The Four-Quadrant Model of Facilitated Learning: Development and Clinical Utility

Craig Greber (2011). The Four-Quadrant Model of Facilitated Learning: Development and Clinical Utility PhD Thesis, School of Health & Rehabilitation Sciences, The University of Queensland.

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Author Craig Greber
Thesis Title The Four-Quadrant Model of Facilitated Learning: Development and Clinical Utility
School, Centre or Institute School of Health & Rehabilitation Sciences
Institution The University of Queensland
Publication date 2011-09
Thesis type PhD Thesis
Supervisor Professor Jenny Ziviani
Professor Sylvia Rodger
Total pages 362
Total colour pages 35
Total black and white pages 327
Language eng
Subjects 11 Medical and Health Sciences
Abstract/Summary Abstract Teaching-learning approaches are routinely used by occupational therapists in the process of enabling clients to master the tasks and activities that comprise occupational performance, leading to goal attainment. Although it has been recognised that occupational therapists draw frequently on these approaches, little has been done to establish how such an approach is congruent with overarching principles of the profession. An understanding of how teaching-learning can contribute to a client’s attainment of occupational performance goals would therefore contribute to the efficacy of occupational therapy practice when task mastery as a focus of intervention. Moreover, although it is apparent that occupational therapists draw on teaching-learning strategies as part of their practice, it is unclear how they develop the skills and accompanying decision-making processes to effectively do so. In consequence, little is known about the ways occupational therapists establish the skill set and reasoning process used to engage teaching-learning approaches as part of their practice. The research undertaken in this thesis is best described as adopting an overarching action research approach in which a variety of research methods were used to answer four research questions across five stages of research. These questions related to the effects of an organisational framework, the Four-Quadrant Model of Facilitated Learning (4QM), on the decision-making of occupational therapists when using teaching-learning as an approach to intervention. The research encapsulated in this thesis comprised five stages, each representing different cycles of an action research process and together addressing the four nominated research questions. These five stages developed, refined, investigated and evaluated the 4QM as a model that informed and organised decision-making as it pertained to teaching-learning approaches within a broader clinical reasoning process. Stage 1 involved speculation regarding the development of a conceptual model able to represent the teaching-learning process within the context of occupational therapy. Stage 1 included three cycles of action research that together identified the issues, proposed and tested various actions and developed a way of conceptualising teaching-learning in an organised way. The result was a model - the Four-Quadrant Model of Facilitated Learning - considered useful in guiding therapists in selecting and organising teaching-learning strategies used in enabling task mastery in an occupationally-focused way. This model formed the basis of subsequent stages of inquiry. During Stage 2, the structure and content of the 4QM was refined following an extensive review of occupational therapy and pedagogy literature. This resulted in modifications to the model, making the structure more conceptually sound and the content more reflective of contemporary pedagogic theories. The manner in which teaching-learning could validly be used as a part of occupational therapy practice was proposed. Through further reviews of literature, an advanced theoretical framework was developed in Stage 3 that described more completely the assumptions, theoretical postulates and practical steps engaged when using the 4QM to guide practice. Stage 3 involved the expansion of theories underpinning the 4QM, advancing it as a new frame of reference in occupational therapy. This was an important step in further validating the model prior to evaluating its clinical utility. Potential applications of the 4QM were investigated during Stage 4. A greater understanding of the experiences and perspectives of experienced occupational therapists regarding teaching-learning was gathered through the combined use of questionnaire and focus group methods. Fifteen experienced occupational therapists participated in focus group discussions that aimed to understand their engagement in teaching-learning and solicit their perspectives on the potential clinical utility of the 4QM. Questionnaires were used as an adjunct to focus group discussion in gathering individual data on the use of teaching-learning. Results indicated that participants engaged in teaching-learning routinely, despite not being able to describe a clear process that drove their clinical reasoning. Proficiency in facilitating learning was described as arising mostly from trial and error. Participants embraced the potential for the 4QM to frame decision-making in clinical situations, noting that it might be particularly useful for novice clinicians. Evaluation of the influence of training in the 4QM on aspects of therapist reasoning formed Stage 5 of the research. Five case studies involving novice occupational therapists were used to explore and describe changes in reasoning about teaching-learning following exposure to formal training in the 4QM. Repertory Grid Technique, a technique arising from Personal Construct Theory, provided qualitative and quantitative data that together reflected how and what participants considered when designing interventions based on teaching-learning. Results from Stage 5 provided initial evidence that more structured reasoning could occur following the introduction of the 4QM as a framework for contemplating the learning process. The overarching action research methodology used to structure the research described in this thesis is proposed as a useful way of continuing the research agenda. As the precursor to further investigations into the 4QM, a description of the reflection and planning aspects of an emerging Stage 6 of action research is proposed. Potential future research into the influence of the 4QM on the practice of therapists, and on the outcomes of therapy, is identified.
Keyword learned helplessness
clinical reasoning
occupational therapy theory
professional education
frame of reference
facilitating learning
Additional Notes Pages printed in colour: 34,39,50,74,112,130,155,157,160,165,167,169,170,177,179,181,182,188,190,192,193,194,199,200,202,204,205,206,207,208,214,216,218,219,240 Pages printed in landscape: 312, 355-362

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Created: Wed, 11 Jan 2012, 08:58:14 EST by Craig Greber on behalf of Library - Information Access Service