Curriculum and degree requirements can be found in the most current Undergraduate Bulletin.
Philosophy and Curriculum Design
The philosophy and curriculum design is based on a narrative meta-model. A narrative meta-model is predicated on the assumptions that learning is:
- Competency fluid
- Process and performance over finished work (AOTA, 2009)
The core documents that create the foundation of our narrative meta-model are the Theory of Occupational Adaptation (Schkade and Schultz, 1992), Bloom’s Revised Taxonomy (Krathwohl, 2002) and the Spatiotemporal Adaptation model (Gilfoyle, Grady, and Moore, 1990).
Context of the Institution
Arkansas State University (AState) is nestled in the northeast corner in close proximity to the “boot heel” of southeast Missouri and northwest corner of Tennessee. Jonesboro, Arkansas is located in the lower Mississippi delta region of the United States forged from an agrarian past with key present industries of manufacturing, healthcare, logistics, professional services, and agri-business (http://www.jonesborounlimited.com/key-industries). Arkansas State University plays a vital role in producing a workforce for the lower delta region and beyond. The mission of AState is to “educate leaders, enhance intellectual growth and enrich lives” (https://www.astate.edu/info/about-asu/).
The history of AState began as agricultural and mechanical but in 1969 the nursing program was instituted and in 1982 the College of Nursing and Health Professions (CoNHP) came into existence. The college now boasts 30 undergraduate and graduate degrees through a wide variety of programs, departments, and the school of Nursing (http://www.astate.edu/info/about-asu/history/historic-timeline/).
Occupational therapy is the second newest department in the college of Nursing and Health Professions. The department houses both OTA and OTD programs. The genesis of the OTA and OTD programs began in 2015. The first OTA class graduated in August 2016 followed by the first OTD graduating class in August of 2018. The mission of the Occupational Therapy Department states, “The Department of Occupational Therapy in the College of Nursing and Health Professions at Arkansas State University is committed to the development of exceptionally safe, ethical and culturally aware practitioners, life-long learners, advocates, leaders, and scholars who will focus on the unique needs of local communities, the state of Arkansas, the lower Mississippi Delta region and beyond.” (http://www.astate.edu/info/academics/degrees/degree-details.dot?mid=8c5288d4-c26f-44e0-a3cf-ac3db90f25e4).
Profession’s Philosophy, Vision, and Trends
The practice of Occupational Therapy is guided by the fundamental principles articulated in the Philosophical Base of Occupational Therapy (2017). Five specific principles frame the philosophy of AState occupational therapy:
- Persons are born with an internal drive to participate in meaningful occupations.
- Participation is an essential element of health. Health and wellness are the building blocks of adaptation.
- The outcome of occupational engagement is a fluid experience due to the micro and macroscopic changes of internal individual drive, contextual conditions, and qualities of the occupation.
- Occupation is the cornerstone for “health promotion and wellness, remediation and restoration, health maintenance, disease and injury prevention, and compensation and adaptation”.
- It is essential to understand the impact of occupation at the individual, community, and population levels (Commission on Education, 2017, p. 1).
The American Occupational Therapy Association’s Philosophy of Occupational Therapy Education (2018) influenced the development process of the program’s philosophy, mission, and vision through:
- The fundamental belief that both curriculum and pedagogy is necessary to fully articulate a program’s view of students engaged in a process to learn
about humans as occupational beings where participation is a right and affects
a person’s health.
- The fundamental belief that “education promotes clinical reasoning and the integration of professional values, theories, evidence, ethics, and skills.
- The fundamental belief that education is the way students acquire their professional identity.
Therefore, a program’s philosophy and mission should mirror the values of occupational therapy education by:
- Including a “client-centered, occupation based, and theory driven” clinical reasoning process.
- Using “best evidence and outcomes data” to drive teaching and learning decisions.
- Designing a curriculum that includes “active and diverse learning” in and out of the classroom.
- Developing learning that is collaborative and builds on previous knowledge
- Creating opportunities for students to self-reflect, evaluate, and use professional judgment
- Promoting life-long learning (AOTA, 1)
The Occupational Therapy Assistant program at Arkansas State University affirms the aforementioned professional and educational beliefs and values as articulated by the American Occupational Therapy Association.
