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Many health sciences disciplines have adopted team-based learning (TBL) as part of their education pedagogy, with studies showing increased classroom participation and learner satisfaction. However, it will be beneficial to explore the learning experiences of occupational therapy students in TBL using a mixed methods approach. In an undergraduate occupational therapy program, students undertook three clinical modules using TBL in years two and three. This study explored their perceptions and experiences of TBL. This was a mixed methods prospective cohort study, during which two cohorts of students from Academic Year (AY) 2016 and AY2017 completed the Team-Based Learning Student Assessment Instrument (TBL-SAI) at the end of their first (midway evaluation) and third clinical module (final evaluation). In addition, they completed a semi-structured survey to share their learning experience. One-hundred twenty-seven occupational therapy students from both cohorts had full data and their results showed higher than neutral for Accountability, Preference for TBL, and Student Satisfaction sub-scales and composite scores at midway and final survey. Collectively, there were no significant changes in TBL perceptions, and no significant relationships were found between TBL-SAI scores and module results. Within the AY2017 cohort, there was positive moderate association between Accountability sub-scale midway score and module results. Qualitative analysis produced four themes: 1) power of discussion; 2) time use; 3) changed learning process and outcome; and 4) tailoring aspects of TBL to enhance learning. Occupational therapy students��� scores in the TBL-SAI domains were higher than neutral at midway and final evaluation. TBL may be a suitable method to aid learning of clinical occupational therapy knowledge.

Assessment of human movement performance in activities of daily living (ADL) is a key component in clinical and rehabilitation settings. Motion capture technology is an effective method for objective assessment of human movement. Existing databases capture human movement and ADL performance primarily in the Western population, and there are no Asian databases to date. This is despite the fact that Asian anthropometrics influence movement kinematics and kinetics. This paper details the protocol in the first phase of the largest Asian normative human movement database. Data collection has commenced, and this paper reports 10 healthy participants. Twelve tasks were performed and data was collected using Qualisys motion capture system, force plates and instrumented table and chair. In phase two, human movement of individuals with stroke and knee osteoarthritis will be captured. This can have great potential for benchmarking with the normative human movement captured in phase one and predicting recovery and progression of movement for patients. With individualised progression, it will offer the development of personalised therapy protocols in rehabilitation., Measurement(s) voluntary movement behavior • grip strength measurement • Pinch Strength Technology Type(s) motion capture system • force plates • sensor • dynamometry Factor Type(s) gait • Timed Get Up and Go Test • balance • reaching • key turning • hand to mouth • hand to back • hand on head • cross obstacle • folding towel • step up and down Sample Characteristic - Organism Homo sapiens Sample Characteristic - Location Asia Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.12808187

Research Objectives To describe the experiences of one's post-stroke life in the midst of an ongoing COVID-19 pandemic, which surfaced as a salient discovery when investigating individuals with stroke's quality of life, lived experiences and unmet needs. Design Using a cross-sectional, qualitative, semi-structured interview, participants with first time stroke (≥ 21 years) were recruited. Findings were stratified at four time points (1, 3, 6, >12 months) post-stroke. Inductive thematic analysis was conducted using the NVivo 12 software. Setting Outpatient rehabilitation centre and general community were two settings where participants were recruited from. Participants Participants were (1) first-time stroke survivors, (2) aged 21 and above and (3) have adequate communication skills. 23 adults (15 female, 8 male) were included in the final analysis. Interventions Not applicable. Main Outcome Measures An interview guide containing questions that investigated participants’ quality of life after stroke was used as an outcome measurement. Results The key themes were (1) Experiences across continuum and context (2) Altered social participation (3) Resuming valued activities and occupations and (4) “Blessing in disguise”. Interaction in the community were significantly affected due to social distancing measures. The ability to resume valued activities had to be shifted virtually, or temporarily put to a halt. On a positive note, working from home opportunities emerged widely following the pandemic. Conclusions Individuals with stroke experienced a range of implications due to the pandemic. Clinicians should establish other rehabilitation delivery options, such as telerehabilitation, in times of a pandemic. Future study can help to foster a smooth transition to telerehabilitation by investigating the required steps needed for this virtual shift. Author(s) Disclosures All authors have no conflict of interest.

1) To explore family members' lived experiences of driving disruption at early and later stages of the recovery continuum following acquired brain injury (ABI). 2) To describe health-related quality of life of family members of individuals with ABI who are experiencing driving disruption.Mixed methods phenomenological research approach.Semi-structured interviews and health-related quality of life questionnaires were conducted with 15 family members of individuals with ABI (early group: 1-12 months post-injury, n = 6; later group:1 year post-injury, n = 9).Two main themes were identified: Different for everyone: how driving disruption affects families, and Making it harder: context of driving disruption. The challenges of driving disruption were reported more frequently and with a more intense focus by family members who were caring for their relative for more than 1 year post-injury. This group also reported higher caregiver strain and poorer health-related quality of life. Reduced satisfaction with life, poor mental health and affected family functioning were reported by both groups.Driving disruption impacts on family members and has long-lasting consequences. It is important for clinicians to work with family members to manage these challenges even years after ABI and consider individual contextual factors.

