Doctorate of Occupational Therapy, Research Paper Example
Words: 5415Research Paper
Occupational Therapy (OT) provides services to patients that are designed to assist them in doing activities that are meaningful to them. This includes activities of daily living (ADL) such as tying one’s shoes or preparing a simple meal, and activities that are related to vocational skills. OT works with those who are disabled through disease, accident or other emotional, mental, or physical disability to help them improve their quality of life.
OT has been a specialty only since the era of World War I and during that period has progressed from being termed a medical “aide” position to one that is itself a profession with unique and sophisticated professional training requirements. As with other medical professionals, the training and education required for OT specialists has deepened over the years as research in the field has produce more sophisticated and helpful theoretical foundations. Currently, a master’s level degree program is considered the entry-level degree for accreditation as an OT professional. However, there is a movement in the field to raise this standard to that of a doctoral degree, a similar level required of medical doctors, pharmacists, and certain other medical professionals.
This paper considers the importance of a doctoral degree as the entry level for OT professionals. First, the next section takes an in-depth look at the history of required training in OT since the field’s founding in 1917. The following section considers current perspectives on OT training, and in particular, the rationale behind the movement to require a doctoral level degree as the entry level to the profession. Finally, a concluding section summarizes the results of this paper and presents conclusions and recommendations.
Case 1: Historical View of Occupational Therapy
To understand the rationale for establishing a doctoral degree as the entry-level for licensure in OT, it is worthwhile first to gain an understanding of the historical development of the profession. The discussion that follows will trace the history of OT as a profession, the history of OT course curricula, and present a discussion of how OT training has enhanced the professional identities of occupational therapists.
Progression of OT from Medical Aide to Specific Profession
Occupational therapy began as a profession in 1917 during World War I (WWI), deriving from the patients coming back from the war with chronic disabilities (Coleman, 1992). Once the U.S. entered WWI, larger numbers of patients required the assistance of occupational therapists to transition back to a relatively normal life. The founders of the profession defined the National Society for the Promotion of Occupational Therapy in 1917 (Coleman, 1992). One of the first issues defined by the new organization was the issue of who qualified to be considered an occupational therapist and what educational standards were appropriate requirements to enter the field. At the time, an occupational therapist was known as an aide rather than a therapist. The new organization was concerned that the aides should have their work recognized as a profession and garner the respect of having that professional recognition (Coleman, 1992)..
The result was a debate over what constituted proper training for the profession, a debate that has been raging for nearly a full century. On the one hand, some people believed in the importance of extensive education, and felt that those who wanted to enter the field, even already trained nurses, would need to undergo extensive education in the field (Coleman, 1992).. Others, in contrast, were concerned that the level of training espoused simply was not justified either by the salary or the number of positions available (Coleman, 1992)..
To complicate the discussion, the number of war wounded demanded a large number of new therapists very quickly (Coleman, 1992).. To this end a series of short, intensive courses were offered to those who had prior experience in hospitals or as teachers (Coleman, 1992).. Once the war ended, however, the profession still had no specified entry requirements, and the degree of training needed was still a matter of great debate (Coleman, 1992).
Between the two world wars, the debate on the necessary requirements continued, with those who favored more academic education opposing those who favored more experiential training. Finding the right balance between comprehensive education and specific clinical techniques proved to be controversial and challenging. Furthermore, there were issues over who was responsible for setting educational standards for the field, with various contenders including schools themselves, hospitals, and the professional organization. By 1921, the National Society for the Promotion of Occupational Therapy had reorganized and renamed itself the American Occupational Therapy Association (AOTA) (Coleman, 1992). A similar set of War Emergency Courses were established and ran for two years from 1944 to 1946 (Coleman, 1990).
Once WWII ended, the debate over the best training for OT professionals returned, again with the issue of how to recognize those who had graduated from those War Emergency Courses.
The reasons the debate over educational standards was so important was that education was perceived to be a way of gaining respect for the profession and of ensuring consistent quality of care (Coleman, 1992). By 1923, the AOTA had established a committee with the mandate of defining standards for training and certification of occupational therapists (Coleman, 1992). Yet, after surveying the existing programs, the committee found such divergent standards and so few graduates that no real conclusions could be drawn regarding existing training programs (Coleman, 1992). Complicating the discussion over academic versus experiential training was the fact that the intensive short courses offered during WWI had proved quite effective at training new occupational therapists (Coleman, 1992).
