Enhancing graduate supervision in occupational therapy education ...

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Occupational Therapy International, 7(3), 163–172, 2000 © Whurr Publishers Ltd

Enhancing graduate supervision in occupational therapy education through alternative delivery

SYLVIA RODGER Department of Occupational Therapy, University of Queensland, Brisbane, Australia G. TED BROWN Children’s Hospital of Eastern Ontario, Ottawa, Canada, and Department of Occupational Therapy, University of Queensland, Brisbane, Australia ABSTRACT: Sophisticated information technology systems have made distance education both possible and highly desirable. Distance graduate research degrees have contributed to the globalization of occupational therapy research. An exploratory study using qualitative methodology was conducted to further understand the perspectives of four distance students and three supervisors. All students perceived many personal and professional advantages in undertaking graduate study by distance; however, they acknowledged a number of challenges, such as social isolation and lack of access to resources. Supervisors and students identified issues relating to the university bureaucracy, infrastructure, time and isolation. A number of supports that promote successful graduate education were identified, including associate supervisors, on-campus residency and informal social networks. Students and supervisors needed excellent time management and communication skills, and a commitment to maintaining contact. Students needed to balance multiple demands and supervisors needed to be student advocates. The small sample size in this study limits generalizability of the findings. Further research into methods of optimizing the use of information technology is required. An awareness of the issues and challenges is essential if graduate distance education is to be a mutually beneficial experience for supervisors and students. Key words: distance education, flexible delivery, Internet. Introduction Distance education has become increasingly popular as new technologies become accessible and the associated cost decreases (King, 1999). Distance

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education represents a variety of models that have in common the physical separation of academic faculty and some or all of their students (Institute for Distance Education, 1997). The digitalization of print materials, the Internet, email, video-conferencing, on-line chat rooms and access to electronic databases represent some of the new technologies that have impacted on distance education (Burwash and Cotkin, 1999). These developments have led to innovative educational technologies to deliver instruction, an emphasis on student-centred, lifelong learning, and an internationalization of education (Bates, 1997; Crist, 1999). Alongside technological advances, occupational therapists’ interest in graduate education has increased. Graduate education provides opportunities for: engaging in personal and professional development; increasing skills and knowledge; career advancement; becoming university faculty; and engaging in clinical research (Dickerson and Wittman, 1999). Pursuing graduate education is essential to developing a scientific approach to practice since it can provide answers to clinical questions as well as contributing theoretical knowledge. In the profession of occupational therapy there is a shortage of doctorallevel trained therapists to fill university and clinical research positions (Crepeau et al., 1999). There is also a need for researchers to develop new models of practice and evaluate current approaches to intervention (Yerxa, 1991; Case-Smith, 1999). Lifelong professional education opportunities for allied health professionals in rural or remote areas require innovative use of information technologies (Sheppard, 1995; Sheppard and Mackintosh, 1998). Another factor in the rapid development of alternative delivery technologies has been pressure from university administrators to capitalize on these technologies. With bases of traditional funding shrinking, universities have had to become entrepreneurial in terms of generating revenue. The use of distance-education technologies is one means through which universities can generate much-needed income through the enrolment of international students, who pay differential fees. Through the marketing of virtual education courses, universities can become competitive in the global economy. When Dickerson and Wittman (1999) surveyed occupational therapists participating in graduate education in the USA, several factors were rated as important: cost, a clinical emphasis, the availability of faculty mentors, access to occupational therapy electives, an emphasis on advanced assessment, and alternative delivery programmes. Factors important to potential students included having faculty with doctorates and active research careers, using seminars and having a thesis requirement (Dickerson and Wittman, 1999). Although there is a growing body of literature about educational innovations in occupational therapy, such as distance education (Burwash and Cotkin, 1999), interactive videoconferencing (Crist, 1999), Internet use (King, 1999) and email (Zimmerman, 1999), there is a dearth of literature about the supervision of graduates in research-intensive programmes and the

