SISTEMATIZATION OF CONTRIBUTIONS TO OCCUPATIONAL THERAPY EDUCATION DAY – CHILE – MAY 2010.
In order to generate a participative process and define the themes to be discussed in May 2010, the Education Day organizing committee sent a five-theme guideline for debate to the various Schools and faculty of participating countries. The most interesting and cross-cutting themes were identified from the information received, in an effort to group common themes and interests expressed by participants.
The themes initially suggested by the organizing commission were the following (see attached guideline):
- Formal and informal training of occupational therapists.
- The role of occupational therapy trainers and the tension between professional/technical and disciplinary aspects.
- Relationship between educational space and community social participation.
- Theoretical and practical training and its relationship with social, cultural, economic conditions and local policies.
- Work/professional exercise and the relationship with the educational training process.
- Other themes that have emerged from group reflections, not considered in the pre-defined themes.
This systematization seeks to represent the reflections and common themes contributed by the teaching teams and the various Schools that have participated in this process, so that it may also be used as an input for education Day discussions.
- Formality and informality in the training of Occupational Therapists.
The information returned enables us to identify an imbalance between theoretical and practical training, recognizing that there is a mismatch between theoretical training and the demands posed by reality in practice. There is a reality which challenges the training of occupational therapists and is not satisfied by theoretical training.
In this sense, representatives of Latin American universities claim that on the one hand, this is the result of the fact that many therapists who supervise clinical practice are not trained in all theoretical models, and on the other, that students receive a plurality of theoretical, bio-psycho-social and cultural contributions. This accounts for the diversity that is gradually integrated to each personal training process.
Part of this process is linked to the contribution of informal training. Formal education is a defined route followed by each subject differently, according to his/her experiences and skills developed during their professional activity. Students construct their own reality through personal reflection, determined by the beliefs they incorporate from their social origin. These can be reverted or modified through their own creativity or flexibility to look upon the world, something that is precisely obtained from informal training. General experience shows that the education of Occupational Therapy is the result of formal training, plus the contribution of informal training.
In formal training, what seems relevant is its alignment with the mission of the University where the Schoolexists, to the extent that it seeks an ethical and humanistic education that incorporates research and demanding education to ensure the permanent updating of its students as wholesome professionals.
In most Schools, the scope for formal and informal training is not clearly established. In most cases, evaluations are not comprehensive; formal aspects are evaluated, especially cognitive ones, and each work space with students is used for formal training, failing to value informal training as part of the educational process.
There is consensus in understanding that formal training is that which is provided within academic spheres, directly accompanied by teachers in its approach to knowledge and the social reality of the local, regional and national context,in compliance with the academic parameters of the University.What is also identified in formal education is the diversity of field practices and the participation of students in the historical process of constructing and creating field practices in various contexts.
In one way or another, informal education is understood as the autonomous work that students undertake during their training;for example, participation in social projects or extra-curricular field practices which constitute a fundamental element, because through this competency they acquire the discipline and rigour to make knowledge and technology fundamental tools for their adequate academic performance. It is in this sphere where the exchange with students is possible, so that they may connect with the opportunities and concrete difficulties, as well as the different ways of resolving professional situations, generating scope for reflection and discussion that stimulates participative learning and the link between theory and practice, only if and when this scope is validated and duly accompanied.
In some contributions, it seems that there is recognition of the fact that training as OccupationalTherapists has been an integration of formal and informal training, with the clinical/professional practice as a sphere where these come together and as a training milestone.
In formal education, it is important to know from the very first year of education the different areas of work of occupational therapy, and to facilitate practical experiences in each stage of training, enabling direct contact with the places and people where professional work is conducted and facilitating the integration of learning.
In informal education, we can highlight the presence of teachers with great vocation who have acted as motivators and models capable of having a great impact upon students. In the community sphere, personal experiences are valued: as volunteers, with professional networks, friends and colleagues. Contact with them leads to learning and reflection.
There are difficulties in some countries in order to satisfy the scarcity of local Occupational Therapists. Therefore, formal programmes have to deal with the lack of occupational therapy supervision of fieldwork.
Traditionally, training has focussed on individuals or groups with whom the teacher works, but recently the focus has shifted towards cultural perspectives, moving away from a strictly medical model that used to be the centre of Occupational Therapy creating stress in the education of this discipline. In order to overcome this tension, it is important to have a very good link between formal university education and the more informal experiences, enabling students to apply theory to practice and vice-versa.