Standards wereeventually defined in 1927, but the AOTA had no mechanism for enforcing the standards. The American Medical Association’s Council on Medical Education and Hospitals (AMA-CMEH) was even drawn into the discussion of OT training standards in the 1930s and in 1935 agreed to be responsible for accrediting OT training schools. This ceding of authority by the AOTA to the AMA created more controversy that lasted into the post-World War II (WWII) years (Coleman, 1992).
The inter-war years of saw controversy coming from the relationship with the AMA, which was perceived as a loss of authority and autonomy to many within the AOTA, and the evident need to be able to handle an increasing number of war wounded as the march toward WWII progressed (Coleman, 1990). Once certain educational standards for OT professionals were established, one of the key issues was that of grandfathering in those who had been trained in the short, intensive courses during WWI (Coleman, 1990). In addition the AOTA established a register, controlled solely by the organization (i.e., with no consent needed by the AMA) which would create a list of OT professionals, with their training defined as primarily “academic” or primarily “experiential” (Coleman, 1990).
By the mid-1930s, the AMA-CMEH and the AOTA had jointly established a set of “Essentials” for OT educational programs (Coleman, 1990). Yet, shortly thereafter the approach of WWII was evident enough that there was concern over how to best meet the needs of the wounded from that conflict. While the “academicians” pushed for more general educational standards for OT graduates, the need to push out competent graduates quickly argued against requiring extensive general academic coursework (Coleman, 1990). The deciding factor was the army, which, again recognizing the need for efficient training, came down on the side of experiential training rather than academically based programs; this was in part due to the effectiveness of the short courses in WWI in the AOTA register (Coleman, 1990). Eventually it was decided that those who had graduated from the emergency courses and had practiced appropriately, would be listed on the register, and the format of the listings would change to a simple, unembellished acknowledgment of qualifications (Coleman, 1990).
With the Korean Conflict in the early 1950s, another set of War Emergency Courses were established, but in this case the attendees were restricted to women who already had a college degree (Coleman, 1990). After this experience, the AOTA shortened the academic program from five years to four and began recruiting older students and those with more experience (Coleman, 1990).
As the years have progressed since 1917 when OT was founded as a profession, there has been a need for more and more advanced training to reflect the advancement of the theories underpinning OT. Thus, the trend toward more advanced degrees for OT professionals has continued. Such training can only enhance the respect for the profession, as well as making those who receive such advanced training more capable and knowledgeable in their profession.
Progression of OT Course Curricula from Initial Training to Current Curricula
In comparing the OT training programs as they were defined shortly after WWII with those of the late 1980s, substantial changes can be seen. For example, in 1949, there were not enough OT graduates to fill all the available jobs, in part because (female) students often quit to get married instead of working professionally (Grant, 1991). Also, no training program existed in 1949 for an occupational assistant. In addition, programs had as few as a single faculty member teaching the entire curriculum as opposed to having a faculty of OT (Grant, 1991). In 1949 there also existed the “theory” (as in, one theory) of OT and the program included training in administration, general medicine and surgery, pediatrics, orthopedics, psychiatry, and tuberculosis (Grant, 1991, p. 297). In 1949 OT candidates were expected to have technical proficiency and experience in both the fine and applied arts, in special and adult education (including home education and library science), and in recreational arts like music, drama, gardening, and similar activities (Grant, 1991). Training in 1949 also included nine full months of clinical training, with rotations in psychiatry (12 weeks), physical disabilities (8 weeks), tuberculosis patients (4 to 8 weeks) and general medicine and surgery (4 to 8 weeks) (Grant, 1991).
In contrast to those 1949 standards, by 1989 there were nearly 70 programs for OT assistant and over 1,000 graduates in the 1989 academic year (Grant, 1991). Faculty staffing had increased to over 900 in both OT programs and in technical programs (Grant, 1991). One of the more dramatic changes by 1989 was that there was no longer a single OT theory but multiple theories and even the language of the OT Essentials had transformed (Grant, 1991). The OT curriculum content had expanded substantially as a reflection of expanding research in the field (Grant & Labovitz, 1989). Further, by 1989 the amount of clinical practice was down to 6 months and was replaced with fieldwork, which simply included a variety of client experiences rather than formal rotations through specific medical specialties (Grant, 1991). OT curricula changed perspectives from a focus on hours spent in courses to a perspective based on the practical tasks of OT and the theories that support those tasks (Grant & Labovitz, 1989).
