Merry Christmas to you all and a Happy 2014 - here's to more blog posts.....

Transitions from unhealthy to healthy behaviour- a personal journey

  "If one does not believe in one's capability to perform a desired action, one will fail to adopt, initiate and maintain it".

Schwazer:  Health Action process Approach

In this blog post I attempt to consider the notion of transition from an unhealthy behaviour to a healthy behaviour using the Model of Human Occupation (MOHO) as a loose frame to focus my personal experience of being diagnosed with Type2 Diabetes. Firstly some very quick definitions to key you into the terminology I am using.

  I thought it best to go to the official site to define MOHO here:

MOHO seeks to explain how occupation is motivated, patterned, and performed. By offering explanations of such diverse phenomena, MOHO offers a broad and integrative view of human occupation. Within MOHO, humans are conceptualized as being made up of three interrelated components: volition, habituation, and performance capacity. Volition refers to the motivation for occupation, habituation refers to the process by which occupation is organized into patterns or routines, and performance capacity refers to the physical and mental abilities that underlie skilled occupational performance. MOHO also emphasizes that to understand human occupation, we must understand the physical and social environments in which it takes place. Therefore, this model aims to understand occupation and problems of occupation that occur in terms of its primary concepts of volition, habituation, performance capacity, and environmental context. 

Type 2 Diabetes, taken from the UK website

Type 2 diabetes develops when the insulin-producing cells in the body are unable to produce enough insulin, or when the insulin that is produced does not work properly (known as insulin resistance).Insulin is a hormone. It works as a chemical messenger that helps your body use the glucose in your blood to give you energy. You can think of it as the key that unlocks the door to the body’s cells. Once the door is unlocked glucose can enter the cells where it is used as fuel.

 

It is said that health is a process through which people become who they want to be (I apologise that I cannot find the original reference for this that came from nursing research). Much of the self-help literature offers the idea (myth?)  that it takes 28 days to adapt to change or 3 weeks to learn, 6 weeks to adopt and 6 months to internalise a new behaviour - but there is little evidence to support this within specific research areas, however, it seems to have worked for me this way. 

MOHO seeks to explain how occupation is motivated, patterned, and performed. By offering explanations of such diverse phenomena, MOHO offers a broad and integrative view of human occupation. Within MOHO, humans are conceptualized as being made up of three interrelated components: volition, habituation, and performance capacity. Volition refers to the motivation for occupation, habituation refers to the process by which occupation is organized into patterns or routines, and performance capacity refers to the physical and mental abilities that underlie skilled occupational performance. MOHO also emphasizes that to understand human occupation, we must understand the physical and social environments in which it takes place. Therefore, this model aims to understand occupation and problems of occupation that occur in terms of its primary concepts of volition, habituation, performance capacity, and environmental context. - See more at: http://www.cade.uic.edu/moho/resources/about.aspx#sthash.Nq8aLYPW.dpuf

MOHO seeks to explain how occupation is motivated, patterned, and performed. By offering explanations of such diverse phenomena, MOHO offers a broad and integrative view of human occupation. Within MOHO, humans are conceptualized as being made up of three interrelated components: volition, habituation, and performance capacity. Volition refers to the motivation for occupation, habituation refers to the process by which occupation is organized into patterns or routines, and performance capacity refers to the physical and mental abilities that underlie skilled occupational performance. MOHO also emphasizes that to understand human occupation, we must understand the physical and social environments in which it takes place. Therefore, this model aims to understand occupation and problems of occupation that occur in terms of its primary concepts of volition, habituation, performance capacity, and environmental context. - See more at: http://www.cade.uic.edu/moho/resources/about.aspx#sthash.Nq8aLYPW.dpuf

MOHO seeks to explain how occupation is motivated, patterned, and performed. By offering explanations of such diverse phenomena, MOHO offers a broad and integrative view of human occupation. Within MOHO, humans are conceptualized as being made up of three interrelated components: volition, habituation, and performance capacity. Volition refers to the motivation for occupation, habituation refers to the process by which occupation is organized into patterns or routines, and performance capacity refers to the physical and mental abilities that underlie skilled occupational performance. MOHO also emphasizes that to understand human occupation, we must understand the physical and social environments in which it takes place. Therefore, this model aims to understand occupation and problems of occupation that occur in terms of its primary concepts of volition, habituation, performance capacity, and environmental context. - See more at: http://www.cade.uic.edu/moho/resources/about.aspx#sthash.Nq8aLYPW.dpuf

