Promoting an appreciation for research-related activities: the role of occupational identity.
Abstract: The profession of occupational therapy faces the challenge of introducing research as an occupation to undergraduate students. Occupational therapists value occupation, the influence of the environment and the role of culture within a specific environment. Therefore, these aspects should be considered not only when working with clients but also when educating students. A process for promoting an appreciation for research-related activities (PARRA) is introduced and scrutinised for its ability to promote a research culture. The components of this process suggest engagement in research-related activities that would influence students' occupational identities and enable transformation towards a lifelong engagement in research.

Key words: PARRA process, research, occupational identity.
Subject: Health education (Usage)
Occupational therapists (Practice)
Occupational therapists (Services)
Occupational therapy (Analysis)
Authors: Toit, Sanet du
Wilkinson, Annette
Pub Date: 10/01/2011
Publication: Name: British Journal of Occupational Therapy Publisher: College of Occupational Therapists Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 College of Occupational Therapists Ltd. ISSN: 0308-0226
Issue: Date: Oct, 2011 Source Volume: 74 Source Issue: 10
Topic: Event Code: 200 Management dynamics; 360 Services information
Geographic: Geographic Scope: South Africa Geographic Code: 6SOUT South Africa
Accession Number: 271053264
Full Text: Statement of context

This article describes the research-associated learning process undertaken by students in occupational therapy at the University of the Free Sate (UFS), South Africa, and how current research-related activities were analysed and reconsidered. Consequently, a process for promoting an appreciation for research-related activities (PARRA) is suggested and discussed for the potential it may have on promoting a research culture at undergraduate level. As will be shown, this process closely mirrors the growth and development process inherent in the Model of Human Occupation.

At the UFS, small-scale research projects during practice placement education are part of the students' undergraduate curriculum in their final year. There are also numerous other activities in the curriculum that advance the development of research skills and attitudes in these students' education (see Table 1).

Despite this exposure, only a limited number of students later engage in postgraduate degrees in occupational therapy at the UFS or at other institutions in South Africa. Furthermore, little evidence exists that undergraduate research-related activities are welcomed as an integral part of occupational therapy practice, and 'occupational therapists appear not to embrace a lifelong inclination towards doing and sharing research' (Du Toit and Wilkinson 2009, p2).

Internationally, this phenomenon is supported by the observed divide between theory and practice in occupational therapy, an issue that continues to receive attention in current occupational therapy literature. Occupational therapists admit to not using research findings and specify numerous obstacles that hamper research capacity building (Forsyth et al 2005, Lencucha et al 2007). In essence, this limitation in research literacy (Lencucha et al 2007) apparently intensifies the academic-practice gap, as occupational therapists acknowledge that they do not identify with the generation and presentation of knowledge by scholars (Forsyth et al 2005). If research is neglected in practice, as it apparently is, and clinical experience is also not shared extensively, alternative ways to generate and exchange ethically sound knowledge should be explored.

Lencucha et al (2007, p596) suggested that knowledge translation should be considered to model research use, because learning is 'socially informed by tacit and explicit knowledge'. The argument in this discussion is that undergraduate education potentially provides a milieu to promote knowledge translation, since natural interaction exists between students, academics, researchers and clinicians. The interaction among occupational therapy students specifically could assist with facilitating a research culture at undergraduate level. Culture depicts an ethos of traditions and customs, associated with specific roles (Kielhofner 2008), and would form a natural part of what occupational therapy students do and expect themselves to do. As in any culture, these traditions and customs would have to be part of 'infant' student life and mature with the students during their education.

With the idea of facilitating a research culture, a formalised process for promoting an appreciation for research-related activities (PARRA) was developed at the UFS. An extensive action learning action research (ALAR) approach led to the development of the process, as the undergraduate occupational therapy programme stretches over 4 years. There are, therefore, ample opportunities for interaction and collaboration among students during their involvement in a variety of research-related activities that are not optimally used.

In addition to pinpointing new opportunities, the PARRA process endeavoured to connect all existing research-related activities that could culminate in a conceptual basis for promoting a research culture. This process could potentially contribute towards adding research to professional socialisation, where values, roles and habits are acquired during engagement in the occupation.