IntroductionCaregiving associated with driving disruption following an acquired brain injury is challenging and impacts on family members’ daily lives. However, little is known about the activities...

Biology education relies heavily on visual representations, many of which contain arrow symbols. Many different styles of arrows are used, with no correlation to their underlying meaning. This creates a problem for students, who struggle to interpret and learn from figures containing arrows in biology., In this article, we begin to unpack the phenomenon of representational competence by exploring how arrow symbols are used in introductory biology textbook figures. Out of 1214 figures in an introductory biology textbook, 632 (52%) of them contained arrows that were used to represent many different concepts or processes. Analysis of these figures revealed little correlation between arrow style and meaning. A more focused study of 86 figures containing 230 arrows from a second textbook showed the same pattern of inconsistency. Interviews with undergraduates confirmed that arrows in selected textbook figures were confusing and did not readily convey the information intended by the authors. We also present findings from an online survey in which subjects were asked to infer meaning of different styles of arrows in the absence of context. Few arrow styles had intrinsic meaning to participants, and illustrators did not always use those arrows for the meanings expected by students. Thus, certain styles of arrows triggered confusion and/or incorrect conceptual ideas. We argue that 1) illustrators need to be more clear and consistent when using arrow symbols, 2) instructors need to be cognizant of the level of clarity of representations used during instruction, and 3) instructors should help students learn how to interpret representations containing arrows.

Background:It is recognized that people with dementia are likely to need to stop driving at some point following diagnosis. Driving cessation can lead to negative outcomes for people with dementia and their family caregivers (FC), who often experience family conflict and tension throughout the process. Family experiences surrounding driving cessation have begun to be explored but warrant further examination.Methods:Using a descriptive phenomenological approach, semi-structured interviews were undertaken with key stakeholders, including 5 retired drivers with dementia, 12 FC, and 15 health professionals (HP). Data were analyzed inductively to explore the needs and experiences of people with dementia and FC.Results:The data revealed a range of possible interactions between people with dementia and FC. These were organized into a continuum of family dynamics according to levels of collaboration and conflict: in it together, behind the scenes, active negotiations, and at odds. At the in it together end of the continuum, people with dementia and FC demonstrated collaborative approaches and minimal conflict in managing driving cessation. At the at odds end, they experienced open conflict and significant tension in their interactions. Contextual factors influencing family dynamics were identified, along with the need for individualized approaches to support.Conclusions:The continuum of family dynamics experienced during driving cessation may help clinicians better understand and respond to complex family needs. Interventions should be tailored to families’ distinctive needs with consideration of their unique contextual factors influencing dynamics, to provide sensitive and responsive support for families managing driving cessation.

Family members often assume the caregiving role after an individual sustains an acquired brain injury (ABI). A mandated period of driving disruption following an ABI means that individuals will often rely heavily on family members for transport and emotional support. However, research on driving disruption has largely focused on the impact, assessment and rehabilitation of the individual with ABI, with little attention given to family members. In order to develop an understanding for approaches to support family members better, this thesis aimed to explore the needs and experiences of family members during driving disruption following an ABI. The first aim of the thesis was to gain a broader understanding of the issue by conducting a scoping review of the literature on family membersr needs and experiences during driving disruption across all health conditions. The scoping review found that driving disruption is a stressful and complex issue with communication and emotional implications for family members. The review highlighted differences in experiences according to health condition, permanence of driving disruption and nature of the caregiver occupation, and identified the need for further research on the issue of driving disruption for family members of individuals with ABI. A prospective, mixed methods, longitudinal study, with a phenomenological approach was conducted with family members of individuals with ABI who were experiencing driving disruption. Recruitment was stratified according to time post-ABI to gain a range of perspectives. Data were collected from 15 family members at three time-points: recruitment to study, 3 and 6 months later. Self-report questionnaires measuring family membersr quality of life and well-being were administered at the first time-point, and semi-structured interviews were conducted at each time-point. All interviews incorporated the use of a map to elicit qualitative and quantitative data about family membersr current travel patterns as a result of driving disruption. The data were analysed using different approaches in a series of four studies. The first two studies aimed to gain an in-depth understanding about the experiences of family members of individuals experiencing driving disruption due to ABI across the recovery continuum. Both studies examined the mixed methods cross-sectional data from the first time-point. The first study explored the differences in family membersr experiences at the early (l1 year post-ABI) and later stages (g1 year post-ABI) using a mixed methods, phenomenological approach. Family members in the later group reported more challenges with greater intensity. These challenges included changes in everyday activities, the impact on their emotions, consequences for the whole family, and effects on physical health. The later group had lower ratings of health and well-being, and higher caregiver strain. The second study investigated the specific changes family members experienced in everyday activities with a focus on the impact of driving disruption on lifespace (the geographic area in which people travel and participate in activities). Quantitative analysis revealed lifespace increased for nine family members, decreased for five, and remained unchanged for one. Subjective meanings of lifespace changes were captured in four typologies using a narrative approach. The most common narrative of lI will do everything for him or herr showed that family members were willing to give up their personal lifespace to accommodate for driving-related caregiving activities. The final two studies aimed to understand family membersr needs and experiences over a 6-month period, and used thematic analysis to examine the qualitative data across all three time-points. The third study captured the changes over time as four phases: (1) Wait and see, (2) Holding onto a quick fix, (3) No way out, and (4) Resolution and adjustment. The duration of driving disruption was perceived as indefinite by some family members who even after 10 years saw lno way outr. These findings suggest that supports are needed in the second phase to facilitate the resolution of issues without the escalation of problems in the third phase. The theme of the caregiver occupation emerged inductively while examining family membersr experiences over the 6-month study period. Consequently, the fourth study investigated the occupational experience of family members during driving disruption. Analysis of the activities and their meaning revealed that family members provided more than just transport. They managed broader responsibilities beyond the travel itself, performed driving-related caregiving activities that they perceived as unseen or undervalued, and took on roles similar to a therapist. The thesis concludes that driving is an important domain of caregiving with complex and unique challenges for family members of individuals with ABI. Although driving disruption may be perceived as a less important issue earlier on post-ABI, the longstanding consequences for family members are substantial. Specific supports are necessary for family members throughout the different phases of driving disruption. Regular follow-up in the long-term may be necessary due to the enduring nature of this issue. Occupational therapists can play a crucial role in supporting family members in the caregiver occupation during driving disruption.

