Making the Connection: Linking Education, Research, and Practice
By Ashley Opp Hofmann
Think of three areas—education, research, and practice—linked together in a powerful circle of knowledge. Working within this circle, occupational therapy practitioners could develop and research clinical questions and apply the new knowledge gained. The stronger the linkages in the circle, the more our profession would benefit.
As AOTA’s Centennial Vision moves forward, leaders and occupational therapy practitioners across the country are considering what it means to strengthen the link among education, research, and practice so that the profession can most effectively and productively wield its influence. This article is the second in a series that focuses on one part of the Centennial Vision—in this case, linking education, research, and practice. It aims to demonstrate the tangible ways in which the broad goals of the Vision are progressing.
Research, education, and practice each have their own separate and specific roles in the profession, but they are intrinsically attached to and dependent on one another. Broadly, universities have the resources to support research and the power to guide what skills students develop during their education. These students then enter clinics and schools, applying research findings to their practice and raising new research questions.
For example, practice constitutes an important starting point for clinically based research ideas. “When we work with patients, we are presented with the real-life clinical dilemmas that need to be figured out if we are to understand how to be the most effective occupational therapists we can be,” says Janice Burke, PhD, OTR/L, FAOTA, member of the Create Better Linkages Between Education, Research, and Practice Ad Hoc Committee, which advises AOTA on projects and activities aiming to strengthen the connections among these three areas. “This is where we are able to ask the critical questions: How is this client the same as other clients I’ve seen? How is he or she different? What techniques are working? Which ones are not? These are the kinds of ideas we are thinking about when we are assessing and treating patients and these are, in turn, the origins of important and relevant researchable questions that help us understand occupational therapy’s effectiveness.”
Occupational therapy practitioners must be able to translate the information, problems, and clinical questions they face in practice into viable research questions by collaborating with those who are skilled researchers. “Partnerships that parlay the best of our practice and research skills allow us to move the patient-based dilemmas we confront in day-to-day practice into fundable, researchable questions that are designed to systematically collect and analyze data,” Burke says. These kinds of projects lead to clear evidence about occupational therapy’s effectiveness.
Education is a major arena of potential, especially because its responsibility to the profession is twofold. First and most obviously, education programs develop occupational therapy practitioners and scientists. “Entry-level students are oriented toward practice—that’s what they enter our curriculum to do, so they need to be involved in practice-oriented research,” says Joan Rogers, PhD, OTR/L, FAOTA, chairperson of AOTA’s and the American Occupational Therapy Foundation’s (AOTF) Research Advisory Panel. According to Rogers, education programs need to teach students how to systematically collect and analyze data from clinical settings, make decisions based on clinical data, plan single-subject research, and grapple with the problems that can arise.
Education also has the opportunity and obligation to facilitate research, particularly at research-oriented universities. Supporting research within education settings might take the form of building strong faculties consisting of researchers; conducting very good entry-level programs; giving those who are qualified to conduct research the time to do so, for everyone’s benefit; or encouraging program directors and faculty to learn the ins and outs of applying for research grants, and how to conduct the subsequent research.
Colleges and universities have immense potential to lead the expansion of occupational therapy research. For example, in September 2007 a consortium made up of Washington University in St. Louis, the University of Delaware, and the University of Pittsburgh secured a 5-year, $4.6 million grant and the University of Florida and the University of Texas Medical Branch created a $5 million grant to create an interdisciplinary career development training program for occupational and physical therapists. The universities received the grants from the National Institute of Neurological Disorders and Stroke and the National Center for Medical Rehabilitation Research of the National Institute of Child Health and Human Development.
Although all three areas are dependent on one another, strengthening their connections even further is key. “The linkages between research, education, and practice are critical to the viability of the profession and to our ability to reach our Centennial Vision,” says AOTA Executive Director Fred Somers. “The generation of new knowledge, imbuing that knowledge into our educational content, and translating the knowledge into practice are all critical pieces that must work together for success. Empowering our practitioners with evidence-based clinical decision making and encouraging the partnership of clinicians and academicians in the pursuit of knowledge are all part of a powerful recipe for success.”
