Improving Occupational Therapy Students' Holistic Care Competencies Through a Structured Holistic Thinking Curriculum: a Mixed Design

Background: Occupational therapy emphasizes the holistic approach, but occupational therapy students are unable to use holistic thinking to design holistic solutions for cases immediately during their internship due to their lack of clinical experience, which requires extensive guidance from clinical occupational therapist.

Study Aim: To improve the holistic care competencies of occupational therapy students using a structured holistic thinking curriculum.

Methods: The study population was occupational therapy interns from a northern teaching hospital. The holistic thinking curriculum was designed as a structured program using mind maps, case-based discussions, and clinical observations to integrate physical, psychological, social, and spiritual aspects. The experimental group took a pre-test after a case report in weeks 4 and 5, a first post-test and course satisfaction after the first structured holistic thinking course, and a second structured holistic thinking course with a second post-test and course satisfaction in weeks 11 and 12; the control group had no course but had a guided version of the holistic thinking case study form for independent study, and the control and experimental groups were tested pre and post using the holistic thinking case study form and the personal learning self-efficacy scale.

Data analysis: Quantitative data for the holistic thinking case study form were determined by three occupational therapists with at least 5 years of teaching experience through consensus conferences to determine the degree of compliance of the case study form with holistic care, and differences between the holistic thinking case study form and the personal learning self-efficacy scale were determined by Kruskal-Wallis with a p-value of 0.05. Qualitative data for the holistic thinking case study form were determined by three occupational therapists with at least 5 years of teaching experience to determine the degree of compliance of the case study form with holistic care and regular meetings were held to achieve consistency in coding.

Study Overview

• Status: Recruiting
• Conditions: Holistic Care Competencies of Occupational Therapy Students
• Intervention / Treatment: Other: Structured holistic thinking course(2 hr); Other: Clinical practice training

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Hanyun Hsiao, master; Phone Number: 1624 +88622490088; Email: 10252@s.tmu.edu.tw

Study Locations

• Taiwan
  • New Taipei City, Taiwan, 235
    • Recruiting
    • Shuang Ho Hospital
    • Contact: Hanyun Hsiao, master; Phone Number: 1624 +88622490088; Email: 10252@s.tmu.edu.tw

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. occupational therapy students who were interns at the Shuanghe Hospital, Ministry of Health and Welfare
2. students who could read, write, and communicate in Chinese
3. students who were 20 years of age or older.

Exclusion Criteria:

1. those who could not attend the entire course
2. those who could not complete the 12-week internship.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental group; During the 12 weeks of the internship, the experimental group took a pre-test after a case report-1 in weeks 4-5, which included completing the holistic thinking case analysis form and the personal learning self-efficacy questionnaire, followed by a 2-hour structured holistic thinking course. At the end of the session, subjects took the first post-test, revised the case analysis form completed in the pre-test based on the case report-1 observed in the pre-test, and completed the personal learning self-efficacy questionnaire and the satisfaction questionnaire again. During weeks 6-11 of the internship, participants continue to receive clinical practice training in assessment, intervention planning, and patient intervention skills. In weeks 11-12 of the internship, subjects took a second post-test after reading case report-2, which included completing the holistic thinking case analysis form and again completing the personal learning self-efficacy questionnaire.	Other: Structured holistic thinking course(2 hr); The holistic thinking curriculum was designed as a structured program using mind maps, case-based discussions, and clinical observations to integrate physical, psychological, social, and spiritual aspects.
Active Comparator: Control group; During the 12 weeks of the internship, the control group had no structured holistic thinking course. During weeks 4-5 of the internship, after viewing case report-1, a pretest consisting of completing the holistic thinking case analysis form and the personal learning self-efficacy questionnaire was completed and a holistic thinking case analysis form - introductory version was given. Subjects will revise the holistic thinking case analysis form completed in the pretest and complete the personal learning self-efficacy questionnaire again. During weeks 6-11 of the internship, participants continue to receive clinical practice training in assessment, intervention planning, and patient intervention skills. In weeks 11-12 of the internship, subjects received the post-test, viewed the case report-2, and were given the holistic thinking case analysis form - introductory version and completed the holistic thinking case analysis form and the personal learning self-efficacy questionnaire.	Other: Clinical practice training; there is no holistic thinking curriculum.Using the holistic thinking case study form - introductory version self-study

