#ukznot

[aneletheot]

UKZN’s OT curriculum, the pros and cons in terms of preparation for practice at a community/PHC level.

When I entered the community block as a first-year student, I was not considering occupational justice, primary health care, or social factors that influence health. I was considering my anatomy exams. I was considering my survival.

This reflection is not about what was good or bad about the curriculum. It is about the way in which the structure of the curriculum contributes to our confidence, our professional identity, and our ability to serve the community, such as the community at Kenville.

First Year Exposure: A Glimpse without a Lens

In first year, I was exposed to Cato Manor. At the time, I was unaware of the value of being within this environment. We assisted fourth-year students, cooking with the community workers, and working with primary school children. Yet there was no exposure to the bigger picture of community-based occupational therapy practice. I now realise that early exposure without theoretical framing can feel disjointed. We were present physically, but were we present professionally?

Experiential learning theory emphasises that experience alone does not automatically lead to professional growth; learning requires reflection and conceptual framing (Zee, 2006). Without exposure to the value of occupational therapy within school and community settings, I found the placement as participation without clarity, or just a placement to complete my clinical hours. I often ask myself: If I had been given a stronger foundation about occupational justice, health promotion, and the OT role in PHC, would that experience have shaped my professional identity differently?

In reflection, I think it was exposure to being within the environment; however, was it exposure to being within the environment as occupational therapists?

The Gap in Second Year: Was It a Missed Opportunity?

There was no community placement in second year. Looking back, I think this was a gap in the continuum of developing competence. Learning in health professions is cumulative and layered (Biggs & Tang, 2011). I sometimes wonder if constant annual engagement in community practice would have aided our progression into third and fourth year.  WFOT’s (2020) Minimum Standards for the Education of Occupational Therapists emphasise that curricula should progressively develop competence across diverse practice contexts, including community and PHC environments. Community practice is not something that is learned in a few weeks or even a few months. It is a process that is learned over a long period of time.

Third Year: Evening Placements and Restricted Access

In third year, we went back to the community – but only in second semester, and on Friday evenings. At this point, crèches were closed, clinics were empty, and schools were closed. We saw kids at the library with difficult behaviours. At this point, we had not yet done paediatrics. Curriculum sequencing plays a critical role in student confidence and perceived competence (Biggs & Tang, 2011). This made me nervous rather than confident. I felt like I was not equipped. I felt like I was observing complexity without the ability to make sense of it.

But here’s the thing: Is paediatrics too late in the curriculum, especially knowing that community-based programs will have large paediatric caseloads?

Strengths of the Curriculum

Although there are challenges, the OT curriculum at UKZN has its strengths, which include:

Early exposure to community settings

Opportunities for group-based interventions

Increasing autonomy in fourth year

A strong theoretical foundation

The curriculum promotes autonomy and problem-solving, particularly in the final year.  Professional identity develops through responsibility, reflection, and authentic practice engagement (Trede et al., 2012). It forces us out of our comfort zones. It presents us with real South African scenarios instead of stimulated cases.

The intention of preparing students for socially responsive practice is evident and aligns with WFOT (2020) standards and occupational justice principles (Whiteford & Townsend, 2011).

Areas for Improvement

Nevertheless, preparation for PHC practice could be enhanced in a number of ways, such as:

Clearer Orientation - Students need to have a clear idea of the "why" before entering community spaces. Otherwise, it is more of a service rather than a professional practice.

Curriculum Sequencing - It may also be more beneficial for paediatrics to be introduced earlier to better align with community practice. Experiential learning theory supports repeated cycles of experience, reflection, and integration for deep learning (Zee, 2006).

Consistent Exposure -It may also be more beneficial for annual community placements to be undertaken to help build student confidence more consistently.

Administrative Coordination - It is essential for clear communication regarding submission dates, coordination of supervisors, and ensuring that handovers are checked to avoid unnecessary stress for the students and ensure that they can focus on their learning instead of worrying about other issues.

