hence, students continuously ask for more hands-on content, believing that they have not seen that content when simply conducting interviews and observing performance.
Given that the skills and tools, and the conceptual understandings with which they are imbued, can all remain opaque, careful design and implementation of assignments is paramount. Assignments must require students to use skills and tools; realize they are using the skills and tools of their profession; and explicitly acquire the conceptual understandings that accompany the skills and tools, particularly understandings of how they relate to enabling occupation. Ideally, skills, tools, and conceptual understandings interact in clearly differentiated ways in every assignment.
When underlying concepts are made apparent, students are engaged in glass box learning, as opposed to black box learning (Wenger, 2014). Creating glass box learning can be simple. Delineating the skill, tool, and conceptual understandings to be gained and writing the assignment with objectives regarding all three could make the procedural and the conceptual dimensions available to students. For example, assignments can have students explain how a skill or tool relates to enabling occupation or require students to position a skill or tool within historical or contemporary conceptualizations of the field. Using skills and tools thus becomes a means to connect with the field’s conceptual understandings inside the black box—when artifact design makes such understandings explicit.
Study Limitations
The artifacts in this study were examined outside the context in which they were developed and used, which likely involved substantive dialogue. Thus, what we found to be implicit in the artifacts themselves could have been explicit in the interactions surrounding them in classrooms. In addition, this study could not include learners’ experiences of what is and is not communicated through the artifacts. There was also no opportunity to discuss the artifacts with their designers.
Implications for Occupational Therapy Research and Education
The aim of this study was to describe occupational therapy education artifacts, a research approach appropriate for early-stage work in a line of inquiry. Future research, however, should go deeper into how artifacts shape students’ skills and conceptual understandings. This step is particularly important if artifacts omit explicit connections to occupation and enabling occupation. In other words, do education artifacts shape learners who take occupation for granted in practice? Could carefully designed education artifacts shape deeper awareness and use of occupation? Future research should therefore follow the recommendation of Quennerstedt and colleagues (2011), who argued for “research into how artifacts play a part in the constitution of actions, activities, and individuals in educational settings” (p. 301).
Implications of this research for educators include the following:
Design assignments with clear, specific, measurable learning outcomes related to the skills, tools, and broader conceptual understandings to be gained.
Consistently require students to relate the skills, tools, and conceptual understandings to the concept of occupation and to the ultimate competency of enabling occupation.
Conclusion
Education artifacts constitute a substantial bulk of the learning environment. Educators create artifacts, such as assignments, to expose students to the tools, skills, and concepts of practice. Artifacts, therefore, offer an important window on occupational therapy education. This study examined artifacts that participants used to address the concept of occupation. The artifacts conveyed the skills and tools that students were to use with more clarity than they conveyed how the skills and tools related to the concept of occupation. Without the same level of clarity given to the core concept underlying the skills and tools, students engage in black box learning; that is, they get clear exposure to the field’s skills and tools without equal exposure to the concepts at the heart of how and why those skills and tools are part of the practitioner’s repertoire.
To make underlying concepts more transparent, educators can design assignments with learning objectives related to the skill and tool to be used and to what students must do to relate the skill and tool to core concepts such as occupation and enabling occupation. Learning that requires students to link the skills and tools they use to the profession’s central ideas equips students with the logic of the field, enabling them to use that logic to solve problems in practice. Assignments intentionally designed to link skills, tools, and occupation can be one approach to advance occupation-based practice.
Footnotes
Acknowledgments
The data analyzed for this study were collected through a larger study supported by the Society for the Study of Occupation and the American Occupational Therapy Foundation.