Group: Qualitative Rigor

1. Group: Qualitative Rigor Faculty Perceptions of the Occupational Therapy Profession Transitioning to an Entry-Level Doctorate as Expressed by Touro University Nevada Occupational Therapy Program Faculty: A Phenomenological Study Johnny Rider, Ian Sande, Josh Hensley, & Gary Pearson

2. Purpose • To gather current perceptions from the Occupational Therapy faculty at Touro University Nevada on the transition to an entry-level clinical doctorate degree.

3. Relevance • The profession of occupational therapy (OT) is currently discussing a move to the clinical doctorate as the entry-level degree. • 5 schools in the U.S. offer entry-level occupational therapy doctorate (OTD) programs (AOTA, 2001).

4. Literature Review 7 Articles were found to have relevance to our topic. These articles were broken down into three main themes. • Practicing Occupational Therapists Perceptions • Possible Effects of the Transition • Level of Interest

5. Literature Review • Practicing Occupational Therapists Perceptions: • Survey results from practicing occupational therapists conclude that recent graduates of occupational therapy programs do not perceive the entry-level OTD to be financially valuable and most are not interested in obtaining this degree (Smith, 2007). • Another survey by Dickerson and Trujillo (2009) examined practitioner perceptions. The majority of them did not approve of moving to the doctoral level for entry-level requirements. The survey found the perceptions of those with a post-professional OTD as being more valuable (Dickerson & Trujillo, 2009).

6. Literature Review • Possible Effects of the Transition: • Fisher and Crabtree (2009) examined two pertinent issues that have been raised as concerns. The two issues are whether the entry-level doctorate would make the occupational therapy profession out of reach for people who are at a financial or social disadvantage, and whether or not there will be sufficient numbers of applicants applying to institutions that offer an entry-level OTD in order to be financially viable. • U.S. News and World Report has consistently listed occupational therapy as one of the best of the top 31 careers and therefore more people will be interested in enrolling in occupational therapy programs regardless of the entry-level degree requirement according to this logic (Graves, 2012). • Royeen and Lavin (2007) have provided perspectives of the clinical doctorate for health practitioners in a contextual format and then organized according to dilemmas, delusions and de facto realities that need to be acknowledged. If the level of education increases for practice, there will be a lack of Occupational Therapists to fill that need. They also argue that the profession continues to move in the direction of the entry-level clinical doctorate despite the lack of evidence.

7. Literature Review • Level of Interest • Griffiths & Padilla (2006) obtained information using questionnaire’s about the current status in decision making with regards to the selection of clinical doctorate degree in occupational therapy as a viable entry-level degree to be offered at academic programs in the Unites States. 26% were in favor of the entry-level OTD and 74% did not favor the entry-level OTD. Factors that support the development of the entry-level OTD included coexistence of physical therapy program, enhanced preparation of graduates, and improved student recruitment into the profession of occupational therapy. Factors listed as impeding the development of the entry-level OTD included limited resources, philosophical objections, and lack of demand from students and employers.

8. Adding To Existing Knowledge Base • Surveys and questionnaires do not allow for additional factors that may support or impede the development of the entry-level OTD programs. For this reason, more research was conducted at Touro University Nevada within the occupational therapy faculty to provide a more comprehensive and open-ended format to express perceptions without limiting individual and unique contributions that may have not been explicitly asked in a survey. • Current research has been focused on practicing therapists (without looking at therapist backgrounds) and program directors. This research will add faculty perceptions with a wide diversity of experience and education.

9. Study Design • Phenomenological. • Individual 20 to 30 minute semi-structured interviews with 6 different faculty members. • Criteria for interviewees included: full-time faculty at Touro University Nevada, licensed OT’s and possessing or pursing a doctoral degree. • The interviews took place in each faculty member’s office, with one interviewee and two researchers asking questions with two different researchers transcribing the responses. • The transcripts from each recorder were then triangulated to produce a higher level of validity. From the triangulated transcript general themes from responses were generated using a phrase count from responses by interviewees.

10. Study Design CentralQuestions: 1. What is your opinion regarding entry-level requirements for Occupational Therapist transitioning to the doctoral level? 2. Please provide rationale for your opinion including your experience and expertise as a student, clinician, researcher and faculty. Sub Questions: 1. What central themes does the faculty discuss as future benefits/restraints? 2. What are the perceptions in the field (as clinicians) and as faculty for entry-level OTD as oppossed to post-professional OTD’s? 3. What benefits, if any, do you foresee with an entry-level OTD? 4. What negative impacts, if any, do you forsesee with an entry-level OTD?