The considerable differences between the curricula of 1949 and that of the late 20th century reflect the continuing improvement in the theoretical understanding of OT. Current theories and current curriculum Essentials has moved away from using standard medical terms to define an OT epistemology that concentrates on human performance, purposeful activities, adaptation, and activity processes (Grant, 1991). This is a substantive change and development over the prior focus on medical specialties. The field now incorporates relevant concepts from sociology, anthropology, neurophysiology, and cognitive science into OT theoretical foundations and vocabulary(Grant, 1991). With such changes, the importance of OT practitioners to have at least some familiarity with each of those fields becomes clear. OT researchers are also making use of the techniques and technologies of the social sciences in terms of statistical analysis, quantitative research, and other research modalities (Grant, 1991). Such expansion of knowledge requires an equal expansion of the training processes of OT students in order to prepare them for practical realities of being an OT professional.
OT Training and Its Enhancements to the Profession
Current OT curricula come in a variety of levels leading to different degrees (Coppard & Dickerson, 2007). These levels begin with the OT assistant curriculum, which is primarily offered by junior and technical colleges. As of January 2007, the entry level for OT professionals is the master’s degree, which provides the minimum training that permits entry into the field (Coppard & Dickerson, 2007). The post-professional program, like the master’s degree, can be entered by anyone who has a professional degree in OT, and are primarily focused on enabling the individual to develop advanced skills in specific specialties, such as gerontology or pediatrics (Coppard & Dickerson, 2007).
The most advanced current degree in OT is the doctorate, which may be either a clinical or research-focused degree; the clinical version is a doctor of occupational therapy (OTD or DrOT). The research-focused degree aims to prepare students for research in OT rather than clinical applications (Coppard & Dickerson, 2007).
The issue of having such advanced curricula and programs is an important one for the OT profession. The point of such advanced degrees is to ensure that graduates of the programs have a broad competency in their professional standard. There are two key perspectives on such advanced training, one is that it is professional training and the other that it is graduate trainingCurrent OT curricula come in a variety of levels leading to different degrees (Coppard & Dickerson, 2007). These levels begin with the OT assistant curriculum, which is primarily offered by junior and technical colleges. As of January 2007, the entry level for OT professionals is the master’s degree, which provides the minimum training that permits entry into the field (Coppard & Dickerson, 2007). The post-professional program, like the master’s degree, can be entered by anyone who has a professional degree in OT, and are primarily focused on enabling the individual to develop advanced skills in specific specialties, such as gerontology or pediatrics (Coppard & Dickerson, 2007).
The most advanced current degree in OT is the doctorate, which may be either a clinical or research-focused degree; the clinical version is a doctor of occupational therapy (OTD or DrOT). The research-focused degree aims to prepare students for research in OT rather than clinical applications (Coppard & Dickerson, 2007). Professional training is exemplified by such specialties as medicine, nursing, dentistry, and other complex professional careers, and the training defines the appropriate epistemology that acts as the foundation for knowledge of that field (Coppard & Dickerson, 2007). The key to professional training is to prepare the individual student for a career in that field (Coppard & Dickerson, 2007). In contrast, the concept of a graduate degree is generally to prepare the individual to become a scholar in the field (Coppard & Dickerson, 2007). A good way to distinguish the two is that the professional degree prepares for a career in the field while a graduate degree prepares for a career in research in the field (Coppard & Dickerson, 2007).
Establishing the need for advanced study in OT provides a number of advantages to the field; the arguments in support of these, as noted earlier, is to enhance the credibility and reputation of OT as a profession. Proponents of academic training for OT have argued since 1917, when the field was founded, that establishing an academic-based curriculum and high educational standards for OT would provide such credibility and professionalism (Coleman, 1992; Coleman, 1990; Grant, 1991).
The relationship between OT professionals and medical professionals is also exemplified by the sometimes rocky relationship between the AOTA and the AMA. From the AOTA point of view, the decision to allow the AMA-CMEH to accredit institutions offering OT training in the 1930s encroached on AOTA’s autonomy (Coleman, 1992; Colman, 1990). The development of the AOTA register was, at least in part, an attempt to establish the organization’s autonomy from the AMA by defining for itself what criteria were needed for listing in the AOTA register (Coleman, 1992; Colman, 1990). While relations with the AMA may have settled some, the availability of OTD degrees enhances the ability of OT professionals to receive respect from the medical profession.
