Valuing the Occupational Nature of Humans
While the complexity of the human race may seem daunting to encapsulate in a few philosophical sentences, the occupational therapy faculty at the Medical University of South Carolina focuses its attention on the underlying beliefs surrounding the occupational nature of humans being and humans doing. As the journey of life unfolds, humans engage in a repertoire of life-sustaining and life-enhancing experiences. These experiences come from an inner drive to explore and master their human and non-human environments in ways that require active participation and quiet reflection. Active participation generates a purposeful sense for doing and quiet reflection allows the doing to be imbued with personal meaning, thereby promoting an idiosyncratic style and rhythm of being in the world. The doing and the being is a universal dynamic that recognizes the essence of peoples from all cultures and acknowledges that humans have an occupational nature different from the instinctual patterns of behavior of other animals.
From a philosophic perspective, we subscribe to definitions of occupation that are multidimensional and show respect for individual choice. Using the Latin root, occupatio, we recognize that humans engage their time and energy in ways that are personally meaningful, socially satisfying, and culturally relevant. When occupation is defined as typical, ordinary, and familiar things that people do every day then the ways in which people orchestrate their daily occupations gives rise to the shape and pattern of their lives. Enabling occupation, whether at
the individual or societal level, serves to promote health, prevent disease, and enhance quality of life. In describing the many dimensions of occupation, commonalities among authors emerge. Clearly, engaging in human occupation requires capacity (physical, psychological, social) and intention (intellectual, emotional, spiritual) if it is to sustain a reasonable level of equilibrium. When individual or societal capacity and intention are challenged by the effects of the disease, delay, deprivation, trauma or stress, occupational disequilibrium results and has a deleterious effect on the amount of pleasure, productivity, and restoration enjoyed in everyday life.
Recognizing Occupation as a Health Determinant in Today’s Society
We take a holistic view of health and uphold the definition of the World Health Organization, which has not been amended since 1948.
Health is a state of complete physical, mental, and social
well-being and not merely this absence of disease. (Preamble, 1946)
We also recognize the further contribution of the World Health Organization and the International Classification of Functioning, Disability, and Health (ICF 2001). This classification moves away from disease oriented language to descriptions of health domains and health related domains related to body functions and structures and activities and participation. The health promoting effects of occupation clearly contribute to a sense of well-being. People typically describe well-being as the ability to enjoy doing what they want in and with their lives. Engaging in occupations that enhance physical, mental, and social health strengthens the overall sense of quality of life for individuals and communities around the world. The notion of thinking globally and acting locally becomes particularly poignant when examined from an occupational perspective. From the richest and most sophisticated to the poorest and simplest of countries, issues of occupational deprivation and occupational justice prevail, and directly affect the health of citizens. We further believe that occupation has the power to re-craft lives that of necessity are different, occupation has the strength to create new meaning for those whose lives are impoverished, and occupation is a powerful health determinant that not only ensures people add years to their life but also life to their years.
Using Occupation as Means and End for Intervening and Promoting Health
Recognizing the wisdom contained in “The Philosophical Base of Occupational Therapy” (AOTA, 2011), we further believe that occupation-centered as well as client-centered therapy is vital for the delivery of a continuum of occupational therapy services. Occupation is the legitimate domain of concern for occupational therapists and keeping occupation as the central focus of occupational therapy is well-articulated in the second edition of the Occupational Therapy Practice Framework: Domain and Process: “Supporting health and participation in life through engagement in occupation,” describes the domain in its fullest sense (AOTA, 2008, p. 626).
Becoming Occupational Therapists
Becoming an occupational therapist, one who effectively enables the occupational well-being of individuals and societies, is an unfolding process in which professional identity is explored, practiced, and ultimately claimed as one’s own. We believe that the occupational nature of humans drives the framework for the educational program by creating and promoting opportunities for the following:
- Active participation and quiet reflection
- Exploration and mastery of the human and non-human environments
- Respect for all peoples of the world and their occupational needs.
