Designing curricula

Creating a renewed curriculum for first-year master’s and doctoral students

by Michele Berhorst  •  October 15, 2019

Left to right: Wanda Mahoney, PhD, OTR/L; Betsy Hawkins-Chernof, OTD, OTR/L, ATP; Steve Taff, PhD, OTR/L, FNAP, FAOTA; Lauren Milton, OTD, OTR/L; and Christine Berg, PhD, OTR/L, FAOTA, discuss the renewed curriculum at the faculty retreat.

In fall of 2019, Program in Occupational Therapy faculty began teaching a renewed curriculum to the first-year master’s and doctoral students. The rollout marks the end of a two-year process of curriculum review, evaluation and renewal spearheaded by Stacy Smallfield, DrOT, OTR/L, BCG, FAOTA, associate professor of occupational therapy and medicine and assistant director of entry-level professional programs. Smallfield’s dedication and commitment to the renewal goes beyond strictly professional interest; it is personal as well. In recent years, she has seen family members receive care in hospital settings both with and without an occupational therapist on the team.

“The health-care system in the U.S. still has the opportunity to make significant improvements in the patient experience while improving health and reducing costs. Occupational therapists are critical members of the team that can make those things happen,” explains Smallfield.

Driving change

Academic institutions and disciplines periodically review, renew and/or revise their curricula. However, not all disciplines do so as often as the Program does. Smallfield says there are three main drivers for such frequency.

“The first driver is simply maintaining a contemporary curriculum. Occupational therapy science has emerged rapidly in the last 20 years, and we need to be teaching current practice and evidence-based interventions to our students. The second driver is the changing health-care systems. Managing chronic conditions are putting a strain on the current system, and we need to think about new models of care. [Occupational therapy] interventions need to be much more community based than ever before,” shares Smallfield. “The third driver was the positioning of the clinical doctorate degree in our profession. When we started this process in 2017, it looked as if there was going to be a single point of entry at the doctoral level. We needed to be prepared to deliver the curriculum to a full class of 90 or more doctoral students.”

The doctoral mandate was eventually put in abeyance, then removed completely before the curriculum renewal was complete. Even without it, Smallfield says the renewed curriculum positions the Program sooner rather than later for a class composed mostly of doctoral students. “When we began our doctoral program in 2001, we were one of only four schools to offer the degree. Now there are more than 140 programs either at or in process of transitioning to a doctoral degree, and that number is growing rapidly. We need to offer the best degree possible while staying competitive in regards to technology, tuition, scholarship and research opportunities.”

Working backward

The curriculum renewal process began with the Program’s Curriculum Committee deciding what the outcomes were going to be. “We started by asking, ‘What skills do we want a WashU OT graduate to have?’ We wrote those outcomes first and then asked ourselves, ‘How do we get there?’” says Smallfield.

As the committee met each month, core members shared information back to all faculty members for input to help make key decisions. When a complicated issue arose, special task groups were created to explore in-depth the various concerns and possible solutions. After months of intense work, the committee had mapped out the renewed curriculum sequence with course descriptions that met the Accreditation Council for Occupational Therapy Education (ACOTE) standards.

The proposed curriculum then went through a series of approvals, beginning with the Curriculum Committee itself and moving internally all the way up to the Washington University School of Medicine Executive Faculty, who approved the renewed curriculum at its Oct. 3 meeting. The necessary documentation was then submitted in November 2018 to ACOTE, and it was approved in January 2019.

To assist with the renewed curriculum design, distinguished educational scholar Barbara Hooper, PhD, OTR, FAOTA, led a two-day retreat for faculty on June 25-26. Hooper has received numerous teaching and scholarship awards, authored several book chapters and regularly consults with faculty groups nationally on designing curricula, courses and teaching/learning activities for transformative learning. Under her facilitation, the faculty applied principles of subject-centered integrative learning as they worked on renewing courses in the curriculum. The retreat also fostered team building and camaraderie.

“Several new faculty members joined the Program in the last two years. Working together at the retreat helped all of us reach a new level of cohesiveness within the Education Division,” says Smallfield. “It’s also put us all on the same page moving forward.”

Weaving threads

The renewed curriculum prepares students for the changing health-care systems by using active teaching and learning strategies with an emphasis on process. Students will learn research-driven, evidence-based evaluation and intervention strategies to support participation and well-being across the continuum of care. The foundation for coursework is the Person-Environment-Occupation-Performance (PEOP) model.

“What makes our program unique is our central focus on the person, the environment and the occupation. Our curriculum model is rooted in five central concepts that we call threads, which are illustrated in our kaleidoscope graphic. The five threads are woven through the curricula, but combined with the kaleidoscope concept, they create individualized experiences for each student,” says Smallfield. “The curriculum is the same, but each student will experience it differently because of their backgrounds, perspectives and experiences. Students can also personalize the curricula to meet their learning goals and objectives to prepare them for the career they want.”

In addition to the technical skills taught, the renewed curriculum provides numerous opportunities for students to engage in experiential learning through fieldwork experiences in the Program’s clinical practice sites and student-run clinics. These interactions with actual clients teach students empathy, compassion and inclusiveness. Smallfield was recently reminded of how equally important those skills are to an occupational therapist.

“Two years ago, my father had a bilateral knee replacement surgery. Post-op, day two, my family sent me a photo of my father with his occupational therapist. I knew it was his occupational therapist because she had been my student,” shares Smallfield. “It was a powerful reminder that educators need to teach students to treat the patient how they would want their family to be treated. And by chance,
I had taught this occupational therapist how to treat my father.”
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