SIGNIFICANCE: Research has demonstrated the importance of epistemic and ontological cognition (EOC) to learning and achievement. Epistemic cognition can be defined as beliefs about the justification of knowledge (e.g., by accepting the word of authority figures, by personal experience, or by logic). Ontological cognition can be described as beliefs about the nature of knowledge (i.e., knowledge as certain, unchanging, simple, and discrete vs. evolving, complex, and integrated). Beliefs in simple and certain knowledge and justification by authority are considered more naïve than beliefs in complex, integrated knowledge and justification by logical evaluation of multiple sources of evidence. Investigators have shown links between EOC and metacognitive skills, persistence in problem solving, the ability to solve problems with more than one potential solution, and academic performance.

INNOVATION: Educators have also begun to recognize the implications of EOC for occupational therapy education and practice. To solve complex occupational performance problems, students must develop the EOC that will facilitate use of multiple sources of complex, integrated knowledge and evaluation of potential solutions based on contextual variables. To date, little research has been done to examine occupational therapy students’ EOC or to determine whether occupational therapy programs promote its development.

METHOD: The specific research question of this longitudinal study was as follows: How does EOC change over 18 mo of didactic coursework in an occupational therapy program? If occupational therapy curricula do not effectively facilitate the development of the EOC needed for successful practice, it will be incumbent on occupational therapy educators to develop and test new methods and techniques to promote more sophisticated EOC. Thirty-one of 33 occupational therapy students completed the Epistemological Beliefs Inventory (EBI), a 32-item Likert scale, in a classroom setting at the beginning, middle, and end of 18 mo of didactic coursework.

RESULTS: Repeated measures multivariate analyses of variance (MANOVAs), univariate follow-up tests, and Tukey post hoc tests indicated that although there was no difference in ontological cognition, there was change in epistemic cognition, with students demonstrating statistically significantly weaker beliefs in justification of knowledge by an omniscient authority by the end of the didactic portion of the program. This is not surprising, as strong beliefs in justification by an omniscient authority are only characteristic of the most naïve EOC and would be unusual for master’s-level students. Further, the change in epistemic cognition might be expected, because occupational therapy programs utilize techniques and approaches such as reflection, authentic fieldwork experiences, and case-based methods incorporating analysis of complex problems—all of which have been recommended as methods to facilitate the development of EOC.

CONCLUSION: Although causal inferences cannot be made from this small study of one cohort of occupational therapy students, it is possible that intensive study in the discipline of occupational therapy contributed to change in these students’ epistemic cognition.