Case 2: Current Perspectives of OT into the Future
The history of OT as a profession has been one of continuing improvement of the educational standards of the practitioners. The issue today is whether changing the entry level degree requirements from a master’s degree to an OTD degree enhances the profession and, if so, how. This section will first consider how research has enhanced the OT profession over the years. Then a comparison will be made of the licensure requirements for OT professionals compared to other similar professionals in fields such as pharmacy, social worker clinical doctoral programs, and practice doctorate in nursing. Finally, there will be a review of the advantages of upgrading the OT professional entry requirements from a master’s degree to a doctorate.
How Research Has Enhanced the OT Profession
Research is a critical factor to enhancing and developing the OT framework on which practice depends (Yerxa, 1987). Research can be defined as a way of observing the world or some aspect of it so it can be better understood (Yerxa, 1987). The role of research in granting respect and legitimacy to OT is critical. Research provides academic respect and legitimacy by focusing on a fundamental advancement of knowledge and understanding—elements which are the cornerstones of academia (Yerxa, 1987).
Respect, however much it is a political reality in all professions, is not the only reason for developing advanced degrees and raising the entry requirements for OT to a doctoral level. Research provides a mechanism for the continuing improvement of the profession’s understanding of critical factors in activities of daily living (ADLs) and thus improves our ability to make those activities easier for patients (Yerxa, 1987). In addition, understanding how human beings act on the environment and otherwise interact with our surroundings provides greater insight into how best to both live within environmental and other constraints and also on how to affect the overall capacity to change ourselves and the environment (Yerxa, 1987). Yet another benefit of research is to gain a much more comprehensive understanding of assessing how best to manage time on a daily basis and thus understand the tempo of how people live in the world (Yerxa, 1987). A fourth benefit of OT research is understand how activities impact human lives longitudinally, from childhood, through adolescence and adulthood, and into old age. This provides an overall lifelong perspective which can improve well-being of people in all ages and create greater life satisfaction and happiness (Yerxa, 1987).
Such research insights provide improved treatments for patients by providing insights into capabilities that can translate into better treatments for disabilities (Yerxa, 1987). Just as importantly, however, this also translates into better communications with other disciplines and greater understanding across disciplines (Yerxa, 1987). Even more striking, however, is that increased professional reputation and respect attracts more and better qualified students to the field and thus assures an ongoing set of professionals entering the field to deal with increased numbers of patients that occur as the population grows, and as the population ages (Yerxa, 1987).
Yerxa proposed two types of science associated with OT: basic science, or knowledge for knowledge’s sake; and occupation science, or knowledge designed to understand how human beings engage in occupations or activities that are goal directed, adaptive, organized, and culturally named and classified (Yerxa, 1987). There are important outstanding types of problems that only research can answer from both these types of knowledge and since the questions themselves tend to cross disciplines (biomechanics, neurophysiology, sociology, psychology, anthropology, and so on), finding answers to such questions contributes to all these other fields. Moreover, for such questions, only someone with appropriate training across all these disciplines can properly pose and research such questions effectively (Yerxa, 1987).
Perhaps an equally important perspective comes from considering the impact on the field if research and academic approaches are eliminated rather than expanded. In such a case, clinical practices become focused on technique rather than theory and descend more to the realm of folklore rather than an evidence-based practice (Yerxa, 1987). No more theories would be developed and the expansion of knowledge in the field would reverse and become a contraction (Yerxa, 1987). The loss of academic respect means that the creativity and interdisciplinary approaches of contemporary OT clinicians would be lost (Yerxa, 1987).
In essence, the goal of an academic program is to teach students not the details of a technique, but instead to teach them how to frame problems, pose questions, research for answers, and apply those answers to clinical situations (Yerxa, 1987). That type of understanding requires extensive academic training to accomplish (Yerxa, 1987).
Comparison of OT Licensure Requirements to Other Professions
In considering whether the entry level degree for OT professionals should be a doctoral level OTD degree, it is a worthwhile exercise to address how and why other professions have established similar requirements for the entry level to those professions. In the following sections, the pharmacy doctoral degree programs, the social worker clinical doctoral degree programs, and the practice doctorate program in nursing will each be considered with respect to how those doctoral programs became entry level requirements and the impact of those requirements on the professions.