The PARRA process

Kielhofner (2008, p106) defined occupational identity as 'a composite sense of who one is and wishes to become as an occupational being generated from one's history of occupational participation'. Occupational participation and, consequently, the ability to perform activities, specifically research-related activities in this instance, is viewed by Law (2007, p602) as 'an experience rather than an observed phenomenon'.

The PARRA process concentrates on creating and combining opportunities that could enforce a positive experience and facilitate an appreciation for research. These opportunities depend upon interaction between students at different stages of their education, which could establish the progressive development of customs and traditions associated with a research culture.

The PARRA process could be depicted as a pyramid comprising four layers representing successive stages or phases towards the development of research competencies in students. These are as follows:

1. Pre-foundational (first) phase

2. Foundational (second) phase

3. Practical (third) phase

4. Reflexive (fourth) phase.

As engagement in research-related activities is part of the undergraduate occupational therapy student's education, each successive phase in the PARRA process is associated with a specific role that students could assume during exposure to such activities (see Table 2). The roles 'mature' in the successive phases of the process into specific research-related values linked to the attainment of habits associated with research. Table 2 summarises the main components associated with the PARRA process.

Competency in the engagement of research-related activities is, for example, encouraged in the pre-foundational phase by teaching junior students about undertaking literature searches, referencing and compiling reports, but they should also be exposed to situations where they can observe presentations and feedback by senior students. As expectations for competency advance from the pre-foundational (first) to the reflexive (fourth) phase, students are involved in a process of 'fulfilling the expectations of ... roles and ... values and standards for performance' (Kielhofner 2008, p107).

Research as an occupation would furthermore be influenced by the student's motivation, how frequently research-related activities are engaged in and how individual capacities impact on levels of performance. The PARRA process mirrors the ethos of the Model of Human Occupation (MOHO) in that the components indicated for each student would be influenced by his or her 'selection, organisation and undertaking' of research-related activities (Kielhofner 2008, p12). Values, roles and habits are also conceptualised ideas inherent to MOHO.

In order to clarify the link with MOHO as visible in the components of the PARRA process, the aspect of research as an occupation, as well as the roles, values and habits establishing a research culture, receives attention. It provides a basis for conceptualising the maturation process promoted by the PARRA process.

Research as an occupation

Research is an inseparable part of university activities. Definitions of research basically stipulate engagement in an organised process in order to learn something. According to French et al (2001), research refers to the process of systematic inquiry and finding out. This process is engaged in to improve the understanding of the topic concerned, which could also include a theoretical dimension. The generation of new knowledge through the application of a scientific method should accommodate interplay between curiosity, creativity, critical thinking abilities and knowledge of research procedures (Isaak and Hubert 1999).

Research as an occupation is influenced by the university environment. In addition to a lack of understanding about the reasons for involvement in research, Winn (1995) identified poor organisation as a component that could have a further negative impact upon undergraduate research development. Therefore, the PARRA process proposes a structure for the occupation of research by encouraging specific roles, values and habits.

Roles

'Much of human occupation involves interacting with others in social groups' (Kielhofner 2007, p92). Within every university, students gain a specific identity or social status to which they relate and according to which they behave. From novice student to newly qualified occupational therapist, a development in roles associated with research-related activities should occur: observer--follower--team player--leader (see Table 2). Fellow students, lecturers and clinicians could all contribute to this process through formal and informal socialisation. However, the impact of the peer group on learning receives particular attention in the PARRA process.

In addition to the phases of role development, the base of the pyramid in the PARRA process represents the acknowledgement that students' levels of prior learning vary and, therefore, they could learn from each other. The concept of learning-while-doing is referred to as action learning (Zuber-Skerritt 1995), and could be viewed in the same light as experiential learning (Dick 2000, De Jager 2002). This implies engaging students in activities where they learn from and reflect on doing, whether from their own or from the experience and actions of other students. Taylor et al (1997) emphasised that this process could encourage students to own their learning, to feel it and to live it more actively.

Values

Personal meaning is reflected by one's values: things of importance to a person (Kielhofner 2007). When facilitating a research culture at undergraduate level, the essence of how students could influence one another positively to promote collective meaning needs consideration.

