05-14-07
Through a Cross-Cultural Lens
Sue Baptiste
Over the past year, I have had the good fortune of participating in the Ad Hoc Working Group exploring fieldwork in occupational therapy established by the American Occupational Therapy Association (AOTA). I was the "Canadian colleague," charged with listening well, reflecting, and asking questions that needed to be asked in order to view fieldwork in a new way. Sometimes, having the chance to be the outsider is a privilege and this was indeed the case in this circumstance. It would seem that we undertake the practical component of occupational therapy education in very different ways on each side of our common border. Our differences were highlighted and our similarities appreciated and celebrated.
The Context
We looked widely at what it means to prepare new practitioners in our fast-paced, ever-changing health care contexts. We saw the importance of recognizing that as the world becomes more neighborly and smaller, its citizens closer to one another, it behooves us to take the opportunity to incorporate broader interpretations of what fieldwork should and could be. Since returning from our past meeting in January, I have been thinking about the importance of building processes and framing expectations that are readily transferable across cultures and countries, while not compromising our desire for excellence in practice. This is no easy task, but one that invites input and investment from all sectors of our profession. The preparation of new professionals is a singularly complex process that needs to be seen as central to our overall curriculum development. For too long, we have allowed fieldwork to exist "just a little bit outside" of the serious business of creating curriculum content within the academic setting and, indeed, have moved to an advanced credential for entry to practice, making even wider the potential chasm between learning and thinking, and reflecting and doing. Without the practical, experiential component of understanding what occupational therapy is all about, our ultimate goal of graduating competent clinicians will never be achieved.
The Challenge
Perhaps the central challenge is for educators to work closely with practitioners, connecting to researchers and current learners as questions arise, in order to create an integrated and balanced experience designed to develop and prepare competent entry-level professionals. This professional preparation is composed of an elegant integration of the academic with the practical, each building on the other in a spiral fashion that allows evolving professionals to be actively engaged in their learning. To enable this convergence and synergy to emerge, flexible and creative ways of translating fieldwork and clinical placement will be at the core of this innovation. No longer will we be cautious or even fearful of clinical supervision models that advocate for several students with one preceptor, several preceptors with one student, or no occupational therapist on site but supervision through a seasoned clinical educator from another profession with links back to the home faculty. I am well aware that such placements exist now, but I wonder to what degree and how often we dare to venture from the tried and true. For sure, fieldwork is not "broken," but it does invite the taking of a fresh view, and one that involves colleagues in new environments, at home and abroad.
The Dream
Imagine, 20 years from now as I sit in my room (God willing), looking at the latest OT journal and reminiscing about friends and events at the turn of the 21st century—what I knew and experienced then will be but a pale comparison to how student occupational therapists and new practitioners are learning in 2027. Obviously, technology will have played an enormous role in the development of innovative delivery methods to enable students across multiple sites and far locations to engage in profession-specific and inter-professional learning. However, technology is but one element that will contribute to future professional preparation models. For me, the power is in the relationships through which we learn more richly, and around which boundaries and limits are only placed by the narrowness of the vision of those involved in the relationship process. Relationship-centered environments are built on values and behaviors that are familiar in the context of "putting the client first." In fact, they are predicated on notions of trust, honesty, and respect; ideas that are comfortable realities for occupational therapy practitioners in their work. To create opportunities for such a future reality, we must engage in enhancing the application of our central beliefs of cultural sensitivity, partnership, authenticity, and mutual regard through an integrated approach to professional preparation for occupational therapy learners.
Sue Baptiste, MHSc OTReg (Ont), has been a tenured full professor within the faculty at the School of Rehabilitation Science at McMaster University, Hamilton, Ontario, Canada since 1998. She is also a past assistant dean for the Occupational Therapy program, having led the process of curriculum development prior to starting the entry-level master's program in 2000. She has consulted around the world in areas of chronic pain, problem-based learning, faculty development, and curriculum reform, and she enjoys facilitating workshops to support continuing professional development and competence.
Reference Information:
Baptiste, S. (2007). Through a cross-cultural lens. [Electronic Version]. OT Practice, 12(8), 14.
©Copyright 2007. The American Occupational Therapy Association. All rights reserved.