Abstract
Intended for occupational therapy and occupational therapy assistant educators, the Occupational Therapy Curriculum Design Framework presents a practical approach to designing occupational therapy curricula with attention to influential factors that should be considered throughout the process. The framework provides an overarching view of occupational therapy curriculum design that can be adapted to a faculty’s vision for their particular institution. Although the unique features of a curriculum will vary from institution to institution, foundational core elements should be present in all curricula. With this in mind, faculty should be deliberate, reflective, and organized when crafting their own occupational therapy curriculum. This framework offers reflection questions, resources, and curriculum examples that may be applied to occupational therapy curricula at all degree levels. This framework does not dictate program content or implementation and is not intended to be used as a guide to ensure compliance with accreditation standards.
Intended for occupational therapy and occupational therapy assistant educators, the Occupational Therapy Curriculum Design Framework presents a practical approach to designing occupational therapy curricula with attention to influential factors that should be considered throughout the process.
Preface
The Occupational Therapy Curriculum Design Framework was developed by a task force appointed by the American Occupational Therapy Association (AOTA) Commission on Education. Intended for occupational therapy and occupational therapy assistant educators, this framework presents a practical approach to designing occupational therapy curricula with attention to influential factors that should be considered throughout the process. The term occupational therapy is used to encompass all occupational therapy and occupational therapy assistant educators, programs, and curricula except in areas in which distinction is necessary. The term occupational therapy practitioners is used to include both occupational therapists and occupational therapy assistants.
This framework provides an overarching view of occupational therapy curriculum design that can be adapted to a faculty’s vision for their particular institution. Although the idiosyncratic features of a curriculum will vary from institution to institution, foundational core elements should be present in all curricula. With this in mind, faculty should be deliberate, reflective, and organized when crafting their own occupational therapy curriculum. This framework offers reflection questions, resources, and curriculum examples that may be applied to occupational therapy curricula at all degree levels. This framework does not dictate program content or implementation and is not intended to be used as a guide to ensure compliance with accreditation standards.
Evolution of This Document
The Occupational Therapy Curriculum Design Framework evolved from two faculty guides that were formerly housed on the AOTA website, the Occupational Therapy Model Curriculum and the Occupational Therapy Assistant Model Curriculum. In 2019, the AOTA Commission on Education surveyed faculty nationwide on the use and usefulness of these model curriculum documents and subsequently initiated a task force to address survey feedback, resulting in the following four priorities: (1) redesign the two model curriculum documents into one document representing both occupational therapy and occupational therapy assistant education for increased collaboration and consistency, (2) publish a searchable document for increased accessibility and awareness, (3) provide concrete examples to stimulate ideas for immediate application, and (4) update the document with the best teaching practices and AOTA’s current vision. The Occupational Therapy Curriculum Design Framework was written to address these priorities and further the goal of excellence and consistency in occupational therapy education.
Vision for This Work
The purpose of this document is to provide a user-friendly tool to assist occupational therapy faculty in designing programs that transform students into health professionals who are effective, influential, inclusive, collaborative, and accessible.
Overview of This Document
This document outlines four essential steps to be considered when designing a curriculum: (1) establish the program philosophy, mission, vision, goals, and curriculum threads; (2) determine and sequence curricular content; (3) design assessment methods and learning activities; and (4) reevaluate the curriculum on an ongoing basis (Figure 1). Although the steps are presented sequentially, the development and revision of a curriculum does not necessarily proceed in such an orderly fashion. The process requires that faculty constantly evaluate the outcomes of each step while considering the integration of a variety of influential factors. These influential factors include the philosophy, mission, and vision of the profession; philosophy, mission, vision, and context of the institution; accreditation requirements; faculty philosophy of teaching and learning; student population and evolving expectations; opportunities for community partnerships; current clinical practice; and trends and needs of society (see Figure 1).
Influential factors and essential steps in developing a curriculum.
What makes a program unique is the way in which these influential factors are intentionally woven into the educational goals, program threads, and learning activities.
This document begins with a summary of the impact of these eight influential factors on the occupational therapy curriculum, followed by an exploration of each of the four essential steps of curriculum design, including concrete examples and suggestions. In addition to the specific references listed at the end of the document, each section offers general resources that may be useful to guide the faculty when planning. Finally, Appendix A provides guiding questions for consideration during each step.
Introduction to Curriculum Design
[The curriculum design is] an overarching set of assumptions that explains how the curriculum is planned, implemented, and evaluated. Typically, a curriculum design includes educational goals and curriculum threads and provides a clear rationale for the selection of content, the determination of scope of content, and the sequence of the content. (Accreditation Council for Occupational Therapy Education [ACOTE®], 2018, p. 48)
Occupational therapy curricula provide entry points into the profession at the associate’s, bachelor’s, master’s, and doctoral levels. Each program must reflect a unique combination of approaches and perspectives on teaching and learning. Making the desired teaching approaches explicit can help refine the curriculum design process and avoid construction of curricula in which underlying perspectives on curricula and teaching collide. Some of the commonly used approaches in occupational therapy curriculum design include backward design, competency-based education, developmental perspective, future-based curriculum design, nurturing perspective, social reform perspective, student-centered learning, subject-centered education, and universal design for learning (Appendix B). Multiple approaches may be used in coordination to support the overall mission and vision of the program.
Thomas et al. (2016) referred to curriculum design as a “planned educational experience” (p. 1) that should be logically and systematically developed, implemented, and evaluated. This document uses backward design to guide faculty through curriculum development. The backward design model recommends starting with identifying the desired end result, then locating related evidence and theory, and last designing assessment methods and learning activities (Fink, 2013). As discussed, the four steps in the Occupational Therapy Curriculum Design Framework will guide faculty specifically through this process while considering eight distinct influential factors.
Consideration of Influential Factors
Occupational therapy programs are holistically designed through their intimate connection with internal factors, such as their institutional mission and faculty teaching philosophies, and external factors, such as their community partnerships and the trends in and needs of society. Figure 2 presents the eight influential factors that should be considered throughout each step of the occupational therapy curriculum design process. A targeted analysis of the needs and opportunities within each of these influential factors may generate ideas for how a program can best serve and benefit from its institution, community, and profession.
Eight influential factors affecting curriculum design.
Philosophy, Mission, and Vision of the Profession
The philosophy, mission, and vision of occupational therapy should serve as the basis for occupational therapy education because it prepares students to become occupational therapy practitioners who will “address the occupational needs of individuals, groups, communities, and populations” (AOTA, 2018b, p. 1) now and in the future. Thus, a curriculum should be well grounded in a philosophical base and simultaneously be future oriented, innovative, and dynamic to guide students to become part of a profession that is recognizable, evidence based, and adaptable.
Philosophy
A profession’s philosophy communicates its core values and contribution to society. The philosophy of occupational therapy is “based on the belief that occupations are fundamental to health promotion and wellness, remediation or restoration, health maintenance, disease and injury prevention, and compensation and adaptation” (AOTA, 2017, p. 1). Occupational therapy practitioners believe that all people have an “innate need and right to engage in meaningful occupations throughout their lives” (AOTA, 2017, p. 1). Through modeling and teaching, faculty enable students to become occupational therapy practitioners who influence the health and health conditions of people, populations, and communities by using meaningful occupations that align with personal, cultural, social, environmental, physical, and temporal contexts and expectations (AOTA, 2017). Through their occupational therapy lens, faculty must also view students as occupational beings and encourage student occupational wellness.
