Hyperchange Curriculum for Occupational Therapy Students

In an Utopian OT world, there would be a weekly 3-hour course that spanned the duration of an occupational therapy student’s career in their master or doctorate OT program. It would primarily consist of guest speakers from other disciplines or expert OTs. Many would require real-world assignments. The curriculum would be extraordinarily interdisciplinary, cutting edge, relevant, and innovative, with a focus on what OT Jim Hinojosa addressed as “hyperchange” in his 2007 Slagle lecture. He discusses how OT student curriculums need to evolve so they better address “how” to learn, rather than “what”, with emphasis on flexible thinking, problem-solving, creativity, efficiency, and a much more interdisciplinary focus. Students would be equipped with cognitive tools to navigate the future, and learn how to access the information they need when in a constantly changing environment. He notes today’s students have spent their entire lives in a hyperchange environment, and are best suited to the challenges we face ahead in this area. Here are some of my (idealistic) class ideas.

• Legalities and Liabilities of Innovative Practice (lawyer)
•  Fundraising, Grant Writing, Finding Sponsors/Volunteers (expert)
•  Entrepreneurialism, Marketing/Branding in Changing Healthcare world (marketer, designer)
•  Keeping Occupations Intact in Face of Productivity/Budget Challenges (OT)
•  Awareness of Eastern Medicine/Naturopaths/Alternative Healing (healer)
• Interdisciplinary Relations: Collaboration and Creation (multi-disciplinary panels)
• Healing Touch and Energetic/Touch Modalities (practitioner)
• Inventions/Product Design, How To (experienced inventor)
• Perspectives of client and therapists in mental Health OT (client, mental health OT)
•  Perspectives of client and therapists in OT Emerging Practice Areas (panel of OTs and clients of differing areas)
• Flexible-Thinking and Problem-Solving (cognitive psych? hmm)
•  Perspectives of OT from Other Disciplines (panel)
• Creative Use of Thrift Store/Dollar Store Materials
• Creating Something out of Nothing: Ninja OT with limited access to materials
• Psychology of Persuasion, Motivation, Hope (specialized psychologist)
• Psychology of Trauma/Grief: Reflective Listening and Clinical Communication Skills (specialized psychologist)
• Psychology of Illusions and Conmen: Skillfully using psychological techniques of distraction, expectation, and perspectives to approach challenging OT sessions (guest performance pickpocketer or similar – see bottom for details – not to be used in a manipulative way but rather helpful).
• Lots more ideas!

I know my program (I graduated in 2009) addressed some of these, and I hope and imagine many current programs are addressing this via prerequisites or within the program itself. I’d love to hear what other OTs would like addressed, or what educators are already starting to address. I’m currently in a post-professional OTD program, so I’m thinking a lot about education!

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Bonus: I highly recommend you look at the youtube video and article on the following two real-life characters: Apollo Robbins is a famed (performance) pickpocket who uses the victim’s expectations and distraction against him:  http://www.newyorker.com/magazine/2013/01/07/a-pickpockets-tale for the article

This 6-minute video amazed me – he was able to pickpocket the victim even though the victim KNEW Apollo was about to try, and when you watch it assuming you will be able to tell, you can’t. Shocking.  

Frank Abagnale was a conman made famous by the movie Catch Me if you Can, although I prefer his autobiography.  http://en.wikipedia.org/wiki/Catch_Me_If_You_Can. He was able to successfully impersonate a pilot and doctor and other highly skilled professions, as well as start a new type of check forgery, by the time he was 19. He did a stint in jail, but ultimately ended up working for the FBI in their check fraud department, because he knew better than any non-criminal how to do it! He also used distractions, expectations, perspectives of other, and illusion, as his methods for success.

Occupational Therapists and Kintsukuroi: Repairing with Gold.

Applicable to the heartbreak sometime seen for people in occupational therapy

As occupational therapists, we often work with those who feel broken. Sometimes I think applying or receiving the lacquer of repair – and seeing the beauty in it – helps us restore our souls.

Will I ever be good enough? OT student Fears

Okay, I got this letter from a sweet OT student, sharing her fieldwork fears, who is clearly going to be JUST FINE. 🙂 So my answer is on top, her e-mail is on bottom.

Regarding the fear of not being good enough yet, or that you’ll never be good enough: ASKING THAT QUESTION MEANS YOU ARE GOOD ENOUGH. 🙂 if you have a healthy respect (sometimes fear) of what you don’t know, you will always strive to learn more – with continuing education, reaching out to mentors, etc. It means you are far above most people/therapists and that you clearly show the compassion/concern/desire for growth that makes you an excellent clinician.

It’s true, your skills aren’t perfect yet -and won’t be for a long time. But with each day you will learn new things and slowly you will see the growth you want. Having a good mentor – or multiple mentors – is huge. Reach out to people you admire in the field. Talk to your co-workers. Read books written by people with the diagnoses you treat. Read community forums for those people. Put yourself in their shoes. Practice with your cooperative friends. Observe people in the supermarket. I promise you, these skills that seem so elusive, will eventually come.

Just keep working at them and realize you are doing your best. Also, everyone has their own strengths and weaknesses. There are things that you as a new practitioner bring to the table that an experienced practitioner can’t – such as fresh eyes, recent education, a (hopefully) still unjaded attitude, a creativity for “out of the box” ideas that mostly comes from not knowing any better/different, and then your own therapeutic value. You may have more compassion, more kindness, more creativity, who knows. A lot of times patients are helped just by having someone there who cares. Realize that half the battle – if not more – is just having the patient feel that sense of value/connection with you. Using your “therapeutic use of self.”

