The 'culture of practice' of Ministry of Education Special Education occupational therapists and physiotherapists

Simmons Carlsson, Carolyn
Wright-St Clair, Valerie
Hocking, Clare
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Master of Health Science
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Auckland University of Technology

Occupational therapists and physiotherapists have increasingly moved into mainstream school-based practice in Aotearoa/NZ over the last ten years, however little is known about what underpins their practice worldview in today’s climate of inclusive education. This ethnography addressed the question: what is the culture of practice of occupational therapists and physiotherapists in the Ministry of Education, Special Education? In search of participants’ emic perspectives of their culture, the ethnographic lens was used to inform the design of this study, which is situated theoretically within interpretive constructionism. Thirteen experienced Ministry of Education, Special Education occupational therapists and physiotherapists participated in this study. Semi-structured, face-to-face interviewing was used with eight therapists and a second email interview format was used with a further five therapists. Data were supplemented by complete-member-researcher observations in the field, as well as journal notes and written archival material from the organisation. Data analysis followed an ethnographic evaluative framework (Katz, 2001, 2002) and a cultural constructs framework, drawn from literature pertaining to ethnography and culture. The findings in this study reveal that the culture of practice of Ministry of Education, Special Education therapists is emergent. This culture is strongly embedded in organisational culture as well as the Aotearoa/NZ Government’s mission towards building an inclusive society. Findings from this study also reveal that contrary to the expectation that therapists may step into the organisation and be .fit to practice. in the education sector, this is indeed not the case. Therapists must be enculturated and supported in order to develop their understandings of the education system and what this demands of their school-based practices. Even given the support of therapy-specific induction, supervision and mentoring, the transition into the education model is huge. Because this, findings strongly point to the need for the organisation to support therapists’ enculturation by offering formal, therapy-specific induction programmes. For the group in this study, theirs is a culture of inclusion, collaboration, consultation, teaming and inclusive practice. Furthermore, it is a culture that values students being students, with passionate aspirations towards fostering and enabling student learning and participation in schooling. To effect such change related to notions of inclusive education, the higher order task of the culture and, therefore the group’s practice, is one of brokering inclusion as agents for societal change. Within this, there is recognition that new entrant Ministry of Education, Special Education (MoE-SE) therapists must shift their traditional practice understandings and ways of being when working in the education sector to unshackle biomedical model perspectives. They must shift their worldview of school-based therapy. Through this study, occupational therapists and physiotherapists are offered an exemplar of what this shift might look like. It also provides a practice exemplar of what it is like to practice in a different paradigm and of environmental practice. Lastly, the findings from this study challenge the occupational therapy and physiotherapy professions, practitioners and lecturers alike, to shift beyond entrenched biomedical perspectives and to take up the staff of occupational practice. Moreover, they challenge the professions to be true to the pursuit of activity and participation outcomes for the clients, whom they all serve. This study therefore provides a tool to help ease transition. It also provides a clear way to articulate the extent of the shift from biomedical model to occupational practice in school-based practice. Further research is required related to capturing the students’ voice in relation to Ministry of Education, Special Education therapy services and how they experience the culture. The range of potential studies remains great, given the paucity of local research related to school-based therapy practice and inclusive education. Studies into teachers’ and parents’ experiences are warranted, as are studies which explore the experiences of Māori therapists and Māori clients. It may be interesting to compare therapists. Cultures across practice contexts, such as the special schools, and between health and education sectors. It may be helpful to look at whether therapists do find it useful to have MoE-SE practice explained in cultural terms. An outcomes-based study would help provide practice-based evidence for what works and what doesn’t. Other studies might address issues such as: when inclusion is achieved, what does it achieve educationally and socially or is harm done when therapy services shift away from dealing with impairment and what is the long-term personal outcome to the student when this occurs. Lastly, a study that addressed whether embracing the culture of practice actually makes a difference in the long term for students would be valuable.

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