Students’ negotiation of practice education in occupational therapy: a case study

Doctoral Thesis


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University of Cape Town

There are persistent problems with the graduation rates of black Occupational Therapy students. The transition from classroom to the practice-based component of occupational therapy education is particularly challenging, and yet, very little research has been conducted on students’ learning in this area. This study explores learning processes in practice education as experienced by African language speakers studying occupational therapy in a relatively elite English medium university in South Africa. The thesis draws on poststructuralist theory to describe and analyse the complex ways in which three students experience, interpret and act within the multiple teaching and learning spaces that characterise the transition to practice education. A single instrumental qualitative case study design was adopted and semi-structured interviews, focus group discussions and document reviews were conducted. Methods of analysis included discourse analysis, thematic analysis and genre analysis. The findings show the complexity of the process of negotiating access to the occupational therapy practice education discourse. This process was marked by navigation of issues that stem from language, curriculum, pedagogy and identity. Three themes emerged that signal creative ways in which participants navigated these issues. These are; enacting primary and previous secondary discourses, negotiating and re-negotiating identities and discovering curriculum expectations through trial-and-error. The findings question commonplace assumptions that language is the reason why African language speakers struggle with the transition from theory to practice. While language is central to learning, the study illustrates the multiple ways in which aspects of practice and the relationship between theory and practice are implicit. The study also shows ways in which varying expectations, past experiences of learning and mismatches between curriculum aims, pedagogy and assessment impact on how students learn. The study also highlights the ways in which the resources that students bring into the academy such as their multilingualism and life experiences, are often under-valued within the practice education context. These findings will be useful in guiding the development of curriculum and pedagogic practices that embrace and value diversity. This thesis recommends a shift of perspective in understanding learning in the practice context that conceives of students as social beings engaged in social practices.