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Occupational therapy programs throughout the United States

are placing an emphasis on designing curriculum to enhance

students cultural competence in order to meet the demands of an

increasingly diverse population. (Kong et al. 1999) Occupational

therapy practitioners need to be aware and educated on how to

interact with people of different cultural backgrounds, including

ways to build rapport, and engage in culturally responsive care

(Humbert, 2012). In alignment with the demand for culturally

relevant practice, the ACOTE requires occupational therapy

programs include both national and international resources in

making assessment and intervention choices, and encourage the

influence of contributions of cultural factors to education,

research, and practice (Sood et al. 2014, p. 13). According to

Horton (2009), one specific way educational programs can enhance

their students cultural awareness is encouraging and offering ways

for students to travel abroad.

The foundation for clinical skills is provided within the

classroom setting, and further developed with level I and level II

fieldwork opportunities throughout the occupational therapy

students education. According to the American Occupational

Therapy Association, the goal of level I fieldwork is to ”introduce

students to the fieldwork experience, and develop a basic comfort

level with an understanding of the needs of clients.” (AOTA, 2013)

In order for international opportunities to be considered part of the

fieldwork experience, placements must comply with the

Accreditation Council for Occupational Therapy Standards. This

requires that the fieldwork placement align with the curricular

themes of the specific university, include a memorandum of

understanding, and ensure qualified personnel supervise the

student (ACOTE, 2007, a,b&c).

Consistency among research regarding international fieldwork

placements (IFPs) highlights the potential for international

placements to foster knowledge in a way that is global and

comprehensive (Haro et al 2014, Barker et al 2010, Humert et al

2012, Whiteford et al, 2007, & Simoenelis et al 2011). Following

an IFP, McAllister et al. (2006), found students reported increased

ability to identify stereotypical patterns of thinking, re-evaluated

their own assumptions, and reconstructed their understanding of

other cultures. Similarly, Humbert et al. (2012) found students

discussed increased cultural awareness, and adaptability by

responding to new challenges. Overall, existing literature supports

the opportunity for the occupational therapy studenst to engage in

the provision of therapy services to diverse populations, as it

exposes students to a unique clientele and fosters the development

of culturally competent practice.

REVIEW OF THE LITERATURE ABSTRACT

Alexandra Groot, OTD/S Faculty Advisor: Elena Espiritu, OTD, OTR/L

Expert Mentors: Janet Braun, Study Abroad Advisor and Operations Director Shelly Jewell, Director of Study Abroad

Residency Project: Exploring International Education Opportunities For Belmont OTD Students

SUMMARY According to the United States Census Bureau, ethnic

minorities will account for 48% of the U.S. population by the year

2050. (United States Census Bureau, 2012). As the health field

pushes for a more global outlook regarding the provision of health

services, educating students on diversity and cultural awareness is a

necessity. Providing the opportunity to participate in international

fieldwork placements can allow future Belmont Occupational

Therapy Students a unique opportunity for both personal and

profession growth.

REFERENCES

The purpose of this residency project was to create a

framework for international experiences (e.g. therapy based

mission trips, and fieldwork experiences) to enrich Belmont

Doctorate of Occupational Therapy student’s education regarding

the distribution of therapeutic services in diverse populations. By

including the opportunity for international involvement within the

curriculum, students can engage in a unique experience for growth

in a way that traditional fieldwork may not.

American Occupational Therapy Association. (2010). Occupational therapy code of

ethics and ethics standards (2010). American Journal of Occupational

Therapy, 64(6 Suppl.), S17-S26. doi:10.5014/ajot.2010.64S17

Barker, A., Kinsella, E.A., Bossers, A. (2010). Learning in international practice

placement education: a grounded theory study. British Journal of

Occupational Therapy, 73(1), 29-37.

Callister, L.C. & Harmer, A.C. (2006). Opening our hearts and minds: The meaning of

international clincal nursing electives in the personal and professional lives of

nurses. Nursing and Health Sciences, 8, 95-102.

Gat, S., & Ratzon, N.Z. (2014). Comparison of occupational therapy students’

perceived skills after traditional and nontraditional fieldwork. American

Journal of Occupational Therapy, 68(2), 47-54. doi:10.5014/ajot2014.007732.

Haro, A.V., Knight, B.P., Cameron, D.L., Nixon, S.A, Ahluwalia, P.A.,Hicks, E.L.

(2014). Becoming an occupational therapist: Perceived influence of

international fieldwork placements on clinical practice. Canadian Journal of

Occupational Therapy, 8(3), 173-182. doi: 10.1177/0008417414534629.

Horton, Ayana. (2009). Internationalizing occupational therapy education. British

Journal of Occupational Therapy, 72(5), 227-233.