In retrospect

In first year, community block was confusing.

In third year, it was underprepared.

In fourth year, it is transformative.

The UKZN OT curriculum does provide us with preparation for community practice – perhaps not as well integrated as it could have been, though. The preparation is there. The intention is there. The potential is there. What is needed is greater integration, better orientation, earlier contextual alignment, and better coordination. Community practice is not an ‘add-on’ in Occupational Therapy in South Africa – it is an integral part of who we are. It is central to occupational therapy’s identity and responsibility within PHC systems (Whiteford, 2011).

References

Biggs, J., & Tang, C. (2011). Teaching for Quality Learning at University Fourth Edition. https://cetl.ppu.edu/sites/default/files/publications/-John_Biggs_and_Catherine_Tang-_Teaching_for_Quali-BookFiorg-.pdf

Trede, F., Macklin, R., & Bridges, D. (2012). Professional Identity development: a Review of the Higher Education Literature. Studies in Higher Education, 37(3), 365–384. https://doi.org/10.1080/03075079.2010.521237

WFOT. (2020). World Federation of Occupational Therapists. WFOT. https://wfot.org/education

Whiteford, G. (2011). From Occupational Deprivation to Social Inclusion: Retrospective Insights. British Journal of Occupational Therapy, 74(12), 545–545. https://doi.org/10.4276/030802211x13232584581290

Zee, J. van der. (2006). kolb84] Experiential learning: experience as the source of learning and development. Www.academia.edu.  https://www.academia.edu/42033149/kolb84_Experiential_learning_experience_as_the_source_of_learning_and_development

Artificial intelligence (ChatGPT, OpenAI, 2025) was used to assist with formatting and grammar editing only.

[thandoluhlengema]

"Mastering Community Practice: Is UKZN’s OT Curriculum Up to the Challenge?"

"Not everything that is faced can be changed, but nothing can be changed until it is faced." — James Baldwin. These words resonate deeply as I open my community module in the final year, giving me a glimpse into my future career. Going to a community in any particular area different from the one you grew up in will always be a culture shock. As a health practitioner, openness and understanding are crucial to exploring what and who makes the community. Are we as future practitioners equipped to meet community and primary healthcare challenges effectively? Let's discuss.

The OT curriculum is structured so that foundational knowledge, practical skills, and specialized areas are all met over 8 semesters. This allows for a broad knowledge base with a crucial understanding of human development, behaviour and physical function. This foundational knowledge is structured to assure effective assessment and intervention which prepares a wide range of needs within community practice (UKZN School of Health Sciences, 2023).

The Community Studies module in the first year was meant to give students a basic understanding of community practice. However, it was not a major focus in the middle years and only came back into focus in the final year. This raises two questions: Was this done so that practical fieldwork could provide real community experience, or was it to allow all the earlier learning to come together in the final Community Theory and Fieldwork 4 module? This approach has had both positive and negative effects. On the positive side, waiting until the final year has helped integrate earlier learning with practical experience, leading to a deeper understanding of community practice. On the negative side, the long gap between the first-year and the final-year module has made it harder to connect what was learned earlier with practical experiences. This delay has affected the ability to effectively apply knowledge in community settings (Wilson & McCabe, 2020).

The re-engineering of Primary Health Care (PHC) in South Africa offers a practical example of how community health practices are evolving. The Green Paper on National Health Insurance (NHI) outlines a re-engineered PHC platform with four key components: Municipal Ward-based Primary Health Care Outreach Teams (WBPHCOTs), the Integrated School Health Programme, District Clinical Specialist Teams, and contracting private practitioners (South African Government, 2023). WBPHCOTs are particularly relevant, as they are designed to assess health status, provide health education, and facilitate referrals to appropriate facilities. This referral system ensures that patients receive comprehensive care across different levels of the health system.