MOHO seeks to explain how occupation is motivated, patterned, and performed. By offering explanations of such diverse phenomena, MOHO offers a broad and integrative view of human occupation. Within MOHO, humans are conceptualized as being made up of three interrelated components: volition, habituation, and performance capacity. Volition refers to the motivation for occupation, habituation refers to the process by which occupation is organized into patterns or routines, and performance capacity refers to the physical and mental abilities that underlie skilled occupational performance. MOHO also emphasizes that to understand human occupation, we must understand the physical and social environments in which it takes place. Therefore, this model aims to understand occupation and problems of occupation that occur in terms of its primary concepts of volition, habituation, performance capacity, and environmental context. - See more at: http://www.cade.uic.edu/moho/resources/about.aspx#sthash.Nq8aLYPW.dpuf

MOHO seeks to explain how occupation is motivated, patterned, and performed. By offering explanations of such diverse phenomena, MOHO offers a broad and integrative view of human occupation. Within MOHO, humans are conceptualized as being made up of three interrelated components: volition, habituation, and performance capacity. Volition refers to the motivation for occupation, habituation refers to the process by which occupation is organized into patterns or routines, and performance capacity refers to the physical and mental abilities that underlie skilled occupational performance. MOHO also emphasizes that to understand human occupation, we must understand the physical and social environments in which it takes place. Therefore, this model aims to understand occupation and problems of occupation that occur in terms of its primary concepts of volition, habituation, performance capacity, and environmental context. - See more at: http://www.cade.uic.edu/moho/resources/about.aspx#sthash.Nq8aLYPW.dpuf

MOHO seeks to explain how occupation is motivated, patterned, and performed. By offering explanations of such diverse phenomena, MOHO offers a broad and integrative view of human occupation. Within MOHO, humans are conceptualized as being made up of three interrelated components: volition, habituation, and performance capacity. Volition refers to the motivation for occupation, habituation refers to the process by which occupation is organized into patterns or routines, and performance capacity refers to the physical and mental abilities that underlie skilled occupational performance. MOHO also emphasizes that to understand human occupation, we must understand the physical and social environments in which it takes place. Therefore, this model aims to understand occupation and problems of occupation that occur in terms of its primary concepts of volition, habituation, performance capacity, and environmental context. - See more at: http://www.cade.uic.edu/moho/resources/about.aspx#sthash.Nq8aLYPW.dpuf

When we look at changing health behaviour, Schwazer offers the HAPA framework using  psychological and social sciences to discuss an approach to this which is designed to examine a set of psychological constructs that jointly aim at explaining what motivates people to change and how they take preventive action. In short, the motivation phase (or perhaps we might call this the initiation phase?)  describes how one needs to believe in one's capability to perform a desired action ("I am capable of initiating a healthier diet in spite of temptations"), otherwise one will fail to initiate that action.  In the subsequent volition phase (perhaps we may call this the adoption phase so as not to get tangled up with MOHO language?), after a person has developed an inclination toward adopting a particular health behaviour, the "good intention" has to be transformed into detailed instructions on how to perform the desired action. 

This had some resonance with me and I began to consider these issues in relation to me as an occupational therapist and using the elements of MOHO in the change I asserted. The sections in red refer to the language of the HAPA framework, I have linked them together with where I believe MOHO best fits with these categories and then given some personal reflection as to what this meant to me in my experience.

Volition:

A minimum level of threat or concern must exist before people start contemplating the benefits of possible actions and ruminate their competence to actually perform them 

• In order to consider change in healthy behaviour it was important to address and explore my relationship with food - values held, traditions practiced etc. 

• Food was a social event, a treat, a marker of time, a consolation. A way of sharing an experience and showing care and consideration with friends and family, and a link to the past.

•  This was all under threat and the advantages of change had to be weighed against the perceived effort and skill involved in making changes to all of this.