A-State Occupational Therapy Assistant Program Philosophy
In concert with the beliefs and values expressed by the American Occupational Therapy Association, the Arkansas State University Department of Occupational Therapy’s philosophy is grounded in the Theory of Occupational Adaptation. Occupational therapy engages clients through the use of occupations to develop or return to meaningful activities that they want or need to do. (AOT, 2018, https://www.aota.org/about-occupational-therapy.aspx.) It is our belief at Arkansas State that in order to engage in meaningful occupations, human beings must have the ability to adapt to circumstances that present challenges or barriers to participation. The Theory of Occupational Adaptation informs us about the way occupational beings adapt. The authors of Occupational Adaptation based the theory on two assumptions:
- Occupation provides the means by which human beings adapt to changing needs and conditions, and the desire to participate in occupation is the intrinsic motivational force leading to adaptation.
- Occupational adaptation is a normative process that is most pronounced in periods of transition, both large and small. The greater the adaptive transitional needs, the greater the importance of the occupational adaptation process, and the greater the likelihood that the process will be disrupted (Schkade and Schultz, 1992).
how occupational beings adapt.
- Combination of a person’s internal desire for mastery and external demand for mastery creates a press for mastery.
- Press for mastery creates an occupational challenge that the occupational being combines with their occupational role expectation.
- An occupational being considers their internal adaptive repertoire in order to create an adaptive response. The adaptive response then becomes an occupational response.
- If an occupational being’ internal adaptive repertoire is sufficient for a task, the occupational response occurs without stress.
- If the occupational response is evaluated as masterful, then it will be integrated into the internal adaptive repertoire for use again.
- Occupational beings can use existing, modified, or new adaptive responses to address an occupational challenge.
- An occupational being becomes dysadaptive when their internal adaptive repertoire is insufficient to overcome the occupational challenge.
In order to graduate leaders that enrich the lives of others in the Mississippi delta region through their knowledge and skills to advocate for and implement occupational therapy services, graduates must learn about the occupational adaptation process, help each other develop internal adaptive repertoires, and lead each other through the occupational adaptation process that is the OTD program.
occupational adaptation model.
Philosophical Frame for Learning
As described in the Occupational Therapy Model Curriculum (AOTA, 2009), “a philosophical frame for learning is a set of beliefs about the processes by which people learn and change” (p. 58). The core documents used to frame our learning philosophy are the Theory of Occupational Adaptation (Schkade and Schultz, 1992), Bloom’s Revised Taxonomy (Krathwohl, 2010), and the Spatiotemporal Adaptation Theory by Gilfoyle, Grady, and Moore (1990).
bloom’s revised taxonomy.
the upward spiral.
Bloom’s revised taxonomy is pictured as an upward spiral to demonstrate our belief that learning is also a developmental process that builds on prior knowledge and experience. Skill-based behaviors and foundational knowledge translates, over time, to internalized professional behaviors and clinical application that can be continuously analyzed, synthesized, and evaluated to perpetuate professional development. The spiral also represents learning as an active process where the learner has the potential to engage in all levels of the spiral simultaneously depending on experience with a topic.
Embedded inside the spiral are the last two models. First is the Spatiotemporal Adaptation Theory by Gilfoyle, Grady, and Moore (1990). The following seven principles come from Spatiotemporal Adaptation Theory (Appendix 10 – A, p. 275).
- Development is a function of maturation that occurs through the process of person-environment adaptation. Therefore, students cannot be expected to bypass any of the stages of the spiral. A student can only mature by experiencing the curriculum in sequence, moving from knowing to evaluating, and expanding their repertoire to included transitional and mature behaviors.
- Adaptation is contingent on attention to and active participation with purposeful events within the spatiotemporal dimensions of the environment. Principle two reinforces our belief in providing an education experience that includes active “real-world” experiences.
- Purposeful events provide meaningful experiences for the enhancement of maturation by directing a higher level of adaptive response by the “doer”. All classes, labs, fieldtrips, fieldworks, and scholarly activities are designed to provide meaningful experiences that help the “doer” retain the information for application, synthesis, analysis, and evaluation.
- Higher responses result from integration with and modification of acquired lower level responses. One cannot analyze, synthesize, or evaluate without knowing,comprehending, and applying. Principle four supports a program where attendance is mandatory for maximum student success.
