Terri Beard

Introduction

           In this rapidly changing world of advances in technology and sharing of information, Hinojosa (2007) describes hyperchange as “rapid, dramatic, complex, and unpredictable change”.  As a health care professional and self-directed lifelong learner, I have experienced and witnessed advances in technology, health care interventions, theoretical models, communication, and research-based evidence. It is through these experiences I recognize the importance in keeping up with these rapid changes. 

            Crist, Wilcox & McCarron (1998) suggest that maintaining professional competence is the responsibility of all practitioners. Moreover, the future of our profession depends upon self-directed professional development opportunities. Using learning opportunities helps practitioners respond and apply knowledge to rapid changes occurring within the health care work place. Occupational therapy (OT) educational learning experiences, especially the cumulative capstone project in this OTD program permitted me to enhance my leadership skills using evidenced-based information; applying those skills by providing online web-based modules sharing general early intervention topics through occupation-based approaches to meet the diverse needs of the early intervention (EI) population I serve. 

            My commitment to pursue a doctorate in OT through Eastern Kentucky University (EKU) OTD program parallels American Occupational Therapy Association’s (AOTA) Centennial Vision (2007); creating leaders in OT, through intense rich evidenced-based research. Consequently, demonstrating OT’s ability to advocate change in health care. As a long-time practitioner and professional member of AOTA, I believe in preserving and enhancing the future of occupational therapy. This was done through developing leadership skills necessary to demonstrate efficacy, resilience, and inculcating awareness of occupational therapy’s core values. OT’s professional vision includes increasing professional membership in state and national organizations, researching theories to amass evidence, and share knowledge using occupation-based practices (AOTA, 2007). 

            Mezirow describes reflection as “gaining a better understanding of our experiences through critical review of content and process by using higher-level critical thought processes” (Plack & Greenberg, 2005).  To better assess my own self-directed learning, I am taking this opportunity to review my experiences. This self-narrative is representative of those experiences.     

Outcome 1 (Occupation-Based Practice)

            Occupation-based practice (OBP), a core belief in occupational therapy, exemplifies our profession’s unique assumptions. OBP proposes meaningful and purposeful occupations benefit people and can be used to improve functional performance in daily life. OPB occurs when the practitioner shapes therapeutic intervention using patient-focused, client-driven outcomes, supporting client’s unique individual occupational performances (Baum & Law, 1997). As a practicing therapist and OTD student, I have demonstrated competency in these areas through a variety of learning experiences. Working in early intervention (EI) has compelled me to learn more about sensory integration, feeding, positioning, neurodevelopmental techniques (NDT), fine and gross motor skills development and most recently through the capstone project: using technology to enhance family awareness, knowledge, and carryover. In accordance with the Division of Early Childhood (DEC) and the American Academy of Pediatrics (AAP) recommended “best practices” in early intervention should be provided using a “parent coaching” model (DEC, 2014; Adams & Tapia, 2013).

            Using this knowledge and applying a “parent coaching” model of treatment intervention allows therapists to collaborate with families; supporting their child’s unique needs. It is through continuing education and experiences with other professional staff I utilized my training to enhance the lives of children and families. This is evident in my capstone project, entitled “Investigating the effectiveness of web-based modules reinforcing therapy topics for caregivers involved in early intervention”. In developing the web-based modules for my research study, I used the Occupational Therapy Practice Framework (OTPF) (AOTA, 2014) and OBP as the focus for identifying topic areas to enhance caregiver carryover. The topics I chose were to help caregivers establish bedtime and mealtime routines.    

            In summer 2016, I participated in OTS 905, which was an applied learning experience (ALE). This course allowed me to work with a mentor (Dr. Dana Howell) developing an online presentation clarifying the parent coaching model in EI. This course supported the efficacy of OT as an evidenced-based change agent in our profession. The intent of the ALE is for the OTD student to create change and expand their sense of ethical leadership by applying knowledge to practice. 

            For my ALE project, I chose to examine communication and use of online resources for families and practitioners involved in the Maryland EI Birth Through Five programs. My self-created assignments included the following:

• Develop a questionnaire to survey other Maryland BTF programs regarding communication and use of Maryland Learning Links (MLL) website.

• Create a resource list of individuals or websites contacted to explore various online learning applications.

• Develop a resource list of application/software identified, identify programming capabilities, as well as, pros and cons for disseminating information to parents/caregivers via this web tool.

• Create an online learning tutorial to share “Best Practices” information on using a “parent coaching” model in Maryland EI programs.In this tutorial, an online quiz was also created to evaluate the effectiveness of the programming.

