Understanding Family Interaction Patterns in Families With Alzheimer's Disease.

This qualitative study explores the dynamic changes that occur in family interaction patterns when Alzheimer's disease is present. Semi-structured interviews were conducted with 15 participants who have a family member with the disease. Using modified analytic induction, guided by the dimensions of the Family Fundamental Interpersonal Relations Orientation (FIRO) Model, participants shared how Alzheimer's disease affected family structure, control dynamics, and intimacy among family members. Findings demonstrate that (a) families reorganize and restructure based on geographic proximity and shifting roles, act out of filial responsibility, and strive to preserve shared meanings and rituals; (b) decision making increases around care of the person with Alzheimer's disease and shifts to the primary caregiver or other family members based on their abilities; and (c) expressions of intimacy intensify while personality is preserved in the person with the disease. The Family FIRO model can inform practitioners using family-centered care with families with Alzheimer's disease.

Interrater Reliability of the Revised Cognitive Performance Test (CPT): Assessing Cognition in People With Neurocognitive Disorders.

The rigor of occupation-based standardized assessments that rely on observational scoring procedures depends on proven reliability among test administrators. This study measured interrater reliability of the Cognitive Performance Test (CPT), a standardized, occupation-based assessment that measures cognitive-functional capacity in older adults with neurocognitive disorders. To capture a range of experience among test administrators, two sets of raters-four expert and three novice-scored video recordings of 10 patients administered the CPT. Interrater reliability results were strong among all raters (intraclass correlation coefficient [ICC] = .93), with expert raters (ICC = .97) yielding higher coefficients than novice raters (ICC = .93). Spearman's ρ correlation coefficients were high among all raters (rs = .92-1.00). Practitioners can be confident that results of the CPT give accurate and consistent information to the health care team, family members, and patients when administered with fidelity using standardized protocols.

Building student community in a hybrid program.

The concept of student community has been shown to enhance learning, empower students, and increase engagement in the learning process. An occupational therapy program transformed classroom-based learning to a hybrid platform with over 70% of the course content online and expanded from one to two learning sites. Based on faculty concerns about occupational therapy students' experience of belonging to a community, this study compared student-perceived sense of community in the first and final didactic semesters of a hybrid Master's program. Using the Classroom and School Community Inventory and a Checklist of 24 Points of Contact, faculty found over 90% of students reported a sense of community with no significant differences from start to finish of the didactic program, or between learning sites. Furthermore, students reported informal, out-of-classroom interactions with colleagues, group assignments, and face-to-face classroom sessions as the strongest points of contact contributing to a sense of student community.

Using cognitive-functional assessment to predict self-care performance of memory care tenants.

A challenge in admitting individuals with Alzheimer's disease and related dementias into memory care residential facilities is determining the appropriate level of service based on abilities and care needs. At intake, the incoming tenant's functional performance capacity is obtained through family or proxy report corroborated with screening results of global cognitive function. Based on this information, the agency determines the level of service needs; if misjudged, inadequate placement can be stressful for the individual and family and costly for the facility. This study examined the predictive validity of a clinically administered assessment of cognitive-functional performance, Cognitive Performance Test (CPT), in gauging service needs in 4 activities of daily living (ADL; dressing, eating/feeding, showering, and toothbrushing) with 57 tenants residing in a memory care-assisted living facility. Linear regression results revealed a significant relationship between CPT scores and ADL performance in all areas (P < .001) with CPT scores accounting for 51% to 62% of the variability in performance.

Online course design for teaching critical thinking.

Teaching critical thinking (CT) skills, a goal in higher education, is seldom considered in the primary design of either classroom or online courses, and is even less frequently measured in student learning. In health professional education, CT along with clinical reasoning skills is essential for the development of clinical practitioners. This study, measuring CT skill development in an online theory course, supports using a cyclical course design to build higher level processes in student thinking. Eighty-six Masters of Occupational Therapy students in four sections of an occupation-based theory course were evaluated on elements in the Paul and Elder CT Model throughout the course and surveyed for their perceptions in their ability to think critically at course completion. Results of this study demonstrated that the online theory course design contributed to improving critical thinking skills and student's perceived CT skill development as applicable to their future professional practice. In a focus group, eight students identified four effective course design features that contributed to their CT skill development: highly structured learning, timely feedback from instructor, repetition of assignments, and active engagement with the material.

Teaching program development and evaluation through a service learning project in community-based adult day services.

ABSTRACT This paper examines an instructional methodology, service learning, as a method for teaching program development and evaluation in adult day service centers. Adult day service, an emerging practice area, provides an opportunity for students to learn program development while they explore and meet the occupational needs of elders living in the community. Students learn to design and implement day service activities to benefit both the agencies and people they are serving. In this study, 39 students were surveyed before and after a service learning experience to determine if they perceived service learning as effective in increasing knowledge and confidence to develop, implement, and evaluate an adult day services program module. In an evaluation of the service learning project, students reported that their knowledge and confidence increased significantly in assessing organizations and populations, designing and carrying out an activity with well elderly, and creating an evaluation measure. Furthermore, students reported a high level of comfort in working with elderly populations before and after the service learning experience.

Incorporating problem-based learning and video technology in teaching group process in an occupational therapy curriculum.

This paper describes an innovative, cost-effective method for teaching group dynamics in an occupational therapy curriculum. The revised "Models of Group Dynamics" course incorporated problem-based learning (PBL) sessions and video technology. In this single-semester course, the class of 24 students was divided into small groups of five to seven students. Each group participated in six hours of PBL sessions and six hours of observation. PBL; effectively served as the instructional methodology to stimulate group dynamics because it demands that the students engage in the group process by creating an open structure for discussion, negotiating goals, and building team consensus in the group. The PBL experience facilitated the integration of the various content areas of the curriculum by expecting the student to apply previous learning to the construction of a therapeutic treatment plan. Through the use of a closed-circuit video monitor, students in the observation group analyzed group process skills in real time without interruption. This format provided the opportunity for students to generate feedback responses about group process with faculty guidance. The use of a closed-circuit video monitor was a low-cost, effective tool that facilitated the learning process. Measures of student learning indicated that the new course design was effective in meeting course objectives. Measures of the effectiveness of the new course design included focus groups conducted in two time periods: after completion of the course and after completion of fieldwork. The results demonstrated that the course had continuing impact on group skills carried into the fieldwork experience.

Qualitative evaluation of a management course project: creating new job possibilities for occupational therapy.

SUMMARY A qualitative analysis of a ten-step management course project in occupational therapy education demonstrates the students changed perception of future job possibilities. The assignment, designed using a student-centered approach, bridges individual skills and interests with the creation of an occupational therapy position in an emerging market. The thematic analysis indicated the outcomes of the assignment were: a changed perception in the importance of a good fit between practitioner skills and the agency or program needs, added confidence in the students' skills based on a review of the two years of academic education, and a positive, anticipated transition of the academic knowledge base into real world experience. Student presentations served to measure the ability to articulate the services of occupational therapy within arenas unfamiliar to the profession.