The message has to be framed in a way that allows individuals to draw on their coping resources and to exercise skills in order to control health threats (fear appeals are limited)

• The current stance by the NHS here in the UK is to approach the issue in a 'soft' way. Everything  in moderation is the message. What I observed through this within an education session with a group of people with a recent diagnosis was that this did not clearly offer the importance of change. There was little consideration of what coping resources or skills might be required 

• Utilising other sources from the internet and books, mainly from Australia (because in my view they seem to have a more well defined approach and attitude to the issue) I was able to find my way through often conflicting and usually complex messages to find a message that spoke to me enough to enable me to draw on coping strategies. The messages I found made me want to exert the effort required and make changes.

• Intrinsic motivation was also impacted by the future requirement of health care professionals to assess and judge my progress - I have never been able to easily accept being judged (I got through 3 driving instructors and 2 tests before I passed my driving test). So to avoid this I needed to adopt healthy behaviours.

 Intention is not enough on its own - it then has to be planned for and instructed within the  development of an internal coping dialogue 

•  Schwazer explains this as outcome expectancies- subjective beliefs on positive and negative outcomes and  perceived capability of a person to implement a certain behavior 

• I had to learn to challenge an internal dialogue that stated such things as "I don't have time to do all that cooking of fresh food", " I couldn't possibly eat that....", "I don't like ....", 

• I had to retrain my thinking on what was a treat, what was sociable, what was consolation etc. This was perhaps one of the hardest things, I had to identify my internal dialogue at each occasion where food was involved, what was I thinking, feeling about this. How did this fit with what I now knew to be "healthy" choice?

 Habituation

Intention has to be transformed into instruction

•  I scoured cookery books and each week I planned exactly what I was to eat every day - breakfast, lunch, dinner and snacks and by doing so learned about the science of food, how different groups work together, understood the concept of low Glycaemic Load (GL) for slow release and complex combinations that slowed sugar release or enhanced insulin effectiveness. And I finally began to understand portion control.

Action plans on how to create and adopt transitional behaviour, then have to be protected by cognitions in order to be maintained and not distracted by competing demands and intentions

•  By doing this I created a new routine for eating incoporating more time for cooking. In this way I began to enjoy making meals, creating an ambient environment (is now the time to admit that my favourite 'goto' music for meal prep is Steps??)

Avoidance of high risk situations

•  This was a bit harder to enforce. At first it was easier to avoid social situations where food would form part of the experience, but friends soon became slightly annoyed with me for this.

• Eventually this was impossible, but taking relearned coping strategies and with the support of friends and family I was able to find the confidence to ask questions of the food others had prepared and could make informed and healthy choices

Prioritise these intentions over other desires and intentions for a specific time period 

• My first HbA1c test would take place 3 months after initial diagnosis, therefore this became my first goal. I intended to keep these new behaviours for this period of time and then re-consider dependent upon the outcome of the test reading.

 Performance

Performing an intended health behaviour is an action, just as is refraining from a risk behaviour. The suppression of health-detrimental actions requires effort and persistence as well.

• As mentioned I learned how to cook healthy food, how to put food together what and how much to eat  

• I developed research skills to find and interpret the information available - there is much that is conflicting and complex in the available literature and learning to navigate through this is very difficult - and not something I have totally mastered to date I'm sure 

• I became so successful at suppressing health-detrimental actions that at the point of trying to 'fall off the wagon' and have treat to celebrate my first 3 months reading - and choose a cream cake - I couldn't do it and actually ..... I didn't want to do it - and I haven't

It is worth recognising, as with MOHO, that I continue to impact  on and be impacted on by the perceived and actual human and non-human environments.

• Human environment of support and personal networks of family friends and colleagues in both real and virtual world. 

• NHS support and advice

 

Outcome: BMI in normal range, HbA1c in non-diabetic range, Cholesterol normal range, weight loss - 3 stone and counting, feeling well :-)

This post is slightly away from the norm here as I feel I am exposing something more personal than I ususally do on this blog. I would welcome your comment and feedback as to whether this post was useful or interesting to your work or even personal circumstance. Any ideas for future posts would also be well received.
Many thanks 
Angela

OT4OT 24Vx 2013

Making the most of placement - a guest post from an anonymous Salford undergraduate.