11. Data Collection • A convenience sample was used due to the faculty being readily available to the researchers. At least 2 members of the research team attended each interview and there were 2 transcribers at each interview. • The interviews were administered between January 7, 2014 and January 16, 2014.

12. Data Analysis • Used the scribed text from each interview to identify significant statements.(“We should just stick a master's program, it is sufficient and adequate to prepare students for an entry level position.”) • All of the researchers identified discrete chunks of data related to the research questions.(“Clinical practice standards are the same for OTD and masters.” “An OTD does not have any more clinical skill than someone with a masters.” “We do not need that much more time to prepare to become a good entry- level therapist.” “Clinically there is no difference”) • These chunks were then used to find central themes. (“An entry-level doctorate does not mean you have better skills as an entry-level therapist.”)

13. Rigor • 2 scribes at each meeting • Triangulation was used to verify central themes • Member Checking

14. Implications and Findings Theme 1 • An entry-level doctorate does not mean you have better skills as an entry-level therapist.

15. Theme 2: • An entry-level doctorate would mean less diversity among student populations, create more hardship financially, and decrease accessibility.

16. Theme 3 • Occupational Therapists need to be viewed as equal medical professional when it comes to providing treatment and evaluations.

17. Theme 4 • An entry-level doctorate will increase the level of leadership, administrative skills, management skills, entrepreneurship, and research skills among working professionals.

18. Theme 5 • Increasing the standard to become an Occupational Therapist will further decrease the amount of working therapists.

19. Theme 6 • A post-professional doctorate would be a better option and alternatives need to be explored.

20. Theme 7 • Transitioning to an entry-level doctorate will make Occupational Therapy a more prestigious profession in the healthcare field.

21. Theme 8 • An entry-level doctorate does not mean a higher rate of pay and the level of patient care will stay the same compared to an entry-level master’s degree.

22. Limitations • Small sample size • One geographic location • Scribed simultaneously during interview rather than recorded and transcribed word-for-word • Faculty of Master’s Level Program Perceptions vs. Faculty of entry-level OTD Program Perceptions

23. Further Research • Further research needs to be done to determine the validity of the varying themes found • Cost-benefit analysis of an entry-level OTD for practitioners and should examine increased cost of tuition and therefore debt load and if it equates to greater return financially or a higher status of employment such as rehab manager or more likely to own a clinic. • Perhaps a study can be done to understand if OTD level practitioners provide better treatment results as compared to Masters level practitioners and could look at tx results of OTD vs. MSOT practitioners with one year of practice, five years of practice, and ten years of practice. • How many faculty positions are held by practitioners with an OTD vs. Doctorate’s in other areas in order to determine if OTD level practitioners are more likely to be hired in faculty positions. • Does having a clinical doctorate alter the client’s opinions of OT’s vs. other Health Care professionals • Further research to validate perceptions of this article and current qualitative literature

24. References American Occupational Therapy Association. (2001). ACOTE sets timeline for postbaccalaureate degree programs. American Journal of Occupational Therapy, 549 Week, 13(33). Retrieved December 5, 2013, from http://www.aota.org/nonmembers/area13/links/LINK16.asp. Dickerson, A., & Trujillo, L. (2009). Practitioner’s perceptions of the occupational therapy clinical doctorate. Journal of Allied Health, 38, 47-53 Fisher, T. F., & Crabtree, J. L. (2009). The Issue is-Generational cohort theory: Have we overlooked an important aspect of the entry-level occupational therapy doctorate debate? American Journal of Occupational Therapy, 63, 656-660. Graves, J. S. (2012, 2 26). The 10 best jobs. Retrieved from http://money.usnews.com/money/careers/slideshows/the-10-best-jobs Griffiths, Y., & Padilla, R. (2006). National status of the entry-level doctorate in occupational therapy (OTD). American Journal of Occupational Therapy, 60, 540-550. Pierce, D., Jackson, J., Rogosky-Grassi, M., Thompson, M., & Menninger, B. (1987). The possible effects of a change to master’s entry level in occupational therapy. American Journal of Occupational Therapy, 41, 658-666. Royeen, C., & Lavin, M. (2007). A contextual and logical analysis of the clinical doctorate for health practitioners: Dilemma, delusion, or de facto? Journal of Allied Health, 36, 101-106. Smith, D. (2007). Perceptions by practicing occupational therapist of the clinical doctorate in occupational therapy. Journal of Allied Health, 36, 137-14