This blog began as a journal of a Winston Churchill Memorial Trust Travel Award visit to the USA to study how Lifestyle Redesign could be used in Occupational Therapy to improve the hospital/home interface for older people. It has continued to record developments and inspiration gained from that experience since returning from Los Angeles early in 2012.

3 Reasons to follow this blog...

Be Inspired-
WCMT travel awards are open to all British citizens

Be Involved- learn about Lifestyle Redesign programs and contribute to the discussion about the potential of this approach.

Be Information Technology savvy- just learning how blogs work is a new skill for many of us!

Monday, 21 November 2011

Student Occupational Therapy Links Scotland conference

Earlier this month I was honoured to have been invited to run a workshop at the Student Occupational Therapy Links Scotland (SOTLS) conference at Glasgow Caledonian University. The conference is organised by and for Scottish OT students- and beyond. Read more about SOTLS here.
The conference theme- Positive Thinking: Positive Future.
The students on the organising committee were so dedicated and enthusiastic and this shone through in the whole conference- a warm welcome, a fantastic team of helpful volunteers (thanks especially to Angela and Morven!). It was very inspiring to see what students and new graduates are doing. They are beginning their careers in OT in a much more difficult economic and employment environment than I did.

 Providing jelly babies ought to ensure they look at my info sheets...

With Nikki (one of the fantastic SOTLS committee)

The keynote speakers were:
Dr Sheena Blair - an exploration of the notion of occupational resilience

Dr Blair spoke about the link between occupation and health and well being, pointing out that although this is very much an implicit part of occupational therapy, but we need to make it explicit. She compared the concepts of occupational and human resilience. She asked the audience to consider:
  • how would you recognise occupational resilience?
  • can you recognise it in yourself?
  • how would you attempt to convey the value of occupational resilience as a concept to others? 
  • how would you facilitate it?
Our chosen occupations are closely linked to our sense of self and identity. Dr Blair gave three powerful examples of people who have developed occupational resilience in order to adapt to, and triumph over illness or adversity in their lives. One short explanation might be 'reinventing self in changed circumstances'.
In view of the importance of occupational resilience, Dr Blair concluded that as occupational therapists, our next big challenge and emerging area of practice is in public health and in the prevention of illness. A lot to think about and there were also some reading suggestions that I know I will want to follow up as Dr Blair's presentation has much relevance to the study visit I will making in a few weeks:

 Hasselkus B, 2002 The Meaning of Everyday Occupation
Wilcock A, 1998 An Occupational Perspective of Health

Dr Edward Duncan- a critical reflection on professionalisation

Dr Duncan spoke about his career, from working in some very challenging areas of practice to moving into research. He gave us much to think about regarding the impact of environment on health and well being, and on occupational opportunities, illustrating this with some startling statistics on life expectancy variations in different areas of Glasgow.
He explained how he moved from a very 'hands on' role into the academic world and spoke convincingly of the need for occupational therapy to build on it's strength as an 'applied profession'.  There is a real need for more quality research papers such as those produced by Professor Florence Clark whose research team I will be visiting on my study visit.
Dr Duncan sees the way forward as
  • increasing the use of high quality theory and evidence to support practice
  • increased use of conceptual models of practice.
  • a focus on applied research
This future vision can be described as 'the art of practice supervised by measurable evidence'. We were signposted to the work on measurement of impact being done by the Nursing, Midwifery & Allied Health Professions council (NMAHP). 
I found this quote on the NMAHP website:
“Measurement is the first step that leads to control and eventually to improvement. If you can't measure something, you can't understand it. If you can't understand it, you can't control it. If you can't control it, you can't improve it."
H. James Harrington

OT Frontiers- supporting the development of occupational therapy in the developing world

OT Frontiers presented information about their work in developing countries, beginning by challenging our thinking about how countries may be defined as 'developing', it is not just about economic prosperity but may also include issues such as gender equality. OT Frontiers hold similar principles to those of the World Federation of Occupational Therapists (WFOT).
We learned about the work the team have carried out in countries such as Uganda, where they aim to support local training of Occupational Therapists who will be able to provide culturally appropriate interventions. The OTs in Uganda do not have access to many of the facilities we take for granted, even in these cash strapped times but the photos that illustrated the presentation demonstrated the high level of creativity and ingenuity used to produce equipment to enable independence.
OT Frontiers gave us a lot to think about regarding the appropriateness of some of the 'support' offered to developing countries, for example, equipment that once broken will have no spare parts available, OT text books that are based on Western cultural ideas and assumptions. In the West there is an emphasis on the individual, whereas in the East and much of the developing world, community is much more important.
A very inspiring presentation that opened our eyes to the global nature of our profession.
I will be visiting the US, one of the world's most 'developed' countries, but I understand there are huge variations in wealth and life opportunities in Los Angeles where I will be based. Despite a common language, the UK and the US are very different cultures so I am sure my assumptions will be challenged.

My workshop:
A travel award to study an Occupational Therapy approach in the USA. Can it improve the hospital to home interface for older people in the UK?

Workshops were presented three times during the day in small informal groups. I presented the information about the study visit I will be making early in 2012 as is also described within this blog.
Given the conference theme, I decided to add one more statement of my own:
'Luck is opportunity seized' (I didn't make it up, but it does fit!). I wanted to present to the delegates who attended my workshop the process by which I came to have such a wonderful opportunity. I felt this was an important message as they are beginning their careers with no certainty of jobs within 'traditional' OT roles and I believe that there are now many ways to work on developing a career in OT, even if you are not in an OT job at all times. There are many opportunities to network as I have been discovering over the internet, there are conferences such as this. So although the jobs market is extremely tough, there are also more ways that individuals can develop knowledge independently and become the designers of their own careers. Even those of us in established jobs can no longer rely on our employers to provide opportunities in the way that some of us used to be able to expect.

I have been a member of the College of Occupational Therapists Specialist Section- Older People (quick plug- any COT member can join, very good value, great information source- check out the link) for some years. Two years ago the Specialist Section offered 2 sponsored places to attend the COT conference in Brighton. I applied and got one of the places. This was where I first heard Prof Florence Clark speak about her work. There being no such thing as a free lunch, this led me to become involved with the COTSS-OP as co-lead of the Acute Care & Emergency Clinical Forum, and as a result, I got to attend conference again in 2010, where I had the opportunity to meet and talk with Prof Clark. It was only when the information about WCMT came to my attention that it occurred to me that this could be the way to find out more about Lifestyle Redesign. I went through the application process (see the link to WCMT at the right of the screen). My application was successful, and this blog is a result!
There is nothing intrinsically special about me- anyone could have applied for the sponsored places at conference, and any British citizen can apply for a WCMT travel award.

This discussion and the information about the study visit led to some interesting thoughts and questions that I will be taking with me, and trying to answer during the study visit. A couple of themes were:
  • How can a process like Lifestyle Redesign that is delivered over a period of time be managed within the constraints of fast turnover and emphasis on 'basic ADLs' to get people out of hospital?
  • Are OTs deskilled by working in discharge orientated hospital settings? In other words could they actually deliver something like this?
What do you think?

Many thanks to those who attended the workshop. I really valued your views and observations and hope you will continue to follow this blog.