Editorial Comment

Abstract

I call the readers’ attention to the on line publication of the full text of the articles that were published in Volume 40, No 3, 2010 of the South African Journal of Occupational Therapy that are now available on the journal web site in pdf format. This is in accordance with the journal’s policy of giving the members of the Occupational Therapy Association of SA (OTASA) access to information that is up to date in the form of a printed Journal but only making the information accessible to non members one year later. Readers should log on to the journal web site at www.sajot.co.za, go to the archive section and click on Vol 40, No 3, 2010. The list of articles is displayed. Click on the PDF tab under the page number of the article and this will bring up the full text.

In this edition of the journal, the article the “Role of the school based occupational therapist in a full service school¹ explores the current and potential roles of the occupational therapist (OT) within an inclusive mainstream education system from which no learners are excluded. If schools were to admit learners with special needs alongside the other learners, specialised support should be provided to help them to fulfil their educational needs. This would mean that the OT should play a role in providing some of this support. The question then arises as to what this support should include? From the focus groups and the interview that were held with teachers, managers, parents and an OT it is apparent that the role of the OT is unclear. It is also not clear quite how the private practitioners should fit into the system. In addition the authors identified that there were discrepancies between the inclusive education policy and its actual implementation with insufficient resources to implement the policy and a lack of support for the staff being provided.

The article entitled “The collaborative relationship between teachers and occupational therapists in junior primary mainstream schools”² considers another dimension of the problems which may be encountered in an inclusive education setting. From the focus groups held with firstly occupational therapists and secondly with teachers, four themes were identified i.e. methods of collaboration, the benefits of collaboration, the attitudes and obstacles that are encountered in this collaborative relationship together with an exploration of methods of overcoming the obstacles. The authors concluded from the research that there was a need for collaboration between the OT and the teacher to identify areas in which the OT can be of greater assistance to the learner. This and the previously mentioned paper identified the need for all role players to obtain a greater understanding of the services that the OT can and should offer especially as it was felt that there was a potential for growth and development of the OT service in the inclusive education system.

The paper on the “Achievement of community integration and productive activity outcomes by CVA survivors in the Western Cape Meropole Health district”³ considers the circumstances of stroke survivors after rehabilitation and whether they have been integrated into their communities, are as independent as possible and have become economically self sufficient.  The authors describe a very useful outcome measure that can be used to assess the extent to which this can be achieved. Data for the study were collected from 57 stroke survivors using the outcome measure as well as the Barthell Index and a questionnaire. The results showed that the majority of the members of the cohort improved with only 4 members regressing a level. However only 6 reached the level of .  participation in an income generating activity. The authors make a case for rehabilitation to continue at the community level to improve the employment status of CVA survivors.

Two articles follow which deal with rather different aspects of occupational therapy education. The first describes a process of curriculum review at the University of the Western Cape (UWC)⁵. In this review the staff responded to the challenge of making the curriculum socially responsive and politically relevant. From their analysis of the data collected which covered environmental scanning, feedback from teaching staff and clinicians, students evaluations, to name a few, the staff identified three themes to help them with this process namely: the essence of OT education at UWC; understanding political practice and integrating and operationalising political consciousness into the curriculum. Their conclusion was that merely changing the curriculum was insufficient to bring about change and that internalising political consciousness within the educators was a necessary component of the change process.

The second article related to OT education looked at whether the type of interpersonal communication skills of the clinical supervisors impacted on the students’ ability to acquire clinical reasoning ability during their education in the physical field of practice⁶. It is extremely interesting to note that the supervisors of the students who received good grades in clinical reasoning were predominantly linear in their approach, showed limited empathy and confirmation, were rigid in their expectations and were effective problem solvers. The authors concluded from their study that effective supervisors are norm driven and expect students to deliver high quality occupational therapy in line with their own reasoning. How this impacts on training supervisors is not explored but makes for interesting conjectures on the way in which this information could be used to better the most important aspect of the education of occupational therapists education i.e. clinical education.

There is a need for occupational therapists to consider using out-come measures to produce objective evidence of the success of intervention. While out-come measures have been available in medicine for some time there have been few published for the OT profession. The authors of the paper which describes the formulation of “Domains for occupational therapy out-comes for use in mental health practices”⁷ have described a few outcome measures currently available internationally but none that are uniquely South African other than the Vona du Toit Model of Creative Ability. The latter is a model of practice which is now being used internationally but there is little scientific evidence to support its use. This paper is the first of three which will report on a study to develop an out-come measure to be used in mental health practice in SA and it focuses on the determination of the domains for the model of an out-come measure. This is an extremely important process and will lead, I hope to the production of a uniquely South African measure.

In this Journal we have published a “Commentary” for the first time. This is a new section of the Journal which we hope will enable occupational therapists to publish work that they feel may be useful to the profession but that has not been through the scientific research process. The requirements for submissions of a commentary can be found in the “Instruction to Authors” section of the Journal.

The Commentary published in this Journal looks at the process of using the community process to help identify possible research questions and the production of a research protocol⁸. It describes the process that students follow to refine their research question and the support that they require in the research process.

It is disturbing to note that three of the articles in this edition comment that the role of the occupational therapists is poorly understood – this after approx 70 years of the profession’s presence in SA! I invite the readers to discuss this state of affairs in the form of letters to the editor.

References

1. Sonday, A. et al. School Based Occupational Therapists: An exploration of their role in a Cape Metropole Full Service School. SAJOT, 2012; 42 (1): 2-6. In this edition.
2. Hargreaves A, Nakhooda R, Mottay N, Subramoney S. The collaborative relationship between teachers and occupational therapists in junior primary mainstream school. SAJOT, 2012; 42 (1): 7-10. In this edition.
3. Hassan S, Visagie S, Mji G. The achievement of community integration and productive activity outcomes by CVA survivors in the Western Cape Metro Health District. SAJOT, 2012; 42 (1): 11- 16. In this edition.
4. De Jong J, Hess L, Wegner L. Curriculum transformation: A proposed route to reflect a political consciousness in occupational therapy education. SAJOT, 2012; 42 (1):16-20. In this edition.
5. De Beer M, Voster C. Fieldwork education: Putting supervisors’ interpersonal communication to the test. SAJOT, 2012; 42 (1):21-26. In this edition.
6. Casteleijn D, Graham, M. Domains for occupational therapy outcomes in mental health practices. SAJOT, 2012; 42 (1):26 - 34. In this edition.

De Jong J. Undergraduate occupational therapy students’ engagement in qualitative research: Identifying research problems and questions through reflection while in a community fieldwork setting. SAJOT, 2012; 42 (1):35-39. In thi