Improving Recreational Therapy Curriculum: The Quality Enhancement Plan Model

1. Improving Recreational Therapy Curriculum: The Quality Enhancement Plan Model Peg Connolly, Ph.D., LRT/CTRS Associate Professor andDirector of Recreational Therapy Western Carolina University NCRTA Annual Conference, October 13, 2008 Greensboro, NC

2. Objectives • Describe the structural and substance elements of a quality curriculum in RT. • Describe the importance of advising to link academic and co-curricular experiences into a seamless path to integrated and synthesized learning. • Describe the opportunities and challenges to incorporate engagement and integration in an RT curriculum.

3. What are… • The structure and elements of a quality RT curriculum? • NCTRC Requirements • ATRA Curriculum Guidelines • NRPA Council on Accreditation

4. NCTRC Academic Requirements • Baccalaureate Degree or Higher with a “major in TR” or “major in recreation with an option in TR” • 18 semester hours of TR and general recreation coursework with a minimum of 4 courses in TR is required …; • Supportive courses … a total of 18 semester hours of support coursework with a minimum of: (i) 3 semester hours in anatomy and physiology; (ii) 3 semester hours in abnormal psychology; and (iii) 3 semester hours in human growth and development across the lifespan. The remaining semester hours coursework must be in the content ‘human services’ …; • A minimum 480-hour, twelve (12) consecutive week field placement experience in TR services that uses the therapeutic recreation process as defined by the current NCTRC Job Analysis under the supervision of an on-site field placement supervisor who is both NCTRC CTRS certified and meets the standards for field placement supervision...

5. ATRA Guidelines • Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice • Provide “direction to educators, practitioners, and agencies about the specific knowledge, skills, and abilities required to practice safely and effectively.” (p. 3) • “…are related to professional practice competencies…curricula in RT must be based upon a foundation of liberal arts designed to expose the students to a depth and breadth of education sufficient to ensure a pracitioner is capable of critical thinking, effective verbal and written communication, and is an individual who demonstrates a strong core of central values regarding life, culture and the global community…” (p. 4-5)

6. ATRA Guidelines • RT Suggested Course Content • Foundations of Professional Practice • Individualized Pt/Client Assessment • Planning Treatment/Programs • Implementing Treatment/Programs • Modality/Intervention Skills • Modality/Intervention Skills • Modality/Intervention Skills • Evaluating Treatment/Programs • Managing Recreational Therapy Practice

7. Anatomy/Physiology Kinesiology/Biomechanics Motor Skill Learning Human Growth & Development Psychology Cognitive/Ed Psych Abnormal Psych Counseling Group Dynamics & Leadership First Aid & Safety Disabling Conditions Pharmacology Health Care Organization and Delivery Legal Aspects of Health Care Recreation & Leisure Services ATRA Guidelines: Support Content

8. NRPA Council on Accreditation • Defines set content standards for TR • Does not dictate specific numbers of hours, numbers of courses, nor specific titles • NRPA Council on Accreditation identifies that of 90 programs accredited for the broad field of parks recreation and leisure services, 36 are accredited for the Therapeutic Recreation Option. Source: Retrieved on 10/12/08 from http://www.nrpa.org/content/default.aspx?documentId=826

9. NCTRC Study of Curricula-2005 • Consisted of 2,651 applicants who applied for certification between 2000-2004 • Direct review of applicant transcripts to determine course work in TR/RT content and support • Identified 151 established degree programs in Recreation and courses in TR.

10. Academic Programs: Geographic Distribution n=151 academic programs

11. NCTRC Study:Departments & Degrees • Departments • Health and Human Performance • HPER • Physical Education and Recreation • Recreation and Leisure Studies • Recreation and Park Administration • Recreation Administration • Recreation Management • Degree Titles • 23% (35) contain “TR” or “RT” • 77% had majors in general recreation and/or options or emphasis in TR

12. NCTRC Study: TR Content Courses • 3 most frequently completed courses: • Background Knowledge • Planning the Intervention • Implementing the Intervention • 3 least frequently completed courses: • Documentation and Evaluation • Assessment • Organizing and Managing Services

