Being and becoming interculturally competent: Narrative accounts of occupational therapy students

This thesis describes a qualitative study of occupational therapy students undertaken in New Zealand. The research investigation followed a cohort of occupational therapy students throughout the duration of their occupational therapy degree programme, focussing on their experience of learning to work with people from diverse cultural backgrounds. Three interviews were undertaken over a period of three years with a cohort of sixteen students. The first interview took place at the commencement of the occupational therapy programme, the second was conducted at the end of the first year of study and after completion of the first fieldwork assignment, and the final interview was undertaken at the end of their three year degree programme when all fieldwork and learning requirements had been completed.
Data collected from participants over this period of time addressed three main topic areas; experiences of cultural and intercultural dimensions of the curriculum and learning processes; intercultural experiences and competence development in fieldwork settings; and, reflections on theoretical and professional issues in respect of intercultural occupational therapy. As may be expected, participant experiences were diverse. Some participant's stories describe experiences that were highly positive which contributed directly to the development of intercultural competence, whilst other participant stories indicated experiences that were negative and potentially undermining to the development of interculturally competent practice. Participants additionally reported a lack of clarity in both classroom and fieldwork learning as to the knowledge, skills and processes
requisite to intercultural competence. With some exceptions, demonstration of such skills and knowledge by staff in either setting appeared to be either inadequate or inconsistent.
The major findings suggested by this exploratory study are fourfold. First, it is evident that the prior learning and experiences of students are highly significant in shaping the development of intercultural competence. Second, of the total learning experiences, those described as most valuable to intercultural practice were; face to face contact with people from differing cultural backgrounds; fieldwork; and the development of critical, reflective thinking. Third, the study suggested that students employed a number of heuristic strategies to assist them in intercultural encounters. Interestingly, these strategies parallel the variables of intercultural effectiveness described in the quantitative intercultural literature. The overall finding, however, has been the illumination of intercultural competence as a process of self understanding and identity reconstruction. Being and becoming an occupational therapist, being and becoming interculturally competent, and being and becoming a person were shown to be inextricably linked. These aspects of being and identity are highlighted in the three main data chapters of the thesis, respectively titled;
Development of Knowledge and Understandings
Development of Skills and Competency
Developing Critical Reflective Practice.
Of note, the final chapter also includes reflective commentary by participants on their perceptions of the relationship between culture and occupation.
A number of tentative recommendations based on these findings have been posited. These recommendations, whilst related to the particular context of the study, should provide a valuable basis for reflective consideration by occupational therapy educators in diverse social, cultural and national contexts.