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Distance graduate occupational therapy education

use of emerging technologies. It is the partnership between the research graduate student and the university faculty supervisor that forms the basis of this paper. This supervision relationship no longer needs to take place faceto-face, as in the traditional apprenticeship model. Virtual supervision has altered the modus operandi for both supervisors and students, added to the challenges and raised new issues in the provision of quality supervision and optimal learning. A qualitative research study of distance graduate students and supervisors in the Department of Occupational Therapy, University of Queensland, Brisbane, Queensland, Australia, is described. The two authors of this paper have a relationship as supervisor (SR) and doctoral student (GTB). It inspired us to explore views and experiences of other graduate students and supervisors who share similar distance partnerships. Literature review Distance education models focus on the central components of the instructional process, presentation of content, interaction with faculty, peers and resources, practical application and assessment (Institute for Distance Education, 1997). These models differ according to the types of technologies used and the locus of control over the pace and place of instruction. The traditional approach at the doctoral level has been the apprenticeship model, where the student learns research skills through a closely structured educational process controlled by the university supervisor (Salmon, 1992). Others conceptualize doctoral education as a process in which the graduate student is given a high degree of freedom (Hockey, 1996). There has been ongoing debate about the effectiveness of doctoral education since the 1980s (Linden, 1999), and the traditional PhD approach has been criticized for being overly ambitious and ineffective (Moses, 1994) and having limited relevance to modern society. Essentially, a student undertaking a research doctorate by distance education is required to operate with a high degree of freedom. The traditional apprenticeship model is not likely to be possible or feasible. The PhD process involves a number of steps, including determining a topic of interest, locating a principal and associate supervisor, reviewing the literature, identifying an appropriate methodology, undertaking relevant coursework, gaining ethical clearance, collecting and analysing the data, and writing the thesis (Pierce and Peyton, 1999). The supervisor needs to provide institutional guidelines, references, project management, editorial advice and support for the student to undertake a research project and produce a written thesis of acceptable rigour and quality. For the distance student, written materials may be sent by regular mail or as email attachments. Telephone, email, computer conferencing or Internet chat-lines may be used to maintain regular contact between the graduate

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student and supervisor. Hence, information technology is critical for interaction with supervisors, peers and resources. The University of Queensland requires that distance students spend a minimum of nine weeks’ residency on campus during their candidature to facilitate interaction with their supervisor, other faculty and students. The distance PhD process discussed in this paper involves a model of independent learning in students’ own time and at their own pace. This is flexible for international students who live in different time zones and have varied employment, family and community responsibilities. In this model, the supervisor facilitates the student’s learning around current needs. Doctoral students are responsible for structuring their own time and organizing themselves to meet deadlines. High levels of motivation, commitment, time management, communication and organizational skills are required (Institute for Distance Education, 1997). Case-Smith (1999), in her qualitative study of nine successful occupational therapy researchers, recommended that new researchers learn to take risks, accept criticism, prioritize, manage time and learn about systems that support research. Graduate supervision is based on a partnership. The nature of this relationship and the degree of closeness varies between individuals (Salmon, 1992; Hammick and Acker, 1998). Hammick and Acker (1998) found that gender differences existed in supervisory relationships, with females describing a more equal balance of power than males. Salmon (1992) reinforced the importance of personal support in this relationship. Trust, empathy and mutual resonance represent the essential basis of successful supervisory relationships (Salmon, 1992). Developments in information technology offer the promise of courses delivered anywhere, at any time, greater learning effectiveness, more learnercentred approaches and better-quality interaction, but Bates (1997) cautioned against ‘getting carried away by the hype’ (1997: 93). Cost-effectiveness is not the same as cost-reduction, especially if quality is to be retained. Distance learners have more technological obstacles to overcome than campus-based students, such as access to a computer, fax, fast modems, a telephone line and an Internet service provider. They have to bear these costs despite being able to maintain residence and employment in their home community. Two contexts of interaction are important for learning: the interaction of the student with resource materials; and discourse about the material (Bates, 1997). According to Sherry (1996), the most important factor for successful distance learning is a caring, concerned teacher who is confident, experienced with the application of technology, and interacts with students. Sustained high-quality two-way communication is essential. To date, few research studies have investigated the requirements of university faculty who engage in distance learning and graduate research student supervision. Nor have there been studies comparing distance learning programmes with those that have a residency requirement.