13. TR Content by Number of Courses • Course titles when programs only had 3 TR Courses • Background Knowledge (83%) • Planning the Intervention (75%) • Implementing the Intervention (41%) • Course titles when programs had 4-5 TR Courses • Background Knowledge (87%) • Planning the Intervention (82%) • Implementing the Intervention (57%) • Advancing the Profession (45%)

14. TR Content by Number of Courses • Typical course titles for programs with 6+ TR Courses • Diagnostic Groups (91%) • Background Knowledge (83%) • Implementing the Intervention (83%) • Planning the Intervention (78%) • Organizing/Managing (61%) • Advancing the Profession (51%) • Assessment (47%) • All applicants least likely to complete a course in Documentation/Evaluation

15. Anatomy/Physiology (100%) Kinesiology/Biomechanics (17.2%) Motor Skill Learning (5.2%) Human Growth & Devel. (100%) Psychology (87.9%) Cognitive/Ed Psych (10.3%) Abnormal Psych (100%) Counseling (10.3%) First Aid & Safety (35.1%) Disabling Conditions (2.3%) Pharmacology (4.6%) Health Care Org. & Delivery (4.0%) Legal Aspects of Health Care (2.9%) NCTRC Study: ATRA Support Content Not included: Group Dynamics & Leadership; Recreation & Leisure Services

16. NCTRC Study: Other Support Courses

17. NCTRC Study: Internship Settings Internship Hours: Mean = 539.39; Median=560; Mode = 600

18. Internship Population and Level of Care

19. What is a Quality RT Educational Program?

20. Quality Education • Quality RT Education is not well-defined nor universally applied in our field • The majority of RT education programs are not accredited by the existing NRPA Plan and there is not specific RT accreditation plan currently

21. What is a Quality Enhancement Plan?

22. What is the QEP? The Quality Enhancement Plan (QEP) is a component of the Southern Association of Colleges and Schools (SACS) process of reaffirmation of university accreditation. The institution must identify a topic or issue that is directly related to the enhancement of student learning outcomes.

23. WCU’s QEP “Synthesis: A Pathway to Intentional Learning at Western Carolina University initiates new and enhances current connections among existing programs to create a more holistic approach to educating students. WCU faculty and staff recognize that a major challenge of higher education is the need for students to synthesize their curricular and co-curricular (outside of courses) college experiences.”

24. WCU’s QEP “The Quality Enhancement Plan (QEP) uses synthesis – the ability to integrate knowledge from different areas into an original whole – as the driving framework for teaching and learning. This emphasis on synthesis enhances students’ educational journey and helps prepare them for life beyond college.” “The overarching learning goal of the QEP is one where students will synthesize knowledge and skills from their academic and co-curricular experiences to become intentional participants in their own learning.”

25. WCU’s QEP Goals 1. Identify their aptitudes, abilities, and interests and articulate their future goals and aspirations; 2. Modify behaviors and values in response to knowledge and skills gained from their academic and co-curricular experiences; and 3. Recognize the synthesis of their university experiences and evaluate those experiences relative to their future education and career goals.

26. QEP At Other Universities • Wake Forest University - "Preparing Students to be Global Citizens" – recognizing the University's international programs, as well as the growing importance of understanding and appreciating other cultures and economies of the world • Georgia State University – “Critical Thinking through Writing”, to increase baccalaureate students’ performance on two of the University’s general education learning outcomes – critical thinking and written communication • Southern Mississippi – “Finding a Voice: Improving Oral and Written Competencies”  • University of Texas - “Signature Courses” increases accessibility of distinguished faculty to first-year students and teaches certain skills—oral communication, writing, reasoning, and the interpretation of data

27. QEP At Other NC Universities with RT • NC State University - ""Learning in a Technology-Rich Environment" (LITRE)” • Winston-Salem State University – QEP development underway and will focus on the enhancement of one of the 21st century skills across the curriculum. (2008-2009) • UNC-Greensboro – development of QEP underway • UNC-Wilmington – QEP due in 2010 • ECU – QEP Leadership Team in place and due in 2013 • No information on – Mt. Olive, Mars Hill, Shaw

28. RT and the QEP • What would you do if you had the chance to not merely meet minimum standards for RT education? • What would you do if you had the chance to re-examine the RT curriculum and design quality for student learning and career development?

