MEDEV

School of Medical Sciences Education Development

Introduction

In 1999 a leading exponent of occupational therapy (OT), Ann Allart Wilcock, wrote:

"Despite much current rhetoric, I believe that many occupational therapists are still not acting on the concept of enabling occupation (doing, being and becoming) favouring instead, techniques, splints and aids to daily living. While these can be valuable adjuncts to what we offer, by focusing on these we have failed to include in...our  professional repertoire much that is powerful in terms of people's real lives, their health, their well-being and in terms of them becoming." 1 

Inspired by Wilcock's vision the OT faculty at the University of East Anglia introduced a creative project to ensure that third year BSc OT students re-evaluate the proposition that occupation is "an agent of health and well being"1 The initiative was founded on the recognition that innovative practitioners were required to address the complex needs and challenges within contemporary healthcare. This project facilitated students to:

• Explore the importance of an individual's engagement in occupations that are meaningful to them. 
• Analyse the links between the theory of occupational science and the practice of occupational therapy.
• Reflect on how occupational therapy practice can achieve sustainable health and wellbeing outcomes through occupation.

Organisation

The project spanned a six week period in a final year module. Students were randomly allocated to groups of four, with the rationale that they must be able to work effectively in teams irrespective of personal preferences. A tutor was linked to each group as mentor, to help the students consider their project in depth, and to facilitate the resolution of difficulties.

The groups were assigned one theory of occupation and then required to choose a second theory, adding a dynamic quality to the project. Finally,each group selected a creative media with which to explore the relationship between the two theories (Table 1).

Each group was required to produce a storyboard, abstract and a creative product. Time was allocated for self directed work with an hour long mentor meeting timetabled on alternate weeks. The project culminated in a presentation day.

Groups were responsible for ensuring that their creative work followed an ethical approach, adhering to rules of confidentiality and informed consent. Groups negotiate ground rules in their first mentor meeting and were expected to collaborate professionally to successfully complete the project. 

Presentation day

The audience for the day included the year 3 cohort and course tutors. Groups are required to present their creative product and:

• An abstract including the references used to inform the creative project. 
• An oral presentation identifying the theoretical and therapeutic value of the project, and the application of their work to OT practice.

The presentations, held on the last day of the autumn term, exceeded all expectations with regard toquality of outputs, learning, and most of all an emotional commitment that conveyed enthusiasm and energy. A wide variety of outputs were presented from film and animation to quilting and poetry, for example, Figure 1.

Students evaluated the project through open questions on theoretical reflection and creative engagement, group work, theory practice links and personal development. The feedback indicated that many students benefitted from the responsibility and challenge offered to them:

"It has shown different ways in which to investigate further and consolidate learning, from traditional ways." 

"Being left to organise ourselves in our groups – sink or swim – we chose to swim – we owned all of it."

This was more difficult for some and one student stated:

"Our group struggled with expectations of the project; in fact, the only time it clicked was today – when seeing the other projects."

Thirty-seven students (93%) identified that the project had stimulated their thinking about the theoretical and practical applications of OT:

"It has opened my eyes more to what can be done in practice, and how we can challenge practice."

Table 1. Exploring relationships between theories.

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In addition a number of students wrote about their professional identity:

"I sometimes think that other professions do not take thecreative aspect of OT seriously. This project has enabled me to feel very proud."

Challenges varied from resource constraints such as IT equipment, to conceptualising the expectations and identifying creative possibilities:

"The first week! I didn't really understand – my brain hurt. However, seeing the mentor helped."

Five students (13%) identified that they would have liked the creative project to be credit bearing but most students felt that this may have inhibited their willingness to take risks and push boundaries. The learning from this project contributed to a poster assignment as part of the overall module assessment.

Students were also requested to write down four words that encapsulated their experiences that we themed into five categories (Table 2).

These words demonstrated a wide range of responses to the project. For example, the words used in the motivating and reacting categories gave clear indications that the creative project was both engaging and deeply challenging. This was evident and observable in the commitment shown by the students when they were engaged in the development of the creative work.

We strongly believe in the validity of this approach to engaging with the fundamental, but sometimes hard to grasp, concepts underpinning OT. The creative project has facilitated level three outcomes including theoretical reflection, creative engagement, group work, theory/practice links, and professional/personal development.

In light of the current interest in developing innovative approaches to professional healthcare practice, it is incumbent upon health education providers to instil a culture of creative engagement in the learning process. This can inspire the next generation of professionals to be bold and embrace innovation as normative behaviour and, as our title suggests, can create a profession fit for the future. 

Table 2. Categorising student experiences.

Table 2