The Vision Behind the Duke OTD Curriculum

As you read the other parts of the Duke OTD curriculum infrastructure, consider the internal consistency among all the parts. Do they feel all of one piece to you?

AIM
The program’s aim and mission, like its vision, were derived from the early data from our internal, local, and global communities. An Aim is a general statement about the curriculum’s impact on students. The aim for the Duke OTD reads:

To be a learning community whose members (students, graduates, staff, faculty, and partners):

• Authentically integrate who they are as persons with what they do as professionals; 

• Collaboratively address, through skillful practice and scholarship, the complex transactions that limit and enable peoples’ access to and participation in every day, health-supporting occupations;

• Serve as compassionate, ethical, visionary leaders who anticipate the evolving occupational needs of diverse populations, communities, and individuals, who proactively and creatively address those needs through collaboration, innovation, and scholarship;

• Contribute in diverse ways to the growth of occupational therapy locally and globally;

• Advocate for various populations to create systems that promote access to occupation for all.

MISSION
Duke OTD affirms the vital role of occupation in human flourishing and health through innovative education, research, and collaborations.  

KEY KNOWLEDGE DOMAINS
To move toward this vision, aim, and mission will require that you gain knowledge in particular domains or areas. The domains or areas of study for Duke OTD were established by asking, What areas of knowledge will students need to partially master if they are to advance the OTD mission?

At the core of the Duke OTD curriculum is the deep immersion in the philosophical, theoretical, and empirical foundations of occupation as a fundamental health mechanism. This knowledge forms the bedrock of occupational therapy and serves as the program's central focus. Students will explore the relationship between occupation and health and trace this foundational understanding to the field’s evolving theories and practices. Mastery of supporting domains will also be essential.

The vision and mission of the OTD program presuppose that students will engage collaboratively and compassionately with individuals from all walks of life across the lifespan. They will cultivate ethical leadership in all aspects of their professional work. Additionally, students will gain expertise in the fundamental principles of research, evidence-based practice, and practice-based inquiry. Since occupational therapy is fundamentally about helping individuals learn and make changes to their occupational lives, students will also need to develop an understanding of how people learn and adapt.

• Occupation as a mechanism of health
• The occupational therapy process
• Diversity, inclusion, and belonging
• Innovation and everyday leadership
• Formation for service
• Creating, translating, and assembling knowledge
• Learning and change

If you come to Duke, we will ask you to join us in the following commitments, that like the knowledge domains above help bring alive the vision, aim, and mission:

• Enabling occupation is the core competence of occupational therapists.
• Research and education centered on occupation are paramount.
• Deep learning occurs through diversity, community, and educational excellence.
• Integrity and authenticity are essential to collaborative work with diverse clients, patients, and colleagues.
• Innovation and excellence enliven all and meet real-world needs.
• Intellectual humility and open inquiry advance knowledge

What we have shared so far about the curriculum design or infrastructure, should culminate in the outcomes that you will be expected to meet by the end of the program. The Duke OTD outcomes are organized by the knowledge domains described above.

As you read descriptions below of graduates of Duke, ask yourself if this is a growth journey you would be willing to take:

• Duke OTD students possess an unabated commitment to the premise that engagement in occupations is a human right and key ingredient for the health of people of all ages, abilities, and life circumstances.
• Duke OTD students are unequivocal that collaboratively enabling occupational engagement of populations, communities, and individuals is occupational therapy’s distinct contribution to improving health and wellbeing.
• Grounded in an ethic of occupational justice, Duke OTD students 1) appreciate that the ways people engage in occupation varies across diverse socio-cultural contexts, 2) with cultural humility, seek to understand clients’ unique history of doing things in particular ways, 3) uphold the rights of all people to engage in the occupations that are meaningful to them in ways that are meaningful to them, and 4) work collaboratively to enable access to and participation in diverse occupations.
• Duke OTD students innovate in medical, community-based, and primary care systems to advance the health of populations, communities, and individuals through enabling occupation.
• Duke OTD students link personal and professional callings to provide authentic, collaborative, compassionate care and leadership.

Learning by doing is a commitment across most occupational therapy education. At Duke, you will be expected to apply coursework to real-world issues in every class using case- and team-based learning. This application focus will require a commitment to significant pre-class preparation. In addition to each class requiring the application of content, you will also engage with agencies in the community every semester. Perhaps, most distinctly, every semester will conclude with two weeks of application experiences. The first week will involve simulation experiences; the second week will involve experiences in settings where occupational therapists work or may work. The two-week pairing of simulation and practice at the end of each semester constitutes the Level I Fieldwork experiences in the Duke OTD, totaling almost 500 hours of direct experience. The Fieldwork section of the website contains more detail.

You will also be expected to apply research to real-world problems, apply program evaluation and development to the needs of a community agency, and apply entrepreneurial skills to real project development. These and other direct experiences are all integrated with coursework throughout the Duke OTD Curriculum.

