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This paper presents findings from a qualitative study of healthcare professionals’ practice, where learning is taking place when a digital artefact is implemented for identification of patients’ cognitive impairment. The use of digital artefacts is increasing in various workplaces, to include professionals in healthcare. This paper aims to explore the following research question: How is the professional learning unfolding in patient-based work when a digital artefact transforms the practice?

Various data collection methods are used for this study, consisting of dialogue meetings, interviews and a reference-group meeting. Thematic analysis is used to inductively bring forth the themes of the collected data.

Professionals’ knowledge and experience are of vital importance in learning and changing work practices. Together with their ability to reflect on changes, their knowledge and experience constitute the prefiguration when the introduction of a digital application brings about indeterminacy in the work practice.

This paper makes a contribution to practice-based research as it consolidates previous research and identifies professionals knowledge and learning in a healthcare context. This can be used to further explore and advance the field, as well as to establish the evidence-based importance of transforming practices based on implementation of digital artefacts.

This paper aims to adapt and computerize the Trail Making Test (TMT) to support long-term self-assessment of cognitive abilities.

The authors propose a divide-and-combine (DAC) approach for generating different instances of TMT that can be used in repeated assessments with nearly no discernible practice effects. In the DAC approach, partial trails are generated separately in different layers and then combined to form a complete TMT trail.

The proposed approach was implemented in a computerized test application called iTMT. A pilot study was conducted to evaluate iTMT. The results show that the instances of TMT generated by the DAC approach had an adequate level of difficulty. iTMT also achieved a stronger construct validity, higher test–retest reliability and significantly reduced practice effects than existing computerized tests.

The preliminary results suggest that iTMT is suitable for long-term monitoring of cognitive abilities. By supporting self-assessment, iTMT also can help to crowdsource the assessment processes, which need to be administered by healthcare professionals conventionally, to the patients themselves.

The purpose of this study was to provide an outline of the process of developing an on-road driving test route and rating form. Comprehensive evaluation of medical fitness to drive should comprise of an off-road and an on-road assessment. Much research attention has focussed on the off-road phase of assessment, while there is less standardisation evident in the completion and measurement of the on-road phase of fitness-to-drive assessment.

A scholarship of practice approach was used to inform the development of an on-road test route and an associated generic on-road assessment tool that was guided by research evidence and best practice recommendations.

A step-by-step guide, outlining seven recommended phases in the development of an on-road route for the assessment of fitness to drive that aligns with best practice recommendations, was developed. A preliminary generic on-road assessment tool (the Maynooth–Trinity Driving Test) that includes higher-order cognition alongside element of strategic, tactical and operational driving ability was developed and piloted alongside the newly developed on-road test route.

This paper offers an overview of an approach to developing evidence-based on-road test routes and an associated generic assessment tool that may assist occupational therapists and on-road driving assessors establish a standard practice for testing on-road behaviour as part of a comprehensive approach to evaluate fitness to drive.

In Ireland, the Assisted Decision Making (Capacity) Act 2015 provides a statutory framework to adults who are experiencing difficulties with decision-making. This legislation has significant implications for all who work in health and social care. Increasing age and life expectancy, alongside the rising incidence of chronic health conditions and dementia-related diseases, indicates that more individuals are likely to experience challenges regarding decision-making capacity. Therefore, the need for more consistent, best-practice processes to assess decision-making capacity is likely to increase. To ensure occupational therapists are responsible in their contributions, and to ensure those with disabilities are supported, clinicians must be well-informed of the principles underscoring the Act. The purpose of this paper is to provide an overview of this multidisciplinary issue, including recent legislation, and consider how occupational therapy can contribute.

The authors reviewed current literature and considered occupational therapy’s role in decision-making capacity assessment.

Occupational therapists have potential to play a key role in multi-disciplinary assessments of decision-making capacity for clients. Further research is required to explore professional issues, identify clinical best practices and determine training and resource needs.

This paper seeks to provoke consideration of how occupational therapists can contribute to capacity assessment from a client-centred, occupation-based perspective that is mindful of ethical and legislative considerations.

