What Needs to Change About OT School?

What needs to change about your OT school?

As occupational therapy continues to evolve, our schooling will have to evolve with it. When I glance through forums, I often see similar complaints from dissatisfied OT students. I remember having some of these same thoughts when I was in OT school:  

This post is an attempt to gather these common complaints and suggest ways for OT training to evolve in the future.

I should note that these issues with schooling can seem discouraging, but I have landed in a place where I feel buoyed by all of the compassionate, intelligent OTs out there who work hard to deliver great care to patients. We are in a time when health care and health care education are evolving dramatically and if we settle down and focus, OT can emerge at the other end stronger.

6 Things that Need Change About OT School

1. Less Time on Emerging Practice Areas

As a blogger, I get it. It is so easy to focus on emerging practice areas–they are pretty fun after all. Who really wants to read a blog post about RUG levels? But, as OT continues to diversify, it will become even more important to define what comprises entry-level competence. Training needs to focus on making OT students masters of core competencies, with a general awareness of options for specialization. Do you need to leave school prepared to practice telehealth, hippotherapy or inclusive design assessments? Probably not.

2. More Business Know-How

As health care consumers gain more access to health-related information and have more parties clamoring for their attention, OTs will need to become better at marketing and selling their services. Health care, after all, is a business. OTs would benefit from at least a basic understanding of marketing and the unique value proposition of the services that they deliver. There is a great podcast over at Therapy Insiders about this topic.

3. Instruction in Tracking Outcomes

Yes, it's important to know about research outcomes related to your practice area, but as we enter into pay for performance insurance, it will be equally important to know about the outcomes coming out of your own clinic. I do not remember talking about tracking outcomes at all in OT school. If you have a chance bounce on over to this article by Heidi Jannenga: 3 Reasons PTs Must Start Tracking Outcomes Now. Heidi is the founder of WebPT. If WebPT is investing in tracking outcomes….I'm hedging my bets that this is the wave of the future.

4. Drop Frames of References? 

When people refer to "too much focus on theory," they are often referring to frames of reference. It is common for fieldwork students to ask their supervisors questions about frames of reference and then see their supervisors squirm. Let’s just say frames of reference haven’t been on their minds lately. I have been both that student and that supervisor.

This topic probably deserves a series of blog posts and, honestly, I haven’t done enough research on it. But, my initial thoughts are that yes, models of care are important to understand, but as we move toward team based approaches, I wonder if it would be more fruitful to focus on models that span multiple disciplines- like the recovery model. I can see a basic introduction to MOHO, etc. being important, but the time spent on FORs should not be a semester's worth of mindless memorization. 

5. Increase Critical Thinking Skills Related to Research

Once you enter the workforce, the time allotted to research can be limited, as can your access to publications. I wish in OT school that we had read as many journal articles related to OT as possible. We talked about the importance of evidence-based practice... A LOT, but we didn't spend a lot of time actually looking at the evidence. We memorized the types of research articles, but we didn't spend time thinking critically about research that validates and invalidates OT practice. 

6. Training in Coaching, Motivational Interviewing, Tough Conversations… Or Something Along That Line

We had a semester long class dedicated to group process. As far as I know, I’m the only one to have held a job where I primarily lead groups. That job was five years after the class; I ended up borrowing a social workbook to help me through. How many of my classmates have had to have tough one-on-one conversations? Probably 100%. Other professions have research-backed techniques for one-on-one conversations that we can leverage. It doesn't matter how good our treatment techniques are, if we can't connect with our patients during the interview, our efforts may be fruitless. 

I would love to hear your thoughts on OT school, what are the weaknesses and what are your suggestions for making the process stronger?

Update July 31, 2015: 

I got some great feedback across my social media channels that I wanted to collect in one place! Here are some additional thoughts on where our OT programs should head: 

  • Basic knowledge of PPS, RUG levels, and MDS
  • Knowledge of business practices
  • More emphasis on goal related documentation.  
  • Time management is of increasing importance, due to outrageous productivity levels upward of 95% required by some Rehab Companies. 
  • Better teacher training for professors