In practice, for students to learn an appreciation of research-related activities they should be assisted to develop an openness to be committed observers (so as to orientate themselves to what is involved with research as a process). During the foundational phase, receptivity would be required to accommodate feedback that would promote the acquisition of research-related skills. The practical phase will require group activities. Consequently, interdependence within the execution of research-related activities could be promoted. In the reflexive phase, skills gained thus far should be used when acting as a role model while nurturing fellow students.

Adhering to certain values and roles within the academic environment would support the culmination of internalised ways of accessing, interpreting, applying and/or generating research. Deliberate facilitation of a research culture would therefore promote 'acquired tendencies to respond and perform in certain consistent ways' (Kielhofner 2007, p16).

If students were exposed to situations where interdependence and humanness led and supported learning, they could be encouraged to view research as an important occupation that guided relationships and established familiar routines in the academic setting. Trust, collaboration and openness could, therefore, sway the idealistic concept of a research culture into a practical reality.

Habits

'Habits preserve ways of doing things. through repeated performance' (Kielhofner 2007, p16). The PARRA process suggests that the development of habits to discover, explore, contribute and encourage research at undergraduate level could eventually lead to a way of life where accessing, applying and contributing towards the research basis of occupational therapy would be part of the therapist's normal routine. This implies a regular, ongoing activity that occupational therapists expect to engage in. Kielhofner (2007) specified that repeated patterns of behaviour, like engagement in research-related activities within the context of the university environment, would encourage not only learning how to undertake such activities, but also 'a sense of ability, control, satisfaction, and fulfilment' (Kielhofner 2008, p107).

The maturation process promoted by PARRA

The successive phases within the PARRA process suggest a process of maturation: through engagement in the occupation of research, development takes place in the associated roles, values and habits.

The competency aspect of the PARRA process was developed in accordance with the National Research Framework within the South African Qualifications Authority (SAQA 2001). The degree to which research is embraced as an occupation for undergraduate students would support a process where successive levels for advancement are based on the development of proficiency in knowledge, skills and attitudes. These different levels in competency refer to the endeavoured increase in an ability to do.

The PARRA process proposes that the first two phases should lay the appropriate foundational competencies. Initially, education should be focused on facilitating an openness (value) to research, including discovering the nature of a research culture (habit) from more mature peers and lecturers by being an observer (role). The student should master the basic knowledge and skills associated with becoming aware of the indicated factors. This process could be seen as progression from an unconscious incompetent level to being consciously incompetent and even becoming aware of some basic conscious competencies for the pre-foundational level. (Activities to consider include the how to for engaging in a scientific process, for example, literature searches and different referencing styles. Junior students should also be exposed to the PowerPoint presentations of senior students so as to observe a range of aspects associated with research.) The foundational phase indicates advancement to acceptance (value) of a research culture, following the more mature peers and lecturers (role) and exploring concepts (habit) inherent to a research culture. Activities should promote an emerging ability of conscious competence in foundational skills. (Activities to consider include specific requirements regarding literature searches for assignments.)

Only then should practical competencies be promoted to ensure that students mutually depend on and support one another. Interdependence (value) is a key aspect of this level, where students contribute (habit) as team players (role) to the research process. Skills should be developed to such an extent that a practical level of unconscious competency is established. (Activities to consider include working together on small-scale research assignments while on practice placement.)

Finally, the foundational and practical competencies should be integrated through reflexive competencies, where the student not only adds to the research culture ethos but also acts as a role model for students in the other phases. The student should nurture (value) fellow students by being a leader (role) in fostering (habit) the research culture. Reflexive competencies would not only mirror recognition of the student's own strengths and weaknesses, but would also encourage mastering the ability to model appropriate values, skills and habits that would facilitate a research culture in others. (At this level, students could engage in peer evaluations of one another's research projects and provide support and feedback to students entering the practical competency stage.)

The levels suggested by MOHO (Kielhofner 2007) reflect progression from a level of exploration to a level of competency when establishing an occupational identity. Similarly, the PARRA process reflects a progression in mastering the occupation of research, also from a level of exploration to that of mastery, within a nurturing environment. For the undergraduate students at UFS, the focus for engagement in research-related activities is predominantly to explore how these activities could contribute towards and support sound practice. As a requirement for full registration with the South African Health Professions Council, all these students complete a community service year upon graduation. During this year they need to access, implement or generate research that could support their practice, notwithstanding the level of support from senior staff (Du Toit and Wilkinson 2009). Exposure to the PARRA process should provide them with the skills and confidence to continue their journey with research-related activities even when outside the nurturing university environment.

