Incorporating Patient Storytelling into the MOT

Curriculum

Katherine A. Lawson, OTR, LMSSW, PhD Eugenia C. Gonzalez, OTR, PhD

Objectives• Discuss how a liberating structure (storytelling) can be

incorporated into a professional course related to adult rehabilitation.

• Understand results of a self-reflection measure of students’ reported self-efficacy of clinical reasoning skills after a fieldwork experience.

• Discuss implications for improving courses to target development of clinical reasoning skills.

Liberating StructuresDefinition

Liberating Structures (LS) provide a framework that enables creativity and innovation that facilitates change (Kimball, L. 2011).

For example, LS in the classroom facilitate expression of thoughts, feelings, and needs to find creative solutions for a needed change.

The Issues Students are expected to demonstrate clinical reasoning skills

after completing didactic course work (Lindstrom-Hazel & West-Frasier, 2004).

Professional programs require students to complete a fieldwork rotation to learn to apply theoretical learning to clinical practice. Often, fieldwork supervisors expect students to demonstrate this skill prior to their fieldwork experience.

Did Guest Lecturers/ Story-telling help you make the connection between theoretical

teachings and understanding of application?

"Yes "No"

14

4

Pre

"Yes "No"

16

1

Post

Pre/Post Survey Results on Preparedness for Level 1 Fieldwork Physical Disabilities

Not prepared Somewhat prepared

Neutral Prepared Very Prepared

0

1

2

3

4

5

6

7

8

9

10

Pre

Not prepared Somewhat prepared

Neutral Prepared Very prepared

0

2

4

6

8

10

12

14

Post

How students rated Story-telling compared to Traditional Lecture, Classroom Discussion, Student

Presentations and Lab

2

4

6

5

1

Pre Fieldwork

2

4

9

1 1

Post Fieldwork

Conclusion Prior to the fieldwork experience, 55% of students reported

there was relevance to the storytelling component and one reported it was a “waste of time”. In contrast, 82% of students reported they valued storytelling after completing fieldwork. However, it is important to note that students’ reflections did not demonstrate an understanding of how patient’s stories facilitated their clinical reasoning skills.

Conclusion

The lesson learned was that explicit objectives connecting storytelling to clinical reasoning need to be written and discussed with students prior to using story-telling in future courses (i.e. why am I listening to this person? and what does it mean to me as a future therapist?).

QUESTIONS

Pre- Survey

1. Did any of the following help you make a connection between theoreticalteachings and your understanding of application? (Yes) or (No)If yes indicate which ones.a. traditional lectureb. classroom discussionc. guest lecturers'd. student presentationse. lab activity2. Did any of the following help you in your understanding of how todevelop a treatment plan:a. traditional lectureb. classroom discussionc. guest lecturers'd. student presentationse. lab activity3. Did any of the following help you in your understanding of how to developa SOAP note:a. traditional lectureb. classroom discussionc. guest lecturers'd. student presentationse. lab activity4. What was your understanding of why specific guest speakers were broughtinto the classroom? Specify the speaker and what you learned from thespeaker.5. Please rank order the following according to how well each facilitatedyour learning (1 = most important and 5 = least important)a. traditional lectureb. classroom discussionc. guest lecturersd. student presentationse . lab activity

6. Please explain why you ranked each item from question 5 the way you did.7. Explain the pros and cons of having this as an online course?8. Explain the pros and cons of having this as a hybrid (lecture plus online)course?9. Rate how well prepared do you feel going to your physical disabilitiesservice learning experience:a. not preparedb . somewhat preparedc. neutrald. preparede. very prepared10 . Rate how well prepared do you feel going to your mental health servicelearning experience:a. not preparedb. somewhat preparedc. neutrald. preparede. very prepared11 . Rate how well prepared do you feel going to your pediatric servicelearning experience :a. not preparedb. somewhat preparedc. neutrald. preparede. very prepared

Post Level 1 Fieldwork Learning Survey

1 . Thinking back upon your Level 1 Observation experience, did any of thefollowing help you make a connection between theoretical teachings and yourunderstanding of application during you level 1 fieldwork experience? (Yes)or (No)Indicate which one or ones :A. traditional lectureB. classroom discussionC. guest lecturers'D. student presentationsE . lab activity2. Thinking back upon your Level 1 Observation, did any of the following helpyou in your understanding of how to develop a treatment plan during yourlevel 1 fieldwork experience?A. traditional lectureB. classroom discussionC. guest lecturers'D. student presentationsE. lab activityF. clinical Instructor3 . Thinking back upon your Level 1 Observation experience, did any of thefollowing help you in designing or developing a SOAP note?A. traditional lectureB. classroom discussionC. guest lecturers'D. student presentationsE. lab activityF. clinical instructor4. What was your understanding of why specific guest speakers were broughtinto the classroom? Specify the speaker and what you learned from thespeaker. Did the speaker or speakers increase your understanding of aspecific patient or patients you encountered during your observations?5. Looking back at your Level 1 Observation experience, please rank order thefollowing according to how well each prepared you for your Level 1observation experience (1 = most important and 5 = least important):A. traditional lectureB. classroom discussionC. guest lecturersD. student presentationsE. lab activity

6. Please explain why you ranked each item from question 5 the way you did .7. Explain the pros and cons of having this as an online course?8 . Explain the pros and cons of having this as a hybrid (lecture plus online)course?9. · Please take a moment remember your physical disabilities experience andnow rate how well or not prepared you were for the Level 1 Observationexperience:A. not preparedB. somewhat preparedC. neutralD. preparedE. very prepared10. Please take a moment to remember your mental health experience and nowrate how well or not prepared you were for the Level 1 Observationexperience:A. not preparedB. somewhat preparedC. neutralD. preparedE . very prepared11. Please take a moment to remember your pediatric experience rate how wellor not prepared you were for the Level 1 Observation experience:A. not preparedB. somewhat preparedC. neutralD. preparedE . very prepared12. Please briefly describe your mental health, pediatric and adult rehabexperiences and what each class could or could not have done to prepare youfor your Level 1 Observation?

ReferencesKimball, L. (2011). Liberating Structure. A new Pattern Language for Engagement. OD Practitioner. 43(3), 8-11.

Liberating Structures. Accessed from (www.plexusinstitute.org, January, 9, 2014).

Lindstrom-Hazel, D., & West-Frasier, J. (2004). Preparing Students to Hit the Ground Running With Problem-Based Learning Standardized Simulations. The American Journal of Occupational Therapy. 58,(2), 236-239.