Occupational Therapy education:

1. Occupational Therapy education: An appalling paradox? Dr Jo Watson jdw@soton.ac.uk COT Annual Conference, Brighton, 30th June 2011

2. The Field of Higher Education: Non-traditional students: • likely to be poorly prepared to study in HE (May & Bousted, 2004; Ozga & Sukhnandan, 1998; Sambell & Hubbard, 2004; Yorke, 2001) • require and seek more guidance (Leathwood & O'Connell, 2003; Thomas, 2002) Widening or increasing participation? • expansion driven by 18-21y.o. school-leavers,(Elliott, 2003) and those from more affluent families (Franklin, 2006) • under-representation of those from lessprivileged social backgrounds (Reay et al, 2005) • targeted groups unequally represented across the sector (BIS, 2010)

3. Pre-reg Occupational Therapy Education: • Changing profile of OT student population • 67% of 2005 & 64% of 2008 intake mature (COT, 2007, 2010) • non-traditional academic backgrounds • Nation-wide attrition 15% in 2005 & 12% in 2008 (COT, 2007, 2010) • Non-traditional OT students as successful as school-leavers (Howard & Jerosch-Herold, 2000; Howard & Watson, 1998; Shanahan, 2004) BUT: • More likely to consider leaving (Wheeler, 2001) • Feel courses geared towards school-leavers and offer inadequate support (Graham & Babola, 1998) • Feel at times like they succeed in spite of programmes (Ryan 2001) OT - Helping people regain lost skills and live life to the full

4. Research Outline: How do occupational therapy students from non-traditional academic backgrounds negotiate the learning requirements of the higher education environment? • Exploratory, instrumental case study approach (Stake 1995) • Focus: students with non-traditional academic backgrounds without prior experience of HE • 3 year longitudinal study • 13 participants from a single cohort • Focus groups at entry • Individual reflective diaries • Semi-structured interviews towards the end of 1st & 3rd years of study • Demographic, personal and family background data • Documentary Analysis • Analysis of progression routes and exit awards of 4 cohorts

5. Progression Routes Study: Binary logistic regressions: • Pass at Level 4, 5 & 6 and ‘good’ (1st or 2:1) honours degree • Gender • Maturity at entry • <21 years (school-leaver entrant) • 21-25 years (young mature entrant) • >25 years (older mature entrant) • Entry qualifications • Traditional & Non-traditional • Socio-economic background • Upper, middle and lower socio-economic groups

6. Bourdieu’s Theory of Practice: Focuses on the dynamic interrelationship between social forces and individual dispositions that conceal and perpetuate conventional hierarchies of power and privilege (Grenfell, 2004) Individual behaviour or practice is organised and produced neither entirely consciously nor entirely unconsciously. Continuous learning about the usual patterns of social action and interaction within a given context enable individuals to develop an innate ‘feel for the game’ (Bourdieu, 1990)

7. Field: Bounded social spaces, spheres or arenas of life which form distinct social worlds (Bourdieu and Waquant, 1992) Encompass the ‘rules of the game’ and taken-for-granted practices Define the range of possible and acceptable actions and behaviours (Grenfell, 2004) Habitus: Durable, transposable dispositions through which individuals perceive, judge and behave within, and think about the world (Bourdieu, 1990) Structured by the social forces of the field that produce it while simultaneously structuring behaviours, perceptions and expectations (Wacquant, 1998)

8. Capital: • Any resource that holds symbolic value within a given field and therefore acts as a currency of that field • Economic • Cultural • Social • Positions and trajectories within a givenfield vary with the volume and composition of individual portfoliosof capital (Wacquant, 1998)

9. a:constant or baseline model in which all predictor variables are omitted and it is assumed that all cases fall into the outcome category with the highest frequency (i.e. ‘yes’ in all levels of analysis); * p < .05; ** p < .005; *** p = .001

10. Significant predictors of progression: • The odds of a student from the lower socio-economic groups failing to pass Level 4 are approaching fivetimes higher than for a student from a higher socio-economic group. • The odds of a student from the lower socio-economic groups failing to pass Level 5 are more than fivetimes higher than for a student from a higher socio-economic group. • The odds of a student from the lower socio-economic groups failing to pass Level 6 are over five and a halftimes higher than for a student from a higher socio-economic group. • The odds of a student from the lower socio-economic groups failing to secure a good honours degree are more than three timeshigherthan for a student from a higher socio-economic group.

11. Capital that counts: Feel for the game Practice-oriented Capital Social Capital Linguistic Capital Academic Capital

12. George: A ‘fish in water’ • 33 year old mother of two • Previously a human resources officer then held various un/semi-skilled roles • 11 year study gap • Human Biology A-Level All they used to talk about was shopping and housework and my brain just felt like it was seeping out of my ears! So to finally come and be around people who had a bit more to say for themselves…[laughing]…other than that sort of thing, was brilliant. It’s like meeting a load of like-minded people. 1st Interview

13. And these people who say it wasn’t laid out correctly for them, and people who failed saying, oh, we weren’t told what to do…and I’m going, well, we were. It’s right there, you know! 1st Interview …learning in groups, that’s definitely the key as well. We use a lot of study groups and we find so long as you’ve got like-minded people and they’re on the same wave length… …I think you need to be a little ‘cold’ and strategic and find people with good understanding of subjects and people on similar wavelengths. Reflective diary