Summary

The PARRA process is proposed in response to an appeal by Lencucha et al (2007, p594) for a 'systematic approach to integrate evidence into the community of therapists', rather than simplistically transferring research into practice unilaterally. By promoting roles, values and habits, the PARRA process promotes an appreciation for research-related activities within a community of occupational therapy students at the UFS.

When viewing research as an occupation (a MOHO perspective), the PARRA process suggests an academic environment that would promote socialisation between students to foster the roles, values and habits required for facilitating a research culture. Therefore, continuous exposure to research-related activities could encourage growth and exposure and prompt the evolvement of an identity and competence in research.

Abrahams (2008) explained that not only does engagement in activity influence a person's occupational identity, but that values and beliefs influence the occupational choices that he or she makes. The PARRA process for facilitating a research culture at undergraduate level focuses on promoting a positive attitude towards research as an occupation and instilling roles that could encourage accessing, applying and generating research as an accepted part of occupational therapists' duties.

This practice analysis explains the components of the PARRA process. As a follow-up to the conceptualisation of the process, the development of a framework is foreseen that would suggest specific activities to promote mastery of the identified roles, values and habits for each phase. The concepts inherent to the process need to be further clarified, described and structured in conjunction with the ALAR approach followed in its development.

Key messages

* An occupational identity, valuing research, should be cultivated at undergraduate level.

* The academic environment could be used to foster roles, habits and values for creating a culture that would appreciate research as an occupation.

Acknowledgements

The PARRA process was the result of the first author's PhD in 2008 and has since been applied and developed at the Occupational Therapy Department of the University of the Free State. The authors would also like to pay tribute to Professor Gary Kielhofner. His zeal, motivation and encouragement were an inspiration and he is sadly missed. The efforts of Professor Renee Taylor and staff at the MOHO Institute, as well as their continued contributions to occupational therapy as a profession, are sincerely appreciated.

References

Abrahams T (2008) Occupation, identity and choice: a dynamic interaction. Journal of Occupational Science, 15(3), 186-89.

De Jager A (2002) An integrated and holistic approach to assessment in outcome-based learning in South Africa. Available at: http://www.cdra.org.za Accessed 28.09.07.

Dick B (2000) Data driven action research. Available at: http://www.scu. edu.au/schools/gmc/ar/arp/datadrive Accessed 10.04.07.

Du Toit S, Wilkinson AC (2009) Publish or perish: a practical solution for research and publication challenges of occupational therapists in South Africa. South African Journal of Occupational Therapy, 39(1), 2-7.

Forsyth K, Mann LS, Kielhofner G (2005) Scholarship of practice: making occupation-focused, theory-driven, evidence-based practice a reality. British Journal of Occupational Therapy, 68(6), 260-67.

French S, Reynolds F, Swain J (2001) Practical research: a guide for therapists. Oxford: Butterworth Heinemann.

Isaak DJ, Hubert WA (1999) Catalyzing the transition from student to scientist--a module for graduate research training. BioScience, 49(4), 321-27. Available at: http://web.ebscohost.com/ehost/delivery?vid=17& hid=112&sid=e7a3f3e9-a5cd-4b5cd-89 Accessed 03.01.07.

Kielhofner G (2007) A firm persuasion in our work. Respecting both the 'occupation' and the 'therapy' in our field. American Journal of Occupational Therapy, 61(4), 479-82.

Kielhofner G (2008) Model of Human Occupation: theory and application. 4th ed. Baltimore: Lippincot Williams and Wilkins.

Law MC (2007) A firm persuasion in our work. Occupational therapy: a journey driven by curiosity. American Journal of Occupational Therapy, 61(5), 599-602.

Lencucha R, Kothari A, Rouse MJ (2007)The issue is ... Knowledge translation: a concept for occupational therapy? American Journal of Occupational Therapy, 61(5), 593-96.

South African Qualifications Authority (2001) Criteria and guidelines for assessment of NQF registered unit standards and qualification. Pretoria: SAQA.