AOTA staff and leaders are working hard to strengthen the relationship between education, research, and practice. For its first major step forward, AOTA President Penny Moyers put together the Create Better Linkages Between Education, Research, and Practice Ad Hoc Committee. The Committee made recommendations that will inform new and evolving Association initiatives, particularly in continuing education, evidence-based practice, AOTA’s Annual Conference & Expo, and publications.
Specifically, the Committee was asked to address the ways in which AOTA’s publications might translate research to practice, how to connect practitioners and universities, ways to connect science and education to practice, and how to evaluate the effectiveness of the recommendations.
AOTA’s Board of Directors accepted the committee’s final report in October 2007 and charged staff to determine the feasibility of implementing its recommendations. By February—only a 4-month period—AOTA staff and leaders had made impressive progress. Among other recommendations, the committee pushed the need to promote “practice scholarship,” which Burke describes as “the idea of lifelong learning so that when practitioners engage in their work, they think about the implications of evidence.” AOTA is developing projects related to practice scholarship, such as identifying and publishing a collection of best practices that demonstrate good academic programs that integrate evidence into fieldwork.
The committee also recommended that AOTA and AOTF jointly sponsor a meeting consisting of the editors of the American Journal of Occupational Therapy, OTJR: Occupation, Participation and Health, and OT Practice to determine how these publications can better facilitate the translation of research to practice. AOTA and AOTF are making plans to implement this recommendation.
Another recommendation proposed that an AOTA Annual Conference & Expo center on the theme of “Finding Your Inner Scholar: Focus on Lifelong Learning.” The Association immediately applied the suggestion, making “Linking Education, Research, and Practice” the theme of the 2009 Conference in Houston, Texas.
Creating the Research Advisory Panel
AOTA took an enormous step toward linking research, education, and practice by jointly forming the Research Advisory Panel (RAP) with AOTF. The Centennial Vision includes creating a research agenda and promoting high-quality research. As an advisement body, the panel is reexamining the relevancy of current research priorities that were created in 1999 and reaffirmed—but not revised—in 2003. “We concluded that although much of the essence of those ideas is still current, [the research priorities] are not framed in language that is meaningful or that allows us to be well-aligned with the research priorities of federal funding agencies, such as the National Institutes of Health, Centers for Disease Control, National Science Foundation, or the National Institute for Occupational Safety and Health,” Rogers says. Challenged to come up with something better aligned, a small subcommittee will draft some priorities that the RAP can, as Rogers puts it, “react to, rephrase, or get rid of.”
Still very much in its infancy, the RAP plans to first consolidate the research priorities. As AOTA and AOTF determine the issues on which they want advice, the RAP will respond to and track those issues. Currently, as research-oriented questions arise, the panel channels them to the appropriate members.
Both internally within the Association and Foundation and externally to the public, “the RAP provides visibility for research and looks at what we can do to foster that science,” explains Rogers. “One of the critical problems facing us as a profession is that we have a dearth of scientists. If you don’t have scientists to research the effectiveness of your interventions, then we’re not on a scientific foundation.”
Constructing that foundation is key. “The Centennial Vision has helped focus the profession’s attention on the critical need to continue to build scientific foundation of the profession and link it to practice through excellence in education,” says AOTF President Ruth Ann Watkins, MBA, OTR/L, FAOTA. “This important goal provides multiple opportunities for AOTA and AOTF to work collaboratively to develop and connect occupational therapy research, education, and practice.”
This part of the Centennial Vision—strengthening the bonds between the three disciplines—might have the most tangible influence on the health and well-being of occupational therapy consumers in the future. First, however, a new direction must be taken. “To me, linking research, education, and practice is really about the whole shift in the way we need to manage knowledge in the future,” says AOTA President Penny Moyers, EdD, OTR/L, BCMH, FAOTA. “By bringing research, education, and practice together, I think we will do a better job in understanding how knowledge is created and applied. When we understand how knowledge is created and applied, we can be much more verbal to those who fund research in the application processes about the knowledge we are trying to create and its impact on lives.”
Ashley Opp Hofmann is AOTA’s senior staff writer.