Specifically, occupation and the belief that humans are occupational beings should be at the core of every educational program and intentionally intertwined in every course (Hooper et al., 2018): First, learners must practice seeing through an occupational lens. . . . Next, learners must practice listening through their occupational ears. . . . Finally, [learners] must develop reasoning through [their] occupational mind. . . . No other profession sees, listens, and thinks this way. (Mitcham, 2014, p. 642)
By infusing occupation into curriculum threads, course objectives, and learning activities, students and faculty stay focused on the unique qualities that distinguish occupational therapy from other professions.
Mission
The mission of a professional organization defines its purpose and allows it to allocate resources to the highest priority strategic initiatives. The mission of AOTA is “to advance occupational therapy practice, education, and research through standard setting and advocacy on behalf of its members, the profession, and the public” (AOTA, 2021a, para. 6). Occupational therapy faculty further promote the mission of the profession by engaging students in their local and national professional organizations and by teaching “professional and clinical reasoning; critical thinking; cultural understanding; and the integration of professional values, theories, evidence, ethics, and skills. . . . The teaching–learning experience may include supporting active, engaging, diverse, and inclusive learning within and beyond the classroom environment” (AOTA, 2018b, p. 1) so that professional engagement and learning extend beyond graduation.
Vision
A vision statement serves as a guiding light and inspires the future direction of the profession. AOTA’s Vision 2025 describes occupational therapy “as an inclusive profession” that “maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living” (AOTA, 2019a, para. 3). In line with the five pillars of this vision, a curriculum should inspire students to become occupational therapy practitioners who are effective, influential, collaborative, accessible, and inclusive and to communicate these core tenets to stakeholders.
Resources to Build Congruency With the Profession
When designing an occupational therapy curriculum, faculty may benefit from reviewing the following documents:
Philosophical Base of Occupational Therapy (AOTA, 2017)
Philosophy of Occupational Therapy Education (AOTA, 2018b)
Vision 2025 (AOTA, 2019a) AOTA’s mission statement (AOTA, 2021a)
Value of Occupational Therapy Assistant Education to the Profession (AOTA, 2019b).
Philosophy, Mission, Vision, and Context of the Institution
An occupational therapy curriculum is housed within the sponsoring institution, and thus it is essential to locate the philosophy, mission, vision, and context of the institution and match it strategically to that of the program. Some institutions also have a mission and vision for the individual college and/or department in which the occupational therapy program is located; thus, these statements should also be considered in the curriculum design process. In addition, accreditation requires a curriculum’s design to be consistent with the mission and philosophy of the sponsoring institution (ACOTE, 2018, p. 48).
The program and institution must be congruent with each other, change as one or the other changes, and be interrelated so that each one influences the other. Ongoing and systematic review and comparison of the program and institutional mission, vision, philosophy, and context at all levels provide congruency and support for all aspects of the occupational therapy program. In addition, the institution’s mission may also guide the scholarship agenda of the program (ACOTE, n.d.-c), which will in turn affect the faculty development plans of individual faculty and the program.
Understanding the context of the institution provides a path to situate the curriculum design within the institution. The contexts of the institution may evolve with the mission, vision, and strategic plan as well as with external environmental changes. Contexts can include variables such as student demographics and sociocultural, economic, political, inclusion, and diversity attributes of the communities and populations served by the institution. The contexts of the institution also include an analysis of future trends as influenced by financial and pedagogical changes within the institution. Reviewing and matching the contexts of the institution to the occupational therapy program will guide the aspirations of the program through the strategic planning process and build a more complete curriculum design.
Reviewing Consistency Among the Profession, Institution, and Curriculum
A faculty review of the documents related to the mission, vision, and philosophy (i.e., value statements) of both the profession and the sponsoring institution can guide the development of a table or matrix depicting the key elements in each area and the ways those key elements support and are congruent with each other (Table 1). Whenever the profession or the sponsoring institution edits or modifies the mission, vision, or philosophy statements, the program should repeat the design of the table or matrix to ensure the integration of new elements into the curriculum design.
Example of Congruency Among Profession, Institution, Curriculum, and Learning Activities: Rural Population
Resources to Build Congruency With the Sponsoring Institution
When designing an occupational therapy curriculum, faculty may benefit from reviewing the following documents: ACOTE Program Strategic Plan template (ACOTE, n.d.-b) ACOTE Scholarship Agenda template (ACOTE, n.d.-c).
Accreditation Requirements
Accrediting bodies require accountability for academic quality and ongoing improvement through self-study and external review. ACOTE (2018) has articulated required education standards for occupational therapy and occupational therapy assistant academic programs. In addition, degree-granting higher education institutions are held accountable by national or regional accrediting agencies. Accreditation is necessary to assure community stakeholders of the integrity and quality of an educational program.
At multiple points in the curriculum design process, faculty must ensure that all program and content areas required by educational accreditors are clearly present in the curriculum design, instructional design, course selection, and course sequence. This content must include appropriate activities and assessment measures that show how students have met the learning objectives (e.g., exam questions, lab competency skills, reflective papers). In addition to course content and sequence requirements, the accreditation process requires that all programs meet standards relative to administrative capacity and faculty qualifications, including that all faculty have a professional development plan with personal goals for teaching that align with the program’s strategic plan and areas of teaching responsibility.
Each program must demonstrate compliance with accreditation standards through submission of self-study documentation and participation in an on-site accreditation visit that validates minimal compliance with current accreditation standards. The curriculum’s alignment with the accreditation standards and the program’s strategic plan, evaluation plan, and scholarship agenda should be internally reviewed on an annual basis to ensure preparedness for the annual, interim, and reaccreditation reviews (ACOTE, 2018). The ACOTE website (https://www.acoteonline.org) provides policies and procedures (e.g., the 2018 Accreditation Council for Occupational Therapy Education® (ACOTE®) Standards and Interpretive Guide), report forms, templates (including a curriculum design template), self-study guide, e-accreditation user guides, and links to educational webinars.
Guidelines set by ACOTE for accreditation are minimum standards for practice as an entry-level generalist and can be exceeded with close regard to the total credit-load requirements for the degree level. The Occupational Therapy Curriculum Design Framework encourages consideration of issues above and beyond the minimum standards required by ACOTE to reflect areas of emphasis and specialization in a program’s context.
Resources to Align Curriculum With Accreditation
When designing an occupational therapy curriculum, faculty may benefit from reviewing the following documents and websites: ACOTE report forms, templates, and self-study guide (https://acoteonline.org/accreditation- explained/forms/) ACOTE Continuing Education Institute (https://acoteonline.org/education/) Council for Higher Education Accreditation (https://www.chea.org).
Philosophy of Teaching and Learning
Academic occupational therapy programs need a philosophical frame for teaching and learning to articulate and achieve intended educational goals that will in turn be operationalized throughout the curriculum. A philosophical frame for teaching and learning is a set of beliefs about the processes by which people learn and change and the teaching practices that influence that change, including common foundational beliefs about knowledge, how people obtain knowledge, what roles context plays in learning, and what constitutes evidence that learning has occurred.
Faculty must have a strong understanding of their own personal philosophical frame for learning in order to have a more productive and meaningful conversation about curriculum design. “The needs, attitudes, biases and expectations of both student and teacher regarding learning, knowledge and growth play a significant role in defining the nature and quality of the learning experience” (Fidler, 1966, p. 3). Faculty should engage in discussion to be aware of one another’s philosophy of teaching and learning before designing or redesigning their program’s unique curriculum. Open dialogue and a supportive environment will facilitate a trusting collaboration. The strengths and differences of each individual faculty member can be layered upon each other to build a stronger curricular foundation. These collective tenets guide the design of learning experiences, selection of instructional processes, assessment and grading strategies, roles assumed by the faculty, and roles of the learners.
