Occupational therapy is a holistic and client-centered health profession that promotes health and well-being (Stein & Cutler, 2002). In general, occupational therapists help people across the lifespan to participate in daily occupations through the therapeutic use of everyday activities (American Occupational Therapy Association, 2018). Occupational therapy is recognized as a health profession by the World Health Organization. It is represented through the World Federation of Occupational Therapists (WFOT) (World Health Organization, 2011), which was established in 1952 and is the official international organization that supports and promotes occupational therapy (WFOT, 2016). As members of interdisciplinary health care teams, occupational therapists work with other health professionals and share their unique body of knowledge (Krug & Cieza, 2017). Evidence-based occupational therapy has been used, along with other health and medical interventions, to treat patients of different ages and with diverse diagnoses and has demonstrated its use and effectiveness in managing symptoms and enhancing and/or maintaining functional performance for persons with disabilities (Holm, 2000).
Occupational therapy is a growing health care profession, and the number of WFOT member organizations has been increasing dramatically. A recent WFOT report (2018) indicated that, worldwide, there are 550,000 practicing occupational therapists in more than 94 countries, 63,000 practicing occupational therapy assistants, 900 approved education programs that meet the WFOT minimum standards for education, and 100,000 occupational therapy students studying in WFOT-approved programs (WFOT, 2018). Worldwide, the job outlook for occupational therapy practitioners is promising. For example, U.S. employment of occupational therapists is expected to increase 29% between 2012 and 2022, and growth is expected to be much faster than the average for all occupations (Bureau of Labor Statistics, 2016). Despite this dramatic development, recent studies reported that occupational therapy is not well known or understood and that people lack knowledge and awareness of the profession (Howarth, Morris, & Cox, 2018). A recent study indicated that few members of the public, including patients who receive occupational therapy services, know how to describe the role of occupational therapists (Mason & Mathieson, 2018). On the other hand, most people can identify the roles of physicians, nurses, and physiotherapists (Mason & Mathieson, 2018). Unfortunately, little mention is made of the important role of rehabilitation and occupational therapy in helping persons with disabilities to improve their quality of life (Dickinson, 2003). Additionally, occupational therapy services are not widespread and are not well represented or integrated into many rehabilitation services. Occupational therapy is not available at many clinical and rehabilitation institutions, which has led to poor access and reduced benefit from occupational therapy in many countries (Lin, Zhang, & Dixon, 2015). This may be the result of lack of government and private sector support, weak promotion, and limited public education campaigns to enhance awareness of the occupational therapy profession (Mason & Mathieson, 2018; Royeen, 2002).
Saudi Arabia is among 73 WFOT-approved full members (WFOT, 2018). Currently, in Saudi Arabia, only five undergraduate occupational therapy programs are integrated into the rehabilitation departments at four government universities and one private university. Therefore, most people in Saudi Arabia have never heard of occupational therapy and do not know what it is (Sarsak, 2018). Despite the increasing health, psychosocial, developmental, and cultural needs of the community that have led to a critical need for more occupational therapists in Saudi Arabia, in the current study, a literature review identified one study that highlighted the importance of occupational therapy programs in academic and clinical settings. Sarsak (2018) reported that establishing occupational therapy programs would provide Saudi Arabia and the Arab region with qualified and competent occupational therapists. These programs would enhance services for persons with disabilities, improve their life satisfaction, and empower their functional performance and everyday living skills, increasing their independence, safety, and quality of life. Further, an occupational therapy perspective could lead to a more holistic approach and more comprehensive patient care. Sarsak (2018) indicated that the inclusion of occupational therapy professionals in existing interdisciplinary medical and rehabilitation teams in Saudi Arabia is progressing and will improve collaboration and integrated intervention planning, which will benefit persons with disabilities.
To increase the success of occupational therapy in Saudi Arabia, promotion of the profession and education about its long-term benefits are crucial. Therefore, the primary goal of this survey was to examine the perceptions of the occupational therapy profession among medical and health science students in Saudi Arabia. Secondary goals were to promote learning and knowledge development in the field of occupational therapy and to enhance awareness of this important health care profession among students as well as in Jeddah and surrounding areas in the Western region of Saudia Arabia.