Being on placement: the placement jitters

For me, placements are source of excitement and trepidation. This strange combination means that at around two weeks before placement I start to feel a little on edge (cue the ‘turning up for exams without doing any revision/going to Alton Towers in my pyjamas’ dreams). This build-up of butterflies usually leads to me saying something daft within the first 10 minutes to my educator. Why am I like this? A question I often ask myself. I think that it’s because I treat every placement as a potential employer, a 1-10 week-long job interview testing my practical skills, knowledge and clinical reasoning. It’s a bit like being on the Apprentice but with bottle-green trousers. When I finish university, I could be applying for a job at that workplace, so as well as passing my placement, I want them to have a positive impression of me.  So, if you feel the anxiety rise as placement creeps ever forward on your timetable. I hereby order that you give yourself a break and let me pass on some things I’ve learned to help you along the way. 

Make yourself useful. 

I thought that educators get extra time to supervise students; I was surprised to find out that this is not always the case. So educators may have a full caseload AND have to find time to make sure students under their charge have learning opportunities and supervision. I feel that if educators are sacrificing their time to help me learn then I should try and pay it back by trying to lighten the load for them. Basic things like answering the phone, taking messages, tidying up after a group, writing in medical notes and even the old favourite of making a cup of tea for staff (if not on the ward) or brewing up for patients (say, in groups) have gone down well in my experience.  I have had feedback that the use of initiative is always welcome (i.e. doing something without being asked). A note of caution here; that what you can do will depend on your placement so always check with your educator first. In my last placement there was a regular routine each morning such as cleaning, setting up the equipment and getting patient notes out for the day. I used to get in early to miss the traffic, so I used to do the morning routine when I first got in.

 Go easy on yourself

Whether it’s initial interviews, mini-mental state inventories, or group works, you are not going to be a superstar at something straight away. Go easy on yourself, it takes practise. It’s important to remember that the Oxford dictionary (2013) defines practise as a “repeated exercise in or performance of an activity or skill so as to acquire or maintain proficiency in it”. If you’re finding something difficult, keep trying, it will get better. It’s when you give up that you don’t improve. If you were amazing at something straight away, I would probably label it ‘talent’ and call Simon Cowell immediately.

People skills.

 Placement can be an overwhelming experience and I have heard of students, through the pressure, being nervous about talking to clients in case they say the wrong thing or worry that they won’t be able to answer client’s questions. In less than three years time, I will be seeing clients every day, so I use placement as the time to practice my interpersonal skills. I found that if I have developed a rapport with the client, then they are forgiving if something doesn’t go quite according to plan (common comments I have heard from patients are: “it’s alright love, you’ve got to start somewhere”, “you’re doing fine!”  and “don’t worry, we’ve all been there”. If I am unsure where to start I have found if I introduce myself, smile, make eye contact, am able to explain to the client the purpose of the intervention, actively listen and am polite that everything else seems to come naturally. Remember that patients may feel more apprehensive about their appointment than you so anything that can put them at their ease is helpful. 

You will be tired!

Even if you are just observing, placement is emotionally and physically draining. So be prepared! Look after yourself, try and get a decent night sleep. Exercise can be a good way of re-energising and shaking away any tension. Make your mornings easy, you don’t need anything else getting you into a flap.  Have your uniform (or work gear) all pressed and ready to go, car filled with petrol, lunch packed and some good music for the journey to placement to put you in the right frame of mind.

And finally, make the most of it, learn as much as you can and build some good contacts. I hope it goes well for you.

If you want to read more you can vist my blog TheOTProcess and also  Charlotte's blog  who diarises her daily experiences of her 3^rd  year OT Erasmus  placement. It's a  really good account of how it feels during placement and I certainly respect anyone getting their work experience through ERASMUS (I thought normal ones are scary enough!) 

What are your top placement tips? 

Engaging in occupation through adversity.......

Last evening I sat down to watch the Proms at the BBC - a performance of  Rachmaninov's Piano Concerto No 2 - one of my favourite pieces (think - "Brief Encounter" ). The piano soloist was an extraordinary young Japanese pianist Nobuyuki Tsujii, whose blindness is no barrier to his musical talent. In his interview trailer before the performance he explained how he listens for the conductor's breathing in order to reach his cues and work together with the orchestra and uses muscle memory and touch and sound to learn the pieces rather than use Braille. A fantastic performance was given and then followed by an encore of  Liszt’s La Campanella - one of the hardest pieces to play and clearly a bit of well deserved showing off ensued.