In this sense, it is essential that programmes are updated in terms of health and social care, the evolution of policies and legislation, apart from maintaining a perspective of national and international events and an understanding of cultural contexts in order to establish a practice that is sensitive in cultural terms, allowing students to apply what they have learnt to real situations at a global and world level. This implies preparing students to work in complex social care realities and contexts, whilst enabling them to maintain a strong professional identityand allowing them to focus on the needs of their professional practice.
Occupational Therapists in Europe emphasize that the courses that provide professional competency must comply, as a minimum, with WFOT standards. After that, they have the opportunity to take part in postgraduate studies. In Sweden, for the past 10 years, every teacher wishing a permanent position must hold a PhD.
Between 1970 and 1980 a medical paradigm prevailed, whereby Occupational Therapy focussed on the tasks and activities of functional training. Nowadays, the idea is to focus training on the promotion of health.
In other European countries emphasis is placed on providing various levels of formal training, such as diploma courses, degrees and MAs. These three levels expand opportunities for students.
- Role of OT trainers/educators. Tensions between technical / professional / disciplinary aspects.
Every experience implies overcoming an obstacle and this always leads to tensions or contradictions. Contradictions exist in the teaching process, and as trainers we have to learn to reflect on these differences, to decode them, elaborate on them and reflect so that we can be self-critical and overcome them. In consequence, it is not only the student that learns, but also the trainer, producing a feedback process.
The training of pedagogues, of teachers of other Occupational Therapists, has been primarily the result of their own experience as university students and, subsequently - due to the general absence of specific post-graduate programmes in Occupational Therapy - through training programmes in postgraduate courses dealing with various areas of knowledge.
One of the important roles of the educator in our profession is the demand to train professionals,and thus, to produce science as from Occupational Therapy. For this purpose, specialization is required. This imposes on trainers the need to analyse in greater depth the curricular contents of undergraduate and postgraduate courses. We need to update our knowledge enabling us to improve in the academic and clinical spheres, as well as in research and publications that may become a valid testimony for future generations, enabling us to validate our profession in the various fields where it is practiced.
It is important to promote the possibility of establishing exchanges with Occupational Therapists from other parts of the world, enabling us to seek and reaffirm our own identity. Likewise, we cannot loose sight of the fact that we work in different contexts and that each situation must be analysed within the historical and political reality of each place. Our action must be contextualized and understood as such. It would be very difficult for Eastern parameters to be useful in understanding Western reality. The fields of intervention relate to the different theoretical premises that respond to specific paradigms, as well as social, economic and cultural aspects of our political situation.
Training in professional community practice faces difficulties because there are few therapists working on the community issue. The same does not happen with the rest of the practice. The physical, labour and mental health areas have interesting experiences where recognized spaces have been achieved that encourage the training of students in these aspects.
Various experiences, especially Latin American ones, state that in the community field there is a lack of established tutors holding permanent positions: there is instability for the suject and the process. The positions that do exist are the result of years of unpaid work. This implies that there are few references both in the social and clinical fields. Prospects for the immediate future, in terms of availability of positions in these fields of work are practically non-existent. Students attracted to these types of interventions see no future in terms of possibilities of work in this sphere. Prevention projects lack economic and political support. They are a long-term effort, distant from political interests.
This implies that Occupational Therapy trainers must assume a role of greater participation in public management and develop negotiation capabilities with various entities in order to promote these fields of action.
One of the characteristics inOccupational Therapytraining is the lack of training in university education, as well as in the use of advanced technology. This poses a challenge to the role of trainers and to the transfer of this knowledge to Occupational Therapists in clinical and professional fields.
In our role as educators it is important to focus on the student, as a subject of knowledge that can be constructed and in order to participate in the project that implies the construction of the life of others. This means they hold a place in society, recognizing history and the conditions to improve or limit the possibilities of going beyond this sphere of work. To achieve this, it is necessary for the teacher to generate strategies to motivate critical thinking and creativity.
The Occupational Therapy teacher must develop strategies to be permanently updated in matters related to the efficient use of IT and education, the evolution of concepts and the process of the profession, as well as the scientific progress and research that lead to academic production. Likewise, they must be capable of satisfying the needs of the population through feasible projects that ensure the position of our students and professionals in the different sectors: health, education, social, etc. This implies that the Occupational Therapist, as a teacher, has to play his/her role from an explicit position vis-à-vis social reality.