This study aimed to assess the potential of the Clinical Dementia Rating (CDR) Scale in the prognosis of dementia in elderly subjects.

Dementia staging severity is clinically an essential task, so the authors used machine learning (ML) on the magnetic resonance imaging (MRI) features to locate and study the impact of various MR readings onto the classification of demented and nondemented patients. The authors used cross-sectional MRI data in this study. The designed ML approach established the role of CDR in the prognosis of inflicted and normal patients. Moreover, the pattern analysis indicated CDR as a strong cohort amongst the various attributes, with CDR to have a significant value of p < 0.01. The authors employed 20 ML classifiers.

The mean prediction accuracy varied with the various ML classifier used, with the bagging classifier (random forest as a base estimator) achieving the highest (93.67%). A series of ML analyses demonstrated that the model including the CDR score had better prediction accuracy and other related performance metrics.

The results suggest that the CDR score, a simple clinical measure, can be used in real community settings. It can be used to predict dementia progression with ML modeling.

A recent paradigm-shift in patient care advocates for long-term recovery and quality of life in survivors of critical illness. Evidence suggests that occupational therapists in critical care can contribute to recovery in areas such as functional outcomes, length of stay and delirium, although poor role understanding can limit service-utilisation. The purpose of this study is to investigate current and future roles and practices of critical care occupational therapists in the UK.

Occupational therapists with clinical experience in adult critical care were invited to participate in a mixed-methods design using a locally developed online questionnaire and semi-structured interviews, concurrently. Descriptive statistics were generated through SPSS. Qualitative data were analysed using the framework approach.

Twelve occupational therapists participated in the survey element, with five continuing to interview. Occupational therapists described a multifaceted role in critical care where the majority reported practice in upper limb function, seating/positioning, cognition, psychosocial sequelae and discharge planning. Role and internal characteristics impacted on service delivery. It is envisaged that earlier intervention in a greater percentage of patients, a greater evidence-base, raising awareness and adequate staffing will be features for future development.

This study provides new insight into the current role and practices of adult critical care occupational therapists in England and generates insights into their role in addressing physical and non-physical morbidity for this patient cohort. Findings are preliminary in nature; however, future research is warranted to evaluate the effectiveness of interventions.

We conducted a national study of the Collegiate Leadership Competition (CLC), which since inception in 2015, has included over 75 higher education institutions. The CLC brings students together in collaborative institution-based teams to compete with other teams in competitions to achieve goals and practice effective leadership skills. Our goal was to assess leadership capacity growth over the course of a four-month team practice period through the daylong inter-team competition and evaluate participant leadership assessed several months later. Results suggested students made significant and sustainable gains in leader-self-efficacy and short-term gains in leadership skill and motivation to lead. Our results also indicated the team’s coach played a significant role in student leadership development.

Leadership development programs for students in educational settings are proliferating in number and design. Curricular programs range from academic minors and certificates to doctoral programs in a variety of academic homes (e.g., education, business, healthcare). Co-curricular programs often take the form of drop-in workshops, day-long experiences, alternative spring breaks, service-learning trips, and other programs housed in student affairs and administrative offices (Guthrie & Jenkins, 2018). Moreover, the number of programs has steadily increased over the last 15 years from just under 1,000 in 2006 (Brungardt, et al., 2006) to more than 2,000 (ILA Program Directory, 2021). And while there is some commonality among the approach of these leadership programs in terms of content and delivery (see Harvey & Jenkins, 2014), vast differences exist in the structure and learning goals of student leadership programs compared to other social science disciplines. A potentially fruitful area in which to explore its effectiveness in supporting leadership development is the environment of competitive teams, where individuals work together as a group to compete against other teams. The purpose of our research was to investigate the degree to which such a competitive environment might support or detract from student leadership group, employing a potentially effective example of a formal program that utilizes the innovative approach of team competitions to motivate learning (the CLC).

The paper aims to investigate if the performance of older adults on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were associated or predictive of their functional performance in a geriatric evaluation and management (GEM) inpatient hospital setting. This will inform the occupational therapy assessment and management of older adults admitted to sub-acute GEM settings.

