Date Presented 04/22/2023

The purpose of this study was to demonstrate the use of the Occupation-Centered Intervention Assessment (OCIA) in student assignments to develop an improved understanding of occupation-centered practice. In addition, the researchers utilized statistical analysis of interrater reliability as a measure of student learning. The students demonstrated good rater agreement for the OCIA, and the researchers were able to identify areas of focus for future instruction regarding occupation-centered practice.

Primary Author and Speaker: Kelly Lynn Little

Additional Authors and Speakers: Vanessa Jewell

Contributing Authors: Yongyue Qi

PURPOSE: The occupational therapy literature stresses the importance of increasing occupation-centered education to embody the identity of the profession (Breen-Franklin & Atler, 2022; Hooper et al., 2020). The Occupation-Centered Intervention Assessment (OCIA) can be utilized throughout the occupational therapy curriculum to increase student integration of the threshold concept of occupation-centered practice, a basic tenet of the profession. The OCIA was developed as a reflective tool for students to better understand occupation-centered practice (Jewell et al., 2022). Through deconstructing interventions, students can begin to comprehend the complexities of occupation. Data obtained from assignments using the OCIA can help gauge student understanding of occupation-centered practice. This study utilized de-identified data from assignments rating the occupation-centeredness of video-recorded treatment interventions. The inter-rater reliability (IRR) was established to better understand the students’ comprehension of occupation-centered practice. The research question was: What is the inter-rater reliability of the Occupation-Centered Intervention Assessment with first-year occupational therapy students observing standardized video-recorded physical rehabilitation treatment interventions? In addition, the researchers explored how statistical analysis could be used to inform best pedagogical practices.

DESIGN: A broad methodological approach was used to evaluate student understanding of occupation-centered practice by establishing the IRR of the OCIA during a student assignment (Portney, 2020).

METHOD: Students were provided with a comprehensive interactive lecture regarding the OCIA. The students then completed an assignment using the OCIA to rate 10 videos of treatment interventions with accompanying case scenarios. The interventions were rated for personal, contextual, and occupational relevance. The researchers deidentified the data from the assignments and utilized the SPSS to calculate the IRR of the OCIA utilizing Krippendorf’s alpha. The data was then analyzed by the researchers to gauge student understanding of occupation-centered practice.

RESULTS: Good agreement was demonstrated by the raters for the OCIA total scores (α = .864) and personal relevance (α = .844). Contextual relevance showed a moderate level of agreement (α = .705) and occupational relevance displayed low agreement (α = .643). The mean and standard deviation for each of the intervention videos was calculated and researchers were able to identify which videos had the greatest standard deviations.

CONCLUSION: This study demonstrated the use of the OCIA in a student assignment to increase understanding of occupation-centered practice and established IRR as a method to evaluate learning. Good inter-rater reliability between student raters for the OCIA was demonstrated. Through data analysis, the researchers discovered that the students performed lower in contextual and occupational relevance which is appropriate for first-semester students that have not yet mastered the concepts. This information can guide future assignment development and focus teaching efforts. The use of occupation is fundamental to the profession’s identity and educators need to continually strive for new ways to integrate occupation in an explicit way throughout the curriculum (Breen-Franklin & Atler, 2022; Hooper et al., 2020). Self-reflection is essential for occupational reasoning and the OCIA is a valuable tool that can help students learn to establish that skill. The OCIA can be woven throughout the curriculum to elevate student learning of occupation-centered practice and help bridge the gap between theoretical knowledge and clinical practice.


Breen-Franklin, A. & Atler, K. (2022). Use of the Subject-centered Integrated Learning Model and the Occupational Experience Profile to promote students’ connections among occupation, self, and the profession. Journal of Occupational Therapy Education, 6(1).

Hooper, B, Molineux, M., & Wood, W. (2020). The Subject-Centered Integrative Learning Model: A new model for teaching occupational therapy’s distinct value. Journal of Occupational Therapy Education, 4(2).

Jewell, V.D., Wienkes, T., & Pickens, N. (2022). The Occupation-Centered Intervention Assessment. American Occupational Therapy Association Press.

Portney, L. (2020). Foundations in clinical research (4th ed.). F. A. Davis.