Earn .1 AOTA CEU (one contact hour and 1.25 NBCOT PDU). See page CE-7 for details. The Occupational : New Frontiers in Teaching and Clinical Practice

Kimberly S. Mollo, OTD, OTR/L for years. DT is a human-centered, team-based approach to Thomas Jefferson University, Philadelphia, PA thinking and problem solving that goes beyond considering how things look (i.e., form), and takes into account how Mikael Avery, MS, OTR/L, MArch things work (i.e., function; Ferreira, Song, Gomes, Garcia, Thomas Jefferson University, Philadelphia, PA & Ferreira, 2015). Breaking this down further, the process of DT incorporates five primary steps in which a team (1) This CE Article was developed in collaboration with AOTA’s gains empathy for the user, (2) defines the problem, (3) Education Special Interest Section. develops ideas to address the uncovered issues, (4) generates prototypes, and (5) tests these prototypes to gain additional ABSTRACT understanding (Hasso Plattner Institute of at Stan- Collaborative problem-solving events incorporating individ- ford, n.d.). Outside of design, the DT process has been used uals within the health care, design, and fields by practitioners across myriad fields, including university that use (DT) to address current health and K–12 educators to develop new curriculum and teaching care issues are becoming more commonplace in education- methods; , scientists, and marketing professionals al and professional settings. By recognizing occupational to analyze trends and determine gaps in the market for con- therapy’s creative foundation, bringing it to bear on today’s sumer goods; corporate managers to develop novel business opportunities, and working across disciplines, the occupa- strategies; rural medical professionals to create delivery tional therapy profession can become a key partner in these systems for providing comprehensive eye care in developing interprofessional education (IPE) design experiences, effec- countries; and hospital employees to rethink service delivery tively working to meet the objectives stated in the American methods, including patient handoffs (Brown, 2008; Cahn et Occupational Therapy Association’s (2017) Vision 2025. This al., 2016; Nixon, 2013; Zupan, Stritar, & Nabergoj, 2014). article discusses implications for increasing occupational Within health care education, medical schools have been therapy students’ exposure to and presence within design using DT-based interprofessional education (IPE) design through implementing IPE design experiences as part of collaborations to enhance the skill development of students. current occupational therapy education. Examples of design These collaborations incorporate the principles of empathy, experiences within occupational therapy curricula that meet integrative thinking, optimism, and experimentation, with a Accreditation Council for Occupational Therapy Education goal to improve problem solving (Brown, 2008; Ferreira et ACOTE® (2012) standards and that can enhance student al., 2015; Roberts, Fisher, Trowbridge, & Bent, 2016; Van de learning and future practice within this innovative frontier Grift & Kroeze, 2016). are provided. DT principles can also meld well with our occupational therapy process, as described in the Occupational Therapy LEARNING OBJECTIVES Practice Framework, Domain and Process, 3rd Edition (Frame- After reading this article, you should be able to: work; American Occupational Therapy Association [AOTA], 1. Identify the benefits of engaging in IPE design experiences 2014). The DT process has five parts (empathize, define, using DT ideate, prototype, and test), whereas the occupational therapy 2. Describe IPE design experiences that use DT as a consider- process has three (evaluation, intervention, and outcomes). ation for occupational therapy practice Despite the differences in the number of steps and termi- 3. Recognize current academic environments that can support nology, the two processes are remarkably similar. Within IPE design experiences occupational therapy curricula, students learn from the 4. Identify outcome tools that will objectively measure the outset that the occupational profile and analysis of occupa- efficacy of IPE design experiences tional performance of clients during the evaluation process is meant to be client centered; this process can be focused INTRODUCTION: DESIGN THINKING METHODOLOGY on individuals, groups, or populations that are often affected Design thinking (DT) is a methodology popularized by the by illness, disease, or disability. In DT, these steps directly d.school at Stanford University. It has been applied within correspond to the initial phase of empathizing: “The empa- and design professional platforms in the thizing mode is the work you do to understand people…. It fields of , , and user interaction is your effort to understand the way they do things and why,