In all, 20 participants (11 men, 9 women, mean age 82 years, SD = 6.93) were recruited from a GEM ward in an Australian hospital. Participants’ cognitive abilities were assessed using the MMSE and MoCA, and their functional performance were assessed using the Functional Independence Measure (FIM). Spearman’s rho correlations and linear regression analyses were completed. Bootstrapping was applied to the regression analyses to accommodate the small study sample size.

No statistically significant correlations were obtained between the total and subscale scores of the MMSE and FIM or between the total and subscale scores of the MoCA and FIM. In other words, the cognitive and functional abilities of older adults admitted to a GEM setting were not significantly associated in this study.

The findings suggest that the MoCA and the MMSE were not predictive of participants’ functional performance as measure by the FIM in a sub-acute GEM setting. Occupational therapists should be cautious when interpreting participants’ MMSE, MoCA and FIM results and not depend solely on these results in the goal setting and intervention planning processes for clients on GEM wards. Further studies are recommended to confirm these findings.

This study aims to explore the difference in cognitive strategy use during observed occupational performance between and within different levels of impaired awareness of deficits of individuals with acquired brain injury (ABI).

A cross-sectional study (N = 24) of individuals with ABI receiving rehabilitation and with the capacity to demonstrate goal-directed behaviour (Allen cognitive level screen score = 4.0) was undertaken. Cognitive strategy use during occupational performance of daily activities (measured with the perceive, recall, plan and perform [PRPP]) was evaluated between and within different awareness levels (awareness levels measured by the self-regulation skill interview). Statistical analyses, using independent t-test, Mann Whitney U test, ANOVA and Friedman test, were executed.

Significant differences were shown for both strengths and weaknesses in cognitive strategy use between emergent (n = 13) and anticipatory awareness (n = 11) groups on PRPP items “perceive”, “sensing” and “mapping”; and “searches”, “recall steps”, “identify obstacles”, “calibrates”, “stops”, “continues” and “persists”. Within emergent awareness group, participants scored lowest related to “perceive”, “plan”, “sensing”, “mapping”, “programming” and “evaluating”. Within anticipatory awareness group, participants scored lowest related to “plan”, “programming” and “evaluating”.

This study showed differences in cognitive strategy application during task performance in individuals with emergent or anticipatory awareness deficits that fit with theoretical expectations. It is recommended to make use of the PRPP assessment results (strengths and weaknesses in cognitive strategy application) to support the level of awareness determination. The PRPP assessment results and the level of awareness tailor the clinical reasoning process for personalised intervention planning and cognitive strategy training.

Because impaired awareness has so much impact on the course and outcome of rehabilitation (Rotenberg-Shpigelman et al., 2014), in clinical practice, it is of paramount importance to be aware of the level of awareness of the client (Smeets et al., 2017) and the effect on occupational performance.

The purpose of this paper is to examine the reliability and validity of the Abbreviated Mental Test (AMT) and the agreement with the Mini-Mental State Examination (MMSE).

This cross-sectional study included 446 older adults who were recruited by cluster sampling from 200,481 adults aged more than 60 years. For each participant, the AMT was administered by village health volunteers and, on a separate day, by a trained professional who also administered the MMSE. Descriptive statistics, Bland and Altman levels of agreement, and Receiver Operator Curves (ROCs) were used to analyze data.

Administration of the AMT by village health volunteers during the annual health screening found cognitive impairment in only 1.12% of the sample. When the AMT was given to these same individuals by trained professionals, the rate of cognitive impairment was almost 24 times greater. Two items in the Thai AMT may require modification due to markedly elevated failure rates. At the cut score of 8, the sensitivity and specificity of the AMT relative to the MMSE were moderate (78.83 and 66.67%, respectively). The degree of agreement between AMT and MMSE was 0.49 (p < 0.001) and the correlation between the difference scores and the mean is exceptionally low (0.048).

Reliable and valid cognitive screening assessment requires the administrator to be well trained and the tools to be appropriate for the population. Although AMT is short and easy for a nonprofessional to administer, some items were not suitable due to construct validity and contextual issues.