Chapter 8. Patient Mentorship in Occupational Therapy Education: The Influence of ICE on Student Learning
8.1 Instructional Context
Anne O’Riordan – Queen’s University
Students in the healthcare profession of occupational therapy are expected to work within a client-centred philosophy, meaning in collaboration with their clients (a term used here interchangeably with patients). While this partnership is intended to ensure client engagement in rehabilitation goals and plans, leading to compassionate, efficient, quality care, students’ education and opportunity for application of this philosophy are often lacking. At Queen’s University, developing an understanding and appreciation of the lived experience of clients as they navigate within their respective environments, within relationships, social structures, and the built environment, underpins the development of the healthcare relationship. For 18 years, I coordinated this distinctive learning opportunity through a course called The Lived Experience of Disability. Rather than learn about disability from guest lectures and textbooks, students venture into the community, under the personalized mentorship of an individual whose expertise includes the experience of chronic illness or disability. Learning through mentor visits is supplemented by facilitated tutorial discussions, first-person resource reviews, and reflective journal writing. In this chapter, I offer an authentic case study from the course, including the customized Ideas, Connections, and Extensions rubric, to share an example of using ICE to enhance, challenge, and evaluate my students’ learning. ICE was chosen for its ability to dovetail with the rubric I had initially adopted for the course which included the required content areas for evaluation and feedback. By overlaying ICE onto the original rubric, I was able to create a hybrid rubric to describe a student’s performance more precisely, highlighting their strengths as well as areas in which they could challenge themselves further to yield insights of greater depth.
In 1999, I was invited by the faculty of the Occupational Therapy Program to develop, coordinate, and teach a pilot fieldwork activity for first-year students called the Community Partnership Project. At that time, the program admitted 25 students to this Bachelor of Science degree program each year. To support the profession’s underlying value of client engagement and partnership, the program reviewed its methods of teaching this key element and supported the premise that individuals with lived experience must be part of the process. While this inclusive approach would no doubt be considered common sense today, it was a relatively novel idea two decades ago. The fieldwork activity that I designed with other faculty members involved matching pairs of students with a community mentor—a person with lived experience of chronic health conditions. Through a series of community visits with their mentor, students had the opportunity to observe and reflect on living life with a disability in real-world contexts and engage in a relationship that welcomed questions and curiosity beyond what could be expected or acceptable in their professional relationships with clients in future. I quickly realized, after struggling through the first iteration of the project, that engaging mentors in the course planning would significantly enhance the quality of the course and its effectiveness. An Advisory Committee was created in 2000 with three mentors, all of whom had long-term lived experience of chronic health conditions along with a keen motivation for educating students. They worked alongside me in all aspects of the course including curriculum development, review, documentation, and knowledge dissemination. In so doing, I modeled the client-therapist partnership within an academic context. This was a key step in creating a unique and authentic learning experience for students.
The original rubric chosen for the course, based on The Art of Focused Conversation (R. Brian Stanfield) provided guidance for students as they captured their learning related to Objective, Reactive, Interpretive, and Decisional elements (ORID) of the experience in reflective journal assignments. When the Occupational Therapy Program transitioned to a master’s degree in 2004, the project was developed into a credit fieldwork course called The Lived Experience of Disability (course code OT825) within the new curriculum. It was at this point that I recognized the need to incorporate a more rigorous evaluation of student learning for the program’s 72 first-year students, for both the journal assignments and tutorial discussions. I attended a workshop on the ICE Model of Assessment facilitated by Sue Fostaty Young. What a timely professional development opportunity for me! I realized that ICE could improve the existing evaluation framework by adding depth to its content while maintaining a flexible, reflective, feedback-focused approach. It felt as though ICE was the missing piece of the assessment pie – one that would provide students with detailed and clear feedback while pointing the way to deeper learning opportunities. I could envision improving the evaluation process by providing examples of where the students were currently performing in their reflections and learning continuum while nudging them toward more meaningful and relevant insights.