OCTOBER 2017 l OT PRACTICE, 22(19) ARTICLE CODE CEA1017 CE-1 Continuing Education Article CE Article, exam, and certificate are also available ONLINE. Register at http://store.aota.org or call toll-free 877-404-AOTA (2682). their physical and emotional needs, how they think about WHY DESIGN? the world, and what is meaningful to them” (Hasso Plattner In the past decade, there has been an increasing aware- Institute of Design at Stanford, n.d., p. 2). Similar to DT’s ness within occupational therapy education and practice of process of ideate, prototype, and test, occupational therapy the importance of and need for effective design (Sanders & intervention requires a “dynamic interrelationship … where Stappers, 2012). To augment the skills of the occupational evaluation and intervention planning continue throughout therapy student and future clinician, IPE design experiences the implementation process,” and the occupational therapist’s with design students and/or professionals can be used to clinical reasoning is applied to deliver skilled intervention introduce new ideas and approaches that may help to address with targeted outcomes (AOTA, 2014, p. S15). The three-step limitations during occupational performance that negatively process (for DT: ideate, prototype, test; for OT: evaluation, affect participation for individuals and populations (Camp- intervention, outcomes) is repeated, with insights from each bell, 2012; De Couvreur et al., 2012). Collaborations may “test” or “intervention” being funneled back into the next include working with graphic to promote health phase of “ideate” or “evaluate” until a final solution is reached literacy and improve user accessibility for mobile apps and in anticipation of the client’s discharge or the completion of wayfinding signage systems, consulting with building and a design project. Both processes are similar in that they allow landscape architects to develop accessible home modifica- the designer or the clinician to work in unison, from under- tions, teaming with designers to develop effective standing to action. clothing modifications, and partnering with industrial In specific terms, as outlined in the Framework, the designers to develop tools and objects that can be used occupational therapy process consistently uses the previously within the built environment (McDonagh, Thomas, Khuri, mentioned DT principles effectively by (1) applying empathy Sears, & Peña-Mora, 2011). Practically speaking, occupa- via therapeutic use of self within “client-centered delivery of tional therapists are frequent “end users” of medical innova- occupational therapy services” (AOTA, 2014, p. S12); (2) col- tion products that are ultimately marketed to clients (Silver, laborating with the client during evaluation and treatment to Binder, Zubcevik, & Zafonte, 2016). Any lack of occupational “allow clients more control in decision making and problem therapy involvement in the beginning design stages of those solving” (AOTA, 2014, p. S12); (3) developing custom plans products may unduly lead to ineffective solutions that are of care through collaboration with other health professionals, produced but rarely used by clients, further limiting occupa- including physical therapists, speech-language pathologists, tional engagement and performance (Campbell, 2011; Nasar licensed clinical social workers, registered nurses, and physi- & Elmer, 2016). cians, via direct and indirect service delivery models (AOTA, Within the past 2 years, design has explicitly emerged 2014); and (4) constructing prototypes during intervention as a potential area of enhanced focus within the various via interactive clinical reasoning skills. These prototypes are domains of occupational therapy practice. Bhakta et al. then (5) tested in real time and result in feedback incor- (2017) described collaboration between occupational therapy porated into successive iterations as “intervention review” students and students at Washington Univer- (AOTA, 2014, p. S15). sity. Elsewhere, De Couvreur et al. (2012) spoke of emerging Because of the naturally occurring alignment in these design collaborations occurring among occupational thera- processes, occupational therapy, as a health care profession, pists, caregivers, and individuals with disabilities to co-con- is primed to take advantage of the recent interest in DT struct adaptive devices used within community-based health occurring across health care (Reeves et al., 2016). In occu- care projects. Silverman, Bartley, Cohn, Kanics, and Walsh pational therapy, clients are often observed interacting with (2012) described collaborations to improve inclusion and tools and objects located in their contexts and environments; participation for individuals experiencing a variety of disabil- the occupational therapist considers client factors, perfor- ities at museums in Boston, Philadelphia, and Chicago. Other mance skills, and performance patterns, and analyzes where reported design experiences have included engineering and occupational participation appears functional or affected, occupational therapy students (Waite, 2014), an occupational including how tools and objects are used (De Couvreur et therapist developing toys and games (Waite, 2016), and al., 2012; Sanders & Stappers, 2012). Data collection occurs individuals with spinal cord injuries helping design rehabili- throughout the occupational therapy process; therapists tation solutions (Campbell, 2012). compile data, use insights based on clinical reasoning, and combine it with feedback from their clients to craft evi- INCORPORATING DESIGN INTO CLINICAL EDUCATION dence-based effective care plans that allow them to create According to AOTA’s Vision 2025, occupational thera- appropriate adaptations and measure efficacy of outcomes pists need to be effective, collaborative, accessible lead- while promoting clients’ well-being and participation (DePoy ers, specifically by being “influential in changing policies, & Gitlin, 2016). environments, and complex systems” (AOTA, 2017, p.

CE-2 ARTICLE CODE CEA1017 OCTOBER 2017 l OT PRACTICE, 22(19) Earn .1 AOTA CEU (one contact hour and 1.25 NBCOT PDU). See page CE-7 for details.