- Adaptation spirals through primitive, transitional, and mature phases of development occurring at the same time with different learning. Principle five suggests that at any given time a person can be at simultaneously at multiple points on the spiral as new information and more familiar information is presented. Principle five also supports the program’s activity of presenting concepts multiple times in multiple ways for maximum internalized maturity.
- Environmental experiences may present situations of spatiotemporal stress. With stress, the system calls forth past acquired strategies and sequences to act upon the demands of the environment and maintain the system’s homeostasis. Thus acquired strategies and sequences are adapted with the present situation to direct higher-level responses. Gradual spatiotemporal stress is necessary in education in order for students to move from primitive behaviors to mature behaviors. In occupational therapy this is known as the “just right challenge”. Creating more difficulty in tests, assignments, labs, etc. must be done incrementally so that a student does not become overwhelmed and can gradually adapts existing learning strategies or create new strategies to be successful. Thus, the curriculum is designed with more structured courses in beginning moving forward each semester with courses that require higher
and higher levels of integration.
- Spatiotemporal distress provokes behaviors that result in dysadaptation. Spatiotemporal stress can become distress when persons are unwilling or unable to move away from primitive strategies. Distress then becomes dysadaptation when persons try to apply primitive strategies to every situation. Such dysadaptation is a result of delayed or absent development which is why the curriculum is designed developmentally in order to try to avoid dysadaptive behaviors. We provide courses in a specific sequence to maximize movement through primitive and transitional developmental processes before fieldwork.
The second model embedded, but unseen, in the upward spiral is Occupational Adaptation. Occupational adaptation is unseen because it is an internal process. The only indication that an adaptive response has occurred is through a change in behavior that leads to a transitional or mature response. A key concept in Occupational Adaptation, germane to the curriculum design, is relative mastery. Relative mastery is the moment in time when a person knows they have used the right combination of knowledge and skills to be efficient, effective, and satisfying to self and others (Schkade & Schulz, p. 835). Relative mastery, however, is fleeting as new challenges are constantly arising. Therefore, the ultimate outcome of this program’s curriculum design is to create in each student a repertoire of knowledge, skills, and behaviors that allows them to respond masterfully to the demands of an entry-level practitioner.
Department of Occupational Therapy Curriculum Design: Locally grown. World impact.
Agriculture is the heartbeat of the lower Mississippi delta including the home of Arkansas State University, Jonesboro, AR. Agriculture influences every facet of Jonesboro life from economy and culture to education, healthcare, and business. Hardworking, sun up to sun down people forge this land and take great pride in what they grow for the United States and beyond. Jonesboro, AR produces large amounts of two staple crops that are essential to our country; cotton and rice. Therefore, we have chosen to change our curriculum design from a river to the cotton plant. We think the cotton plant better reflects the culture of our program, university, and geographical region.
The cotton plant is a plant with deep roots, a stem, leaves, flowers, and bolls. What is interesting about the cotton plant is that its utility comes after the stems, leaves, and flowers appear lifeless. When the stem and leaves turn brown and the flowers close, a mature boll emerges with a white fluffy mass that is used to create millions of products. Farmers and Occupational Therapy have something in common. Both often go unnoticed until what we have to offer is needed for people to survive and thrive. Just as Jonesboro Farmers grow cotton to provide the world with a basic ingredient for the manufacturing of food, clothes, and other products, the Occupational Therapy department at Arkansas State University is dedicated to growing educated practitioners to provide services in a region that has a dearth of healthcare providers. Moreover, with more practitioners in the region, we can transform the landscape from meeting basic healthcare needs to developing ideas and interventions that influence the world.
The following is a pictorial representation of the new curriculum design:
Soil, nutrients and roots (unseen): The soil is the professional and educational philosophy of Occupational Therapy from which everything grows. The Theory of Occupational Adaptation provides the nutrients and roots that anchor the curriculum design.
The stem: Bloom’s Taxonomy and the Spatiotemporal Adaptation Theory is the developmental stalk providing a strong core to develop outcomes.
The bolls: The curricular core concepts of professional reasoning, occupation and evidence-based practice, ethics and occupational justice, leadership and advocacy, cultural awareness, health and wellness, and OTD/OTD collaboration.