Educational learning theories (also called pedagogical theories or learning theories) offer guidance for reflecting on what makes teaching and learning successful. Faculty should familiarize themselves with educational theories and use them to challenge their own opinions and ideas about teaching and learning in the classroom (see Appendix C). Rather than adopting one theoretical approach, faculty should consider how multiple approaches may be applied to a given learning situation or be used with different learners and different levels of coursework. Faculty are also encouraged to innovate and think beyond the scope of educational theories when their own experience and knowledge support it.
Resources to Align Curriculum With Philosophy of Teaching and Learning
When designing an occupational therapy curriculum, faculty may benefit from reviewing the following documents: Individual faculty teaching and learning philosophy statements Evidence-based texts on teaching and learning (Bradshaw et al., 2021; Brown et al., 2014; Henderson, 2021; Mackh, 2018; Svinicki & McKeachie, 2014; Swanwick et al., 2019; Thomas et al., 2016).
Student Population and Evolving Expectations
Today’s complex educational environment has resulted from shifts in societal demographics, technological advancements, emerging areas of practice, and characteristics of generational cohorts (Grenier et al., 2020; Smith & Judd, 2020). This complexity influences the types of students applying and their expectations for the program. In response, faculty must stay updated and adaptable to meet students’ needs considering a variety of student factors, such as those listed in Table 2. In addition to these general factors, faculty should assess the needs of the student population in their specific program, which may be different from those of occupational therapy students in general (Thomas et al., 2016). Moreover, faculty need to intentionally identify unconscious biases related to student characteristics and consider training to address unconscious biases as part of faculty professional development (Jauregui et al., 2020).
Examples of Student Factors
Resources to Align Curriculum With the Student Population and Evolving Expectations
When designing an occupational therapy curriculum, faculty may benefit from reviewing the following documents and websites: AOTA’s Academic Programs Annual Data Report (e.g., AOTA, 2018a) U.S. Census Bureau website for local and regional statistics (https://www.census.gov)
Generation Z: Re-thinking Teaching and Learning Strategies (Miranda, 2020)
Generation Y Health Professional Students’ Preferred Teaching and Learning Approaches: A Systematic Review (Hills et al., 2017)
Teaching International Students (Oxner & Bandy, 2020) AOTA diversity, equity, and inclusion (DEI) resources (AOTA, 2021c)
Occupational Therapy’s Commitment to Diversity, Equity, and Inclusion (AOTA, 2020c)
Increasing Inclusivity in the Classroom (Greer, 2014) “Current Landscape of Teaching Diversity in Occupational Therapy Education: A Scoping Review” (Grenier et al., 2020) “Developing an International Cultural Learning Project: An Effort Towards Introducing Internationalization in the Classroom” (Zadnik et al., 2019) “Do Your Students Care Whether You Care About Them?” (Meyers, 2009).
Opportunities for Community Partnerships
The depth and offerings of the program are enriched by community partnerships that are woven into the fabric of the curriculum design. Opportunities exist within and outside of occupational therapy and can be on campus, in the local community, and at the national level (Table 3). For example, a local connection to an academic medical center may provide fieldwork, capstone, or baccalaureate project opportunities that support the program. In addition, a rural community program may lead to opportunities in emerging areas of practice and encourage students to consider working in underserved areas. Students may go out into the community (e.g., to a retirement community or a preschool center), and faculty may invite people from the community to be guests on campus (e.g., guest lecturer, volunteer patient).
Opportunities for Community Partnerships
These partnerships serve community needs while also contributing to the program’s unique value. For instance, nonbillable services provided by students can support uninsured and underinsured populations that may not otherwise be funded while simultaneously allowing students valuable hands-on training time and exposure to varied populations. Community partners also benefit from this relationship by helping to create the types of diverse graduates whom they would want to employ. These relationships are not built overnight; developing them takes effort from faculty to reach out and build opportunities for collaboration.
Resources to Align Curriculum With Community Partnerships
When designing an occupational therapy curriculum, faculty may benefit from reviewing the following documents: “SELTEC: Service and Experiential Learning Through Engagement in the Community: A Level 1 Fieldwork Model: Part 1” (Brown & Mohler, 2020) “The Critical Friend: Development of a Peer Supervision Training for a Student-Run Occupational Therapy Clinic” (Murphy-Hagan & Milton, 2020) “Occupational Therapy Students’ Experiential and Self-Regulated Learning in a Community Program for Breast Cancer Survivors” (Ratcliff & Smith, 2020).
Current Clinical Practice
Occupational therapy practice settings are in a state of rapid change that requires practitioners and faculty to remain responsive and flexible. Academic programs need to develop adaptable practitioners who can respond to these changes and lead positive initiatives for the advancement of the profession. AOTA publishes a workforce and salary survey every 5 years that helps programs understand where occupational therapy practitioners work by setting and how occupational therapy is changing over time (AOTA, 2020d).
Fieldwork educators, adjunct faculty, recent graduates, and employers are helpful in determining how occupational therapy is practiced in the local area and at fieldwork sites. Formal or informal advisory boards can inform the curriculum and keep it relevant to current occupational therapy practice. Another method to keep the curriculum current is to provide faculty with dedicated practice time in clinic or community settings, such as faculty practice, pro bono clinics, student-run or teaching clinics, and faculty-led service learning. Moreover, faculty time dedicated to translational research promotes current evidence-based practice in the curriculum (DeAngelis et al., 2013). Trends and changes in occupational therapy practice are difficult to predict, but a curriculum designed to teach students to evaluate trends and embrace thoughtful changes to occupational therapy practice can help graduates sustain a career over a lifetime.
Resources to Align Curriculum With Current Clinical Practice
When designing an occupational therapy curriculum, faculty may benefit from reviewing the following documents: AOTA’s Workforce and Salary Survey (e.g., AOTA, 2020d) ACOTE Standards and Interpretive Guide (e.g., ACOTE, 2018) AOTA practice resources in the areas of Children & Youth, Health & Wellness, Mental Health, Productive Aging, Rehabilitation & Disability, Work & Industry, and Ethics (AOTA, 2021e).
Trends and Needs of Society
AOTA’s Vision 2025 calls on the occupational therapy profession to be inclusive of all populations and communities in relation to everyday living (AOTA, 2019a). Institutions are responsible for integrating inclusivity and cultural responsiveness across all content areas throughout the entire curriculum. Faculty should also be aware of societal, political, environmental, and global health care issues that may affect the curriculum, including addressing any unconscious biases (Hannah & Carpenter-Song, 2013). All faculty should be involved in making decisions about how to best include occupational therapy’s role in diversity, equity, inclusion, and responsiveness in the curriculum. Student, community, and consumer feedback may be beneficial in evaluating any institution’s effectiveness in addressing the trends in and needs of society.
Faculty should take into consideration that in addition to societal trends that affect all institutions, each occupational therapy program is likely to encounter societal needs specific to their region of the country. For example, an individual program may reside in an area with high occurrences of stroke or substance abuse, large minority populations, or refugee populations that affect the specific needs of that area. When necessary, programs should consider how widespread disasters, such as a hurricane or a pandemic, affect the surrounding populations. Faculty might discuss how many occupational therapy and occupational therapy assistant schools exist in their region and how they can differentiate their curriculum on the basis of relevant societal trends and needs.
Resources to Align Curriculum With the Trends and Needs of Society
When designing an occupational therapy curriculum, faculty may benefit from reviewing the following documents: AOTA’s Vision 2025 (AOTA, 2019a) AOTA Societal Statements (AOTA, 2021d)
Occupational Therapy’s Commitment to Diversity, Equity, and Inclusion (AOTA, 2020c) AOTA Advocacy and Policy (AOTA, 2021b) Campus offices for diversity, equity, and inclusion.