7103420010p1). To this end, incorporating into frame complex situations and to aid in developing interven- clinical education and encouraging practitioners to use it tions (Schell, Gillen, & Scaffa, 2014). Even with this broadly regularly can have a positive effect in that the “more light applicable foundation and approach, much of occupational we shed on creativity, the more therapists will use it, the therapy’s work remains geared toward rehabilitation services more success they will have with it, and the more they will under traditional service models (Hildenbrand & Lamb, enjoy it” (Schmid, 2004, p. 87). Pragmatically, creativity 2013). Originally advocated for as part of the Centennial is required to help future health care professionals shape a Vision a decade ago, several “emerging areas of occupational “well-defined and recognizable practice framework for the practice” were outlined (Baum & Christiansen, 2006) and broad-scaled integration of more creative, interdisciplinary, continue to maintain relevance today, including extending and human-centered approaches to health care management, our reach into ergonomic design and accessibility consulta- innovation, and practice” (Roberts et al., 2016, p. 11). As tion for home modification; helping develop safe, effective creativity is applied, a positive feedback loop is created, as assisted-living communities; and using assistive-device innovation skills are gained by health care professionals and design to support individuals and populations to promote implemented in practice (Steen, 2013). By recognizing occu- participation, health, and wellness. pational therapy’s creative foundation, bringing it to bear on “Similar to the philosophy of occupational therapy the opportunities of today, and working across interprofes- practice,” experiential learning activities promote “learning sional disciplines, the profession stands to actively shape the by doing,” in which students apply knowledge gained in future of health care (McDonagh & Thomas, 2013). the classroom to the needs of communities and individuals One of the best places to initiate this change is within the (Knecht-Sabres, 2013, p. 25). Simply defined, experiential educational system that trains the next generation of practi- learning “is a process through which a learner constructs tioners. Many medical and health care programs are already knowledge, develops skills, and gains value from one’s engaging in DT-based IPE design experiences to help their experience” (Knecht-Sabres, 2013, p. 25). DT emphasizes future clinicians prepare to navigate the changing health collaboration; creativity; discovery; and iterative exploration, care landscape awaiting them (Cahn et al., 2016; Reeves et including prototyping, testing, feedback, and refinement. al., 2016; Roberts et al., 2016; Van de Grift & Kroeze, 2016). Like experiential learning, DT is a hands-on, experiential Future occupational therapists would greatly benefit from process that generates ideas through action (Sanders & Stap- consistent participation in design-centric IPE experiences to pers, 2012; Steen 2013). As Knecht-Sabres (2013) illustrated fully enhance the profession’s marketability and diversity in in her research on experiential learning within an occupa- today’s rapidly evolving health care environment (Steen, 2013) tional therapy program, this method of education enhances a and contribute to achieving Vision 2025. Occupational therapy student’s understanding and application of content, increases practitioners are well positioned to be key players within professional skills and attributes, and works to increase DT-based IPE design experiences, as the profession inherently clinical reasoning. Students in her study noted a desire for possesses distinct skills directed toward enhancing occupa- more experiential learning throughout their programs and tional performance, particularly around client factors; perfor- a belief that experiential learning provided an opportunity mance skills and patterns; and habits, routines, and roles in to “‘bridge the gap’ between academia and clinical practice” various contexts and environments as noted by the language in (Knecht-Sabres, 2013, p. 32). Following from the similarities our Framework (AOTA, 2014). in approach, benefits of incorporation, and stated student desires, using a DT-focused, experience-based educational USING DT WITH EMERGING AREAS OF OT PRACTICE process within an occupational therapy curriculum via Clients living with illness or disability often are required to devices such as the Design Thinking for Educators Toolkit navigate complex, disjointed, dynamic systems to address may provide instructors with a new tool that can be used their everyday needs, while simultaneously being presented to provide effective, first-hand learning experiences. With with limited access to functional objects and tools within such experiences, students gain the skills and attributes to their physical environment to complete desired tasks, nega- transition from educational experiences to occupational ther- tively affecting their ability to engage in meaningful occu- apy and designer positions within traditional and emerging pations (Dahler, Rasmussen, & Anderson, 2016; Lee, Han, practice settings (IDEO, 2013). Kim, & Bang, 2015). Client-centered theoretical models, such as Person-Environment-Occupation, Person-Environ- DESIGN LEARNING EXPERIENCES IN THE EDUCATIONAL PROCESS ment-Occupation-Performance, and the Ecology of Human According to Silver et al. (2016), hackathons are an example Performance, coupled with activity and occupational analysis of a multidisciplinary design process that traditionally “bring and skilled observation (hallmarks of the profession), are together stakeholders in the early design phase … to identify taught to and used by occupational therapy practitioners to the most urgent or important clinical needs and create

