Current Landscape of Teaching Diversity in Occupational Therapy Education: A Scoping Review

Abstract

Importance: Critical research in health professions education makes clear the role of educational institutions in perpetuating problematic discourses related to diversity, as well as their potential role in dismantling and rebuilding those discourses to reflect the realities of power relations that create systemic injustice.

Objective: To provide a comprehensive overview of current pedagogical practices and educational paradigms used by occupational therapy educators to teach concepts of, and skills for, equity and diversity.

Data sources: Seven education and health care databases were searched for articles published between 2007 and 2018.

Study selection and data collection: Consensually developed criteria were refined until an agreement rate of >80% was achieved among the authors. Inclusion criteria focused on entry-level occupational therapy education across the world and explicitly examined approaches to teaching diversity. All articles meeting the criteria were kept for full-text review (N = 87).

Findings: Diversity in professional occupational therapy education programs is taught within five main underlying educational paradigms and theories: competency-based (44%), social justice (29%), critical (11%), social accountability (10%), and constructivism (6%). Within these paradigms, 14 key pedagogical practices were applied, with community service learning (37%), international service learning (25%), and didactic or course-based practices (23%) making up the majority of pedagogical practices.

Conclusions and relevance: Although current occupational therapy research demonstrates a trend toward critical paradigms and practices, problematic cultural competency theories and uncritical international service learning practices continue to dominate occupational therapy education for diversity. Educators should implement pedagogies and approaches within critical educational paradigms.

What this article adds: This article highlights the importance to occupational therapy education of attending to coherence across educational ethics, paradigms, and learning outcomes in teaching for diversity and health equity.