Document Type (Journals)

Educational Innovations


Students often find learning and applying theory difficult and potentially disconnected from practice. Using theory to guide occupational therapy assessment and intervention preserves the distinct value of occupational therapy. One way students develop professional reasoning is by learning how to use theory. Theoretical knowledge guides the professional reasoning questions that students and practitioners seek to answer. Teaching occupational therapy theory needs to involve clear, engaging, and meaningful activities that foster an explicit focus on occupation. This paper presents an innovative way of teaching theory in occupational therapy. We explain a thinking cap analogy to organize the theoretical knowledge that guides professional reasoning. This analogy involves the instructor wearing a hat as a thinking cap to represent an occupation-centered model of practice on which objects (frames of reference) can be added as flair. We describe the thinking cap analogy in detail and how this analogy builds on Ikiugu’s framework for combining theoretical conceptual models. Multiple years of student course feedback demonstrate the usefulness of this analogy as a teaching innovation. This method for teaching theory can advance how students use theoretical knowledge to guide professional reasoning in practice and value occupation, performance, and participation as central to occupational therapy.


Wanda J. Mahoney, PhD, OTR/L, FAOTA is Associate Professor of Occupational Therapy and Medicine at Washington University School of Medicine Program in Occupational Therapy in St. Louis, MO.

Stacy Smallfield, DrOT, OTR/L, BCG, FAOTA is Associate Program Director, Doctoral Capstone Coordinator, and Associate Professor in Occupational Therapy Program Department of Health and Rehabilitation Sciences, College of Allied Health Professions, at the University of Nebraska Medical Center, Omaha, NE.

Declaration of Interest

The authors report no declarations of interest.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.