OCTOBER 2017 l OT PRACTICE, 22(19) ARTICLE CODE CEA1017 CE-3 Continuing Education Article CE Article, exam, and certificate are also available ONLINE. Register at http://store.aota.org or call toll-free 877-404-AOTA (2682). new products, systems, services, datasets, and tools that EDUCATIONAL COLLABORATIONS BETWEEN OT AND DESIGN will improve health care delivery.” In recent years, medical Using innovative methods to implement IPE design experi- schools have increasingly applied hackathon formats using ences that use DT within curricula and implementing cli- DT within their programs to help students learn to think ent-centered design programs benefit all learners, including more creatively and empathically (Thomas & McDonagh, those within the design and occupational therapy professions. 2013). Through using the DT methodology within an inter- For example, ACOTE standard B5.9 requires occupational disciplinary setting, these events are creative opportunities therapy students to “evaluate and adapt processes or envi- for occupational therapy students to engage in experiential ronments by applying ergonomic principles and principles learning. Unlike occupational therapists, designers are tradi- of environmental modification” (ACOTE, 2012, p. 24), and tionally taught human factors and anthropometrics but are B5.10 notes the need for students to “articulate principles of not well-versed in musculoskeletal performance occurring and be able to design, fabricate, apply, fit, and train in assistive within disability or illness (Donati & Vignoli, 2015; Saurus technologies and devices used to enhance occupational per- & Rebola, 2012). Many other health care professionals are formance and foster participation and well-being” (ACOTE, also not trained in how to comprehensively analyze a client’s 2012, p. 24). To address these standards, many occupational performance skills and patterns within various environments therapy curricula use interactive labs that facilitate students’ and contexts; however, current occupational therapy educa- application of principles to adapt objects, tion addresses several of these domains through Accredita- tools, and toys within the personalized environmental spaces tion Council for Occupational Therapy Education (ACOTE®; in which clients function. Solutions developed in these labs 2012) B standards, making occupational therapy an asset on are functional and usable, but they can be limited in innova- design teams. tion, , and refinement. Specifically, occupational Using DT and engagement in IPE design experiences therapists learn how to fabricate (“hack”) objects and tools and hackathons can expand occupational therapy student for individual client use; however, these final products are and faculty thinking beyond current occupational ther- not intended to be professionally manufactured or marketed apy models (Reeves et al., 2016). IPE design experiences for larger populations that may ultimately benefit from use. involving occupational therapy and design professionals can Merging occupational therapy students’ training in evaluation help create a deeper understanding of specific human needs and intervention principles with design students’ creative and may yield innovative, client-centered solutions with processes and understanding of materials can build a deeper universal application. People with diverse skill sets working understanding of specific human needs and yield state-of-the- together in teams improve end products and increase func- art, client-centered tool and object solutions with potentially tion and participation for individuals living with disability universal application that may be useful beyond the individual (Campbell, 2012; Silver et al., 2016). Inherent in both the experience (Sanders & Stappers, 2012; Thomas & McDonagh, DT and occupational therapy processes is an iterative cycle 2013). Using appropriate and measurable outcomes during IPE that encourages the designer or therapist to create and test design experiences can allow educators to capture collabora- new ideas and create successive solutions, with each attempt tive IPE effectiveness at the student, client, and interprofes- coming closer to the desired outcome (Brown, 2008). The sional levels. main difference between the processes is that for DT, the need for these iterations is made explicit from the outset, INCORPORATING DT INTO OT CURRICULA: ASSIGNMENT with failure seen as a natural and inevitable part of the pro- SAMPLES cess. As the founder of the design firm IDEO and one of the Since 2013, Thomas Jefferson University’s Occupational Ther- creators of DT, David Kelley, often says, “Fail faster, succeed apy Department has engaged in interprofessional, DT-based, sooner” (Manzo, 2008). Teaching occupational therapy stu- small-scale design hackathons, incorporating 2- to 3-week toy dents to apply DT within the occupational therapy process and game and playground design problems based on fictional can help them learn the value of experiencing these early case stories. A larger, semester-long independent study elec- failures for building the resilience and grit, understanding, tive is provided for team partnerships for clients with disabil- and complex clinical reasoning skills necessary for effective ities. Additional design-focused health care work has been problem solving (Brown, 2008; Cahn et al., 2016). Using undertaken in a partnership among Philadelphia University, IPE design experiences that use DT in occupational therapy the Sidney Kimmel Medical College of Thomas Jefferson Uni- education can encourage students to engage in teamwork versity, and Thomas Jefferson University’s Occupational Ther- and explore new solutions, stretching their thinking beyond apy Department. This coursework, which is partly sponsored the traditional educational experiences occurring within by Comcast, aims to produce physical prototypes that address their present curricula. the needs of clients and health care providers.

CE-4 ARTICLE CODE CEA1017 OCTOBER 2017 l OT PRACTICE, 22(19) Earn .1 AOTA CEU (one contact hour and 1.25 NBCOT PDU). See page CE-7 for details.