It is appropriate that our curriculum model is the cotton plant as we intend to convert the bolls into threads that become the fabric of our department. Wendy Wood (1995) described the “Warp and Weft” of Occupational Therapy as follows. The warp of the tapestry “consists of those anchoring, longitudinal thread that give rise to the tapestry's core fabric” (p. 44). The warp represents engagement in occupation as a medium for health. The warp of our program consists of threads that represent foundation principles and unique features of the program:
Professional reasoning: The previous curriculum streams of foundational sciences, fundamental skills, and lifespan development are incorporated into professional reasoning along with a greater emphasis on the clinical reasoning process including the guiding theory of Occupational Adaptation. Fleming (1991), in her article, the Therapist with the Three-Track Mind, first articulated the thinking process of an occupational therapist as procedural, interactive, and conditional. A fourth track, narrative reasoning, was added later. The purpose of the professional reasoning thread is to develop the learner’ ability to name and frame clinical situations appropriate reasoning for the best outcome.
Evidence-Based Practice: The learner is expected to ground all clinical decision making and professional reasoning in evidence-based practice. The learner is exposed to the process of analyzing and utilizing research combined with clinical expertise and patient experience in the first semester. The three areas of practice emphasis, behavioral health, pediatrics, and adults, continue to integrate the use of evidence-based practice in the professional reasoning process.
Ethics and Occupational Justice: The previous Occupation curricular domain that supplied students with the understanding, application and creation of concepts, interventions, and products that reflect the unique perspective of occupation in the life of a human-being will now include a unifying thread of ethics and occupational justice. The courses will move from an implicit to explicit lens that considers the ethical, social, economic, political, and environmental opportunities and barriers to occupational participation in a rural setting.
According to Wood (1995), it is the weft, or the colored threads that fill in the warp as they are delicately woven in and out by hand, that gives the tapestry life. The unique nature of the program at Arkansas State University comes to life in the curricular threads of OTA/OTD collaboration, cultural awareness, and leadership and advocacy.
OTA/OTD Collaboration: Arkansas State University is unique in that it has both OTA and OTD programs in the department. Although the programs operate independently, multiple opportunities occur for the two levels of practitioners to collaborate on assignments and other activities. Such collaboration assists both levels of practitioners to better understand their professional roles and responsibilities prior to entering clinical practice.
Health and wellness: The state of Arkansas ranks 48th in the nation for health (United Health Foundation, 2016) https://www.americashealthrankings.org/explore/annual/measure/Overall/state/AR). Other health statistics include 2nd for Stroke, 4th for heart disease, and 6th for cancer related deaths (CDC, 2014) https://www.cdc.gov/nchs/pressroom/states/arkansas.htm. Therefore, health and wellness must be included in the curriculum. Courses such as Emergence of OT Practice and OTA in Behavioral Health help students address the health and wellness needs of local, state, and regional populations. Additionally, the level I service-learning and experiential experiences provide an opportunity for students to implement community education and training that addresses health and wellness needs.
Cultural awareness: We chose the term cultural awareness instead of cultural competency because of our belief in relative mastery and the need for lifelong learning. Courses such as Emergence of OT Practice, Fundamentals of OT Practice, and the clinical courses all have elements that assist the student in becoming a culturally aware practitioner. Early coursework includes cultural awareness as part of our profession’s ethical responsibility. Both level I and level II clinical coursework emphasizes cultural awareness as part of our “commitment to promoting inclusion, participation, safety, and well-being for all recipients in various stages of life, health, and illness and to empowering all beneficiaries of service to meet their occupational needs” (AOTA, 2015, p. 1).
Advocacy and Leadership: Due to the rural community in which the program dwells, OTA practitioners are often practicing in isolation and are expected to hold leadership positions and effectively advocate for the needs of the client. Therefore, advocacy and leadership is a continuous thread throughout the majority of the OTA courses. Students are introduced to advocacy and leadership for the client, group, and population in the first semester through courses such as Emergence of OT Science, Fundamentals of OT Practice, and Behavioral Health for the OTA. In the second semester and through Level I fieldwork experiences, students apply and integrate advocacy and leadership principles throughout population-based courses and corresponding fieldwork experiences.