It's no secret that the broader community often doesn't receive the attention it deserves from today's occupational therapists. Many prefer the familiarity of hospital settings, where their unique skills are sometimes underutilized, or they find themselves invading the roles typically filled by physiotherapists. But community? Community is where the skills of an occupational therapist are truly put to the test. During my practical experiences in hospitals around Durban, I've observed how occupational therapists often struggle to maintain departments, be occupation-based, and miss opportunities to engage with surrounding communities through home visits. And when in those types of hospitals whether being there for physical or psychosocial block, anything community practice-based has not been given attention, this has made a significant impact and overwhelm now being placed in a community in the final year.

One might think that the required 1000 hours of practical work should be enough to prepare students to become competent practitioners. I believe this is generally true. The 1000 hours, which include electives, typically provide sufficient experience. In practice, we often accumulate more than the required hours due to the structure of the fieldwork. This extended exposure not only provides a safety net in case some hours are missed but also provides extensive experience in hospitals, rehabilitation centres, and other settings where occupational therapists work. By the fourth year, students would have interacted with a diverse range of people from different communities and backgrounds. This broad exposure helps prepare for community practice by familiarizing with various social contexts and client needs.

According to a study done by Deshni Naidoo, the UKZN Occupational Therapy curriculum has both strengths and challenges. Participants noted insufficient exposure to preventive therapy and various age groups and felt unprepared for hospital politics and inter-professional teamwork which is important in community practice. They also desired more focus on government procedures and administrative duties. However, the program was praised for providing strong theoretical knowledge and clinical skills, effective service-learning experiences, and a solid orientation to ethical practice and research skills, which positively impacted their work in both hospital and community settings (Occupational therapy graduates' reflections on their ability to cope with primary healthcare and rural practice during community service, 2017)

While the curriculum includes an intense community module in the final year of study, this timing has its cons. Community healthcare practices are rapidly evolving due to technological advances, urbanization, and globalization. Migration and globalization have led to more multicultural communities like the one in Kenville, creating both opportunities and challenges for integration and cohesion (Brown & Harris, 2019). Economic shifts and diverse community engagements add further complexity. Modern challenges, such as digital divides and social isolation, present new opportunities for engagement and collaboration (Smith, 2022). Placing the community module at the end of the curriculum allows for tackling these current issues and application of knowledge to contemporary community practice, making the timing of this module more relevant. Looking at the application of Assets Based Community Development, which is taught in the community module, the curriculum being structured like this may allow to apply these principles to current and relevant community contexts, reflecting the latest trends and challenges faced by communities. "Opportunity is missed by most people because it is dressed in overalls and looks like work." — Thomas Edison. This quote emphasizes that early opportunities, which might require effort and preparation, are often overlooked. It underlines the importance of recognizing and seizing opportunities before they’re fully realized. Something the OT curriculum may benefit from.

As we venture into the world of community and primary healthcare, the journey isn’t just about clocking hours or ticking off modules. It’s about diving into the vibrant diversity of communities, embracing the chaos and charm of new environments, and using our skills to make a real difference. After all, the real adventure begins where theory meets practice, and that’s where we’ll discover the true impact of our work. Ready to jump in? The community awaits!

References

Smith, J. (2022). Understanding Community Evolution. City Press.

KZN School of Health Sciences. (2023). Bachelor of Occupational Therapy Curriculum Overview. Retrieved from [UKZN website link].

Brown, J., & Harris, J. (2019). Community Health and Development: Current Trends and Challenges. Health Press.

Wilson, L., & McCabe, A. (2020). Connecting Theory and Practice in Occupational Therapy: Insights from the Field. Occupational Therapy Review, 32(2), 157-168

[rambling22yearold]

Unveiling the Essence of UKZN's Occupational Therapy Curriculum

Walking through the corridors of healthcare education, we stumble upon a treasure chest of wisdom and wonder—the UKZN Occupational Therapy curriculum. Like a map to hidden treasures, it promises to guide aspiring therapists.