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Method Design Qualitative research methodology was chosen to investigate distance education supervision, to maintain flexibility in the process of data-gathering (Patton, 1990). It also enables researchers to gain in-depth knowledge about people’s ‘lived experiences’. Another advantage of a qualitative design is that the information gained can be used to analyse the effectiveness of supervision and provide feedback to supervisors. This was used as part of the evaluation of distance graduate studies, which in turn forms the basis of ongoing enhancement of teaching and learning activities. Participants The participants were three supervisors and four distance graduate students, of whom three were PhD students and one was a research master’s student. The students were in England, Hong Kong, Canada and Australia. The supervisors were all permanent faculty in the Department of Occupational Therapy at the University of Queensland. Two men (students) and five women (students and supervisors) participated in the study. Three students had completed master’s degrees involving various proportions of coursework and research, and one had completed an undergraduate honours thesis. Procedures Departmental ethical committee approval was gained, and prior written consent, in which confidentiality was assured, was obtained. An interview protocol using open-ended questions was developed for delivery through a face-to-face interview or via email. Three students and one supervisor returned email replies, and two supervisors and one student completed individual face-to-face interviews. The interviews were audiotaped and transcribed and the email responses printed for analysis. The interviews lasted between 30 and 60 minutes. During the interviews, probe questions were used to help the interviewee to expand on responses and clarify comments. This was not possible with the email responses. Content and thematic analyses of written scripts were conducted by both investigators independently. Content analysis is the systematic examination of text by identifying and grouping themes through coding, classifying and developing categories. Independent assessment of transcripts enhanced the reliability of the data analysis (Mays and Pope, 1995). Discussion and the use of peer examination and code, re-code procedures were used to develop consensus between authors (Krefting, 1991). Several methods were used to strengthen the design of the study and to enhance the validity and reliability of the design and findings (Denzin and

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Lincoln, 1994). Triangulation strengthens the credibility, dependability and confirmability of the research (Krefting, 1991). Investigator triangulation involved using several researchers from different backgrounds (supervisor and student) to develop questions, and code and analyse the transcripts. Theory triangulation was explored by using multiple perspectives to interpret the transcribed data (distance graduates and supervisors). Results and discussion The results are presented according to the five emerging themes: 1. The advantages of distance graduate education Students described the flexibility and convenience of distance study as less disruptive to their personal and professional lives. For example, students were able to continue working at their present clinical or academic jobs while completing graduate education, which allowed them to meet their financial obligations. They were thus able to integrate research with their clinical work, as well as use their workplace infrastructure to support their research. They also commented that distance models increased their accessibility to graduate education opportunities. These factors are consistent with those reported by King (1999) and Sherry (1999), who cited economic, work and family commitments as reasons why Internet-based educational programmes were becoming popular. Similarly, participants considered that distance education promoted international collaboration in research and that gaining a PhD would provide them with advanced research skills, further knowledge, the capability for writing for grants, opportunities for publication and the possibility of pursuing academic/research careers. These findings concur with those of Dickerson and Wittman (1999). Participants were positive about the required residency period in terms of access to resources, libraries and blocks of dedicated time with their supervisor. All supervisors were positive about working with distance graduate students in terms of broadening their horizons, expanding networks and fostering international links. 2. The challenges of distance graduate education Students described difficulties such as isolation from the academic community, supervisors, the support of peers and other graduate students. Some students had difficulties accessing resources, library facilities, courses, software programs and computers. All students were challenged by the need to maintain a balance between their work, study and family roles. Although this is an issue for many graduate students, it may be more pronounced for this group because of their isolation from peers and informal support networks.

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Both students and supervisors commented on the challenges related to lack of face-to-face contact, which one participant described as ‘out of sight, out of mind’. This was related to the frustration due to the lack of interactive synchronous discussion between supervisors and student. One student summarized the key concepts discussed by all four students when he reflected: Generally, my experience of being a distance student has been more difficult than I had expected. There are issues around working full-time and studying part-time, but aside from those, the nature of distance study is difficult … isolation from both my supervisors and other PhD students.