 This reminded me of recent stories I had seen on Facebook or on the BBC news that seemed to all form part of a theme. How people continue to engage in meaningful occupations (whether for leisure or productivity) whilst experiencing illness or disability. It often amazes me how people overcome obstacles when they decide they are going to engage in an activity - and how the people around them enable and support them in any way they can by adapting behaviour and/or the environment. By doing this they often challenge the perceptions of others as to what is possible and can act as an inspiration to others by being their own occupational therapist.

Please see the videos below for some truly inspirational stories and ones that have great resonance for occupational therapists..........................

18 years ago a slight lapse in concentration crushed Pascale's dreams of surfing. With the help of a family friend and a roll of duct tape; she can now call herself a surfer.











 A Son asked his father, "Dad, will you take part in a marathon with me?" The father who, despite having a heart condition, says "Yes". They went on to complete the marathon together. Father and son went on to join other marathons. The father always saying "Yes" to his son's request of going through the race together. One day, the son asked his father, "Dad, let's join the Ironman together."

To which, his father said "Yes".

For those who don't know, Ironman is the toughest triathlon ever. The race encompasses three endurance events of a 2.4 mile (3.86 kilometer) ocean swim, followed by a 112 mile (180.2 kilometer) bike ride and ending with a 26.2 mile (42.195 kilometer) marathon along the coast of the Big Island.

Father and son went on to complete the race together!

An Isle of Wight teenager with cerebral palsy has completed a solo journey across the channel.

Natasha Lambert, 16, was born with atheroid cerebral palsy which affects her limbs and speech.
Her 21ft-long (6.4m) boat, Miss Isle Too, has been adapted by her father, Gary, and allows her to steer by sucking and blowing into a tube.







I wonder if these stories say as much about the families who support them as it does about the person themselves. Might this mean that those individuals experiencing occupational deprivation through disability and/or illness who do not have supportive family may be disadvantaged? It would be great to hear of your experiences if you would like to share. Thankyou.

Hitting the target....but missing the point?

There has been much debate, discussion and speculation about the impact the Mid Staffordshire public enquiry and the subsequent Francis Report is having and will continue to have on health care delivery. Today I was invited to attend a presentation by Professor Ian Cumming, Chief Executive of Health Education England the new organisation who explain their role as:

"We are the NHS engine that will deliver a better health and healthcare workforce for England. We are responsible for the education, training and personal development of every member of staff, and recruiting for values. We are England’s health and healthcare people service."

Professor Cumming describes a culture in many organisations (and certainly found in the Mid Staffs culture) of documenting at all costs, even over caring for patients and went on to describe a few scenarios he had witnessed where service user need was secondary to process requirements and meeting targets. The issue of record keeping, documenting client care and statistics recording has always been important but perhaps has  become more so over the last 20 years?

Since the early 1990's with the advent of the Access to Health Records Act 1990 and the free market principles of the Purchaser/Provider split  and subsequent changes with successive governments there has been more accountability, more business culture within the NHS coupled with a social change of a shift in greater litigation culture. This has all had an impact on how we practice as occupational therapists and how we educate and train occupational therapists. As a manager in the early 1990s I remember numerous conversations with practitioners who bemoaned the fact that documentation and statistic recording was time consuming and took them away from patient care - the mantra at that time was "If you don't record, it hasn't happened. If it hasn't happened then we are not a viable or valuable service to patients or to the organisation". Perhaps sewing the seed for the position many seem to be in today of shifted priorities detrimental to patient care.

As an educator of occupational therapists, one of the areas I teach is Legal and Ethical issues in practice. Students' awareness is heightened during these sessions of what could constitute harm, neglect and breach of Code that may result in being struck off the HCPC register or taken to a civil court for breach of duty in common law. These sessions are intended to create best practice, adherence to COT Code of Conduct and HCPC Standards of Practice and to ensure that the ethical principles of autonomy, beneficence, non-maleficence, veracity and equity are considered in everyday practice. I still believe that this is vital for a student to understand before they go out onto their first placement (one week observation not included). However, I would like to pose a question.......

Are we in danger of hitting the target and missing the point? Do we as occupational therapists spend too long on process and administration to the detriment of client contact? Whilst most of the discussion in the arena is currently focusing on nursing and medics, allied health professionals will not be excluded and I would be interested to hear what your experience of hitting targets and missing the point may be.