Faculty can also search the following resources with attention to their specific region: U.S. Census Bureau (https://www.census.gov) National legislative environment (https://www.congress.gov) Medicare (https://www.medicare.gov) U.S. Department of Health and Human Services (https://www.hhs.gov) U.S. data (https://statsamerica.org) State legislature websites (see, e.g., https://www.ncsl.org/aboutus/ncslservice/state-legislative-websites- directory.aspx).
Essential Steps in Developing a Curriculum
To begin with the end in mind means to start with a clear understanding of your destination. It means to know where you’re going so that you better understand where you are now and so that the steps you take are always in the right direction. (Covey, 2004, p. 98)
Evidence supports the use of a backward design approach to curriculum design, beginning with envisioning the ideal graduate and expectations for mastery and then building the learning activities and instructional materials (Mackh, 2018). Thus, the first step in designing an occupational therapy curriculum is to establish broad educational goals and program threads that align with the program’s philosophy, mission, and vision. Guided by these ideals, the next step is to determine and sequence the required content, including prerequisites as needed. With this structure in place, faculty can decide how student mastery will be evaluated and create learning activities that will promote the expected level of skill. Revisiting the curriculum design on a regular basis is a critical step to further refine the process and support student learning (Figure 3).
Essential steps in developing an occupational therapy curriculum.
Step 1. Establish Program Philosophy, Mission, Vision, Goals, and Threads
Philosophy, Mission, and Vision
A program’s philosophy, mission, and vision provide a strong statement of intent for faculty, students, administration, and stakeholders. Moreover, the program’s philosophy, mission, and vision should be publicly available so that potential applicants can determine whether the institution resonates with their own philosophy and reasons for becoming an occupational therapy practitioner.
When writing the program philosophy, faculty should include statements of alignment with the philosophy, mission, and vision of the profession and sponsoring institution; fundamental beliefs about the nature of occupation, humans as occupational beings, and the unique value of occupational therapy (AOTA, 2017); and the faculty’s collective teaching and learning philosophy, specifically how humans learn (AOTA, 2018b) and how the program supports learning through educational learning theories and evidence-based approaches.
When writing the program mission, faculty should integrate the philosophy statements into a concise summary to represent the unique purpose and priorities of the program. Finally, when writing the vision statement, faculty should express the program's idealistic aspirations and seek to inspire faculty, students, and stakeholders. The Consideration of Influential Factors section and Box 1 provide resources for and tips on establishing a congruent philosophy, mission, and vision; see Appendix A for guiding questions to use during Step 1.
Tips for Establishing a Congruent Philosophy, Mission, and Vision
Form a committee or designate a lead faculty member to oversee the process when possible.
Share individual faculty teaching and learning philosophies to identify shared values that can be included in the program philosophy, mission, and vision.
Create a description of what faculty envision the program’s learning experience to be (consistent with the backward design approach).
Compare and contrast the philosophy, mission, and vision of other occupational therapy programs (as well as contexts and resources) to stimulate discussion and ideas.
Consider trends, needs, and opportunities in the community, clinical practice, and student population.
Develop a visual map or Venn diagram that explicitly connects the program’s philosophy, mission, and vision to those of the sponsoring institution and profession.
Engage in dialogue with internal and external stakeholders for input on program statements.
Build a process to continually review the program’s philosophy, mission, and vision.
Educational Goals and Curriculum Threads
Once the program’s philosophy, mission, and vision are established, the next task is to determine how they will be reflected in each graduate of the occupational therapy program. Educational goals “reflect broad abilities of graduates” (Iwasiw et al., 2020, p. 15) and include descriptions of students’ characteristics upon graduation. Faculty may create educational goals by asking the question, “What do we want our graduates from this program to look like?” or by completing the statement “Graduates of the _______ program in occupational therapy will be _______.” Although educational goals are visionary, they should guide the more specific learning objectives at the course and activity levels and should be reflected in student outcome data for use when analyzing the program as a whole (Figure 4).
Relationship of program educational goals to course and activity learning objectives and student learning outcomes.
Example of a scaffolded curricular content sequence.
Educational goals are intertwined with curriculum threads, which are defined by ACOTE (2018) as themes or “areas of study and development that follow a path through the curriculum and represent the unique qualities of the program, as demonstrated by the program’s graduates” (p. 48). Curriculum threads add cohesion to the selection and sequencing of courses and should be reflected in course objectives, assignments, and teaching and learning strategies. These threads or themes can be used to prioritize a program’s responsiveness to the needs of the individual, the profession, and the broader society. Box 2 offers examples of common occupational therapy curriculum threads. When writing educational goals and curriculum threads, faculty should keep in mind each influential factor described previously as well as the guiding questions in Appendix A.
Examples of Occupational Therapy Curricular Threads
Step 2. Determine and sequence content
The content of the curriculum includes the courses that are offered, the sequencing of those courses, the course learning objectives, the breadth and depth of course topics, and the evaluation strategies used to assess student knowledge. The Occupational Therapy Practice Framework: Domain and Process (4th ed.; OTPF–4; AOTA, 2020b) and the 2018 Accreditation Council for Occupational Therapy Education (ACOTE®) Standards and Interpretive Guide (ACOTE, 2018) provide guidelines for developing content that help programs maintain accreditation and graduate generalist occupational therapy practitioners. Once a program has ensured compliance with both the OTPF–4 and the ACOTE standards, course content can be shaped to highlight what makes the program unique. Note that not every program will have the same content because of the unique interaction in each program of its history, location, resources, institution, faculty, students, and community. When determining and sequencing content, faculty can consider the guiding questions in Appendix A.
Curricular content determines and supports student learning outcomes, which are measured and reviewed during curriculum evaluation (Step 4). The curricular content, including prerequisites and course learning objectives, must be developed with intentionality related to the influential factors discussed earlier.
Faculty should outline the level of expertise that students need to attain with the content over the course of the program (e.g., exposure, simulation, real experience) and how the expected level of expertise will influence content delivery and assessment measures. The content should be scaffolded to allow for increasingly complex concepts to be introduced as the student moves through the curriculum, representing higher levels of learning that occur toward the achievement of competency (Figure 5). For example, a prerequisite course focused on human development prepares students for courses about clinical conditions, both of which prepare students for adult or pediatric occupation-based practice.
Curriculum Mapping
Curriculum mapping is a useful process for organizing content and ensuring alignment with accreditation standards and the visions of the profession, institution, and program (Sellar et al., 2018). Mapping the curriculum sequence allows faculty to view course content longitudinally, identify gaps and redundancies, and compare how activities are graded to reinforce learning at higher levels over time. Curriculum mapping also provides an overview of faculty teaching load, encourages dialogue related to teaching philosophies, and facilitates communication with stakeholders.
Prerequisite Courses
Prerequisite courses are courses students are required to take before they enter the program (Tables 4 and 5) because they provide the foundational and preparatory information necessary to support program coursework. Prerequisites must integrate with the curricular plan and design. For example, a psychology prerequisite course builds a foundation for courses related to occupational theory and human development. Faculty must carefully consider the number, cost, and specificities of prerequisites to avoid creating barriers for program applicants; for example, the cost and availability of a required human cadaver lab may discourage applicants. When selecting prerequisites, faculty should ask, “In order to build a successful foundation for student success, what knowledge, skills, and attitudes do students need before entering the program?”
Examples of OT Prerequisite Courses in Relation to ACOTE Standards, the OTPF–4, and the Program Curriculum
Note. ACOTE = Accreditation Council for Occupational Therapy Education; OT = occupational therapy; OTPF–4 = Occupational Therapy Practice Framework: Domain and Process (4th ed.).
Examples of OTA Prerequisite Courses in Relation to ACOTE Standards, the OTPF–4, and the Program Curriculum
Note. ACOTE = Accreditation Council for Occupational Therapy Education; OT = occupational therapy; OTA = occupational therapy assistant; OTPF–4 = Occupational Therapy Practice Framework: Domain and Process (4th ed.).