The issue of student isolation from supervisors, other faculty and graduate students is frequently cited in the literature (for example, Angelo and Zukas, 1997; Bates, 1997; Burwash and Cotkin, 1999). One of the major implications for alternative delivery is that learning is a social activity and this component is not well served when students are working in isolation. Burwash and Cotkin (1999) stated that distance education programmes must attend to the social environment to ensure that there are opportunities for interaction and participation in the students’ communities of practice. This interactivity (Sherry, 1996) includes the connections that distance graduate students make with distant faculty members, colleagues, supervisors and other researchers. Helping distance graduate students to become part of the research culture of a university and the profession is a challenge since they are unable to participate in regular research seminars, graduate student meetings and lectures given by visiting scholars, unless special arrangements are made for teleconferencing. Distance graduate students need assistance to become part of a research community, as well as to get to know other researchers, in order to provide opportunities for interaction. All participants relied almost entirely on email for communication. This was frustrating because of the asynchronous nature of the interaction and the time required to provide extensive written responses. All participants described the lengthy process of composing emails, delay in receiving replies, especially due to time differences, and the limitations to interactive discussions. At the time of data collection, none of the respondents had used Internet chat channels or video-conferencing. Telephone contact was often infrequent because of cost and time zone differences, but was used as needed. King (1999) and Zimmerman (1999) reported an increased use of the Internet for distance instruction by email. The utility of email to provide social support and a feeling of being connected with other students is often overlooked. The informal conversational style of email enables written communication to become more social and interactive. A new set of skills is required in relation to effective communication in written form to allow effective collaboration between people who may never have met (Sherry, 1996).

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3. Issues related to distance graduate education Students and supervisors raised issues such as the need to negotiate expectations between associate and principal supervisors in terms of approach, style and roles. Negotiating the administration of the university in terms of formal policy, procedures and finances was often difficult for both students and supervisors. Dealing with institutional bureaucracy can be daunting for distance students. The supervisor may have to take on the roles of advocate, negotiator and problem-solver for the distance student. Both parties described the need to acknowledge the time commitments, relative isolation and challenges in making this partnership work effectively. Supervisors felt the need for support from other colleagues, whereas students would have liked the support of other distance students. Students commented on the need for adequate financial resources to cover costs such as phone, mail, fax, photocopying, travel, on-campus residency and technology expenses. 4. Supports and strategies that promote successful distance graduate education Students commented on the following elements: having a supportive principal and associate supervisor, the on-campus residency periods, and developing informal support networks of friends, colleagues and other students. Students and supervisors commented on the importance of email discussion, the need for prompt responses to email, as well as the essential aspect of open and honest communication between student and supervisor. These aspects are also highly valued by research graduates in face-to-face contact with supervisors (Salmon, 1992). 5. Distance graduate student and supervisor requirements Qualities required by distance education students – such as initiative, independence, flexibility and adaptability, personal perseverance, resilience and persistence, time management and self-discipline – were mentioned by all participants. Several students mentioned that technical skills were necessary, including computer skills, written communication skills and a working knowledge of data analysis and research methods. Other studies have found that graduate students who manage distance learning well are those with an internal locus of control, who are autonomous learners, active listeners, are self-directed and have information technology skills before admission (Charp, 1994; Burwash and Cotkin, 1999). Graduates who balance the multiple demands of family, work and study make many sacrifices and require support from and negotiation of acceptable solutions with employers, colleagues, family members and friends (Kember, 1999). According to the participants, distance supervisors also needed to have good time-management skills, be honest communicators, provide timely written feedback, be encouraging, and advocate for their students. In addition, they needed to be knowledgeable about the research topic, realistic and seek support

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as required. These supervisor qualities were also identified by graduates in a previous study (Burwash and Cotkin, 1999). Supervision of research students requires an intimate collegial relationship that can withstand potential conflict and time pressure, as well as provide personal and professional support. Summary and conclusions A qualitative research design was used to investigate the perceptions of four graduate students and three doctoral supervisors. The small sample size in this study limits generalizability. However, many of the findings concur with the literature about distance learning and doctoral supervision. There is a growing interest in graduate supervision as a professional competence requiring both practical skills and conscious reflection (Linden, 1999). Distance supervisors need support, training in technology, knowledge of effective distance education models, as well as student feedback. Graduate students undertaking research degrees at a distance encounter additional challenges to most on-campus students. Not the least of these is the potential for social isolation from other graduates, supervisors and faculty and lack of involvement in the university research culture. Supervisors need to be cognizant of this and to support these students to embrace the occupational therapy research culture at an international level, through conference attendance and presentation, contact with international experts through the Internet, and establishing networks with other researchers. Residency periods in an academic department help to overcome social isolation and provide experience with the department’s research culture. Further research could address the effectiveness of the support strategies suggested by these participants, students’ and supervisors’ satisfaction with distance models used, thesis completion rates and the development of global research networks. Distance graduate study and supervision is one example of the globalization of occupational therapy education and is likely to generate collaborative projects and research networks. By being aware of these challenges, graduate study and supervision can be a mutually beneficial experience for all involved. References Angelo J, Zukas R (1997). Reaching beyond the classroom: New methods of teaching at the professional level. Paper presented at the annual conference of the American Occupational Therapy Association, Orlando, Florida. Bates AW (1997). The impact of technological change on open and distance learning. Distance Education 18: 93–104. Burwash SC, Cotkin K (1999). Deus ex machina: Distance education as solution. In PA Crist (ed.) Innovations in Occupational Therapy Education. Bethesda, MD: American Occupational Therapy Association, pp. 1–12. Case-Smith J (1999). Developing a research career: Advice from occupational therapy researchers. American Journal of Occupational Therapy 53: 44–50. Charp S (1994). Viewpoint. The on-line chronicle of distance education and communication, 7(2): Available Usenet Newsgroup alt.education.distance, 3 May 1994. Crepeau EB, Thibodaux L, Parham D (1999) Academic juggling act: Beginning and sustaining