As the role of Occupational Therapists continues to be dynamic and continuously evolve, the need for practitioners who are well-prepared to work in community and primary healthcare (PHC) settings has become increasingly apparent. At the University of KwaZulu-Natal (UKZN), the OT curriculum plays a pivotal role in shaping the future of OT practice. In this blog, we delve deeper into the fabric of this curriculum, it becomes imperative to scrutinize its efficacy and in this,, we embark on a journey of reflection, dissecting the curriculum through the lens of community care.

Occupational Therapy is a health Profession which utilizes human occupation as the intervention media to promote health and well being

At the heart of UKZN's OT program lies a four-year undergraduate journey, crafted to shape empathetic professionals equipped with the knowledge and skills to transform lives. Guided by seasoned educators, students delve into a myriad of subjects ranging from Anatomy, Psychology and Physiology to the philosophical underpinnings of OT Theory and Practice. Theory comes to life through hands-on experiences during Fieldwork Placements. Here, students immerse themselves in clinical settings, applying classroom knowledge to real-world scenarios where these placement within the KZN province  are the crucible where theory meets reality, fostering the development of competent and compassionate practitioners. Complementing the core curriculum are electives designed for the curriculum. From assistive technology to community-based interventions, these electives empower one to carve your niche within the profession, nurturing unique talents and interests.

Delving into the heart of occupational therapy education at the University of KwaZulu-Natal (UKZN), one finds a curriculum that transcends the confines of clinical walls, embracing the principles of community-based practice and primary healthcare (PHC). Within the fabric of core courses like Occupational Therapy Theory and Practice and Professional Issues in OT, the curriculum intricately weaves discussions on community interventions and the imperative of addressing health disparities in diverse populations.

Moreover, UKZN's commitment to community-centric care is palpable through dedicated courses and clinical placements designed for this purpose. These courses delve into community assessment, program development, and advocacy strategies, equipping students with the tools to effect change beyond traditional healthcare settings. Clinical placements then provide the crucible for experiential learning, immersing students in community health centers, schools, and nonprofit organizations. Here, they apply theoretical knowledge to real-world contexts, fostering cultural competence and collaboration within multidisciplinary teams.

The community I currently serve has numerous areas requiring the intervention of Occupational Therapists. However, once students depart, the community lacks ongoing support. This reality is disheartening and requires attention, with no profession better suited to address it than ours. We consider the individual holistically. We assess their home environment, support systems, available resources, mental health, HIV status, nutrition, and sleep patterns. Despite having much to offer, our valuable work isn't fully utilized where it's most needed.

I found this amazing article that highlights our readiness to practicing within rural settings, please have a quick look.

Introduction Despite greater needs in rural areas, occupational therapists are maldistributed to urban spaces which limits service access an

There are several challenges and limitations that warrant consideration. Significant challenges being resource constraints, potentially impacting the availability of state-of-the-art equipment, technology, and facilities essential for comprehensive training. Limited clinical placements in community settings also poses a barrier, as hands-on experience in diverse environments is crucial for developing practical skills and cultural competence. In the beginning of my degree we were faced with the unfortunate introduction of the COVID-19 pandemic in which we were not able to go into the community and gain essential practical knowledge from the Community Studies module present withing the OT curriculum. Additionally, there might be gaps in the curriculum content, such as insufficient emphasis on advocacy training or addressing the social determinants of health, which are essential for effective community-based practice. Overcoming these challenges requires a concerted effort from educators, policymakers, and healthcare institutions to allocate resources effectively, expand clinical placement opportunities, and continuously review and update curriculum content to ensure that students are adequately prepared to address more complex needs of communities in PHC settings as communities are constantly evolving.

One notable aspect is the emphasis on experiential learning opportunities embedded throughout the curriculum. Through clinical placements in diverse community settings, students gain first-hand experience working with individuals and populations in need. 