Pharmacy Doctoral Programs
In many respects, the Doctor of Pharmacy (PharmD) degree is in a similar state to the OTD. The profession has chosen to move from a bachelor’s degree as the entry level requirement to a doctoral degree using a model similar to that of medicine (Pierce & Peyton, 1999). In the case of pharmacy, the dramatically increasing complexity of modern medications and their side effects, drug interactions, and dosage requirements all argue strongly for a more advanced degree as the starting point for a professional (Pierce & Peyton, 1999). The critical aspect of the pharmacy curriculum at the bachelor’s level is that it is primarily vocational in nature and even in the (typically) five-year bachelor’s program, the time is inadequate to properly train new pharmacists in the complexities of their chosen profession (Pierce & Peyton, 1999).
The PharmD program began as an optional advanced degree for those students more ambitious and more knowledge seeking than others. The initial approach to the PharmD degree was to add an additional year of graduate level coursework plus a second year of clinical practice. This eventually transmuted into a full two-year post-professional program with a clinical rotation as part of that two-year program (Pierce & Peyton, 1999).
The move toward a PharmD doctoral entry level has been driven by the professional association, the American Pharmaceutical Association (APA), supported in 1992 by the American Association of Colleges of Pharmacy (AACP). In addition to the drivers previously mentioned, new requirements for pharmacist-patient interactions and other societal pharmaceutical needs have pushed the move to the PharmD entry level (Pierce & Peyton, 1999). In addition, pharmacists are taking on new roles, ranging from home infusion care, to influenza vaccinations (Pierce & Peyton, 1999). The final transition to an all-PharmaD entry level was planned for full implementation by 2005 (Pierce & Peyton, 1999).
In addition to the differences in training, a doctoral-level pharmacist do more work in teaching, in patient education, in collaborative clinical research, and less work in filling prescriptions than those with bachelor-level degrees (Pierce & Peyton, 1999). There also is in intermediate master’s level degree program in pharmacy, intended primarily for those interested in research in fields including toxicology, administration, and medicinal chemistry (Pierce & Peyton, 1999).
The PharmaD entry level degree offers interesting comparisons to the OTD. As with OTD, during the period of development , the curricula in pharmacology were changing dramatically, just as OTD’s curriculum standards have changed (Pierce & Peyton, 1999). In particular, however, moving to a doctoral entry level degree in pharmacy has provided a powerful voice and influence of practitioners in pharmacy, just as it did for medicine and dentistry (Pierce & Peyton, 1999).
Social Worker Clinical Doctoral Programs
The clinical doctorate in social work (Clinical DSW) is an advanced degree that is not yet required as an entry level degree in clinical social work. Membership in the Clinical Social Work Association (CSWA) currently requires a master’s degree as the entry-level degree for membership.
Yet clinical social workers, like OT professionals, struggle with their professional reputation and perceptions in the media, the general public, and among other professionals. One of the key issues highlighted by the CSWA is that the training and licensure requirements for clinical social workers vary tremendously from state to state, as do the definitions of what job responsibilities and scope of practice for social workers (CSWA, 2011). With a confusing muddle of state laws and a corresponding muddle of practice limitations, training requirements, and other issues, the lack of having a universally recognized set of criteria for professional clinical social workers has impacted not only their professional reputations but also their ability to do their jobs effectively (CSWA, 2011).
The licensure requirements for clinical social workers vary substantially. Not all states regulate even the titles that may be used (i.e., Licensed Clinical Social Worker), and the training levels and experience required for licensing vary from state to state. For example, the number of supervised hours ranges from 3000 to 4000 hours over a period of two or three years and between 90 and 150 hours of individualized supervision (CSWA, 2011).
A second social workers professional organization, the National Association of Social Workers (NASW), offers professional credentials for social workers in a variety of specialties, including a variety of clinical social worker credentials. In these cases, however, the required degree for a clinical social worker is the Master’s in Social Work (MSW) degree.
The clinical social work profession is in much the same position the AOTA was in the mid-1930s when the very definition of basic requirements to be a professional in the field were not clearly defined.
Practice Doctorate in Nursing
Most nursing doctorates are PhD degrees that have focused on advanced knowledge of clinical practice (and thus are “practice doctorates” in Nursing) rather than on discovery of new knowledge, as would be the case in the case of a research-oriented degree program (Pierce & Peyton, 1999). The concept of a clinical PhD in nursing, first introduced in the 1970s, and the issue of distinguishing a “PhD” in nursing vs. a “clinical PhD” program became an object of discussion (Pierce & Peyton, 1999). In fact, there are eight or more different types of nursing doctorate degree programs, with the differentiation among them based in large part on the degree of research required as opposed to the specialty in advanced clinical practice (Pierce & Peyton, 1999).