The social and political responsibility of the Occupational Therapy trainer is rooted in a permanent cooperation with the student so that processes can be promoted and become as fluid as possible. The aim is to develop competencies through problem-solving and the generation of critical thought, favouring the sense of commitment and awareness that students must possess faced with the changes experienced by our society. This enables them to use their capacity to create, think globally, understand and interpret phenomena and provide solutions based on experience and knowledge. This implies facilitating the training of Occupational Therapy students with an ethical and critical standpoint about their practice, and thus, their training must include understanding health, welfare, education, employment and justice needs within the specific context of public policies.
The trainer must provide alternatives for students to exercise their reasoning. The difficulty lies in the vulnerability of students. They have no time, no time to read; they are stressed and have many subjects to learn at the same time. Our task should focus on helping the student, on offering reasonable and creative alternatives to alleviate their stress situation so that they can better perform their role as students.
The teacher is well poised to strengthen the principles that belong to the discipline and its history, guiding self identity and incorporating new interventions that expand the fields in which we perform our work.
When student are accompanied in these processes, they learn. This demands that the teacher must analyse the tensions between students and their learning process. Alleviating their fears makes this process easier. The teacher must be a person that anticipates and resolves problems to facilitate the process.
In summary, this role generates tensions that generally coincide with the adjustment of academic programmes aimed at being generalists and the practical sphere with the different local realities and their needs, in addition to the difficulty of assessing students in their professional practice. There is a gap between what we teach and what is presently done in practice. To a certain extent, there is no problem for this gap to exist since educating for the future and in practice takes place today, but it is important to understand this difference. In practice, very often the student develops a critical posture towards Occupational Therapy trainers, but at the same time, professionals are their models. How can we, as educators, reconstruct our role as models for our students? How can we achieve a better understanding of how the practice and training perspective can complement each other?
- Educational space and social/community participation.
From the educational sphere, is it possible to contribute to inclusion processes and to social participation for the exercise of citizenship by the people with whom we work? What experiences can be rescue related to the violation of rights and social and community participation?
Within Occupational Therapy educational programs, social and community participation occur through established field practices, the development of research projects and interdisciplinary social projects in various practice contexts.
In some experiences of Occupational Therapy training, studentsare linked to social organisations where they can observe and participate in inclusion processes for populations at risk, and evidence how occupational therapy interventions promote social participation of different populations. Such diversity requires specialisation, in-depth proposals and the strengthening of strategies. Students learn to establish networks, and analyse processes as a network, as a relational grid that multiply and enhance the significance links of a subject.
In Latin America and the Caribbean, this promotion task is often undertaken by NGOs. Fieldwork and projects are major opportunities for students. Following their graduation, many will probably find work opportunities with these NGO groups where they may contribute their skills and the Occupational Therapy perspective to improve their work.
Occupational therapy is a discipline that exists within social dynamics. This determines the formation of competent resources to conduct health promotion actions, prevention of occupational dysfunction and disability rehabilitation, as well as the use of methods to deal with the differentiated impact of the life cycle, habits and socio-economic condition, among others, on the occupational performance of the population and problem-solving in accordance with the unique characteristics of individuals or populations. This requires an expansion of sectorial and inter-sectorial actions in search of equality.
The educational programme of the Occupational Therapy career is guided by a unique philosophical vision of occupation and occupational performance. It emerges from a combination of perspectives and national and international beliefs, dealing with opinions shared by the world that encompass the nature and meaning of occupation and the type of problems and satisfaction experienced by people about their participation in occupations. Therefore, Occupational Therapists must act in a series of scenarios where individual, group and community interventions are expected, and where their philosophical framework will guide their performance. In consequence, the philosophy of the training programme is grounded on the principles that generate social development, under the principles of equality, solidarity and trust for the production of well-being, prevention and management of occupational dysfunctions, as well as decision-making related to social inclusion.
Some Latin American universities have incorporated community service whereby Occupational Therapy students contribute to communities. From this perspective, work with communities and with vulnerable groups is validated as a sphere where it is possible to conduct occupational therapy interventions as a contribution to the training of students who canwitness, in practice, how to work with groups and communities, in both the physical and mental health sector. The link that is established in the mental and physical health sector enables the Occupational Therapist to intervene actively in programmes aimed at people living in vulnerable situations.