British Journal of Occupational Therapy

Practice education is fundamental to pre-registration learning for many health and social care professions, yet finding sufficient opportunities for students is challenging. One-to-one student–educator pairings are common, and while different models could increase placement opportunities, the associated terminology is inconsistent and an overview of advantages, challenges and available evidence is missing. This mapping review identifies, categorises and critically considers the evidence for different models of practice education used by health and social care professions.

Papers from 2008 onwards reporting on practice education approaches in allied health or social care profession courses were identified in three databases. Data was extracted, methodological quality categorised and a typology of practice education models developed.

Fifty-three papers were reviewed and developed into a typology of 14 models. Mapping indicated issues with a lack of high-quality research and limitations in available outcome indicators. Pre-requisites for the effective operation of different models include preparation, communication and allowing sufficient time for new ways of working.

Practice education discourse is characterised by varied terminology and practices. Various models for structuring practice education exist, though the evidence for their effectiveness and impact on capacity is limited. Using consistent language and considering wider impacts and outcomes is recommended in future study.

Therapists’ interpersonal skills are important contributors to client participation. Providing therapists with opportunities to self-reflect on their approach to therapeutic communication can support occupational therapy best practice. The aim of this study was to evaluate the reliability and validity of the observer version of the Pediatric Clinical Assessment of Modes.

The Pediatric Clinical Assessment of Modes was used to rate therapists’ overall and individual communication mode use according to the Intentional Relationship Model. Successful and unsuccessful attempts were rated separately.

The observers rated 125 therapist–child interactions. The successful and unsuccessful domains of the Pediatric Clinical Assessment of Modes demonstrated appropriate internal consistency, inter-rater reliability, and structural validity for evaluating the therapist’s overall communication and individual use of the collaborating, empathizing, encouraging, instructing, and problem-solving modes. The empathizing, encouraging, and problem-solving subscales demonstrated greater than expected floor effects and could not effectively separate therapists into high and low performance groups for the unsuccessful domain. The observers reported low frequency of successful and unsuccessful communication attempts for the advocating subscale, raising concerns related to the reliability of this subscale for evaluating therapist–child interactions.

Study findings support the reliability and validity of the Pediatric Clinical Assessment of Modes for use in pediatric outpatient rehabilitation.

Upper limb motor impairment after a stroke is an important sequela. Constraint-induced movement therapy is a rehabilitation approach that has strong evidence. The incorporation of transcranial direct-current stimulation has been proposed; however, there is a lack of studies that confirm its benefits. The principal aim is to compare the effectiveness of 7 days of active versus sham bi-hemispheric transcranial direct-current stimulation, combined with modified constraint-induced movement therapy, for motor and functional recovery of the hemiparetic upper limb in subacute stroke patients.

Randomized, double blind, sham-controlled, parallel group clinical trial in two stroke units. Participants: adults over 18 years, at least 2 days post unihemispheric stroke event, with hemiparesis, and without severe pain, aphasia or cognitive impairment. Intervention: Patients will receive 7 days of continuous therapy and be assigned to one of the treatment groups: active bi-hemispheric transcranial direct-current stimulation or sham bi-hemispheric transcranial direct-current stimulation. Measurement: Evaluations will take place at days 0, 5, 7 and 10, and at 3rd months. The Fugl-Meyer Assessment – Upper Extremity, Wolf Motor Function Test, Functional Independence Measure and Stroke Impact Scale are considered.

Modified constraint-induced movement therapy plus transcranial direct-current stimulation in subacute stroke patients with hemiparesis could maximize motor and functional recovery.

Trial registration: ClinicalTrials.gov identifier NCT03452254.

Stroke is a major cause of mortality and disability in childhood. There is a false belief that children will recover better than adults and recent research confirms that younger age at injury can have a negative impact on rehabilitation outcomes, resulting in lifelong disability. Self-care is a key rehabilitation outcome for children and young people.

This service evaluation reviews routinely collected clinical self-care data from one specialised residential rehabilitation centre in the United Kingdom. Admission and discharge scores from the United Kingdom Functional Independence Measure +Functional Assessment Measure, Rehabilitation Complexity Scale – E and Northwick Park Nursing Dependency Scale were analysed.

Twenty-six children and young people age 8 years and over with severe stroke were included. Mean scores of independence increased and mean scores of complexity and dependency decreased. A proportion of the sample had ongoing self-care needs in relation to support needed in washing, dressing and bathing. A small number remained highly dependent, requiring assistance from two carers.

Children and young people make significant gains in self-care independence during specialised rehabilitation. However, a proportion return to the community with high self-care needs. Occupational therapists and the wider care team should address ongoing self-care needs in this population.

The aim of this retrospective cross-sectional study is to examine the routine use proportion and factors determining the use of the Canadian Occupational Performance Measure in the real-world subacute rehabilitation setting.

This study retrospectively collected data from all inpatients and occupational therapists at a single Japanese subacute rehabilitation ward during 2017, including Functional Independence Measure motor/cognitive scores, years of experience, and rate of Canadian Occupational Performance Measure administration (that is, Canadian Occupational Performance Measure proportion). Multiple logistic regression analyses were used to identify the determining factors of daily routine Canadian Occupational Performance Measure use/non-use, after which cut-off values were calculated.

Of the 619 included clients, the Canadian Occupational Performance Measure was applied in 232 cases (37%). A multiple logistic regression analysis revealed two significant determining factors of its use: Canadian Occupational Performance Measure proportion (odds ratio, 1.06) and Functional Independence Measure cognitive item (odds ratio, 1.22). The cut-off value, sensitivity, and specificity, respectively, were 35.4%, 0.73, and 0.36 (p < 0.0001) for the Canadian Occupational Performance Measure proportion and 25.5, 0.84, and 0.45 (p < 0.0001) for the Functional Independence Measure cognitive score.

The client’s high-level cognitive skill and occupational therapist’s attitude may determine the use of the Canadian Occupational Performance Measure.