            Engaging in OBP in EI comes naturally for most OT’s, as children are treated within their natural environments. By the time I finished my ALE and Capstone project (Summer 2017), I had created three online instructional presentations demonstrating “best practice” in parent coaching and establishing bedtime and mealtime routines [for young children]. These supplemental presentations were used within my research study to reinforce carryover supporting families and caregivers involved in EI. Using technology to “bridge the gap” in providing strategies and recommendations of everyday daily routines using evidenced-based resources supported by the AAP and the DEC. My intention and hope was to positively impact successful intervention for Birth Through Five EI programs and potentially use this type of online programming to allow families/caregivers access to information pertaining to early intervention topics.     

            In OTS 910 (Policy Analysis for OT), I created a policy program development model. This assignment allowed me the opportunity to create a feeding program examining young children’s feeding routines, identifying difficulties for some children to transition from baby foods to solid table foods, and developing a program to help address these needs. Through the examination of government policy focusing on Healthy People 2020 objectives, I recognized societal needs, and created a program model based on those identified needs. This learning opportunity provided the experience to gain awareness of the processes involved in exploring funding sources, developing community partnerships, and recognizing areas of need within the entire U.S. population. 

 

Outcome 2 (Diversity)

            Identifying and discovering health disparities and understanding how to ethically meet the needs of a diverse population is an area I recently concentrated on. Kielhofner, de las Heras and Suarez-Balcazar (2011) discuss the importance of using the Model of Human Occupation (MOHO), occupational therapists can combat social injustices by understanding their position in the social system. Occupational therapists examine professional values and beliefs, being mindful and cognitively aware of each client’s unique situation and background; helping clients by encouraging them and providing tools to live meaningful, fulfilling, and engaging lives guiding them out of oppression (Kielhofner, de las Heras & Suarez-Balcazar (2011). Although I recognize the importance of this responsibility, it is only recently that I have been fully emerged in focusing my attention to these matters at local, national, and global levels. 

            In 2013, I wrote a small grant to purchase sensory equipment and materials supporting the children in the Carroll County Maryland Birth through Five (BTF) Program and preschool autism program. I was awarded the grant which was used to support the diverse needs of the growing autism population. This opportunity provided me an increased understanding of the grant writing process and increased my awareness about what information stakeholders are interested in reviewing. The opportunity also granted me the opportunity to explore potential funding sources located within government and public agencies.

            In September 2014, I attended AOTA Hill Day in Washington D.C. This experience afforded me the opportunity to recognize the power of commitment from large professional groups, such as, AOTA and MOTA, Maryland Occupational Therapy Association. By representing our profession in face-to-face meetings and written correspondence, I assisted in presenting occupational therapy professional contributions to society and shared OT’s concerns with policy makers. This opportunity reiterated the significance of our profession to policy makers and more importantly reaffirmed my strong commitment to our profession.  

            The OTD program provided me the opportunity to expand my understanding of how OT’s ethically disseminate information in a reasonable and responsible manner. Developing an online learning course allowed me an opportunity to meet the needs of diverse client populations. Completing the institutional review board (IRB) process for my Capstone project facilitated enhanced understanding of the complexity and importance of developing ethically sensitive research on humans, weighing risks and benefits, conflicts of interest, and ensure the rights and welfare of participants were protected. Further this experience provided me an outlet examining how and where information can be developed and shared using an online format which might benefit society locally, regionally, and nationally.

Outcome 3 (Leadership)

            Instructional technology became a focus of interest due to the rapid changes occurring within the school system, social networks, communication systems and health care systems. It is through my graduate level courses at Towson University and obtaining my master’s degree in instructional technology, I began employing a variety of enhanced instructional techniques. My work here at Eastern Kentucky University (EKU) has further allowed me to develop leadership skills using technology to support my colleagues and clients. 

            Recognizing these advanced changes, I acknowledged an intrinsic desire to provide innovative and up-to-date materials in practical cost-effective manner. I felt if I learned how to use technology in meaningful ways, I would be able to intrigue children and caregivers, sharing information with many regardless of location, time, or space restrictions. 

            Using online Web 2.0 tools and websites, such as, Audacity, CourseSites, Google Forms, Prezi, Playbuzz, QZZR, Screencast, Survey Monkey, Weebly Wordle, and Wix; I developed online learning resources. My EKU Capstone project enhanced my understanding and application of creating an online course. I used CourseSites powered by Blackboard to create, Recommended Practices in Early Intervention, an online course used as the intervention in my research; this included developing course content and testing measures. Within the course, I created modules using Prezi presentations, Screencasts, YouTube videos, surveys, and pre-test/post-test evaluations which were analyzed through Microsoft Excel data analysis packages. Previously, in my professional role, I worked in partnership with two other therapists creating a Carroll County Public School Birth through Five (BTF) website and the Carroll County Infant and Toddler Blog for parent and providers to access. 

            Accessing technology has afforded me the opportunities to share knowledge with parents, caregivers, and colleagues through online video tutorials, blogs, wikis, web-based survey tools, websites, smartphones, and podcasts. By committing to change, and gaining an understanding of technology advances, I created several tools that enabled my colleagues to access information by sharing resources through DropBox, accessing and inputting information in Maryland’s online Individual Family Service Plan (IFSP) program, and obtaining information using online survey tools. 