Example 1: Toy and Hackathon design. Teams comprised two industrial design students, two In this brief, 3-week design program, 82 students total occupational therapy students, and one client experiencing a were assigned to 12 teams, each of which was composed of physical and/or cognitive disability. Teams used an empathic a ratio of up to seven occupational therapy students (sec- design framework. Occupational therapy students used ond-year bachelor’s-to-master’s and first-year master’s) to structured interviews pre- and post-design with the Cana- one industrial design student (undergraduate or graduate dian Occupational Performance Measure (COPM; Law et al., ). Teams were provided with a case story during week 2014) and iterative discussion coupled with environmental 1. They used large sheets of brown craft paper, permanent observational research within each client’s work or home markers, and sticky notes for sketching purposes to come up environment to locate areas of occupation where participa- with a concept. During week 2, “chunky monkey” (a type of tion was compromised. Occupational therapy students were rough prototype design) production occurred at the indus- additionally required to locate one pre-existing self-report trial design studio at a local university, and in week 3, teams assessment tool that demonstrates good reliability and valid- presented their prototypes with accompanying PowerPoint ity and that could be used pre- and post-design to capture presentations to their peers and instructors. Occupational client outcomes. With ongoing feedback from their client, therapy students were required to complete a separate occupational therapy and industrial design students identi- worksheet justifying their toy and game design in relation fied a specific design problem causing occupational dysfunc- to developmental level, age appropriateness in relation to tion. Teams conducted research, sketched, brainstormed play expectations, environments in which the toy and game ideas, created prototypes, and rendered multiple potential could be used, and an explanation of the child’s needs and solutions for feedback and input from their client. Occu- the rationale as to how the adaptation provided met those pational therapy students located applicable peer-reviewed needs. Specific ACOTE B standards addressed by the expe- literature to further validate their team’s intervention design. rience included B1.1, B1.2, B4.8, B5.1, B5.8, B5.9, and B5.10 Several physical prototypes created by each team were tested (ACOTE, 2012). by their client during the semester. At the end of 10 weeks, each team had developed a new product that was usable or Example 2: Playground Design Assignment potentially usable by their client to enhance participation. The playground design activity occurred over a 2-week period Specific ACOTE B standards addressed by this elective and engaged 80 occupational therapy students. During the included B1.1, B1.2, B4.1, B4.8, B5.1, B5.8, B5.9, B5.10, B6.2, first week, two graduate-level industrial design students laid B6.3, and B9.3 (ACOTE, 2012). the foundation for the (a meeting by design team members to agree on and finalize a design ) by presenting Example 4: Design and Health Care Course a critical review of current playground systems, a survey of In this full-semester class, 10 industrial design students, 20 contemporary playground principles, and the effect of these medical students, and 3 bachelor’s-to-master’s occupational factors on the development of play skills and social behav- therapy students learned about and created solutions for ior. Occupational therapy students then toured four local client- and/or clinician-focused needs within a hospital setting. playgrounds and public spaces with varied spatial configura- Because of the mixed backgrounds of the student cohort, at tions, completing photographic documentation and detailed the start of the semester students received didactic content observation logs. During week 2, the occupational therapy covering a wide range of topics, including the current health students, in 20 groups with three to four members each, cre- care landscape, materials and processes used to physically create ated hand-drawn schematic plans for a new playground to be hospital-grade equipment, and common conditions and medical situated within an adjacent urban square. Through this work, equipment present in the hospital. Following this initial phase, students were exposed to and needed to consider the effect of 11 mixed student groups were assigned to clinical mentors large spatial and contextual factors and the realities of working located throughout the medical system (including, but not within an urban environment while creating an inclusive and limited to, the emergency, surgical, oncology, and rehabilitation engaging play environment for children of varying abilities. departments). Through several onsite observations, in-person Specific ACOTE B standards addressed by the playground interviews with clinicians and clients, and successive rounds of experience included B1.1, B1.2, B4.8, B5.1, B5.8, B5.9, and prototyping and testing, each group developed an original solu- B5.10 (ACOTE, 2012). tion to an uncovered opportunity for improvement. Solutions involved both developing physical objects as well as procedural Example 3: Industrial Design Independent Study Elective changes to existing workflows. Specific ACOTE B standards Second-year master’s students registered to participate in addressed by this elective included B1.1, B1.2, B4.1, B4.8, B5.1, a semester-long immersion in industrial design product B5.8, B5.9, B5.10, B6.2, B6.3, and B9.3 (ACOTE, 2012).

OCTOBER 2017 l OT PRACTICE, 22(19) ARTICLE CODE CEA1017 CE-5 Continuing Education Article CE Article, exam, and certificate are also available ONLINE. Register at http://store.aota.org or call toll-free 877-404-AOTA (2682).

