Date Presented 04/01/2022

Many students and new graduates report ranging levels of confidence in and understanding of applying theory to practice. The purpose of this study was to redesign a graduate-level OT theory course to address this gap in confidence using andragogical, learner-centered, and active learning principles. This topic advances practice by demonstrating the effectiveness of these teaching principles to bridge the gap between theory in the classroom and real-life application in practice.

Primary Author and Speaker: Mackenzie Feldhacker

Additional Authors and Speakers: Diana Feldhacker

Prior studies have concluded that students struggle to connect theoretical content and practice. This associates directly to the principles that adult learners require hands on learning experiences to explicitly see the link between what they are learning and real-life application. The purpose of this study was to redesign a graduate-level occupational therapy course on theory to address this disconnect using andragogical, learner-centered, and active learning principles. A mixed methods retrospective cohort design was utilized. This included a pretest/post-test along with student survey responses that were collected as part of normal course evaluations. Eighty-four graduate occupational therapy students across three consecutive cohorts from a midwestern university were included in the study. Students ranged in age from early-to-mid-20s to early-40s, with 72 females and 12 males overall. A six item pretest/post-test survey was designed based upon ACOTE standards for the course on which students responded using a 5-point, Likert-type scale. An anonymous 23-item end-of-course evaluation which was designed by the University for use in all occupational therapy courses was used for to collect data regarding general course structure, instructor responsibilities and skills, contribution to learning, and overall quality of the course using a 5-point, Likert-type scale. Qualitative responses for most useful or valuable aspects of the course and areas for improvement were also collected. Approval from the University’s Institutional Review Board (IRB) was obtained. The informed consent process was waived due to the retrospective nature of the research. Students from each cohort completed the pretest/post-test at the beginning and end of the course, and the Course and Instructor Evaluations were conducted at the end of the course. Each cohort was instructed by one of the two investigators who collaborated to ensure similar procedures. Quantitative data were analyzed with descriptive statistics and frequencies, as well as a Wicoxon Signed Rank test. Spearman’s correlation was used to evaluate the relationship between post-test survey response and final course grade. Kruskal-Wallis was used to assess differences between cohorts. Qualitative data were coded openly using Saldana’s (2016) methodology, reviewed and compared among investigators, and then categorized to draw connective themes. Preliminary results from pretest/post-test data analysis demonstrate significant improvement in all six survey items (p = 0.00). Results remained statistically significant when sorted by gender or cohort. Spearman’s rho demonstrated no significance between survey responses and final grade (p> 0.05). Preliminary qualitative themes mirror Kolb’s Experiential Learning Cycle (1984): concrete experience abilities with small group presentations; reflective observation abilities with discussion; abstract conceptualizing abilities with flipped classroom format; active experimental abilities with active learning, real-life application, and problem solving abilities; and general course feedback including multiple modes of learning and student feelings. This proposal is important to practice because it demonstrates the effectiveness of using learner-centered, active learning principles when educating on occupational therapy theory. Adult, graduate-level occupational therapy students need active theoretical learning experiences to bridge the gap between theory in the classroom and theory in real-life application during practice. This type of course redesign can improve students’ ability to engage in theory-driven practice, powerfully influencing the field as a whole.


Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Prentice Hall.

Merriam, S. B., & Bierema, L. L. (2014). Adult learning: Linking theory to practice. Jossey-Bass A Whiley Brand.

Ikiugu, M. (2012). Use of theoretical conceptual practice models by occupational therapists in the US: A pilot study. International Journal of Therapy and Rehabilitation, 19(11), 629-639.

Saldana, J. (2016). The coding manual for qualitative researchers (3rd ed.). Sage Publishing.