Given our beliefs in life as an unfolding journey, we see that the path along which we all travel is paved with ongoing opportunities for learning and instruction. In concert with in AOTA’s (2007) “Philosophy of Occupational Therapy Education” statement, we acknowledge that the reciprocal nature of learning and instruction is such that it embraces the qualities of participation, collaboration, and adaptation. Further, we believe that professional graduate education requires the entering student to make a shift in orientation from the subject-centered educational experiences of college life in general to a more focused approach required for development of a new occupational role. Consequently, the way in which the learning takes place is modified in a professional graduate entry-level program to reflect the repertoire of new responsibilities for which the learner will be held accountable by the profession and society. That said we believe learning is a dynamic process that continually moves in an upward and onward direction from simple to complex, and is enhanced when there are frequent opportunities to revisit and reinforce what is being learned.
Professional graduate education requires that learners develop new knowledge, skills, and attitudes in an integrated fashion. Bloom and colleagues (1956) suggest that learning takes place in the cognitive, psychomotor, and affective domains, and they were the first educational psychologists to propose and validate a taxonomy of learning for each of the three domains. Using a taxonomy requires that every desired learning outcomes has its place and movement up the taxonomy requires increasing levels of complexity. Not only must learning be a dynamic process but also one in which the just right challenge presents itself often enough to ensure motivation for continued learning. In the cognitive domain, we believe that learning is enhanced when interest is stimulated by opportunities to grapple with problems that meaningfully connect
the learner with the therapy world. Similarly, in the psychomotor domain, we believe that learning is enhanced when learners have sufficient time to practice newly acquired skills and are held accountable for their performance. Likewise, in the affective domain, we believe that learning is enhanced when learners interact with a variety of different contexts and environments that offer support and promote confidence, and the giving and receiving of feedback is critical for success.
Overall, we are committed to respect and inspire our students, serve as professional role models, and provide them with the best possible learning opportunities. We provide a learning environment that is characterized by mutual trust, respect, and acceptance of differences and diversity. Intellectual curiosity and a positive attitude towards learning are encouraged and, where possible, learners are given a role in developing goals and learning experiences, thus enhancing active participation and self-direction in the learning process. We recognize the many differences in learning styles, and use multi-sensory and varied approaches to promote and enhance creativity. We consider accurate and constructive feedback as a vital component in the learning process, and we encourage learners and instructors to be mutually responsive. Finally, we ensure adequate mechanisms for giving learners feedback about the progress they are making towards their professional goal of becoming an entry-level practitioner in occupational therapy. To uphold our beliefs in learning, we as faculty members must assure that our instructional approaches are in correspondence with the students’ learning needs in the cognitive, psychomotor, and affective domains.
Designing instruction for the cognitive domain, now revised by Anderson and Krathwohl (2001), requires developing learning activities that first promote remembering and understanding; for example, using interactive lectures imbued with instructional technology to help learners acquire new information before adding problem-solving activities in small group activities that foster opportunities for applying and analyzing new learning. Learning activities that require evaluating and creating are best included in later stages of instruction when thoughtfulness and reflection is paramount; for example, writing papers or proposals and critiquing the literature.
Designing instruction for the psychomotor domain requires developing learning activities that first lend themselves to the pre-clinical laboratory setting and promote perception, set, and guided response; for example, bringing clients into the laboratory for practice sessions and designing laboratory practical exams. When learners are sent out into the field they have opportunities to refine the mechanism, and complete complex overt responses. Finally, fulltime fieldwork is designed for adaptation and origination as learners adjust to the therapy world and prepare themselves for entry-level practice.
Designing instruction for the affective domain requires developing learning activities throughout the curriculum that enrich the repertoire of professional attitudes and the therapeutic use of self. Learners begin by receiving and responding to the new requirements for professional graduation education and become aware that a different orientation to learning is needed. As soon as learners make this shift they begin valuing the mores of their chosen field. Through organization learners begin to accept responsibility for their own professional development, behavior, and demeanor. Finally, learners take on their own set of professional characteristics, which they will carry with them throughout their professional lives. This last stage is called characterization of a value or value complex.
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*Published work that has influenced our collective thinking and philosophical beliefs.