Through the eyes and voice of an OT student analysing the theory and preparedness for practice at the community level.
The global north ideology runs the ship of occupational therapy's theoretical structures, models, and practices. The need for African contextual theories and frameworks contradicts the essence of our role in healthcare. Karen Whalley (2018) further highlights how assessments lack the inclusivity of cultural and contextual factors that are norms to the global south communities. Therefore, students and professionals must apply critical reflections and reasons behind the chosen activities and the appropriateness of the assessment. However, based on experience, occupational therapy's knowledge and academic structures are transformative and kinaesthetic, allowing for altering treatment to suit individual needs. To find more about the Western influences on the practices of occupational therapy, refer to the link below:
Ask yourself why we care so much about the mark we get yet forget about the impact we make in community practice. Naidoo and Van Wyk (2016) elaborate on how, as students, we are focused and anxious about our marks, and the fear of failure is the internal driver of our learning. This further has detrimental effects on confidence in practice, causing a gap in the connection between trust and positive rapport between the therapist and the client. The fourth year allows a sense of independent practice due to the minimized supervision and specific expectations as guidelines during fieldwork. Hence, how can you awaken and integrate the social, political, and economic factors in maintaining the PHC principles? Community practice forces you to analyze and understand the interconnected factors that influence an individual's overall function and quality of life. It exposes us to the harsh realities of most of our country, highlighting the importance of the treatment you give, which may be the first and only during the allocated time. Hence, the mark pressure becomes a maladaptive personal chase, forgetting the oath taken at the beginning of the block. Disregarding the primary principles of client-centredness.
To those asking what primary health care is, Alma Ata defines it as “the community being active participants and is essential based care that relies on the practical, scientific sound and socially acceptable methods and technology made universally accessible to all individuals at a cost the community can afford. That is a lot to take in, but in simpler terms, primary health care is the bridge that serves communities to access the public health system. It incorporates the different structures that are important in a community. Look at the link above explaining primary health care(PHC).
The academic structures emphasize the importance of evidence-based practices, utilizing science to treat holistically and consider the communities and the social, political, interpersonal, and economic factors at play. In 2021, my first encounter with what community is, I was bombarded with loosely used information terms, not understanding the meaning and relevance of the social determinants of health, sustainable developmental goals, and community structures and our role. COVID-19 left us vulnerable, minimizing the initial community experience and preparation for the fourth year. Proceeding to 2023. Here I am, doing projects but lacking the foundation of knowledge and the “why” regarding the needs or gaps in the community. The poor exposure during both years proved the need to re-centre my focus and think beyond the four lines of what I see or is presented, resisting the urge to be oblivious. For example, the mother's word-of-mouth responses are challenged. This is due to possible internalized stigma when the child is delayed in terms of milestones, has difficulty accepting, or is in a state of shame or guilt. Therefore, understanding the role of OT in PHC in addressing social determinants of health, alleviating health disparities in the community, and looking at the policies, social and interpersonal factors to ensure quality of care equips students to strive in community practice. It is crucial to consider the individual as a person in a community with various essential components at play that affect the quality of life and functioning. For example, when treating a parent, adult, or child, it is crucial to ask for valuable information that may evoke feelings of embarrassment, requiring communication skills to prompt the client.
The cons of the OT curriculum are the challenges of the student’s lack of understanding of lived experiences and the integration of diversity in the context of the client’s impact on treatment outcomes and effective therapy (Naidoo & Van Wyk, 2016). Therefore, based on the community block experience, the questions asked, along with handling and presentation skills, are vital in collecting information about social and interpersonal issues. The lack of a primary language skills package limits the engagement between clients and therapists, causing a loss of meaning and understanding. The loss of communication causes detrimental effects on treatment compliance and health outcomes. However, problem-solving skills as an OT are vital to making in-action changes to facilitate understanding through physical demonstration, use of the translator, breaking down words and use of laymen's terms. Read more on the article below:
Clinical reasoning develops with experience, highlighting the importance of the role of the supervisor and lecturers (Thavanesi Gurayah, 2022). A knowledgeable and conscious lecturer—we will call her Mrs Joe—planted seeds in us years before the final year of study, and she kept watering the plant with anecdotes that are starting to sprout now. Emerging and evolving perceptions as an OT: how to see an individual as a person, not a diagnosis. How to align our practice with the PHC principles. We, as Ots, need to continuously evolve, displaying flexibility with the needs of a community. Collaboration between clinical and academic supervisors is required to equip students with professional skills to ensure that treatment is valuable, purposeful, and appropriate for better health outcomes. To enhance the validity of the qualification.
In conclusion, the University of KwaZulu Natal has equipped its students with the fundamental skills to assist in the beginning stages of community-based practice. However, it will require individuals to shift their thinking patterns, broadening their views on livelihood and realities within the global South communities. To understand our role in providing prevention, promotion, and education regarding PHC principles. The ability to emerge in critically identifying the gaps and how to problem-solve. We may lack the resources, but we are exposed to the lived experiences of most South Africans, justifying the preparedness of students to strive in the community.
LET US TAKE A POLL: WHO WOULD YOU PREFER TO TREAT YOU?
A therapist that cares about their mark and personal atrributes
A therapist who's holistic, considers the clients as a whole looking at context.
References
Dennill, K., King, L., & Swanepoel, T. (1999). Aspects of Primary Health Care (2nd ed., pp. 19–35). International Thomson Publishing (Southern Africa) (Pty) Ltd. (Original work published 1995)
Naidoo, D., & Van Wyk, J. (2016). Fieldwork practice for learning: Lessons from occupational therapy students and their supervisors. African Journal of Health Professions Education, 8(1), 37. https://doi.org/10.7196/ajhpe.2016.v8i1.536
Think Business Event. (2019). WFOT 2018 Final Day Plenary - Karen Whalley-Hammell. Www.youtube.com. https://youtu.be/9WipUPXx_Kk
Thavanesi Gurayah. (2022). An exploration of the facilitating factors in completing an undergraduate Occupational Therapy degree at the University of KwaZulu-Natal, South Africa. Africa Education Review, 19(3), 1–18. https://doi.org/10.1080/18146627.2023.2278050
World Health Organization. (2019). Primary health care throughout our life. YouTube. https://youtu.be/QX7Q0a8GxaA
