Anita Witt Mitchell; Epistemic and Ontological Cognition of Entering and Postdidactic Occupational Therapy Students. Am J Occup Ther 2014;68(Supplement_2):S3-S11. doi: 10.5014/ajot.2014.011882.
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Beliefs about knowledge and knowing, also called epistemic and ontological cognition (EOC), are associated with many aspects of learning and achievement; no published studies have described the EOC of occupational therapy students. This study compares and contrasts occupational therapy students’ EOC at entry and on completion of didactic coursework. Twenty-one incoming and 33 postdidactic students completed the Epistemic Beliefs Inventory and the modified Four-Quadrant Scale and provided explanations for their self-ratings. Results indicate that the postdidactic students held more sophisticated stances toward occupational therapy–specific knowledge. The entering students demonstrated dogmatist and skeptic perspectives, with minimal evidence of a rationalist view of knowledge, whereas the postdidactic students showed evidence of primarily skeptic stances, with the emergence of rationalist views. Implications for occupational therapy theory, education, and research are discussed.
My reasoning for this area is in regard to my belief that while some practices, procedures, etc. in the field may be fixed, research is constantly allowing the field and treatment to change and improve. Therefore, one must be flexible to learn and adapt in order to effectively and efficiently treat their patients.
Although two clients may have the same diagnosis, every single client is different and should be approached in a different way. There may be occasions where you can use the same approach with two patients of the same diagnosis; however, each client should be approached in a unique manner. There are no two individuals alike; therefore their treatment and approach should be customized to fit each one. There is no one correct way to assess and treat a client; therefore, two clients with the same diagnosis can have multiple approaches to their care, all of which are beneficial and produce optimal outcomes. As new evidence arises, changes should also be made in the approaches used with patients. Better information and results lead to better outcomes for our patients. . . . There is not a cookie cutter approach to assessment or treatment that should be used for a specific diagnosis.
The therapist should decide what assessments and interventions should be done. . . . The client will have to be willing to participate in the treatment process, but the therapist was educated to treat patients so they should decide what treatment should be done.
Each individual is different, and occupational therapists are known to be client-centered, involving the client in every decision in the process. In order to build rapport with your client, you must be honest and involve them in all decision making. After all, the decisions are about them, not the therapist. The client is the most important member of the team because he or she will determine the plan of treatment with what is most important to him or her. The client is able to best define the disability’s effect on his or her life and can make the best choices in adapting and/or restoring functionality in everyday life.
Occupational therapy students demonstrated more sophisticated ontological cognition than that of the realist.
A developmental trajectory is likely for both domain-general and domain-specific EOC, with ontological cognition evolving first.
Further clarification of the factors making up ontological cognition seems warranted; the EBI SCK scores differed significantly between entering and postdidactic students, and both groups tended to address themes related to Certain Knowledge more than those related to Simple Knowledge.
Greene et al.’s (2008) timetable for attaining the rationalist position in domains such as occupational therapy was not supported because evidence of dogmatism and skepticism were apparent; however, Muis et al.’s (2006) hypothesis that simultaneous study of both well-structured domains and less-structured domains might interfere with the development of EOC was potentially supported.
Longitudinal research is needed to confirm whether participation in an occupational therapy program contributed to the differences in students’ occupational therapy–specific EOC at entry and at the end of the didactic portion.
Case-based assignments and evidence-based decision-making may be challenging for students with more naive EOC.
Knowledge of students’ EOC could provide a lens through which educators might interpret students’ learning difficulties and identify effective remedial approaches.
Inclusion of probing questions and an objective measure of personal justification could help elucidate occupational therapy students’ epistemic cognition and reveal subtle differences between novice and more experienced students.
Longitudinal studies of domain-specific and domain-general EOC could shed light on the developmental trajectories and relationships between the two.
Future research could examine the relationships between measures of achievement and EOC.
Studying EOC during both didactic coursework and fieldwork might reveal the relative contributions of the experiential versus didactic aspects of an occupational therapy program to the development of EOC and offer evidence to determine whether curricula provide the educational context and rigorous study that promote change in these beliefs.
Research examining the relative effectiveness of instructional methods may help identify efficacious techniques for facilitating development of occupational therapy students’ practice epistemology.
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