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The quantitative data of the Holistic Thinking Case Analysis Form	The Holistic Thinking Case Analysis Form: Taken from cases (caregivers) to see if subjects can analyze holistic abilities/problems based on physical, mental, social and spiritual aspects. Higher scores indicate better analysis of the problem and are quantitative data. The holistic occupational therapy intervention plan extract looks at whether the subject can present an occupational therapy intervention plan with the concept of holistic care, which is qualitative. The higher the score, the more appropriate it is, which is quantitative data. The above information was coded and analyzed by three occupational therapists with more than five years of teaching experience, and quantitative information was determined through consensus conferences.	Change from baseline after immediate intervention/Change from baseline at week 12
MSLQ:Motivated Strategies for Learning Questionnaire	Measuring subjects' learning self-efficacy	Change from baseline after immediate intervention/Change from baseline at week 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Course Satisfaction Questionnaire	The purpose of the questionnaire was to understand the subjects' satisfaction, usefulness, and suggestions regarding the course content and to increase the subjects' connection to the holistic care curriculum, clinical experience, and skills knowledge through course reflection.	After each training session(week 4-5/week 11-12)

Collaborators and Investigators

• Sponsor: Taipei Medical University Shuang Ho Hospital

Publications and helpful links

General Publications

• Profetto-McGrath J. Critical thinking and evidence-based practice. J Prof Nurs. 2005 Nov-Dec;21(6):364-71. doi: 10.1016/j.profnurs.2005.10.002.
• Girot EA. Graduate nurses: critical thinkers or better decision makers? J Adv Nurs. 2000 Feb;31(2):288-97. doi: 10.1046/j.1365-2648.2000.01298.x.
• Holden RJ. Lean Thinking in emergency departments: a critical review. Ann Emerg Med. 2011 Mar;57(3):265-78. doi: 10.1016/j.annemergmed.2010.08.001. Epub 2010 Oct 29.
• McCombie RP, Antanavage ME. Transitioning From Occupational Therapy Student To Practicing Occupational Therapist: First Year of Employment. Occup Ther Health Care. 2017 Apr;31(2):126-142. doi: 10.1080/07380577.2017.1307480. Epub 2017 Apr 24.
• Chen SL, Liang T, Lee ML, Liao IC. Effects of concept map teaching on students' critical thinking and approach to learning and studying. J Nurs Educ. 2011 Aug;50(8):466-9. doi: 10.3928/01484834-20110415-06. Epub 2011 Apr 15.
• D'Antoni AV, Zipp GP, Olson VG, Cahill TF. Does the mind map learning strategy facilitate information retrieval and critical thinking in medical students? BMC Med Educ. 2010 Sep 16;10:61. doi: 10.1186/1472-6920-10-61.
• Jenicek M, Croskerry P, Hitchcock DL. Evidence and its uses in health care and research: the role of critical thinking. Med Sci Monit. 2011 Jan;17(1):RA12-7. doi: 10.12659/msm.881321.
• Wu HZ, Wu QT. Impact of mind mapping on the critical thinking ability of clinical nursing students and teaching application. J Int Med Res. 2020 Mar;48(3):300060519893225. doi: 10.1177/0300060519893225.

Study record dates

Study Major Dates

• Study Start (Actual): July 17, 2023
• Primary Completion (Estimated): June 30, 2024
• Study Completion (Estimated): June 30, 2024

Study Registration Dates

• First Submitted: May 2, 2023
• First Submitted That Met QC Criteria: May 11, 2023
• First Posted (Actual): May 22, 2023

Study Record Updates

• Last Update Posted (Actual): November 15, 2023
• Last Update Submitted That Met QC Criteria: November 14, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: Holistic health care; occupational therapy student; mind map
• Other Study ID Numbers: N202212038

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No