Hand Therapists’ Experiences and Perspectives of Support in Hand Therapy Training
Hand therapy is a clinical area of practice for occupational therapists (OTs) and physiotherapists (PTs) undertaking rehabilitation of the upper limb. Occupational therapists and PTs start as associate hand therapists (AHTs) and can train over three years to become registered hand therapists. The training combines academic and clinical experience, with most learning occurring through clinical experience in the workplace. However, the structures and supports for AHTs within the workplace are limited, with supervision being the only mandatory support requirement set by Hand Therapy New Zealand. Literature surrounding training for hand therapists is sparse and it is unclear if AHTs receive sufficient support to facilitate their transition to becoming registered hand therapists. The purpose of this research is to explore the experiences and perspectives of hand therapists regarding support received during AHT training. I aimed to discover what support is provided, how support is experienced, and how support could be improved.
An Interpretive Description methodology was employed. Participants (n=12) were AHTs and registered hand therapists who had experienced training in Aotearoa. Purposeful sampling allowed for a broad range of perspectives to be gained. These included perspectives from the occupational therapy and physiotherapy professions as well as Māori and Pasifika cultural perspectives. Data were collected by individual interviews completed online, transcribed verbatim, and analysed using reflexive thematic analysis.
Four themes were constructed: 1) Recognising and valuing the diversity of Aotearoa hand therapy, 2) A therapist-centred approach to learning, 3) An accessible community, and 4) Hand therapy - a unified professional identity. These findings indicate that AHTs’ experience of support depends on who they are and where they work. Participants suggested that hand therapy structures and supports were dominated by Pākehā and physiotherapy worldviews and appeared to limit the progression of AHTs who fall outside these spaces. Aotearoa hand therapy holds a professional, cultural, and geographically diverse membership that requires individualised and therapist-centred support. Furthermore, this support needs to be accessible and present through all professional and organisational levels.
Establishing support processes that recognise and value the identity of each therapist would allow AHTs to feel safe bringing their whole selves to their practice, to build confidence in their abilities, develop a sense belonging to the community, and become grounded in their positioning as a hand therapist.