Moreover, the Community module in our final year fosters a culture of community engagement by encouraging us to participate in community-based projects and service-learning initiatives. By collaborating with local organizations, such as community health centers, schools, and advocacy groups, we have the opportunity to apply their knowledge and skills to address real-world challenges and contribute to positive social change. These experiential learning opportunities not only deepen our understanding of community health issues but also cultivate their empathy, cultural competence, and advocacy skills—essential attributes for effective practice in community and PHC settings. The way that the curriculum is structured allows for being a dynamic OT who is able to work in various community settings, encourages working under pressure to meet goals and prepares us for the real word by the hours we spend within the communities.

One of the common responses found from the study below was that the participants found it challenging to practice within the realities of a rural setting because of the resource constraints and because the undergraduate programme and clinical skills development had mainly occurred in well-equipped tertiary hospitals. It's not uncommon for practitioners to find it challenging to transition to rural settings due to resource constraints and the focus on training in well-equipped tertiary hospitals during our education. This disparity in experiences and resources can create barriers to effective practice in rural areas.

In reimagining the Occupational Therapy (OT) curriculum at the University of KwaZulu-Natal (UKZN) to better equip students for community and primary healthcare (PHC) settings, several key recommendations emerge. Firstly, integrating more robust community-based learning opportunities throughout the curriculum, including extended clinical placements in diverse environments, could provide invaluable hands-on experience. Additionally, fostering interprofessional education (IPE) initiatives would enhance collaboration skills essential for interdisciplinary PHC practice. Strengthening cultural competence training and expanding community-based research projects could deepen students' understanding of the complexities of working with diverse populations. Moreover, integrating advocacy training and offering elective courses in community health would empower students to advocate for policy changes addressing health disparities. Finally, forging stronger partnerships with local organizations would facilitate expanded clinical placements and community-based projects, enriching students' engagement with PHC initiatives. By embracing these recommendations, UKZN can ensure that its OT curriculum remains dynamic, relevant, and impactful in preparing future practitioners for the multifaceted challenges of community-oriented practice.

As we draw the curtains on our exploration of the UKZN Occupational Therapy curriculum, one thing becomes abundantly clear: the journey to community care excellence is a dynamic and evolving one. Through the lens of our analysis, we've glimpsed the strengths and opportunities embedded within the curriculum, each a testament to the dedication of educators and the aspirations of future therapists.

Yet, within this journey to finding the treasure chest, there are obstacles in the road and peaks to conquer. My reflection on the curriculum's pros and cons serves as a guide towards innovation and improvement. Let us harness the insights gleaned here to nurture a curriculum that not only prepares students for the rigors of community and PHC practice but also instils within them the spirit of compassionate care and unwavering dedication to those they serve.

As the sun sets on our discussion, let us carry forward the torch of inquiry and advocacy, knowing that the seeds of change we plant today will bloom into a future where community care thrives and flourishes.

In the ever-evolving landscape of healthcare, the role of occupational therapists as champions of community care and primary healthcare has never been more crucial. Through our exploration of the UKZN Occupational Therapy curriculum, we've journeyed through the corridors of learning, uncovering both its strengths and areas ripe for growth.

So, after all, do you think our curriculum prepares us enough to work in the community?

Yes, it definitely does

No, it surely doesn't

I am not quite sure

Voting ended onMar 22, 2024

References

Hayes, K., Santos, V. D., Boyd, N., Connelly, B., & Lustig, K. (2024). Preparing occupational therapy students for practice in rural areas: a scoping review protocol. BMJ Open, 14(2), e075886. https://doi.org/10.1136/bmjopen-2023-075886

Home - Discipline of Occupational Therapy. (2018, January 11). Ot.ukzn.ac.za. https://ot.ukzn.ac.za

Naidoo, D., Van Wyk, J., & Waggie, F. (2017). Occupational therapy graduates’ reflections on their ability to cope with primary healthcare and rural practice during community service. The South African Journal of Occupational Therapy, 47(3), 39–45. https://doi.org/10.17159/2310-3833/2017/v47n3a7