14. …if I found out that there was an activity on somewhere that I thought was interesting, and not within the service, then I would go out and spend an afternoon. And quite often, later on in Placement, I would wind up referring someone to that and I generated a lot of ideas from different things that I’d seen. 2nd Interview The place where myself and friends feel inspired and truly learn about OT is at Uni […]. All the wonderful lectures show and inspire me as to what I want to do with the role and what OT truly is. Reflective diary

15. Betty: Growing and changing • 34 year old mother of one • ex- beauty therapist and call centre manager • ‘very working class’ [1st Interview] • 9 year study gap • Access Certificate … I’m not going to become somebody that I’m not. You know, I’m very…I want to remain quite grounded and I don’t want to lose myself along the way. This is going to help me grow. …I don’t feel that I’m changing. I feel like I’m growing. 1st Interview

16. I remember a lot of note-taking. I remember a lot of…the thing that sticks in my mind is this, writing down words. I didn’t have a clue what they were, I just wrote them down…[laughing]…Not just medical words…just normal…language. Sometimes some of the words that we used, I was thinking, I don’t know. I haven’t got a clue what that means, so I’ll write that down and I’ll look it up when I get home…[laughs] 1st Interview …on placement, I tend to do it with medical terms, which I think everybody does […] but in university, it just can be a word. One of the girls, she’s great for telling me words. We’ll sit and have a chat and I’ll go, “Whatever are you talking about?” [laughs] She’s great at explaining and just giving me a definition of words…”OK; and how would you use that in a sentence?” [laughs] 2nd Interview

17. I think you gather pieces of people really, and this is what I was saying about learning from all your experiences. Even if it was a negative experience it made me think “Well, that’s not how I think. That shouldn’t have been done.” 2nd Interview …Because I’m away; I’m in a different town. I haven’t got people around me with a similar sort of experience or even who have gone through Uni themselves… …when you are sort of struggling a little bit with your academic work, you think, “I could have done with that”, you know, just to sort of bounce ideas off.’ 2nd Interview

18. I think you grow because you want to adapt to the society that you’re in as well […] I don’t want to just pass my degree or pass my exams, I want to do well in them. So I’ve had to sort of change my language, change my terminology and just fit in here at university 1st Interview …it’s quite funny actually, because my husband looks at me sometimes and says “What was that you just said? I haven’t a clue what you’re on about there!” [laughs] And I’ll come out with a word and [my daughter] will just look at me and then just walk off [laughs] 1st Interview

19. It’s a huge pool, isn’t it, that you step into and you’re up to your neck rather than up to you knees […] I had to step on the side of the pool, delve into what I needed to get me though, rather than get in, immerse myself with it 2nd Interview

20. Academic Capital: Feel for the game • the depth and level of disciplinary & related knowledge, • skills associated with searching for, accessing and critically appraising, integrating and synthesising knowledge sources, • ability to justify and substantiate ideas applicable to professional practice, • accurate use of appropriate referencing and citation conventions, • style and delivery of oral presentations and written work, including the structure and tone of academic writing Practice-oriented Capital Social Capital Academic Capital Linguistic Capital

21. Linguistic Capital: Feel for the game • grammar • linguistic repertoire • forms of phraseology • tone and mode of written and verbal expression or expressive style • Relationship between linguistic and academic capitals • Influences accessibility of various learning activities and assessment tasks Practice-oriented Capital Social Capital Academic Capital Linguistic Capital

22. Social Capital: Feel for the game • access to collaborative study groups • peer-review of draft submissions • haring of resources and skills • practical and emotional support • ‘multiplier effect’ (Bourdieu 2006 p.110) facilitates acquisition of other capitals • Social capital derived from different social networks is unequal Practice-oriented Capital Social Capital Academic Capital Linguistic Capital

23. Practice-oriented Capital: Feel for the game • Related to but distinct from academic capital • depth and breadth of knowledge appropriate to the practice context • suitably professional disposition & appearance, • enactment of core underpinning values and skills • e.g. client-centredness, EBP, CPD, reflective practice, communication and team-working skills, personal and caseload management skills • proficient execution of the OT process • including assessment, prioritisation, planning, implementation, evaluation and revision of interventions Practice-oriented Capital Social Capital Academic Capital Linguistic Capital

24. Key points: • ‘Rules of the game’ are largely implicit • Habitus can and does shift (variably) upon entry to unfamiliar fields • Congruence of habitus with the dominant culture of a field influences the portfolios of capital accrued and the ‘affinities, convergences and divergences (Grenfell 2007 p.138) experienced • That is – social background can have a marked impact on educational experiences in HE • Translatability of academic, linguistic, social and practice-oriented capitals to other professional programmes and more broadly across HE • Can we reduce the opacity of ‘the game’ & enable development of relevant captials to facilitate students’ achievement, ‘success’ and experiences?

25. Acknowledgements: My genuine thanks are extended to: • All of the participants who made this research possible: to those who consented to their information contributing towards the progression routes study and particularly to those who generously give up their time over a three-year period and allowed me to explore and learn from their experiences in higher education. • My doctoral supervisors, Dr Alan Borthwick, Professor Melanie Nind and Professor Debra Humphris, for their guidance, support and encouragement. • Dr Peter Nicholls for his advice regarding the development of the database and data analysis for the progression routes study.

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