In addition to the doctoral programs, there now exist nurse specialty board certification programs for such areas as nurse practitioners, nurse anesthetists, and nurse midwives (Pierce & Peyton, 1999). Thus, the nursing profession is moving towards greater specialization (Pierce & Peyton, 1999).
Nursing professional organizations are still struggling to determine how to resolve the various types of doctoral degrees and differentiate among them (Pierce & Peyton, 1999). Also, the entry level degree is still unresolved, with current requirements not even specifying a bachelor’s degree. This is due to the reality that most current registered nurses do not have a bachelor’s degree and thus the issue of grandfathering the majority of the profession in is a problem (Pierce & Peyton, 1999). In terms of more advanced degree preferences, the trend appears to prefer the PhD degrees rather than the specialty professional degrees in nursing (Pierce & Peyton, 1999).
In the late 1990s, a new doctorate was introduced, the Nursing Doctorate (ND) which would be intended as an entry level professional degree, similar in structure and curricular plan to that of other professional doctorate entry level degrees (Pierce & Peyton, 1999). Admission to an ND program requires a bachelor’s degree including specific prerequisite courses; the degree itself requires three years of academic courses plus a one-year clinical rotation (Pierce & Peyton, 1999).
The critical lesson from the nursing doctoral program is that the nursing doctorates combine research programs with advanced clinical practice and education. Thus, the professional doctorate program provides a useful means of training professionals in advanced competencies (Pierce & Peyton, 1999).
Benefits of Upgrading Entry Level Degree to an OTD
Transitioning the OT profession to mandate an OTD as the entry level degree to the profession is in process. The AOTA mandated that a master’s level entry degree was required for entrance to the profession as of 2007. Griffiths and Padilla (2006) studied the status of the entry level OTD nationally to determine what plans colleges and universities had to implement an entry level OTD program and how far they had progressed in those plans. Three key factors emerged from this study on positive impacts on such plans. These factors included whether a physical therapy program co-existed at the entry level doctoral level was an important positive factor; the need for enhanced preparation of graduates to enable them to successfully enter the workforce in the profession; and the improved ability of the schools to recruit students with such programs in place (Griffiths & Padilla , 2006). The impediments to establishing an OTD program included, first, limited funding and support; second, philosophical objections to the OTD degree because of not understanding the purpose of the degree and lack of data supporting the need for the degree; and, third, a lack of demand from students for such a degree program (Griffiths & Padilla , 2006).
There are significant benefits to upgrading the entry level degree in OT to an OTD. The rationale for this comes both from the enhancements that derive within the profession for mandating such a level of education, and from the external professional benefits deriving from that mandate.Entry level OTD requirements enhance the research and clinical practice understanding of the career (Yerxa, 1987). On a professional level, such requirements also generate greater prestige from the public and from other professionals (Pierce & Peyton, 1999). And from a pragmatic basis, the OTD entry requirement generates greater student interest in entering the field (Yerxa, 1987)
The OT field has emphasized the importance of academic training and research since its foundations. A thorough understanding of the theoretical foundations of the field provides confidence and assurance that services provided to patients are based on best evidence standards and represent the best available practices.
To that end, it has become more important to give OT professionals a thorough grounding in a variety of medical and scientific fields, all of which are incorporated in OT theoretical foundations and clinical practices. These include sociology, anthropology, neurophysiology, and cognitive science, as well as other cross-specialty disciplines (Grant, 1991). In addition, the need for further research into OT is critical to our underrstanding of how to design, develop, and execute well-thought-out research programs. This in turn requires an understanding of statistical, quantitative, and analytical methodologies, all of which are typically taught at the doctoral level (Yerxa, 1987).
In addition to the improvements in theoretical foundations, best practices, and overall knowledge of the discipline, making the OTD the entry level degree enhances the prestige and reputation of the field, making it a far more attractive career path and providing incentives to develop in the field. As the population ages, more OT professionals will be needed to assist older adults in learning how to cope with the limitations that often accompany chronic disease and ageing. Thus, providing a means to entice intelligent, capable people into the field is essential to ensuring sufficient OT professionals are available to meet the demand.
Raising the entry level degree requirements to the OTD is thus prudent and wise, as it strengthens the field and brings more professionals into the discipline.
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