Abstract
As a co-author of The Issue Is column, “Promoting Health Equity Through Holistic Admissions in Occupational Therapy Education,” appearing in the September/October issue of the American Journal of Occupational Therapy (Anvarizadeh et al., 2023), I write to convey my present-day perspective on the column, given developments that have occurred since it was first written in March 2022.
On one hand, I am honored to have spearheaded and established this critical work at USC Chan’s Division of Occupational Science and Occupational Therapy. Under my leadership as Admissions Director between March 2019 and June 2022, USC Chan implemented my vision of a new brand of holistic admissions in our occupational therapist and occupational therapy assistant educational system, which was well received nationally and internationally. USC Chan was a living laboratory, proving that holistic admissions was transformative in achieving historic changes to student demographics in order to better reflect the diversity of those whom our profession seeks to serve and to secure improved health outcomes.
On the other hand, my position as Admissions Director at USC Chan to continue to build upon its holistic admissions practices was ended abruptly and prematurely in June 2022. Since then, the benefits of holistic admissions that showed such great promise at its formative stage crumbled under the weight of not having the enduring commitment and support of USC Chan’s higher-level decision-makers. Consequently, although the influence and impact of holistic admissions generally have been positive, and the reputation of USC Chan’s Division of Occupational Science and Occupational Therapy has excelled due to the admissions changes, the work is incomplete and its full benefits are unrealized.
Holistic admissions embodies the core values of justice, equity, diversity and inclusion and is, and should be, an integral element of every educational institution and occupational therapist and occupational therapy assistant curriculum. But holistic admissions policies are just one piece necessary for equitable access for all. Intentional recruitment, retention, inclusive curriculum, and funding are other equally integral pieces of creating and maintaining holistic education experiences. Those entrusted to implement holistic admissions policies must be able to envision and accomplish this vital work while navigating institutional barriers and natural resistance to established procedures and protocols. Success in this endeavor requires a unique skill set that eludes definition, but outcomes tell whether that skill set is present. The importance of having the best persons to lead and champion holistic admissions, and having the best persons to provide unwavering support for it, cannot be overstated. When outcomes fall short, it is imperative to question why and seek honest answers to understand the cause of the failures, in order to reverse them and to once again make holistic admissions a reality, rather than a principle or program to which lip service is given.
A call to action is for all students, academicians, researchers, and practitioners to recognize and demand accountability when harm has occurred to individuals of our professional community who work tirelessly and with integrity to actualize the American Occupational Therapy Association’s Vision 2025, especially in work for which change is sorely needed but for which there is no template to achieve it. When barriers are erected to obstruct progress in holistic education, we must ask ourselves if institutions and their decision-makers are genuinely committed to ensuring that all people, populations, and communities are included and embraced. Real change, along with true restorative healing, cannot take place without those institutions and decision-makers first acknowledging that their actions or inactions have caused harm and being held to account for that harm.
When we, as a profession, embark on work such as holistic admissions and focus on “gate-opening” goals, we are reminded that the core of this work is rooted in anti-racism and anti-oppression. We must stand together against institutions and decision-makers who resist the lasting change that is necessary to decrease barriers and increase access for all students. Those students are the future of our profession, and their prospects are shaped and transformed by our collective actions today.