Fieldwork
After time and dedication to academic coursework, students can participate in fieldwork experiences that integrate their newly acquired knowledge, skills, and attitudes in a real-life setting under the supervision of a qualified mentor (see Figure 5). The organization, timing, and sequencing of fieldwork should be carefully structured within the overall curriculum design to ensure adequate competency and confidence to support a successful transition from student to practitioner (Commission on Education, 2013). The academic fieldwork coordinator (AFWC) oversees this process, ensures compliance with ACOTE standards, and communicates the curriculum design and learning objectives to fieldwork educators (FWEs; ACOTE, 2018). All objectives should be agreed upon by the AFWC, FWEs, and the student before the start of Level I and Level II fieldwork.
The availability of fieldwork placements plays a large role in how these experiences are designed because all occupational therapy programs rely on a finite supply of fieldwork sites (Coppard et al., 2021; Evenson et al., 2015). Programs may choose to create internal fieldwork experiences, which may require financial and human resources, such as hiring adjunct faculty or locating additional space. Faculty practice, student-directed clinics, and role-emerging settings may provide more flexibility and control over when and where students are able to complete fieldwork experiences.
The ability to select Level I sites outside of traditional occupational therapy settings allows more flexibility to create innovative experiences and helps to preserve clinical settings for Level II fieldwork. Grenier (2015) suggested that “nontraditional fieldwork education models could help resolve or minimize fieldwork site shortages by allowing multiple students to be paired with one FWE” (p. 7) after her survey findings revealed that students prefer this nontraditional model. In some situations, fieldwork sites may have Level II students provide mentorship to Level I students, which in turn provides the Level II students with an opportunity to practice as an FWE. Alternatively, pairing occupational therapy and occupational therapy assistant students together at one fieldwork site provides them with a chance to learn from each other and understand the collaborative nature of the relationship (Jung et al., 2008).
Communication and collaboration between programs competing for placements is essential. For example, competition may be alleviated if students from different programs are on fieldwork at opposite times. Many states have FWE training, continuing education, or consortiums to help occupational therapy and occupational therapy assistant programs work collaboratively on placements. Programs may also provide continuing education and regular communication to ensure that FWEs are aware of creative fieldwork options and possess the necessary skills to support fieldwork students.
Programs may organize Level I and Level II fieldwork experiences on the basis of specific patient diagnostic categories (e.g., musculoskeletal, neurological, mental health), practice settings (e.g., community-based, inpatient, outpatient), or stage in the lifespan (e.g., pediatrics, adults, geriatrics). ACOTE (2018) recommends that “the student be exposed to a variety of clients across the lifespan and to a variety of settings” (p. 42) and requires that at least one fieldwork experience (either Level I or Level II) “address practice in behavioral health, or psychological and social factors influencing engagement in occupation” (p. 40). ACOTE requires that all Level I and Level II fieldwork experiences include at least one psychosocial objective.
Level I Fieldwork.
Level I FWEs are not required to be occupational therapy practitioners, which allows flexibility to provide nontraditional occupational therapy experiences and preserve occupational therapy practitioners as Level II FWEs. Level I fieldwork can be organized in a variety of ways to meet ACOTE and program requirements, including “simulated environments, standardized patients, faculty practice, faculty-led site visits, [and] supervision by a fieldwork educator in a practice environment” (ACOTE, 2018, p. 41). These experiences can be delivered in person or virtually.
Variations include the amount of time each program devotes to Level I fieldwork and the types of assignments and expectations students must meet during the experience. ACOTE does not require a minimum number of hours for Level I fieldwork, but all Level I fieldwork experiences must be “comparable in rigor” (ACOTE, 2018, p. 41). Some programs send students for Level I fieldwork experiences a few hours each week throughout a semester; other programs’ experiences may be a week or more at a time.
Fieldwork should be viewed by faculty, students, and FWEs as an integral part of the whole curriculum in that fieldwork directly supports and supplements knowledge recently gained in the classroom and may involve related assignments for coursework (AOTA, 2016). Typically, students take related didactic courses just before or during the same semester as a corresponding Level I experience. For example, pediatric coursework would occur just before or during a pediatric Level I experience to allow the student to apply didactic content to real clients for mentored learning.
Level II Fieldwork.
Level II fieldwork requires a minimum of 24 weeks full time for occupational therapy students and 16 weeks full time for occupational therapy assistant students (ACOTE, 2018). Level II fieldwork can occur after the primary didactic courses or at some point during the didactic curriculum. Level II experiences that occur earlier allow students to apply new knowledge and skills from Level II experiences to future coursework, which can facilitate a meaningful connection of didactic content to authentic clinical experiences. Level II experiences that occur at the end of the didactic curriculum can benefit students financially on the basis of housing circumstances (e.g., by minimizing the number of times a student may need to move). The program’s model must be clearly communicated to the FWE and student to ensure the expectations are realistic.
Of note, ACOTE permits Level II fieldwork to occur in placements in which occupational therapy is not provided if there is a “minimum of eight hours of direct supervision” by an occupational therapy practitioner (occupational therapist for occupational therapy students and occupational therapy assistant for occupational therapy assistant students) who has “at least 3 years' full-time or its equivalent of professional experience” (ACOTE, 2018, p. 43). In this case, supervision is often provided by adjunct faculty or community therapists who are paid by the institution. Regardless of the placement setting, all students should be prepared to articulate the value of occupational therapy in new settings. Many programs have found that this model is a good introduction to occupational therapy for community partners, and the partners may go on to add occupational therapy practitioners to the organization (Jaegers et al., 2020).
Doctoral Capstone and Baccalaureate Project
The doctoral capstone for entry-level doctoral programs and the baccalaureate project for entry-level baccalaureate programs must be fully integrated into the related program’s curriculum design with individualized specific objectives. With guidance from a faculty mentor, these intensive learning activities allow a doctoral student to gain “in-depth exposure to . . . clinical practice skills, research skills, administration, leadership, program and policy development, advocacy, education, and theory development” and a baccalaureate student to gain “in-depth experience in . . . clinical practice skills, administration, leadership, advocacy, and education” (ACOTE, 2018, p. 44). Both the doctoral capstone and the baccalaureate project should have a “formal evaluation mechanism for objective assessment of the student’s performance during and at the completion” of the experience (ACOTE, 2018, p. 46).
The doctoral capstone consists of a 14-week experience completed after coursework and a capstone project that demonstrates synthesis of knowledge gained during the capstone experience. In preparation for the capstone project, a literature review, needs assessment, individualized student learning goals, and evaluation plan must be completed before the capstone experience is initiated. These activities may be integrated into coursework as assignments (e.g., the needs assessment may satisfy requirements for participation in a scholarly study in a research course). For improved mentorship and outcomes, capstone experiences should be prioritized to match and align with the faculty’s current scholarly activities (e.g., students may be placed at a capstone site that is already being used for experiential learning in a clinical or community-based course). For sustainability, faculty should build on current relationships and established projects, especially ones that are mutually beneficial for the program, student, and community.
Selecting nontraditional capstone placements or projects may alleviate competition for and time burden on clinical fieldwork sites. The on-site capstone mentor does not need to be an occupational therapy practitioner, and many programs choose to place students in capstone settings with mentors who do not typically take a Level II fieldwork student. The doctoral capstone coordinator position requires a full-time core faculty member to oversee the capstone process, ensure compliance with ACOTE doctoral capstone requirements, and communicate the curriculum design and learning objectives with capstone site mentors (ACOTE, 2018). Programs should ensure that sufficient course workload time is provided to faculty members who mentor capstone planning, development, and implementation.