PRACTICAL CONSIDERATIONS REFERENCES Implementing DT-based IPE design experiences can be a Accreditation Council for Occupational Therapy Education. (2012). 2011 time-consuming but worthwhile proposition for occupational Accreditation Council for Occupational Therapy Education (ACOTE®) standards. American Journal of Occupational Therapy, 68, S6–S74. https://doi. therapy educational programs. The IPE partnerships described in org/10.5014/ajot.2012.66S6 this article occurred among a health professions college associ- American Occupational Therapy Association. (2014). Occupational therapy ated with a hospital, a private art university geographically located practice framework: Domain and process (3rd ed.). American Journal of Occu- within five city blocks, and the medical school at Thomas Jeffer- pational Therapy, 68, S1–S48. https://doi.org/10.5014/ajot.2014.682006 son University. Initial collaborations continue to occur informally American Occupational Therapy Association. (2017). Vision 2025. American Journal of Occupational Therapy, 71, 7103420010p1. https://doi.org/10.5014/ between the medical school and the occupational therapy depart- ajot.2017.713002 ment to develop future IPE courses. In addition, an occupational Bhakta, J., Ulfers, S., Hyde, M., Heeb, R., Egan, M., Grover, M., … Berg, C. therapy doctorate residency is being planned. (2017). Functional and fashionable: An interprofessional experience explor- The Toy and Game Design hackathon was trialed and ing fashion design. OT Practice, 22(9), 14–17. implemented 2 years before implementing the Industrial Design Baum, C., & Christiansen, C. (2006) AOTA’s Centennial Vision: Shaping the future of occupational therapy. Retrieved from http://www.aota.org/~/media/Corpo- Independent Study Elective Course. Feedback from previous rate/Files/AboutAOTA/Centennial/Background/vision2017-baum.ppt years’ toy and game hackathon experiences necessitated tailor- Brown, T. (2008). Design thinking. Retrieved from https://hbr.org/2008/06/ ing the fictional pediatric case stories to conditions that would design-thinking easily allow for usable physical design solutions (e.g., for clients Cahn, P. S., Bzowyckyj, A., Collins, L., Dow, A., Goodell, K., Johnson, A. F., with cerebral palsy or amputation as opposed to attention deficit … Zierler, B. K. (2016). A design thinking approach to evaluating interpro- fessional education. Journal of Interprofessional Care, 30, 378–380. https://doi. hyperactivity disorder) and that contained enough specifics to org/10.3109/13561820.2015.1122582 allow teams to develop a final prototype within the brief, 3-week Campbell, E. (2011). Design and rehabilitation: A three-day workshop in design for hackathon timeframe. For the Independent Study Elective, people with spinal cord injuries. London: RSA Projects. securing clients who were willing and able to share their full Campbell, E. (2012). Report on the RSA’s design & rehabilitation project at three medical history, provide ample access within home and/or spinal cord injury centres. London: RSA Projects. work environments, and tolerate frequent visits from a team of Dahler, A., Rasmussen, D., & Anderson, P. (2016). Meanings and experiences of students was essential. Providing teams with a budget for sup- assistive technologies in everyday lives of older citizens: A meta-interpretive review. Disability and Rehabilitation: Assistive Technology, 11, 619–629. plies ($100), an open and undisturbed work with access De Couvreur, L. D., Detand, J., Dejonghe, W., Goossens, R., Brassett, J., Hekkert, to power tools (available in the industrial design department’s P., … McDonnell, J. (2012). Expect the unexpected: The co-construction of facilities), and consistent times within the students’ schedules assistive artifacts. Presentation at the 8th International Design and Emotion in which both programs could regularly collaborate as teams Conference, London, England. were also beneficial. DePoy, E., & Gitlin, L. (2016). Introduction to research: Understanding and apply- ing multiple strategies (5th ed.). St. Louis: Elsevier. Locating local universities that offer design programs Donati, C., & Vignoli, M. (2015). How tangible is your prototype? Designing and that can foster partnerships may not be feasible for all the user and expert interaction. International Journal on Interactive Design and occupational therapy curricula. In lieu of this, occupational Manufacturing, 9, 107–114. https://doi.org/10.1007/s12008-014-0232-5 therapy educational programs may consider reaching out Ferreira, F. K., Song, E. H., Gomes, H., Garcia, E. B., & Ferreira, L. M. (2015). to local design firms (if available) to determine collabora- New mindset in scientific method in the health field: Design thinking. Clinics, 70, 770–772. tion possibilities. Professional organizations, such as the Hasso Plattner Institute of Design at Stanford. (n.d.). An introduction Industrial Designers Society of America, the Professional to design thinking: Process guide. Retrieved from https://dschool-old. Association of Design, and the American Institute of Archi- stanford.edu/sandbox/groups/designresources/wiki/36873/attach- ments/74b3d/ModeGuideBOOTCAMP2010L.pdf?sessionID=573e- tects, provide directories of members located throughout the fa71aea50503341224491c862e32f5edc0a9 United States. Hildenbrand, W. C., & Lamb, A. J. (2013). Occupational therapy in prevention and wellness: Retaining relevance in a new health care world. American CONCLUSION Journal of Occupational Therapy, 67, 266–271. https://doi.org/10.5014/ To date, combining disciplines has provided occupational ajot.2013.673001 therapy students with exposure to DT, prototyping, and con- IDEO. (2013). Design thinking for educators toolkit (2nd ed.). Retrieved from https://designthinkingforeducators.com cepts of mass production. Learning opportunities for students Knecht-Sabres, L. J. (2013). Experiential learning in occupational therapy: Can it extended in many directions, including increasing their enhance readiness for clinical practice? Journal of Experiential Education, 36, understanding of what is required to live successfully with a 22–36. https://doi.org/10.1177/1053825913481584 disability in today’s society. Given the pervasiveness of inter- Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. th disciplinary teamwork, the lessons gleaned from these types of (2014). Canadian Occupational Performance Measure (5 ed.). Ottawa, Ontar- io: CAOT Publications. collaborations can have positive implications for occupational Lee, M., Han, S., Kim, H., & Bang, H. (2015). Identifying user experience elements therapy education and enhance the profession’s position as it for people with disabilities. Presentation at ACHI: The Eighth International moves toward Vision 2025. Conference on Advances in Computer Health Interactions, Lisbon, Portugal.