29. RT and the QEP • Why did we volunteer? • In an effort to improve the recreational therapy degree program through further assessment and a review of the proposed QEP, the plan to improve education at WCU resonated with our goals for the RT academic program. • It seemed like a plan that would allow us to meet the educational needs and interests of the recreational therapy majors and prepare “better” professionals for recreational therapy practice

30. RT and the QEP • Where to begin… • It was easy to look at the educational content of our academic program in recreational therapy. We have a set of national job tasks and knowledge areas that guide the development of our practice and our educational programs. • However, in studying the QEP, it became clear that there were many more elements to consider in the transition to piloting the RT degree within the QEP.

31. Where to begin • Gap analysis: examined the current curriculum in relation to the basic purpose and goals of the QEP • Description of Standards of knowledge, skills and abilities of a recreational therapist (NCTRC Job Analysis and ATRA Guidelines) • Four Educational Goals for the curriculum: • develop foundational knowledge for professional practice. • develop professional skills to practice in service delivery. • develop the ability to organize professional services for clients. • acquire the skills necessary to participate as a practicing professional in the advancement of the profession.

32. What the RT Curriculum Already Had… • Established curriculum that fostered the “ideal” of engagement • Portfolio process that encouraged student synthesis of learning prior to completing their senior clinical internship • Senior clinical internship was a capstone experience that allowed engagement and synthesis for a full semester of practice in an actual recreational therapy entry-level apprenticeship in a health care agency

33. RT “Gaps” • Lack of a clear admission process and higher academic standards • ADDED: 2.5 min. GPA to enter/stay in program and admission assessment, strategic plan, and reflective essay • Advising process to guide students in career development not just course completion • Surveyed all students on adequacy of advising • Electronic Briefcase to be added in 2009

34. RT “Gaps” • Curriculum structure and sequencing • Not enough opportunity for engagement in RT practice • Did we have the right courses in the right sequence? • Developing a plan for curriculum evaluation and revision • Co-curricular opportunities for engagement • EXTREMELY limited practice sites in Western NC • Had to begin to develop our own opportunities • Using the student Recreational Therapy Association as one vehicle

35. WCU RT Content Courses • RTH 200 Foundations of Rec Therapy • RTH 350 Rec Therapy for Persons with Physical Disabilities • RTH 351 Client Assessment in RT • RTH 352 RT Processes & Techniques • RTH 360 RT for Older Adults • RTH 395 Pre-Intern Seminar • RTH 400 RT for Rehabilitation Patients • RTH 417 Administration of RT Services • RTH 450 Advanced Methods of RT • RTH 470 Adventure Based RT • RTH 484 and 485 Clinical Internship in

36. Quality RT Curriculum • Will involve continuous quality improvement techniques to refine and improve the curriculum • Faculty are a key element in the process • Advising has to include career exploration, planning, and monitoring student learning goals and outcomes • Integration of instruction and learning activities in all experiences throughout the curriculum

37. What’s next? • Relationship between our professional accreditation standards and a quality enhancement plan • Interdisciplinary specialties • Pediatrics • Behavioral health • Adventure based therapy • International and Global Opportunities • Faculty and undergraduate student research

38. Conclusions • In essence, I really believe it is simply a paradigm shift from an educator-centered model to a learning-centered model with emphasis on student synthesis and engagement rather than faculty teaching

39. Teaching Paradigm often focuses on the quantity and quality of transmitting information Many classroom professors are searching for effective ways to change from a transmission mode of instruction to a focus on improving the learning and mastery of content by students. Learning Paradigm focuses on the efficiency and effectiveness of the learning process regarding “What do students know and understand?” “What can they do with the new information?” A Shift from a Teaching Model to a Learning Model

40. Conclusions • In summary, we all have a unique opportunity to be central with the missions of our universities • Engaging the RT curriculum within the QEP of our universities will foster improvements and quality enhancements • It is time we become innovators in education and focus on the learning of our students and the enhancement of practitioner knowledge skills and abilities for the practice of recreational therapy

41. Questions