Incorporating Patient Storytelling into the MOT Curriculum Katherine A. Lawson, OTR, LMSSW, PhD Eugenia C. Gonzalez, OTR, PhD

Objectives Discuss how a liberating structure (storytelling) can be incorporated into a professional course related to adult rehabilitation. Understand results of a self-reflection measure of students’ reported self-efficacy of clinical reasoning skills after a fieldwork experience. Discuss implications for improving courses to target development of clinical reasoning skills.

Liberating Structures Definition  Liberating Structures (LS) provide a framework that enables creativity and innovation that facilitates change ( Kimball, L ).  For example, LS in the classroom facilitate expression of thoughts, feelings, and needs to find creative solutions for a needed change.

The Issues  Students are expected to demonstrate clinical reasoning skills after completing didactic course work (Lindstrom-Hazel & West- Frasier, 2004).  Professional programs require students to complete a fieldwork rotation to learn to apply theoretical learning to clinical practice. Often, fieldwork supervisors expect students to demonstrate this skill prior to their fieldwork experience. 

Did Guest Lecturers/ Story-telling help you make the connection between theoretical teachings and understanding of application?

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

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

Conclusion  Prior to the fieldwork experience, 55% of students reported there was relevance to the storytelling component and one reported it was a “waste of time”. In contrast, 82% of students reported they valued storytelling after completing fieldwork. However, it is important to note that students’ reflections did not demonstrate an understanding of how patient’s stories facilitated their clinical reasoning skills.

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

QUESTIONS

Pre- Survey 1. Did any of the following help you make a connection between theoretical teachings and your understanding of application? (Yes) or (No) If yes indicate which ones. a. traditional lecture b. classroom discussion c. guest lecturers' d. student presentations e. lab activity 2. Did any of the following help you in your understanding of how to develop a treatment plan: a. traditional lecture b. classroom discussion c. guest lecturers' d. student presentations e. lab activity 3. Did any of the following help you in your understanding of how to develop a SOAP note: a. traditional lecture b. classroom discussion c. guest lecturers' d. student presentations e. lab activity 4. What was your understanding of why specific guest speakers were brought into the classroom? Specify the speaker and what you learned from the speaker. 5. Please rank order the following according to how well each facilitated your learning (1 = most important and 5 = least important) a. traditional lecture b. classroom discussion c. guest lecturers d. student presentations e. lab activity 6. Please explain why you ranked each item from question 5 the way you did. 7. Explain the pros and cons of having this as an online course? 8. Explain the pros and cons of having this as a hybrid (lecture plus online) course? 9. Rate how well prepared do you feel going to your physical disabilities service learning experience: a. not prepared b. somewhat prepared c. neutral d. prepared e. very prepared 10. Rate how well prepared do you feel going to your mental health service learning experience: a. not prepared b. somewhat prepared c. neutral d. prepared e. very prepared 11. Rate how well prepared do you feel going to your pediatric service learning experience : a. not prepared b. somewhat prepared c. neutral d. prepared e. very prepared

Post Level 1 Fieldwork Learning Survey 1. Thinking back upon your Level 1 Observation experience, did any of the following help you make a connection between theoretical teachings and your understanding of application during you level 1 fieldwork experience? (Yes) or (No) Indicate which one or ones : A. traditional lecture B. classroom discussion C. guest lecturers' D. student presentations E. lab activity 2. Thinking back upon your Level 1 Observation, did any of the following help you in your understanding of how to develop a treatment plan during your level 1 fieldwork experience? A. traditional lecture B. classroom discussion C. guest lecturers' D. student presentations E. lab activity F. clinical Instructor 3. Thinking back upon your Level 1 Observation experience, did any of the following help you in designing or developing a SOAP note? A. traditional lecture B. classroom discussion C. guest lecturers' D. student presentations E. lab activity F. clinical instructor 4. What was your understanding of why specific guest speakers were brought into the classroom? Specify the speaker and what you learned from the speaker. Did the speaker or speakers increase your understanding of a specific patient or patients you encountered during your observations? 5. Looking back at your Level 1 Observation experience, please rank order the following according to how well each prepared you for your Level 1 observation experience (1 = most important and 5 = least important): A. traditional lecture B. classroom discussion C. guest lecturers D. student presentations E. lab activity 6. Please explain why you ranked each item from question 5 the way you did. 7. Explain the pros and cons of having this as an online course? 8. Explain the pros and cons of having this as a hybrid (lecture plus online) course? 9. · Please take a moment remember your physical disabilities experience and now rate how well or not prepared you were for the Level 1 Observation experience: A. not prepared B. somewhat prepared C. neutral D. prepared E. very prepared 10. Please take a moment to remember your mental health experience and now rate how well or not prepared you were for the Level 1 Observation experience: A. not prepared B. somewhat prepared C. neutral D. prepared E. very prepared 11. Please take a moment to remember your pediatric experience rate how well or not prepared you were for the Level 1 Observation experience: A. not prepared B. somewhat prepared C. neutral D. prepared E. very prepared 12. Please briefly describe your mental health, pediatric and adult rehab experiences and what each class could or could not have done to prepare you for your Level 1 Observation?

References Kimball, L. (2011). Liberating Structure. A new Pattern Language for Engagement. OD Practitioner. 43(3), Liberating Structures. Accessed from ( January, 9, 2014). Lindstrom-Hazel, D., & West-Frasier, J. (2004). Preparing Students to Hit the Ground Running With Problem-Based Learning Standardized Simulations. The American Journal of Occupational Therapy. 58,(2),