PURPOSE: The objective of this study was to expand knowledge of how 1st-yr MOT students perceive changes in occupational roles, patterns, and routines and what strategies are used to adapt to these changes.

BACKGROUND: Health care educational programs are found to be especially stressful as students experience changes from previous occupational roles, patterns, and routines. The shift to an entry-level master’s for occupational therapists led to greater imbalance of occupations, with more rigorous academic requirements, and a greater emphasis on theory, research, and clinical reasoning skills. Students’ perceptions of how they manage time once in a MOT program suggest the first semester can be overwhelming and stressful. Pfeifer, Kranz, and Scoggin found that 67% of MOT students rated stress at “above average” to “highest in my life.” Additional stress was reported when using higher level clinical reasoning skills, concepts, theory, and research.

Findings support occupational imbalance, noting that MOT students were motivated but lacked preparation for the energy, effort, and time required. Findings suggest that graduate school is dominated by a shift in balance of daily occupations. Although this experience is anecdotally known to be stressful, data on how MOT students define their experiences with shifts in occupational performance are absent from these studies.

METHOD: A phenomenological design examined perceptions of 22 entry-level students in a traditional MOT program. Potential informants were contacted via email by researchers, informed of the purpose and method of the study, and asked to participate in 1-hr individual, semistructured, in-depth interviews in their first semester. Four overarching questions guided the data collection.

Data analysis began when the first data were collected and progressed throughout the study as interview transcripts were read and important themes were noted. Open coding procedures were used to analyze the data. Reflexivity was addressed through inward reflection of each researcher’s feelings and reactions during the data collection process, and data triangulation was ensured with review of data from three researchers.

RESULTS: Preliminary themes that emerged from this study were related to occupational transitions and occupational shifts. Occupational imbalance, lifestyle rebalancing, and developing new occupations were the three predominant themes. Findings support prior research noting a challenging shift in occupations for many MOT students and use of various adaptations and coping methods. Greater knowledge of occupations is evident, as well as awareness of students’ own level of occupational balance. The aim is for findings from this study to lead to better understanding of helping students manage stress during transition into graduate and doctoral school.

IMPLICATIONS: With approximately 17,332 students enrolled in MOT programs and intent to move to doctoral entry level, there may be a significant increase in occupational imbalance among occupational therapy students. It should be a priority of occupational therapy program administrators and faculty to help occupational therapy students achieve and retain occupational balance. The core of our profession supports a healthy balance of meaningful occupations as vital to health and well-being, and today’s students are tomorrows educators.