This descriptive cross-sectional research study used a survey design. A survey was developed for this study and distributed to students from March 2019 to April 2019. The survey, which consisted of 13 questions on occupational therapy, took 5 to 10 minutes to complete. The survey questions examined students' knowledge about the occupational therapy profession (i.e., meaning of occupation, role of occupational therapists, services and benefits of occupational therapy, populations served, work settings of occupational therapy practitioners) and explored ways to enhance student awareness of occupational therapy and interest in learning more about the profession. A sample of these questions is shown in Table 1. This study received approval from the medical college research and ethical committee. A convenience sample of medical and health science students was recruited from the medical college. Written informed consent was obtained from all participants. Included in the study were existing undergraduate medical and health science students who were 18 years of age or older and had adequate cognitive and language skills to participate. Descriptive statistics, including simple percentages and frequencies of responses, were calculated to analyze the demographic features and survey results. Cross-tabulation of the response variables with Pearson's chi-square test was used to identify differences in rates of awareness and knowledge across levels of education. Data were analyzed with IBM SPSS Statistics, version 22.
Sample of Survey Questions and Student Responses (N = 303)
A total of 303 students participated and completed the survey. Of the total, 65% were women. Students who participated were enrolled in different programs (Table 2) and had different educational levels (Figure 1).
Demographic Features (N = 303)
Percentage of students at different educational levels.
Table 1 shows a sample of the survey questions and student responses. Of the 303 students, only 179 (59.1%) had heard of occupational therapy (Table 1). A majority of students (252 students; 83.2%) stated that occupational therapy plays an important role in the interdisciplinary rehabilitation team (Table 1). All students were able to identify the most common health conditions that an occupational therapist addresses, but 57 students (18.8%) were not sure about the focus and main domain of occupational therapy (Figure A, available in the online version of the article). When students were asked where they thought an occupational therapist works, most of them were able to answer this question accurately (263 students; 86.6%); however, 40 students (13.2%) did not know (Table 1). Of the 303 total respondents, 113 (37.3%) said that occupational therapy and physical therapy are similar, 70 (23.1%) said that occupational therapy and physical therapy are not similar, and 119 (39.3%) were not sure. When students were asked whether they were satisfied with their knowledge of occupational therapy, only 99 (32.7%) stated that they were satisfied and 204 (67.3%) stated that they were not satisfied. Most of the students (272 students; 89.8%) answered yes to the question “Would you like to be educated about occupational therapy?” and only (31 students; 10.2%) answered no (Table 1). The only significant association found was between awareness of occupational therapy and educational level (p = .02).
Students Responses: “What are the focus and the main domain(s) of OT?”
The study findings suggest that many medical and health science students in Saudi Arabia do not understand occupational therapy. Few studies have explored public knowledge and understanding of occupational therapy. A recent study indicated that although occupational therapy is now 100 years old, it is still not well known or understood by the general public (Mason & Mathieson, 2018). In the current study, 232 students (76.6%) did not know the difference between occupational therapy and physical therapy (37.3% reported that occupational therapy and physical therapy are similar, and 39.3% were not sure). A previous study reported that the term “occupation” is not clear to the public. Misconceptions result in role confusion for the health care team (Dickinson, 2003). In the current study, some students thought of occupation as finding jobs for people (4.0%) or performing massage (4.0%), and some respondents were not sure what occupational therapists do (18.8%) or where they work (13.2%). One interesting finding was that physical therapy students were more familiar with occupational therapy compared with students in other programs. Of the 45 physical therapy students, 42 answered yes to the question “Have you heard of occupational therapy?” This finding may be explained by the close collaboration of physical therapy and occupational therapy professionals, their many common features, and their regular communication in academic and clinical settings as part of the rehabilitation curricula and team. The current study also found a significant association between students' awareness of occupational therapy and their educational level. It is expected that medical and health science students at higher educational levels will have more opportunities to learn about other health care professions, especially in clinical practice and during the internship year, when all work together within a team.