Step 3. Design Assessment Methods and Learning Activities
After the faculty have determined what students need to learn, the next step is to determine how students will learn. Instructional design is focused on the delivery of course content and refers to the development of engaging learning activities with specific learning objectives, tasks, materials, strategies, and assessment methods. ACOTE (2018) describes instructional design as “learning materials and methods that are aligned with the curriculum and convey content to meet the needs of the student” (p. 50).
With a backward design approach, the expectations for demonstrating mastery of course learning objectives are determined before the development of learning activities. Envisioning how the student will show competency directs the design and delivery of instructional content. For example, if the expectation is that the student will demonstrate competency with transfers in the context of a simulated case study, then the lab activities should include transfer practice in the context of case studies rather than transfer practice alone. Likewise, if the instructor plans to write exam questions that require application of new concepts, then the lecture time should include opportunities to problem solve and apply new knowledge.
Formative Assessment
The purpose of a formative assessment is to check student understanding, provide feedback, and adjust content as the course progresses. These assessments are typically low-stakes assignments (graded or ungraded), such as weekly quizzes, 1-minute reflection writings, and homework assignments (Table 6). Multiple data points are recommended to get a real understanding of how well students are grasping the material over time. Assessments that are simple, reliable, accessible, nonjudgmental, and quick are the most helpful. Technology offers easy ways to get a quick assessment through online polling, uploaded videos, and discussion forums. Formative assessments are most effective when they are used to reteach a topic as needed, allow students to correct mistakes, and support students who are falling behind (Mackh, 2018; Wood, 2019).
Examples of Formative Assessment Methods
Note. SOAP = Subjective, Objective, Assessment, Plan.
Summative Assessment
The purpose of a summative assessment is to measure the extent to which a student learned what was outlined in the course objectives. Summative assessments are used at the middle or end of an instructional unit or course and are typically high stakes, which means that they contribute to a large percentage of the course grade (Table 7). A summative assessment may also be used as a formative assessment when information gained guides subsequent coursework (Thomas et al., 2016).
Examples of Summative Assessment Methods
Note. OSCE = Objective Structured Clinical Examination.
Grading Tools and Expectations
For every assessment, the student should be provided with the purpose, expectations, and grading criteria. Rubrics promote a standard of objectivity and fairness by presenting clear criteria in an organized format for both students and faculty to follow (Thomas et al., 2016). Charts and tables can be used to display the categories of graded items (e.g., content, presentation, and evidence) and the point value for varying levels of performance (e.g., exceeds expectations, meets expectations, needs improvement, does not meet expectations). Online rubric generators can be helpful in creating and stimulating ideas for rubric structure. In addition, study guides, detailed assignment handouts, checklists, and examples of student work may be beneficial for communicating expectations when appropriate (Svinicki & McKeachie, 2014).
Learning Activities
Learning activities are carefully planned activities used by faculty as a means to promote the acquisition, organization, and integration of new knowledge (Box 3). Faculty design learning activities that reflect the uniqueness of the academic program and their own teaching philosophy. Activities are designed to meet the course objectives and may be flexible and individualized to address multiple student learning preferences. With careful planning, learning activities should be scaffolded across the curriculum, within courses, and within assignments to guide students toward competency-based student learning outcomes (Box 4 and Figure 6). Learning activities should challenge students by requiring reflective critical thinking and should culminate in effective problem solving to resolve a professional practice problem (Henderson, 2021).
Examples of Learning Activities
Example of Scaffolding Learning Activities Across the Curriculum to Match an ACOTE Standard
Note. OTPF–4 = Occupational Therapy Practice Framework: Domain and Process (4th ed.).
Optimal learning occurs when students build on previously acquired experiences and knowledge for a clear and meaningful purpose in an atmosphere in which they feel safe and respected (Brown et al., 2014). Adult learning is enhanced by hands-on experiences that involve students in directing the learning process. Multiple opportunities for achieving competency in new skills increase the likelihood of retention and real-life application. Active learning encourages collaboration, participation, and independent thought. Examples of active learning include case studies, research projects, problem-based learning assignments, small-group discussions, role-playing and simulation, and peer-teaching activities. Educational learning theories guide the selection, design, and delivery of learning activities (see Appendix C).
Learning activities that connect students with the community and clinical practice nurture the student’s personal identity as a health care professional, including their relationship to patients, families, community services, and other health care providers. For example, occupational therapy and occupational therapy assistant students can work together to create and implement a treatment plan in a community-based center (Carson et al., 2018). Faculty should consider bringing in an expert on a topic, such as a person with a disability, caregiver, clinician, or related professional (e.g., vision specialist, assistive technology professional, vocational rehabilitation counselor). Inviting a guest instructor with lived experience (e.g., person with spinal cord injury teaching a lab on wheelchair skills) can also have a profound impact on students' understanding of the complexity of life with disability, including cultural and socioeconomic factors.
Program Resources for Learning Activities
The options for teaching and learning methods are dependent on the availability of resources, including faculty and student time, classroom and lab space, and educational technologies. A thorough review of available resources is critical as a program develops or revises a curriculum. Resources and needs vary depending on the population of students, location of the program, strategic mission of the institution, and philosophy of the program and its faculty. Many occupational therapy faculty members are not trained to be educators and require additional resources for effective teaching. Programs may need to seek support within the institution and from external sources (e.g., foundation grants). When resources are limited, faculty must prioritize their teaching methods on the basis of the program’s mission, vision, and educational goals. See Boxes 5, 6, and 7 for suggested resource needs and requirements to support learning activities.
Key Areas of Inquiry for Designing Learning Activities
When designing a learning activity, the following questions should be considered: What course objectives am I trying to meet? Given my resources, what are the best teaching strategies to teach this content? Does my learning activity meet the learning needs of all students? Is the purpose of the assignment clear and meaningful to the students? Are the grading procedures clear to the students? Do I need a rubric? Does my learning activity present the just-right challenge for students at this stage in the course and curriculum? Should I include a formal student reflection in this activity? Is my learning activity doing what it was designed to do?
Step 4. Reevaluate Curriculum on an Ongoing Basis
Ongoing curriculum evaluation is crucial for quality assurance and improvement of the overall program. According to ACOTE (2018), “Programs must routinely and systematically analyze data to determine the extent to which the program is meeting its stated goals and objectives” (p. 23). A collaborative and coordinated approach can improve support for student learning, create opportunities for further curricular refinement, meet the evolving needs and expectations of stakeholders, and ensure compliance with accreditation standards and university reporting requirements (McKimm & Jones, 2018; Swanwick et al., 2019). By applying a continuous process improvement model, faculty can develop a structured, ongoing system to identify needs and opportunities, implement small and large changes, and measure outcomes and impact. Commonly used methods for continuous process improvement include the Plan–Do–Check–Act Cycle, Six Sigma, Lean, and total quality management (Boutros & Cardella, 2016; Plenert, 2012; Wellwood, 2021).
A thorough plan includes evaluation and revision at the course, curriculum, and program levels. Curriculum evaluation and program evaluation are distinct, and both are important for quality improvement and alignment with accreditation requirements. Curriculum evaluation “is an organized and thoughtful appraisal of elements central to the course of studies undertaken by students, and of graduates’ abilities” (Iwasiw & Goldenberg, 2015, p. 360) and should include the effectiveness of the instructional design. Program evaluation is more extensive and includes curriculum evaluation along with a broad scope of elements such as “institutional support for the school; administrative structure of the school; faculty members’ teaching, research, and professional activities; and the school’s relationship with other academic units, student support services, research institutes, and healthcare and community agencies” (Iwasiw & Goldenberg, 2015, p. 360).