CE-6 ARTICLE CODE CEA1017 OCTOBER 2017 l OT PRACTICE, 22(19) Earn .1 AOTA CEU (one contact hour and 1.25 NBCOT PDU). See below for details.

Manzo, P. (2008). Fail faster, succeed sooner. Retrieved from https://ssir.org/ articles/entry/fail_faster_succeed_sooner McDonagh, D., & Thomas, J. (2013). Innovating alongside designers. Austral- asian Medical Journal, 6, 29–35. How to Apply for McDonagh, D., Thomas, J., Khuri, L., Sears, S. H., & Peña-Mora, F. (2011). Continuing Education Credit Empathic strategies: Designing for, with, and by people with disabilities. In A. Silva & R. Simoes (Eds.), Handbook of research on trends in and development: Technological and organizational perspectives A. To get pricing information and to register to take the exam on- (pp. 58–79). Hershey, PA: IGI Global. http://doi.org/10.4018/978-1-61520- line for the article The Occupational Designer: New Frontiers 617-9.ch004 in Teaching and Clinical Practice, go to http://store.aota.org, Nasar, J., & Elmer, J. (2016). Homeowner and homebuyer impressions of visit- or call toll-free 800- 729-2682. able features. Disability and Health Journal, 9, 108–117. B. Once registered and payment received, you will receive instant Nixon, N. (2013). Viewing ascension health through a design thinking perspec- email confirmation, with password and access information to tive. Journal of Organizational Design, 2(3), 23–28. https://doi.org/10.7146/ take the exam online immediately or at a later time. jod.15575 Reeves, S., Fletcher, S., Barr, H., Birch, I., Boet, S., Davies, N., … Kitto, S. C. Answer the questions to the final exam found on pages CE-7 and (2016). A BEME systematic review of the effects of interprofessional educa- CE-8 by October 31, 2019. tion: BEME guide no. 39. Medical Teacher, 38, 656–668. https://doi.org/10.31 D. On successful completion of the exam (a score of 75% or more), 09/0142159X.2016.1173663 you will immediately receive your printable certificate. Roberts, J. P., Fisher, T. R., Trowbridge, M. J., & Bent, C. (2016). A design thinking framework for healthcare management and innovation. Healthcare, 4, 11–14. https://doi.org/10.1016/j.hjdsi.2015.12.002 Sanders, E., & Stappers, P. J. (2012). Convivial toolbox: Generative research for the front end of design. Amsterdam: BIS Publishers. Final Exam Saurus, C., & Rebola, C. B. (2012). Teaching co-design in industrial design: Case studies of existing practices. Presentation at IDSA Education Symposium, Article Code CEA1017 Boston. Schell, B., Gillen, G., & Scaffa, M. (2014). Willard & Spackman’s occupational The Occupational Designer: New Frontiers in Teaching therapy (12th ed.) Philadelphia: Lippincott, Williams, & Wilkins. and Clinical Practice • October 30, 2017 Schmid, T. (2004). Meanings of creativity within occupational therapy practice. Australian Occupational Therapy Journal, 51, 80–88. https://doi.org/10.1111/ To receive CE credit, exam must be completed by j.1440-1630.2004.00434.x October 31, 2019 Silver, J. K., Binder, D. S., Zubcevik, N., & Zafonte, R. D. (2016). Healthcare hackathons provide educational and innovation opportunities: A case study Learning Level: Intermediate and best practice recommendations. Journal of Medical Systems, 40, Article 177. https://doi.org/10.1007/s10916-016-0532-3 Target Audience: Occupational therapists and occupational therapy Silverman, F., Bartley, B., Cohn, E., Kanics, I. M., & Walsh, L. (2012). Occupa- assistants tional therapy partnerships with museums: Creating inclusive environments that promote participation and belonging. International Journal of the Inclusive Content Focus: Education, Academic program, design thinking, Museum, 4, 15–30. clinical reasoning Steen, M. (2013). Virtues in : Cooperation, curiosity, creativity, empowerment and reflexivity. Science and Engineering Ethics, 19, 1. The main principles of design thinking (DT) include: 945–962. http://doi.org/10.1007/s11948-012-9380-9 A. Empathy, integrative thinking, optimism, and Thomas, J., & McDonagh, D. (2013). Empathic design: Research strategies. Aus- tralasian Medical Journal, 6, 1–6. https://doi.org/10.4066/AMJ.2013.1575 experimentation B. Therapeutic use of self, integrative thinking, and collaboration Van de Grift, T. C., & Kroeze, R. (2016). Design thinking as a tool for interdisci- plinary education in health care. Academic Medicine, 91, 1234–1238. https:// C. Client-centered care, collaboration, and rapid prototyping doi.org/10.1097/ACM.0000000000001195 D. Flexibility of use, tolerance for error, low physical effort, Waite, A. (2014). Open style: MIT program allows OTs to collaborate with engi- and equity of use neers and designers. OT Practice, 19(19), 17–18. Waite, A. (2016). Q&A: Holly Cohen. OT Practice, 21(7), 32. 2. The following statements are key learning features of Zupan, B., Stritar, R., & Nabergoj, A. (2014). Design thinking as a course design a DT-based interprofessional education (IPE) design methodology. Presentation at the 8th International Scientific Conference on experience except: Economic and Social Development and 4th Eastern European ESD Confer- ence: Building Resilient Economy, Zagreb, Croatia. A. Working alongside a mix of health care and design professionals B. Developing a highly resolved solution based on a predeter- mined goal C. Taking risks and developing new ideas within a support- ive environment D. Hands-on testing and multiple iterations