Humbert, T. K., Burket, A., Deveney, R., & Kennedy, K. (2012). Occupational therapy

students’ perspectives regarding international cross-cultural experiences.

Australian Occupational Therapy Journal, 59(3), 225–34.

Kong, H., Hom, H., & Kong, H. (1999). Cross-cultural awareness and occupational

therapy education. Occupational Therapy International, 6(1), 24–34.

Knecht-Sabres, L. J. (2013). Experiential learning in occupational therapy: Can it

enhance readiness for clinical practice? Journal of Experiential Education,

36(1), 22–36.

McAllister, L., Whiteford, G., Hill, B., Thomas, N., Fitzgerald, M. (2006). Reflection

in intercultural learning: examining the international experience through a

critical incident approach. Reflective Practice, 7(3), 367-381.

Overton, A., Clark, M., & Yvonne, T. (2009). A review of non-traditional occupational

therapy practice placement education: a focus on role-emerging and project

placements. British Journal of Occupational Therapy, 72(7), 294-301.

Simonelis, J., Njelesani, J., Novak, L., Kuzma, C., & Cameron, D. (2011).

International fieldwork placements and occupational therapy: lived

experiences of the major stakeholders. Australian occupational therapy

journal, 58(5), 370–377.

Whiteford, G. E., & McAllister, L. (2007). Politics and complexity in intercultural

fieldwork: The Vietnam experience. Australian Occupational Therapy Journal,

54, 74-83.

Whiteford, G., & St-clair, V. W. (2002). Being prepared for diversity in practice:

occupational therapy students ’ perceptions of valuable intercultural learning

experiences. Australian Occupational Therapy Journal, 65(3),129-137.

CURRICULAR THEMES

Faith-Based

Advocacy

Clinical Excellence

Entrepreneurial Leadership

Phase 1

• Exploration of existing literature

• Identify ACOTE standards regarding international fieldwork opportunities

Phase 2

• Collaborate with Study Abroad department

• Identify international opportunities

• Gain an in-depth understanding of cultural competence

Phase 3

• Experiential Component in Guatemala

• Create Student Pre-travel Manual

Phase 4

• Create potential student activities

• Dissemination of project with academic fieldwork coordinator

MISSION

My mission is to demonstrate faith-based advocacy by exploring

international educational opportunities for future Belmont OTD

students. This will provide client-centered, occupation-based

services to a population in need, as well as allow future students

the potential to develop a deeper sense of cultural awareness and

understanding.

Barker et al (2010)

Personal and professional

development

Thinking outside the

box/Confidence

Adaptability

Cultural sensivity

Haro et al (2014)

Active Ingredients: confidence

•Creativity

•Cultural Sensitivity

•Problem Solving

OT roles:

•Communication

•Client-centered practice

Competitive Edge

Simonelis et al (2011)

Collaborative Learning

Cultural Negotiations

Thinking on my own

Humbert et al (2012)

Connectedness

Cultural awarness

Complexity

Whiteford et al (2007)

Client-Centered practice

Learning through doing

Doing

Callister & Harmer (2006)

Cultural competence

Interpersonal connections

Commitment to making a difference

Personal and professional

development

McAllister et al (2006)

Aspirations and expectations of the intercultural

experience

Culture Shock

Awareness and overcoming stereotypes

Intercultural communication

issues and strategies

Figure 3. Common themes within existing literature discussing the perceived benefits of international fieldwork placements.

Figure 2. Residency Timeline

Figure 1

GUATEMALA MISSION TRIP 2015

Belmont occupational and physical therapy students were

given the opportunity to participate in a therapy based

mission trip to Guatemala over the 2015 Spring Break.

Four clinicians and 21 students collaborated together

while working with children with various complex medical

conditions. The team was able to immerse themselves

within the Guatemalan culture while visiting a variety of

different settings including schools, orphanages, homes,

an adaptive tennis center, and a Church. Students

creativity soared by utilizing limited resources in various

ways to meet the specific needs of the individual.

The experience challenged students to think outside of

the box, and put the foundational skills learned in the

classroom to work in a diverse environment.

Interprofessional development also occurred due to the

occupational and physical therapy students need to use

each others skillsets to provide optimal care. Students

groups always had a representation from both disciplines

to ensure all needs were met. The team provided

donations including clothing, therapy supplies, toys, and

candy to a variety of schools, homes and orphanages. The

trip was an unbelievable experience which resulted in my

personal and professional development.

CONTENT WITHIN MANUAL

AOTA Guide for planning IFP

ACOTE Standards for Fieldwork

Memorandum of understanding

Going Global, Live Beyond, and World Relief overview

Passport 101

Travelers Insurance options

Recommended Packing List

Spanish to English cheat sheet

Recommended Vaccinations

Mission trips available through Belmont

Optional culturally relevant assignments