So have faith in yourself. Believe in yourself. Know that as long as you ALWAYS know – even twenty years from now – that you don’t know everything and that’s okay. Know that we are in a profession that thrives on constant growth and development, and NONE of us, not even the AOTA president or your most revered OT mentor, know it all. There will be periods you feel great about your growth, periods where you are depressed about what you don’t know, and periods where you don’t care or think you are doing fine. It will all balance out. Just keep growing the way you are now and you will be fine.

PS: I guarantee you will do things in your first year (or years) where you will look back and go WHAT WAS I THINKING OH MY GOSH. Or “I’m such a fraud. They like me and think I am doing a good job but I have no idea what I’m doing.” That’s okay. Everyone feels like a fraud. Everyone has those movements of retrospection where they realize what all they didn’t know. Just keep working to improve your skills, realize you don’t know what you don’t know, but as long as you follow the mantra of “Do no harm”, you’ll be okay, and you’ll survive those moments of WHAT WAS I DOING?! 🙂
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Hi Karen,
I am a fourth year OT student at the University of EDITED, currently on my level II Fieldwork. I came across your blog when researching one of my many projects and it was a big encouragement (and nice distraction!) for me. Thank you for writing it!  I needed a little humor, and reading many of your postings rung true with my own experiences in OT school! It’s so nice to know that you have been there, made it through and are now a successful practitioner (because sometimes we wonder…is it all worth it? Will I make it through, graduate, practice for a while, learn, become awesome, and NOT hurt my patients? lol)

As I have been both excited and challenged by my experiences in fieldwork,  I found that I would really love to ask you a few questions, if you wouldn’t mind.

First, I am very afraid for my first patients. I have learned treatment planning pretty well in an inpatient rehab setting (as well as can be expected after three months), but I am still struggling with evaluations. I’m missing silly things like tone, or misjudging ROM or balance, things that I am super super annoyed with because I feel like I should know them! Ugh! I really want to believe that I’ll be a great OT, but that’s hard right now when I can’t imagine it, although I’ve been trying very hard to master skills, (I know I lack clinical reasoning). I’m scared that I won’t be able to pick up on all the details I need to to holistically treat my patients and give them the quality care that they deserve, It’s so frustrating! Any suggestions for how to improve, and/or what the first few years are like after graduation?

I won’t take up any more of your time, but I am so glad I found your blog, wish you all the best, and hope to hear from you soon!

Thanks so much!
Sincerely,
JANE DOE, Occupational Therapy Student
University EDITED

Top Ten Ways to Impress your Occupational Therapy Professors

10. Have the attitude that any occupational therapist/student caught having patients stack cones (which is NOT occupation-based!) will be immediately slaughtered. Period. (weallknowtherearegoodexcusesforthissometimes
butprofessorsneverseeitthiswaysojustgowithit)

9. Be able to rattle off areas of occupation, performance skills, and client factors, without blinking an eye. (It’s all about the OTPF, baby!)

8. Worship the concept of being client-centered and holistic and occupation-based. Burn occupation candles on your altar and sacrifice small goats in its honor.

7. Realize that when in doubt, answer “Occupational Profile” (it’s a top-down process!) and you will probably be right.

6. Be a member of your state’s OT association as well as AOTA. Know the main leaders of these two associations, and go to the annual conferences. (NETWORK NETWORK! NETWORK!) Also get the enhanced student membership that allows you to get the magazine OT Practice. Read it and write in if you have anything to say. They might publish you, I swear. My blog link got in there! That means pigs are flying around in a frozen Hell, so you might as well try too.

5. Know the famed names Case-Smith (pediatric occupational therapy textbook), Willard & Spackman (OT Bible textbook), Trombley (Physical Dysfunction textbook), Carol Kranowitz (The Out-of-Sync Child), Eleanor Clarke Slagle Lecturer (huge honor, awarded speaker gets to speak at AOTA Conference each year), and Ora Ruggles (OT Pioneer).

4. Tell the following joke when discussing the patella or pisiform bone: What did the anatomy professor say to the closed passageway? OPEN SESAMOID. Okay this is actually a way to get your professor to groan and hate your guts (have a “visceral” reaction), but it’s totally my favorite joke and I am so proud of it so I had to put it somewhere.

3. Save absolutely EVERYTHING you do, including good e-mails you send/receive. You might have professional development evaluations (PDEs) at some point and it would be great if you could whip out a ton of evidence showing how amazing and professional you are, showing lots of initiative, actively networking, and exhibiting a strong OT identity.

2. Refresh your memory every month or so on major muscles, major frames of references, ROM, goniometry, and other things you spent a lot of time on. Most people (including me) forget everything they learn. Try to retain your knowledge. This will also impress fieldwork supervisors, on both Level I and Level II fieldworks.

1. Don’t whine about having so many group projects, and don’t be the Type-A project manager every time. Show you are a versatile team player who can lead or follow, depending on what is needed. And remember that a good leader makes leaders, not followers.

0. Don’t be narrow-minded with your career focus. Professors can’t stand knowing you have come into the program with the intention of ONLY going into pediatrics or some other narrow specialty. You might fall in love with something else. Just let yourself be open to the possibilities. (And if you can eventually align yourself with a smaller specialty like vestibular or low vision, the occupational therapy world could totally be your OysTer.)

-1. Don’t do the steps above all at once! Otherwise, everyone, including the professors, will think you are a know-it-all-genius-freak. That’s not good.

I sincerely hope that after reading this list you all feel ready to go out and impress your new occupational therapy professors!