COT Annual Conference ---- and Occubuzz

Today sees me trying to return to "normality" following 3 days in Glasgow for the COT annual conference. Sarah and I were in attendance having had a number of abstracts accepted for poster facilitations, a seminar and an innovative technology stand. At the time of submitting abstracts (usually September time) it feels such a long way away to the following June - however it crept up on us and with the usual last minute flurry of activity ensuring posters were designed and printed, presentations were ready and we had material to make our stand "stand out".

Highlights of the 3 days:

a) Meeting so many people in "real world" that we had met and connected with through our social media networking - in particular a number of our Post graduate students on our online MSc programme that we have never actually "met" before. Watching people move and hearing them speak is a fascination that never wanes - so now, when we return to virtual space we can have a more rounded picture of our connections. So if you came and found us to say hello - thanks - we loved meeting you.

b) Of course catching up with everyone was great.

c) Introducing Michael Iwama to Occubuzz and almost having a preview of his dance moves perfected for the evening's gala - Michael -we may not have been there to see them - but we now have eye witness accounts and photos - so we know it happened - and good reports have been filed :-)

d) Coming away with potential collaborations to explore further including being approached both by a publishing company to consider writing a book and a USA recruitment agency interested in our online training capacity and capability.

e)

OCCUBUZZ - the interest generated out-performed our expectations. We were swamped everytime we were on the stand by people wanting to talk about the app and it's potential. Our "sticky bee" stickers became cult with people coming to ask for one - however they had to listen to our spiel before we would give one out.
You can find out more about this on the Occubuzz tab at the top of the page. Please download the app and play with it - it is a prototype and there are some gremlins but your feedback is vital to our development of version 3 which we are then hoping to use in some research with practitioners and the general public. We hope to have a blog and a facebook page just for Occubuzz coming very soon......



f) Attending the Student presentations where 2 of our students were presenting their experiences of a volunteer project using occupation as the focus for a Carer Support group we have worked on with a local Trust. Sam Tozer and Louise Hesketh - you were great, professional, clear and extremely interesting in your reflections and what you shared -great experience for the CV. (Of course not forgetting Helen Hampson and Maria Lynch who were part of the project too). More information about this project can be found on our poster (Evaluating an Occupation Focused Group for carers of people with mental health conditions). Click here

g) Dare I mention the free food and drink copiously provided on the first evening back at the hotel by the recruitment agency that over-predicted numbers of delegates. Our gain I believe :-).

h) Making some headway in the development of social media guidelines for health and social care professionals. Our seminar on Professionalism in the Digital Age was well attended (even at 9am!) and we received some useful comments on the risks and challenges ahead that need to be addressed. Watch this space as we work with our national and international colleagues on this project.

At the moment this is about all I can remember. I return to be swamped in emails, admissions queries, marking and other bits that don't seem to care that I have been away - I will attempt to follow up with more info very soon - and yet again I make a resolution to be a better blogger.
Any hints and tips on how to be a more regular blogger would be well received. Thanks for your continued support.

Reminiscing ..... how about you?

My student room 1980

 Having recently taken on the role of Admissions Tutor I have been learning the ropes as I go along and also considering what, if any, changes we may need to make in light of the recent Francis Report which recommends we consider values and attitudes of new recruits with particular reference to dignity and compassion. After a few consultation sessions with staff, students and service users, I am in the process of writing up my report to present to the team in a few months time.

Last week saw the last of our interviews for next year's BSC (Hons) Occupational Therapy full time  students so I now have the hard task of selecting 56 students from the 120 students invited for interview... phew - I may need lots of coffee and chocolate over the next few days. Luckily I have Heather Davidson to help me as the experienced admissions tutor I have taken over from.

As my current focus is on this process, a small period of reminiscence raised it's head as I discussed with a colleague our own interview for OT training and our subsequent experience of being an OT student. The difference between then (dare I say my interview was 33 years ago now ?!) and today is rather extreme and I thought it may be something to share here. I would be interested to hear your comments and to read about your own experience, whenever that was.