Family members often assume the role of driver for individuals who are not driving post-acquired brain injury (ABI). Given that return to driving can be unpredictable and uncertain, the impact of driving disruption on family members may vary at different stages post-injury. This study aims to understand the needs and experiences of family members over time during driving disruption following an ABI.A qualitative prospective longitudinal research design was used with semi-structured interviews at recruitment to study, 3 and 6 months later.Fourteen family members completed 41 interviews. The longitudinal data revealed four phases of driving disruption: (1) Wait and see, (2) Holding onto a quick fix, (3) No way out, and (4) Resolution and adjustment. The phases described a process of building tension and a need for support and resolution over time.Holding onto a quick fix is a pivotal phase whereby supports, such as engagement in realistic goal setting, are essential to facilitate family members' resolution of driving disruption issues. Family members who see no way out might not actively seek help and these points to a need for long-term and regular follow-ups. Future research can explore ways to support family members at these key times. Implications for rehabilitation Health professionals need to facilitate the process of fostering hope in family members to set realistic expectations of return to driving and the duration of driving disruption. It is necessary to follow-up with family members even years after ABI as the issue of driving disruption could escalate to be a crisis and family members might not actively seek help. Health professionals can consider both practical support for facilitating transport and emotional support when addressing the issue of driving disruption with family members.

Family members of a person with an acquired brain injury often provide transport assistance during driving disruption with potential impacts on their own travel and participation within the community. The geographic area in which people travel and conduct their activities is known as lifespace. This study aimed to describe the quantitative changes in family members' lifespace after brain injury and understand their subjective experiences through interacting with maps during narratives.Mapping was embedded within in-depth semi-structured interviews with 15 family members. Two sets of maps were generated per participant showing the number of travel locations before and after brain injury. In the interviews, participants reflected on the perceived meaning of lifespace change. Qualitative data were analysed using a narrative approach.Quantitative data from the mapping revealed an increase in travel locations for nine participants, a decrease for five, and no change for one participant. Data analysis revealed four typologies which complemented and enriched the quantitative data: (i) I will do everything for him or her; (ii) Trying to fit all in; (iii) We spend all our time together now; (iv) I need to also care for myself.The findings describe the change in family members' lifespace after taking on the driver role following acquired brain injury. This study highlights the importance of understanding both quantitative and qualitative aspects of lifespace. The subjective experiences and consequences of lifespace changes are different from the impact on individuals with health conditions. Mapping in an interview as a tool has potential clinical utility.

Family members often assume the caregiving role and provide practical assistance and emotional support when an individual is experiencing driving disruption due to health conditions or ageing. The purpose of this study was to understand the experiences, viewpoints and needs of family members with regards to an individual undergoing driving disruption across various population groups.A scoping review was conducted through searching across six databases and hand searching articles published from 1985 to 2013. Findings from the articles specific to the aims of the review were extracted and summarised into common topics.Twenty-seven articles were included; dementia or cognitive impairment (16 articles), older adults (8 articles) and brain injury (3 articles). The most common topic raised was related to decisions and consequences for the individual. Other concerns were related to family members' occupational role changes, emotional and communication issues and support needs of family members and their recommendations for services.This review revealed the impact of driving disruption on family members but research is limited, especially in the area of brain injury. The majority of articles did not set out to explore family members' experiences and needs and this highlights an area that requires critical attention.Health professionals should be aware of the potential impact of driving disruption on family members. Family members frequently raise concerns regarding the decisions and consequences for their relative, but also bring up personal concerns such as changes to their own occupational roles and the communication and emotional issues they face during driving disruption. Unique challenges arise between family members of individuals of different health conditions, thus highlighting the importance of family caregiving research in various population groups.