Early Considerations
Faculty, students, and other stakeholders should provide input into any comprehensive plan for evaluation. A lead faculty member, given sufficient release time to oversee the process, can be useful in providing continual oversight of both the curriculum and the program evaluation (Edwards et al., 2019). This faculty member may also serve as a curriculum coordinator and ensure that faculty members are oriented to the complex interaction of individual courses in the overall curriculum design. When extensive changes to a curriculum are needed, it may be helpful to engage a committee to oversee this more complex process.
Key Areas of Inquiry for Evaluation
Evaluation of an educational program at any level can be structured using the following key inquiries with faculty members: What are your questions? What is it that you would like to know about your course, student experience, curriculum, or program overall? Refer to Appendix A for sample guiding questions. What are all possible—and most relevant—ways to answer those questions? How will you acquire the information? Whose perspectives should be represented? Box 8 lists potential sources of outcome data. What do you plan to do with the information acquired? What action steps might be taken in response to the evaluation outcomes? What resources are needed? See Boxes 5, 6, and 7 for recommended resources.
Suggested Resources
At a minimum, one or more faculty members must have the following: Knowledge of the program’s available budget and financial management skills Regular communication with the dean, provost, or chief academic officer and the financial coordinator to communicate needs and determine the financial climate of the institution Working relationship with the instructional technology staff and an understanding of the available instructional technology Working relationship with the administrative office staff and an understanding of approved companies from which to purchase furniture, equipment, and supplies Working relationship with the university librarians and a list of library resources Working relationship with members of the program advisory board Ongoing faculty meetings and formal trainings to provide support and mentorship Floor plans of the available space and an effective working relationship with the facilities management director and staff (including representation on a building committee if building or renovating a relevant space) Awareness of policies and procedures for ensuring health and personal safety and obtaining necessary safety equipment Ongoing inventory of occupational therapy classrooms, labs, and storage space and development of policies to help maintain the inventory Annual faculty meetings to review the budget and resource needs in relation to pedagogical philosophy and curriculum design, content, sequence, and outcomes
Resources for Faculty Training on Teaching and Learning
AOTA’s Resources for Educators (AOTA, 2021f)
Communities of practice
Faculty internal and external to the program and institution
Formal and informal mentorship opportunities
Local, national, and international conferences and meetings
Online webpages and webinars
Published journal articles and texts in teaching and learning
Pedagogical study groups and journal or book clubs
Professional blogs
Subscription-based courses
Teaching podcasts
University librarian, instructional technology specialist, or instructional design consultant
Sources of Qualitative and Quantitative Data for Program and Curriculum Evaluation
Note. NBCOT = National Board for Certification in Occupational Therapy; OTKE = Occupational Therapy Knowledge Exam; SWOT = strengths, weaknesses, opportunities, and threats.
aSupports ACOTE Program Evaluation Standard A.6.3. bRequired for ACOTE® annual report.
Quantitative and Qualitative Outcome Data for Evaluation
Formative and summative feedback may be systematically gathered to provide informative qualitative and quantitative data (Lindeman & Lipsett, 2016). For example, a formative assessment (e.g., midpoint student focus group) might suggest a student preference to avoid two heavy science-based courses in the same semester. Moreover, a summative assessment may include a review of alumni satisfaction 1 year after graduation and employment rates 6 months after graduation. Accreditation standards associated with program evaluation (ACOTE, 2018, Standard A.6.3) also identify specific items to be assessed and reported in the ACOTE annual report, such as effectiveness of the faculty and instructional design, student competency in clinical skills, and student performance on the National Board for Certification in Occupational Therapy exam. Refer to Box 8 for suggested qualitative and quantitative outcome data sources for evaluation.
Comprehensive Action Plan
To maximize a program’s growth potential, a comprehensive action plan for improvement should be outlined and pursued using concrete and well-defined steps, a timeline, and a system for accountability. Of equal importance, programs should also take time to celebrate successes through informal and formal gatherings, award ceremonies, marketing brochures, social media posts, and other outlets. Celebrating success with faculty, students, and stakeholders can build excitement and passion needed to meet the future goals of the program.
Conclusion
This document serves as a guide for designing and modifying curriculum for both new and established programs. Occupational therapy curricula are unique because they combine evidence-based teaching with the profession’s focus on meaningful occupations in the context of the sponsoring institution and relevant community. The influential factors described in this document serve as a reference point for reflection when navigating the stages of curriculum development. Below are guiding principles to help faculty focus their reflection and thinking during curriculum development: Allow adequate time for undertaking a comprehensive review of the occupational therapy curriculum. Consider forming a curriculum committee to assist with this process when possible. Ensure that student, faculty, and stakeholder perspectives are represented in your curriculum to make it congruent with institutional, regional, and professional contexts. Consider how your faculty’s and stakeholders’ collective vision of the ideal occupational therapy–occupational therapy assistant program fits and supports the values and expectations of the profession and sponsoring institution. Assist all faculty in understanding the significance and application of the program’s chosen pedagogical philosophy, goals, and curriculum threads in coursework. Map the curriculum to identify gaps, avoid redundancies, ensure a logical progression of content, and confirm that accreditation standards are met. Keep current with best teaching practices and innovations through formal and informal faculty development training and faculty development plans. Create opportunities for students to connect course content to clinical practice and professional leadership opportunities. Engage students in lived experiences that bring the curriculum to life and allow knowledge to be constructed and reconstructed by each student individually. Invite lifelong learning, expecting that students will work through questions, problems, and tensions to create meaning for themselves. Loop back and revisit ideas explored in earlier courses to allow students to look at them afresh in light of the introduction of new ideas. Seek opportunities to be a change agent in your program, institution, and community. Create a welcoming environment for a diverse population of students, faculty, staff, clients, and stakeholders. Promote diversity, equity, inclusion, and accessibility in your learning content. Reflect as individual faculty on your teaching and assessment methods each semester, using student feedback, student performance measures, and peer and mentor feedback, when possible; make necessary changes in the context of institutional and accreditation requirements. Revisit each step in the curriculum design process on a regular basis to ensure effectiveness and ongoing compatibility of all associated components.
When combined with a positive, open-minded, and thoughtful approach, these guiding principles will facilitate the design or modification of a curriculum that is fresh and innovative and meets the profession’s need for qualified graduates.
Footnotes
Acknowledgments
The Commission on Education expresses sincere appreciation to all those who contributed to the dialogue, feedback, and concepts presented in this document.
Authors
Amanda K. Giles, OTD, OTR/L, FAOTA, Task Group Chairperson
Tiffany Bolton, OTD, OTR/L
Dennis Cleary, OTD, OTR/L
Julie McLaughlin Gray, PhD, OTR/L, FAOTA
Kim Hartmann, PhD, OTR/L, FAOTA
Mary Elizabeth Patnaude, DHSc, OTR/L
Kim Qualls, OTD, OTR/L
For
The Commission on Education
Tina DeAngelis, EdD, MS, OTR/L, Chairperson
Appendix A. Questions to Consider at Each Step in the Curriculum Design Process
These questions may be used at any stage of the curriculum design process. They are not intended to be hierarchical; rather, they provide guidance when working on any of the steps. Faculty may use them as prompts for guided discussion or insert them into curriculum worksheets.
Appendix B. Approaches to Curriculum Design
A unique combination of approaches may be used when designing the curriculum.