The Duke OTD will focus on the direct application of concepts to your prior experience and future growth as a professional.

The learning community at Duke will include the students, OTD faculty, interdisciplinary faculty, community practitioners as mentors, members of the Durham community, service recipients, standardized patients, researchers, and authors outside of Duke. Each learning community member will support your developing knowledge about occupation and its role in health and how to enable occupation as a therapist.

The following initiatives are intended to create a diverse learning community:

• An application and admission process that welcomes applicants from many walks of life and a wide range of undergraduate fields
• A faculty position to evaluate and help build holistic educational structures and practices
• A commitment to learning through varied perspectives

At Duke, learning is integrated, subject-centered, and transformative; learning is active and grounded in how expert occupational therapists solve real occupational problems. Integrated means that you will take what you learn in one course and use it in several other courses, take what you learn in one semester and apply it to future semesters, and take what you learn in coursework and apply it in fieldwork. Integrated also means you will grow your understanding of who you are as a person and apply it to who you are as a professional. Subject-centered means that you will continuously link the topics you learn to the core subject of occupational therapy, occupation as a mechanism of health. You won’t learn concepts and skills in stand-alone fashion; you will learn concepts and skills in light of their relevance to how people perform and experience occupation. Transformative means that you will examine assumptions about knowledge, yourself, and others and, when needed, transform those assumptions and habitual ways of approaching some things. For example, to be successful in the Duke OTD, you will need to become comfortable with knowledge as fluid and in process rather than as fixed and static. For some, embracing the idea that knowledge is always in process can be challenging until they transform their assumptions about knowledge and embrace a new perspective. 

The learning community includes students, faculty, practitioners, interprofessional colleagues, community members, clients, guests, and others. A learning community is a community of people from diverse backgrounds, with diverse knowledge and skills, and who hold diverse perspectives, who come together around a subject about which they collectively care deeply, even love. The learning community has a shared goal of participating in deep learning and educational rigor related to the subject they love. Deep learning requires presence. Individuals in the community vow to show up with authenticity, bringing their whole self to the learning. The community commits to honor diverse views, learn through difference, practice intellectual and cultural humility. This participation is caring—care for each other, care for the subject we all gather to know.

At Duke, you will engage with research and evidence-based practice in multiple ways. Most will occur in mentoring relationships with faculty, practitioners, community members, and interdisciplinary colleagues. One, each class will expect you to use the published literature and research as one element in your professional reasoning. Two, you will engage in a series of six research courses and complete a mentored research project. Three, your Capstone project and experience will include growing and/or implementing evidence for a program implemented with a community agency. Four, you will have a full course on Occupational Science which will guide the inquiry for your own projects. Five, you will demonstrate the value of occupational therapy services using evidence. Six, you will disseminate your research-based projects publicly through presentations and publications.

Yes! And Yes! Our faculty's research, scholarship, and consulting focus on creating tools and processes for occupational therapy educators to design learning centered on occupation. A commitment to occupation as the core idea of occupational therapy is one of the criteria for hiring faculty to teach in the Duke OTD. As an example of this commitment, Duke OTD research, and scholarship address participation in religious occupations among people with intellectual disabilities. Additionally, our faculty is committed to creating an occupation-centered fieldwork curriculum and we collaborate with interprofessional educators and leaders who are selected based on their engagement in improving how people engage in meaningful occupations.

In your investigations, you will discover that many programs are organized by lifespan categories, such as pediatrics, adults, and older adults, or by sub-specialties like orthopaedics, neurology, hand therapy, and wellness. Some programs are structured around specific settings, such as school-based, community-based, or medical-model practice. However, rather than focusing on sub-specialties or lifespan stages, the Duke OTD program of study is organized around the enduring principles of the profession. These fundamental ideas are woven throughout all practice areas.

In your first year, you will explore why occupation is a core health mechanism, learning various models that guide expert thinking about occupation. This learning spans from understanding geopolitical factors that influence occupation to examining specific body functions that impact it. You will also delve into how occupation can be disrupted by events such as acquired disabilities, stigma, bullying, life transitions, natural disasters, and poorly designed environments. Throughout the program, you will gain insight into how expert occupational therapists think about occupation, engage with clients, observe their activities, analyze what they hear and see, and collaborate to set goals. You will develop the skills that occupational therapists use to enable access to and participation in meaningful occupations, including coaching, adapting, consulting, educating, and designing. Together, these skills will form the foundation of the occupational therapy process you will master in Year One.

In Year Two, you will learn how expert occupational therapists apply the occupational therapy process to impact occupation at the group, organizational, and community levels. You will develop skills in creating educational programs, conducting program evaluations, designing interventions, and conducting research. Additionally, in Year Two, you can tailor your studies through Advanced Practice Courses and Electives, allowing you to focus on specific areas of interest.

Year Three culminates with your hands-on practice experiences. These include two 12-week Level II Fieldwork placements and a 14-week Capstone experience designed to integrate your learning and prepare you for professional practice.