One of things that stick in my mind at interview was being asked "what does you father do?" and "do you have a boyfriend?". I imagine that the former was to see what my background may be and the latter to see whether I was dedicated to study or if I was going to have a distraction in the form of a relationship. Can't imagine asking these questions today!! I seem to have vague memories of a group discussion and certainly a written task where I had to choose between writing about a holiday I had taken and what I knew about learning disability. I chose to write about a holiday - but have no recollection what I actually said. I got offered a place though and started September 1980 so I must have done something right.
The letter of acceptance asked us to bring certain things to college (wasn't university in them days!) which included:
a) tape measure
b) scissors
c) an apron
d) a travel rug (never did find out what this was to be for).

I arrived  at St Andrew's School of OT in Northampton (in the grounds of a very grand Psychiatric Hospital) and was given accommodation in the Nurses' Home with all the other first year students (we had to source outside accommodation in year 2). Meals were provided in the hospital canteen - although we were allowed kettles and toasters in our rooms (at least I think we were allowed - we did anyway).  Our timetable was full Monday through Friday 9am-5pm with 2 nights of evening classes at a local FE college for touch typing and woodwork.
Our days in college were taken with lectures (psychology, sociology, medicine, surgery and orthopaedics, communication and management and then anatomy and physiology which was an all day event every Thursday at Nene College - a local polytechnic) and practical activities of weaving, basketry, stool seating, lathe and fretwork, metal work, cookery and printing. We also had to put on a show for the resident patients within the hospital at the end of the first year - I remember dancing a hornpipe and singing a solo (don't ask!!).
Unlike now where our students have placements throughout each level and sourced locally,  our placements were mainly in final year and we could be sent anywhere in the country. We had a one day observation placement running through 6 weeks of first year, one month at the end of second year (I was sent to Hounslow Social services and lodged with an Archdeacon and his family) and then the final year was totally out on placement - returning for one day periods through the year to sit exams and then a final 6 weeks back in college for revision and final exams. My placements were in London, Poole and Norfolk - so every 12 weeks or so I would be packing up and moving to the next placement with very little contact from College at this time (as far as I remember).
I left with a Diploma and a clear desire to work in Norfolk in Mental Health - and one that I achieved.
So, just a little indulgence there - thankyou for allowing me this - but I really would like to hear what your training was/is like whether in the UK or anywhere in the world.

PS: Oh, and my student uniform was blue!

Is it 4 months already?.......

Wow!! Almost 4 months since our last blog post - our apologies if you have been visiting the blog and hoping to read and engage with new posts. I have no specific reason other than the pressure of other priorities. I guess you could say I was grappling with occupational balance - with my work role taking a priority as the University introduces changes to many of our systems for assessment, grading and feedback. These are now mastered and so I feel I may have brain space to consider blogging again.

Much has been happening since the last post. We are currently in the process of selecting applicants for our Full Time BSc (Hons) programme and will begin interviewing soon. I (Angela) have recently taken on the role of admissions tutor and am undertaking a project looking at values based recruitment. We have had a number of high profile cases in the UK media recently involving nursing staff in situations where their ability to demonstrate care and compassion for an individual has been questioned, leading many to question how people are being selected to go into the profession. The recently published NHS Constitution identifies values that should be held by all staff and so I am looking at this and other drivers and holding consultations with staff, students, service users and employers about what values are a priority for an occupational therapist and how we may assess for these before offering a place on the programme. This has become an interesting project and I shall be delivering my results to our Directorate Board later in the year and hope to share my findings in relevant professional forums.

Our application process for the online MSc Advanced Occupational Therapy programme is still open (closing August 2013). You can find more information about it here - or contact us if you have any specific queries.

Four of our second year students have been given a volunteering opportunity to work with a local mental health trust to design and deliver a carer's group with an innovative focus - sorry if that sounds mysterious - but we don't want to publicise what we are doing too far and wide at the moment - we are intending to present at COT conference in Glasgow later on in the year - and then we will happily share with you here too. However, in the process of the discussion and design period one of the students drew my attention to this website: Patient Voices- excellent resource and some great stories for sharing that highlight issues experienced from all points of views.

OK, perhaps that's all I can offer at the moment, we are considering having a regular newsletter to distribute which will give more news and views from the directorate staff and students which we will link through the the blog. In the meantime I will start to write more pieces that you can start to engage with again very soon. Thanks for sticking with us.