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an academic career. American Journal of Occupational Therapy 53: 25–30. Crist PA (1999). Teaching occupation-centred practice through interactive videoconferencing. In PA Crist (ed.) Innovations in Occupational Therapy Education. Bethesda, MD: American Occupational Therapy Association, pp. 76–88. Denzin N, Lincoln Y (1994). Handbook of Qualitative Research. Thousand Oaks, CA: Sage Publications. Dickerson AE, Wittman PP (1999). Perceptions of occupational therapists regarding postprofessional education. American Journal of Occupational Therapy 53: 454–8. Hammick M, Acker S (1998). Undergraduate research supervision: A gender analysis. Studies in Higher Education 23(3): 335–47. Hockey J (1996). Strategies and tactics in the supervision of UP social science PhD students. Qualitative Studies in Education 9: 481–500. Institute of Distance Education (1997). Three models of distance education. http://www.umuc.edu/ide/modldata.html. University of Maryland, Institute of Distance Education (accessed 17 December 1999). Kember D (1999). Integrating part-time study with family, work and social obligations. Studies in Higher Education 24(1): 109–24. King TI (1999). Internet use by occupational therapy education programs. In PA Crist (ed.) Innovations in Occupational Therapy Education. Bethesda, MD: American Occupational Therapy Association, pp. 53–8. Krefting L (1991). Rigor in qualitative research: The assessment of trustworthiness. American Journal of Occupational Therapy 45: 214–22. Linden J (1999). The contribution of narrative to the process of supervising PhD students. Studies in Higher Education 24(3): 351–69. Mays N, Pope D (1995). Reaching the parts other methods cannot reach: An introduction to qualitative methods in health and health services research. British Medical Journal 311: 42–5. Moses I (1994). The graduate research experience and supervisory practices – An Australian perspective. SSHRCC: Shaping our future. Proceedings of a national conference on graduate research and studies in the social sciences and humanities, Ottawa, Canada, 5–7 November, pp. 1–14. Patton MQ (1990). Qualitative Evaluation and Research Methods. Newbury Park, CA: Sage Publications. Phillips EM, Pugh DS (1987). How to get a PhD. Buckingham: Open University Press. Pierce D, Peyton C (1999). A historical cross-disciplinary perspective on the professional doctorate in occupational therapy. American Journal of Occupational Therapy 53: 64–71. Salmon P (1992). PhD supervision. In P Salmon (ed.) Achieving a PhD – Ten Students’ Experience. Staffordshire: Trentham Books, pp. 19–28. Sheppard L (1995). Rural and remote allied health professionals: Is distance education a viable option for graduate study? Australian Journal of Rural Health 3: 62–7. Sheppard L, Mackintosh S (1998). Technology in education: What is appropriate for rural and remote allied health professionals. Australian Journal of Rural Health 6: 189–93. Sherry L (1996). Issues in distance learning. International Journal of Educational Telecommunications 1(4): 337–65. Yerxa EJ (1991). Nationally speaking – Occupational therapy: An endangered species or an academic discipline in the twenty-first century? American Journal of Occupational Therapy 45: 680–5. Zimmerman SS (1999). Integrating e-mail and the classroom: Two teaching strategies. In PA Crist (ed.) Innovations in Occupational Therapy Education. Bethesda, MD: American Occupational Therapy Association, pp. 68–75. Address correspondence to Sylvia Rodger, Senior Lecturer, Department of Occupational Therapy, University of Queensland, Brisbane, Queensland 4072, Australia. Email: [email protected]