The ideal practice includes interdisciplinary teamwork and collaborative and integrated intervention planning among health care professionals. The team comprises a variety of specialists who have different backgrounds, training, values, and world views, and sometimes different goals. Successful intervention involves a collaborative and mutual process during which practitioners and clients develop a care plan together. Occupational therapists are concerned with understanding the occupations of human beings and the ways in which people organize the activities that fill their lives and give them meaning. Ideally, interdisciplinary team members share a common concept of the client's concerns and a common philosophy of intervention. They synthesize the diverse information gathered from their own evaluations and those of outside consultants, and they work together to formulate and implement a comprehensive care plan based on available data. Most importantly, the team should act as a functional unit whose members are willing to learn from each other and modify their opinions, when appropriate, on the basis of the group's combined observations and expertise (Willard & Schell, 2014). Although most participants indicated that the role of occupational therapy in the rehabilitation team is vital (83.2%) and 89.8% showed interest in learning more about occupational therapy, this study showed low overall awareness of occupational therapy by medical and health science students, indicating a gap in their knowledge and understanding of the diverse aspects of occupational therapy. This finding is similar to a previous study that reported little public understanding of the occupational therapy profession (Mason & Mathieson, 2018). A previous study indicated that youth may not enter occupational therapy because of lack of awareness, leading to multiple problems, such as: (1) the shortage of occupational therapy professionals is expected to increase, and (2) clients will not have full access to occupational therapy if these services are unknown or unavailable (Lin et al., 2015). Other studies reported that occupational therapy is not highly visible in the media and that its presence in news and online platforms could be stronger, suggesting that a clear professional identity for occupational therapists must be communicated through different academic and social platforms. Such advocacy promotes the profession and allows occupational therapy to remain prominent in today's health care marketplace (Howarth et al., 2018; Royeen, 2002; Walsh, 2018). Therefore, there is a critical need for public awareness campaigns in Saudi Arabia to create accurate and powerful images of the distinct value of occupational therapy.
This study had some limitations. The convenience sample included students from only one university. Not all students were available, and access to students was limited because of other curricular demands and university workloads. Further study with a larger sample that includes more universities and other medical and rehabilitation programs is recommended.
Although occupational therapists are perceived as playing an important role in the interdisciplinary rehabilitation team, this study found low overall awareness about occupational therapy, indicating a gap in the understanding of the profession and a need to include occupational therapy in the medical and health science curricula in Saudi Arabia. Outreach campaigns and educational programs to raise local awareness and enhance community perception and knowledge of the occupational therapy profession in Saudi Arabia should be considered.
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Sample of Survey Questions and Student Responses (N = 303)
|Have you heard of occupational therapy?|
| Yes||179 (59.1)|
| No||124 (40.9)|
|Do you think the role of occupational therapy in the interdisciplinary rehabilitation team is vital?|
| Yes||252 (83.2)|
| No||51 (16.8)|
|Where do you think an occupational therapist works?|
| General hospitals||88 (29.0)|
| Orthopedic and neurological clinics||58 (19.1)|
| Schools||46 (15.2)|
| Skilled nursing facilities||35 (11.6)|
| Home health care||26 (8.6)|
| Psychiatric hospitals||16 (5.3)|
| I am not sure||40 (13.2)|
|What type of conditions do occupational therapists work with?|
| Neurological conditions||36 (11.9)|
| Psychiatric conditions||25 (8.3)|
| Orthopedic conditions||24 (7.9)|
| Hand injuries||24 (7.9)|
| Pediatric conditions||19 (6.3)|
| Geriatric conditions||19 (6.3)|
| Palliative care conditions||11 (3.6)|
| Cardiopulmonary conditions||9 (3.0)|
| Rheumatology conditions||9 (3.0)|
| Burn conditions||8 (2.6)|
|Do you think that occupational therapy and physical therapy roles are similar?|
| Yes||113 (37.3)|
| No||70 (23.1)|
| I am not sure||119 (39.3)|
|Are you satisfied with your knowledge of occupational therapy?|
| Yes||99 (32.7)|
| No||204 (67.3)|
|Would you like to be educated about occupational therapy?|
| Yes||272 (89.8)|
| No||31 (10.2)|
Demographic Features (N = 303)
| Female||197 (65)|
| Male||106 (35)|
| Preparatory year||22 (7.3)|
| Medicine||58 (19.1)|
| Physical therapy||45 (14.9)|
| Dentistry||61 (20.1)|
| Health care administration||20 (6.6)|
| Radiology||14 (4.6)|
| Pharmacy||37 (12.2)|
| Nursing||21 (6.9)|
| Respiratory therapy||25 (8.3)|