OCTOBER 2017 l OT PRACTICE, 22(19) ARTICLE CODE CEA1017 CE-7 Continuing Education Article CE Article, exam, and certificate are also available ONLINE. Register at http://store.aota.org or call toll-free 877-404-AOTA (2682).

3. Of the following, which Occupational Therapy Practice 8. When implementing DT-based IPE design partnerships, Framework: Domain and Process, 3rd Edition process which of the following is least likely to be a barrier to component is not readily used within DT methodology? collaboration? A. Therapeutic use of self A. Delineating available collaboration time B. Collaborating with other disciplines B. Meeting ACOTE B standards C. Analyzing occupational performance C. Locating potential design partners D. Applying clinical reasoning skills D. Procuring power tools

4. Occupational therapy students learn from the outset 9. In designing and creating solutions, what component that the occupational profile and analysis of occu- does DT philosophy account for via the need for multiple pational performance of clients during evaluation is iterations? meant to be client-centered. In DT, these steps most A. Failure closely correspond to the initial phase of: B. Learning A. Prototyping C. Human factor analysis B. Integrating D. Collaboration C. Empathizing D. Experimenting 10. Which of the following is least necessary to run a successful DT-based IPE design experience? 5. An occupational therapy theoretical model that can A. Access to a range of disciplines expand a team’s understanding of a client’s needs during B. Eager and engaged faculty a DT-based IPE design experience is: C. Space for students to work on physical models A. Model of Human Occupation D. Commercial grade tools and machinery B. Biomechanical Model C. Transtheoretical Model 11. Which is likely to be the most readily accessible option D. Ecology of Human Performance Model for occupational therapy educators who want to support DT-based IPE design experiences but whose college or 6. A “hackathon” occurring within a DT-based IPE design university does not offer design as a major? experience is: A. Design an online course A. An interprofessional collaboration currently occurring B. Join the Industrial Designers Society of America within occupational therapy curricula C. Search for a local design firm to teach B. An interdisciplinary team event to improve health care D. Locate design websites, blogs, and online publications solutions in the early design phase C. A clinical event that provides experience for occupation- 12. Educators can most efficiently measure and track al therapy students to obtain design skills student outcomes pre- and post-DT-based IPE design D. A DT team event limited to health care professionals to experience by: create new products, systems, or services A. Holding focus groups for occupational therapy students and designers 7. The following are benefits of incorporating DT-based IPE B. Having students administer the Canadian Occupational design experiences into occupational therapy education Performance Measure tool to the client before and after except: C. Deploying targeted electronic course evaluations A. Exposing other health professionals and designers to the D. Conducting individualized student interviews distinct value of occupational therapy B. Providing students with new tools and techniques for use in clinical practice C. Evaluating students on their use of standardized assess- ments in a clinical setting D. Increasing the opportunities for experiential learning within curricula

CE-8 ARTICLE CODE CEA1017 OCTOBER 2017 l OT PRACTICE, 22(19)