            Over the years, I have committed to improving my leadership abilities by explaining and exhibiting best-practice in occupational therapy through roles as supervisor, mentor, and committee member. Evidence of these experiences includes my commitment to the supervision of COTA’s and occupational therapy students. I have served as a member of the Maryland Department of Education (MSDE) OT/PT Steering Committee. November 2016, I presented a poster at the Maryland Occupational Therapy Association’s (MOTA) annual convention. 

            Helping others to understand complexity of the Individual Family Service Plan (IFSP) and Individual Education Plan (IEP) process is something that I feel passionate about. In a self-directed leadership capacity, I created documents to share with families involved in EI programs, providers, and occupational therapy students. Examples of such documents include:  Understanding least restrictive environment (LRE), Transition of preschoolers from Part C to Part B under the IDEA (Individual with Disabilities Education Act) and Understanding meetings that occur regarding developing and sharing information under the IFSP and IEP documents and processes. 

            Outcome 4 (Reasoning)

Application of advance clinical and ethical reasoning has been instrumental in enabling me to utilize knowledge promoting effective treatment intervention plans with my clients. Evidence of skill acquisition is evident in my understanding of learning theories applicable to both children and adults. Understanding adult learning theories was critical in the development of my Capstone project, as adult caregivers were the intended audience of my project.  

Attendance at AOTA conferences and ongoing professional development courses provided me opportunities to enrich my professional repertoire of clinical and ethical skills. Likewise, journaling, reading professional journals, and research articles through AJOT, Division for Early Childhood (DEC), Council for Exceptional Children (CEC), and other professional evidenced-based materials helped enhance my knowledge of resources, practice methods, and research available. 

Committing to graduate level educational courses has improved my professional writing abilities. Further, I have been inspired through my graduate coursework and desire to gain knowledge regarding current educational and clinical practices through rich evidenced-based research. This pursuit has enhanced my ability to implement professional judgment in coordinating and collaborating programming efforts and in applying treatment intervention. 

Evidence of these applied skills is noted in my application of technology, sensory intervention, neurodevelopmental techniques, positioning, activities of daily living, and so forth.  In early childhood special education preschool settings, I provided students and instructional staff with the instruction and training necessary to carryover recommended strategies and suggestions. More specifically, this carryover of strategies and recommendations has been utilized to help staff utilize tablet technology, positioning techniques, sensory diets, fine motor activities, and activities of daily living therapeutic intervention. Likewise, in natural environments such as, home, preschool, library, grocery story, and parks I have worked with families and caregivers to enable children purposeful and meaningful experiences. Within the school-settings I have worked with special education instructional staff in the utilizing effective strategies to implement feeding programs, sensory diets, and development of handwriting and fine motor programs for children requiring special instruction. 

Conclusion

            In conclusion, it is my intent to continue to enhance and develop effective leadership skills, and expand my knowledge using evidence-based practices.  The activities shared in this self-assessment demonstrate active engagement in mentoring opportunities and in supporting other occupational therapy practitioners and the families I service. 

Working closely with a mentor has allowed me to expand my learning; sharing information about developing instruction and applying “best practice” in my instructional capacity. The mentorship provided throughout this OTD program has been instrumental in directing and facilitating my OTD journey. This is a critical area of professional development and I recognize is lacking within many professional settings. Working with a group of highly educated OT’s reinforced the importance of OT’s professional roles and responsibilities to our clients. Mentorship during the ALE and Capstone project, provided me opportunity to recognize my own strengths and weaknesses. Specifically, I noticed I tend to look at the “big” picture and have grand ideas requiring many steps to facilitate and achieve. My faculty mentor, Dr. Leslie Hardman helped expand my understanding of implementing instructional techniques, but moreover helped me narrow my focus and critically re-define areas of concentration as I completed the OTD Capstone project.

Understanding my own strengths and weaknesses as a therapist helped expand my leadership skills. Using OBP to provide OT services using innovative methods will continue to challenge and inspire me. Through this knowledge, I understand the importance of further refining my leadership skills. I am certain that ever changing global advancements in health care, technology, communication, and treatment interventions will continue to challenge my thinking in new and diverse ways.

By responding to change, I am positive I can be an effective OT leader. Hinojosa (2007) quoted Darwin, as he wisely said, “It’s not the strongest of the species that survives, nor the most intelligent, but the one most responsive the change.”  I have focused my attention on change by seeking out opportunities to cultivate my professional attitudes and attributes. I’m fully aware that progressing my skills and knowledge is dependent on recognizing my own strengths and weaknesses as an OT practitioner.  Through self-awareness, I will be able to continue improving my leadership skills demonstrating effectiveness using technology; cultivating my professional writing skills; and providing exceptional OT services to my clients.   

 

References:

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