Document Type (Journals)
Critical thinking is an essential component to the occupational therapy process that is a timely skill with the rapid pace of change in our healthcare system. Critical thinking exposes assumptions, biases, beliefs and points of view and challenges a shift in epistemology by asking, ‘how do we know what we believe to know?’ Case studies are a tool to engage the learner in critical thinking and are commonly employed in occupational therapy curricula. Social determinants of health (SDH) describe environmental circumstances that affect health. The authors propose that SDH, embedded in case studies, serve as a threshold concept. A threshold concept serves as a means of transformative learning and promotion of critical thinking in occupational therapy education. Social determinants of health taught through case study presentation represent the authentic complex lives of those therapists serve, bolster student critical thinking, and help to consider the multiple perspectives that may challenge long held beliefs. Qualitative content analysis of 59 case studies for SDH content across one curriculum and five semesters, revealed cases built on client factors and foundational knowledge with missed opportunity to add SDH context. Eleven guidelines for case development are proposed to foster transformational learning. Intentional instructional approaches can assist educational programs to develop the professional change agents needed to serve communities and populations with a larger goal of health equity.
Christine Berg, PhD, OTR/L, FAOTA is an Associate Professor in Occupational Therapy and Neurology in the Program in Occupational Therapy at Washington University School of Medicine.
Rachel Philipp is pursuing her occupational therapy doctorate degree at the Program in Occupational Therapy at Washington University School of Medicine.
Steven Taff, PhD, OTR/L, FNAP, FAOTA is an Associate Professor in Occupational Therapy and Medicine and Education Division Director in the Program in Occupational Therapy at Washington University School of Medicine. He also directs the Teaching Scholars Program at Washington University School of Medicine.
Declaration of Interest
The authors report no declarations of interest.
Berg, C., Philipp, R., & Taff, S. D. (2019). Critical Thinking and Transformational Learning: Using Case Studies as Narrative Frameworks for Threshold Concepts. Journal of Occupational Therapy Education, 3 (3). https://doi.org/10.26681/jote.2019.030313
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