Responsive Learning: Learning from and With Each Other - A Grounded Theory

Harvey, Caitlin Mary
Hocking, Clare
Jones, Margaret
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Doctor of Philosophy
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Auckland University of Technology

Occupational therapists work collaboratively with parents of children needing support with their development. In delivering therapy intervention, a key role is to help parents learn about their child’s condition, treatment options, and skills to enhance their child’s development and participation in family life. Learning can impact parents’ decisions regarding their child’s treatment, commitment to services, and subsequent outcomes. Concurrently, therapists need to learn about families to provide tailored interventions and support, while ensuring appropriate use of health resources. This grounded theory research aimed to construct a theory explicating the process of learning between parents and occupational therapists who work with children. This study is unique in that the process of learning is considered from the perspective of both parents and occupational therapists and in the use of multiple sources of data. Constructivist grounded theory methodology and methods were used to analyse data generated through 23 interviews, five filmed, routine therapy sessions, and nine photographs of learning resources provided to parents, with 11 parents of pre-school aged children and eight occupational therapists who worked with this client group. Data were analysed using constant comparative analysis. A dynamic, substantive theory of ‘Responsive learning: Learning from and with each other’ was constructed, with three theoretical categories: Establishing relationship, Partnering in learning and Integrating learning. The key findings of this research are that learning between parents and therapists is a complex, dynamic, and bidirectional process where parents and therapists are learning from and with each other and responding to each other as needs, situations and contexts change, through a process of responsive learning. Learning described in occupational therapy literature relating to practice predominantly frames learning as unidirectional with clients learning from an expert therapist. In contrast, responsive learning acknowledges the expertise and leadership of both client and therapist―that they teach, and learn from, each other, and that learning needs are always situational, dynamic and in flux. How, and what, therapists teach cannot be considered in isolation from how, and what, parents need or want to learn, nor from how, and what, therapists must learn to engage with families to provide relevant intervention. A further key finding is that the learning process is deeply relational, where ongoing connection and partnership are crucial for mutual learning, moving forward together, and integrating learning into everyday life. These findings will inform and challenge clinical practice, enhancing the learning experiences of occupational therapists and parents. They potentially extend beyond the specific practice context within which data were generated, to inform the practice of clinicians in all areas of health care. Understandings gained from this research may encourage more efficient, equitable, and effective engagement with clients in a range of health settings. This research also has potential to advance improvements in health outcomes and better meet the needs of service users by prioritising establishment of collaborative relationships, embracing enhanced mutual learning strategies, and responding to learning in clinical practice.

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