Perceptions of the use of occupation in occupational therapy practice and education

  • Amelia Di Tommaso

    Student thesis: Doctoral Thesis


    This thesis describes the perceptions of new and recent occupational therapy graduates about occupation-based practice and occupation-centred education in Australia. For several decades leading occupational therapists have advocated for the profession to re-focus on its foundational ‘occupation for health’ philosophy. However, due to the dominance of the biomedical model prominent throughout Australian health care services, therapists have found it challenging to implement occupation-based practice. Despite this, occupational therapy students are taught the significance of occupation within occupational therapy. It is unclear if these educational messages are translated into practice upon graduation. Currently, there is limited research in Australia which examines the use of occupation-based practice from the perspective of new and recent occupational therapy graduates. There is also a dearth of studies which investigate whether new and recent graduates value and choose to implement occupation into their practice. Consequently, the aim of this thesis to uncover the new and recent graduates’ perceptions about their use of occupation in practice and their experiences of learning about occupation and occupation-based practice at university. Three studies were completed, where the findings and insights from one study were used to inform and shape the next. First, a study was designed to test the research questions and feasibility for a larger study. Eight new and recent occupational therapy graduates were recruited to participate in two focus groups. Second, a qualitative phenomenological study was designed to utilise in-depth, semi-structured interviews to gather the perspectives of new and recent graduates. Eighteen occupational therapists were interviewed. Finally, a study was designed to interview eight occupational therapy educators to gain their perspectives of occupation-centred education to supplement the findings of the previous studies. Findings from this research uncovered that occupation is important but peripheral in the everyday practice of new and recent occupational therapy graduates. Educational experiences left the graduates with a sense of confusion about occupation within occupation therapy practice. The pilot study highlighted that although occupation was deemed to be important, the realities of current day occupational therapy practice inhibited the use of occupation-based practice. From the pilot study further exploration of the topic was necessary. Interviews with new and recent graduates uncovered that occupation-based practice was deemed unnecessary to occupational therapists’ practice and in fact, other occupational therapists were discouraging of the use of occupation in favour of impairment-based techniques. The graduates’ educational experiences highlighted that educators were providing differing and confusing messages about occupation in practice. Upon graduating, mentors were found to be more useful when attempting occupation-based practice change than university educational experiences. Interviews with occupational therapy educators emphasised the complexity of occupation-based practice in the Australian health care landscape and the need for university educators to drive change within occupational therapy. In conclusion, it is challenging for therapists and educators to implement occupation-based practice and occupation-centred education in Australia. Moreover, this research has uncovered barriers to occupation-based practice not previously discussed in the literature thus far. In particular, from the graduates’ perspective that university educational content did not adequately inspire them to use occupation in practice. Rather, graduates in this study left university with a sense of confusion and uncertainty about occupation. Further discussion and research is required about how occupational therapists and educators perceive, value and include occupation in their daily practice.
    Date of Award2018
    Original languageEnglish
    SupervisorStephen Isbel (Supervisor), Jennie Scarvell (Supervisor) & Alison Wicks (Supervisor)

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