Taylor J, Marais D, Kaplan A (1997) Action learning--a developmental approach to change. Available at: www.cdra.org.za Accessed 28.09.07.

Winn S (1995) Learning by doing: teaching research methods through student participation in a commissioned research project. Studies in Higher Education, 20(2), 203-15.

Zuber-Skerritt O (1995) Models for action research. In: S Pinchen, R Passfield, eds. Moving on: creative applications of action learning and action research. Brisbane: Action Learning, Action Research and Process Management Association, 3-29.

Sanet du Toit (1) and Annette Wilkinson (2)

(1) Senior Lecturer, Department of Occupational Therapy, University of the Free State, Bloemfontein, South Africa.

(2) Professor, Centre for Teaching and Learning, University of the Free State, Bloemfontein, South Africa.

Corresponding author: Dr Sanet du Toit, Senior Lecturer, Department of Occupational Therapy (G44), University of the Free State, C R De Wet Building, PO Box 339, Bloemfontein 9300, South Africa. Email: dutoitsh@ufs.ac.za

Reference: Du Toit S, Wilkinson A (2011) Promoting an appreciation for research-related activities: the role of occupational identity. British Journal of Occupational Therapy, 74(10), 489-493.

DOI: 10.4276/030802211X13182481842029

Submitted: 28 January 2010.

Accepted: 14 July 2011.
Table 1. Research-related exposure in the undergraduate occupational
therapy curriculum at the University of the Free State

First year                           Second year

Generic skills module                Communication media

Library use                          Use of posters
Referencing styles                   Compiling brochures, pamphlets
Academic writing                     and newsletters
Group-work assignment with           Writing submissions for funding
specifications (written format:      Compiling PowerPoint
layout of written document;          presentations
literature included, for example,
www, scientific journals,            Statistics module in 2008
textbooks)                           Data management and checking
Referencing styles                   Descriptive statistics
                                     Parametric/non-parametric
Practice placement education         Comparison of groups: confidence
Group activity: compiling a          intervals and p-values
community profile                    Categorising
Feedback: orally with PowerPoint     Correlation/regression and
presentation                         associations
                                     Risk determination
Theoretical lectures                 Diagnostic tests
Literature studies                   Data summation
Portfolio work                       (Tests and laboratory activities
Essays                               on computer)

                                     Clerical activities
                                     Identify problem
                                     Formulate problem
                                     Formulated aim
                                     Literature study
                                     Compare area with literature
                                     Graphically portray findings
                                     Conclusion
                                     Recommendations

                                     Practice placement education
                                     Pathology studies to support
                                     assessments
                                     Verbal presentation for
                                     assessment

                                     Theoretical module work
                                     Literature studies
                                     Portfolio work
                                     Essays
Third year
                                     Fourth year
Research module
                                     Group research project
Introduction to research process
Search and evaluation of             Executing research study
literature                           Analysing data
Study design                         Writing research report
Sampling and randomisation           PowerPoint and oral presentation
Z-scores and percentiles             on research day
Questionnaires
Measuring instruments                Practice placement education
Interviewing                         Small-scale research projects
Validity and reliability             (important part of final clinical
Ethics                               examination; could include
Protocols for group research         qualitative/quantitative; verbal
project                              presentation for final assessment
Literature study                     with poster)
                                     Long cases--as in 3rd year
Attend 4th year project              Portfolios
presentations in August
                                     Management assignments
Practice placement education         Three done in groups and one
Small-scale research projects        individually
(usually given as an additional      Presented orally with PowerPoint
task; taken through process of a     in specified time
mini-research project; mostly        Data collection includes
includes literature study)           interviews and scientific
                                     literature
Long cases:
Pathology studies to support         Theoretical module work
assessments                          Literature studies
Verbal presentation for              Topical debates (express critical
assessment with poster               thinking)

Theoretical module work              Portfolio work
Literature studies                   Essays
Portfolio work
Essays

Table 2. Components associated with promoting an appreciation
for research-related activities

Phase       Role            Value          Habit         Competency

First    Observer      Openness          Discover     Pre-foundational
Second   Follower      Receptivity       Explore      Foundational
Third    Team player   Interdependence   Contribute   Practical
Fourth   Leader        Nurture           Foster       Reflexive
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