Appendix C. Educational Learning Theories
| Theory | Assumptions | Examples and Application |
|---|---|---|
| Andragogy | Learning occurs when the adult student sees immediate value in the topic and builds on prior experience. Adult learners are assumed to be self-directed, internally motivated, and ready to learn (Knowles, 1984; Taylor & Hamdy, 2013). |
Learning objectives Independent study Asynchronous learning Choice assignments Self-reflection |
| Antiracist pedagogy | Learning occurs when the faculty exemplify antiracism thoughts and behaviors within their classroom teaching and beyond (e.g., research, service) through self-reflection and awareness (Kishimoto, 2018). |
Case studies Open dialogue (safe/brave spaces) Reflection |
| Behaviorism | Learning occurs when the student passively absorbs environmental stimuli (information). The teacher provides positive or negative reinforcement (extrinsic motivation) to shape learning. This is not ideal as the primary approach for adult learners (Skinner, 1954; Taylor & Hamdy, 2013; Thorndike, 1911). |
Drills, rote work Repetitive practice Bonus points Participation points Verbal feedback and reinforcement Grades, point system Tangible rewards |
| Cognitive flexibility theory | Learning occurs when the student reconstructs prior knowledge to adapt to new situations, contexts, and perspectives. The student is challenged to take on a new way of thinking about difficult subject matter by using creativity and flexibility, often in real-world environments (Spiro et al., 2003). |
Concept maps Complex and unfamiliar case studies Open discussion Diverse caregiver interviews Minicases (vs. one long case study) |
| Cognitivism | Learning occurs when the student actively thinks about new information and relates it to prior knowledge (“schemas”). Students acquire knowledge through thinking and problem solving (Piaget, 1952; Taylor & Hamdy, 2013). |
Classifying or chunking information Linking concepts, concept maps Real-world examples Discussions Problem solving Analogies Imagery, pictures Mnemonics |
| Connectivism | Learning occurs when a student connects to a learning community and takes an active role in feeding information through that community. Learning is connected through a matrix or network, can be stored in a variety of digital formats, and depends on the learner’s ability to continually seek new information and filter it for accuracy (Durning & Artino, 2011; Kop & Hill, 2008). |
Concept maps Collaborative learning Group work |
| Constructivism | Learning occurs when the student interprets and creates new information on the basis of prior knowledge and sociocultural experiences. The knowledge process is uniquely subjective for each student (Bruner, 1960; Clark, 2018; Kay & Kibble, 2016). |
Case studies Research projects Problem-based learning Simulations Collaborative learning Group work Interprofessional projects Modeling and coaching |
| Critical theory | Learning is influenced by the sociocultural context in which information is presented. Core concepts and facts about a topic are implicitly biased by the values and beliefs of the source (e.g., faculty, textbook, or both; Brookfield, 2001). |
Presentation of multiple views on a topic |
| Experiential learning | Learning occurs when the student engages in hands-on experiences, specifically doing, reflecting, planning, and redoing. Knowledge is strengthened through increased opportunities to experience, reflect, and try again (Kolb, 1984; Kolb & Kolb, 2017). |
Hands-on practice Simulations Community-based projects Student-run free clinics Student presentations |
| Heutagogy (self-determined learning) | Learning occurs when the proactive and self-directed student is given access to course materials and freedom to structure their own learning, often in an online environment. The student is expected to learn how to learn, reflect, question, adapt, and communicate (Blaschke, 2012). |
Postprofessional online courses Choice or optional assignments |
| Humanism | Learning occurs when the student sets personal goals; chooses learning activities, methods, and materials; and evaluates individual work. Focus is on autonomy, creativity, and self-actualization (Schon, 1983; Taylor & Hamdy, 2013). |
Self-reflection Professional development goals Mentoring programs Independent study |
| Pragmatism | Learning occurs when the student participates in real-world application and hands-on experiences. Focus is on unity, interest, experience, and integration (Nohl, 2009). |
Case-based learning activities Simulation Fieldwork Group activities and exercises |
| Problem-based learning | Learning occurs when the student actively works to find a solution to a real-world problem (Scaffa & Wooster, 2004; Wood, 2003). |
Community-based activities Capstone projects Student-run free clinic operations |
| Sensory theory | Learning occurs when the student engages all 5 senses (Fowler & Bilyeu, 2010). |
Hands-on practice Simulations Experiential labs Videos or images in presentations |
| Situated learning | Learning occurs when the student is part of a learning community that instills its social norms and practices. Learning takes place in real-world contexts (Lave & Wenger, 1991; Taylor & Hamdy, 2013). |
Fieldwork Capstone Conference presentations |
| Social learning theory | Learning occurs through direct experiences or through the observation of others’ behavior (Bandura, 1971; Lave & Wenger, 1991; Taylor & Hamdy, 2013; Wenger, 1998). |
Problem-based learning Simulations Case studies Group work Experiential labs |
| Sociocultural learning theory | Learning occurs through immersion in the culture and social context of a profession with guidance from a “more knowledgeable other” (e.g., faculty mentor, peer mentor, clinical instructor). Focus is on scaffolding learning through the zone of proximal development (i.e., the just-right challenge; Jaramillo, 1996). |
Mentorship and advisement Peer-to-peer mentorship Shadowing and fieldwork Group discussion and projects Teacher as a role model Conference participation Scaffolding content |
| Transformative learning | Learning occurs when new information is presented that causes an adjustment in thinking. Adult learners benefit from looking at new perspectives to gain new understanding (Mezirow, 1995; Taylor & Hamdy, 2013). |
Reflective assignments Group work |
Appendix D. Educational Technology Tools
| Communication technology | Email, text message (Internet Relay Chat), audience response systems (Poll Everywhere, clickers), synchronous audio–video conference (Skype, Cisco Webex, Zoom, Adobe Connect, GoToMeeting), social media (Facebook, LinkedIn, Twitter, Instagram, Snapchat, blog, wiki, social media stories), podcast, bulletin or discussion board, listserv, online scheduling tool (Doodle, Rallly, NeedToMeet) |
| Course management systems and assessment tools | Open source and proprietary learning management systems (Moodle, Blackboard, Skillsoft, Desire2Learn, Canvas, Sakai, Jenzabar, Pearson LearningStudio), content management systems (SharePoint, WordPress), massive open online courses (edX, Khan Academy, Coursera), collaborative peer grading (Mobius SLIP), assessment tools (ExamSoft, Respondus LockDown Browser, BioSig-ID), plagiarism checkers (Turnitin, SafeAssign) |
| Organization and presentation technology | Presentation software (PowerPoint, Keynote, Prezi), lecture capture tools (Panopto, Tegrity), animation and video software (Flash, iMovie, GoAnimate [Vyond], CrazyTalk), webinars, interactive whiteboards (SMART board, Promethean) |
| Information search and management technology | Internet, electronic databases (PubMed, CINAHL, ProQuest, OvidSP, ERIC), reference management software (ProCite, EndNote, RefWorks), data collection and analysis software (Excel, SPSS, REDCap, SurveyMonkey), file hosting services (OneDrive, Google Docs, Dropbox, Box) |
| Specialized simulation equipment | High-fidelity manikin-based simulators (SimMan, VitalSim), task trainers (blood pressure training arm), virtual and augmented reality (Second Life, Active Worlds) |
| Electronic resources | e-books, e-journals, mobile applications (GONI [goniometry], MOBI [mobility aids], OT Exam Prep, OT Kinesiology Pro Consult), asynchronous video platforms (International Clinical Educators Video Library, YouTube, OccupationalTherapy.com) |
Note. Examples listed in parentheses represent a sample of what is available and are not intended to be all-inclusive. Any reference to a specific educational technology in this document does not constitute or imply the endorsement, recommendation, or favoring of that product.
From “Educational Technologies: Enhancing Learning, Engagement, and Global Connectedness,” by A. K. Giles and W. Janes, in S. D. Taff, L. C. Grajo, & B. R. Hooper (Eds.), Perspectives on Occupational Therapy Education: Past, Present, and Future (pp. 189–198), 2020, Slack Incorporated. Copyright © 2020. Reprinted with permission from Slack Incorporated.