Program Philosophies:Medical Model v. Community Based?

[Elana]

---

Members do not see this ad.

Hey everyone. I am currently visiting Colorado State and I learned that their program doesn't have an anatomy class (which was so surprising to me, I thought OT school is heavily anatomy based with a cadaver, etc.) It's not that I was looking forward to memorizing all the body parts and that stuff, but I was looking forward to becoming very knowledgable in how the body worked, in order that in my (future) practice, I would be able to identify or be informed about peoples movement patterns, issues, whatever, in a way that I cannot do now (As a layperson/ pre-OT student.)

They say that their program is "community based" , and the gist I got was that instead of trying to get a person in a wheelchair to walk again, they try to help that person find meaningful alternative activities and resources to feel good and productive. I know that's a gross oversimplification, but perhaps I'm getting the wrong idea? I thought OT was a little bit of both.

Apparently CSU is this way in part, because they are not affiliated with a large Hospital right here in Fort Collins, (I'm assuming, in contrast to Pitt- UPMC and NYU and the NYU Rusk Rehab hospital, and other schools like that.)

Will this type of program prepare me "less"? What do you all think about these differences? Or are they not really big deals once you're in the program?

 

[STCM]

This is a great question and it might be one you ask each program you apply to: how do you integrate both the medical model and community based approach?

I think part of this might come from so many OT's working with PT's and not wanting to tread on their toes, so to speak. I know that in SNF settings, billing can get tricky and overlap between the two causes problems when the company is trying to get paid by Medicare. A PT might focus on walking and an OT might focus on getting the patient to independently get to the bathroom and become proficient in using it and other basic self-care. Getting to the bathroom usually involves walking, so it would be important for the OT to know how to increase a patient's capability to do so. But when they take their notes, they have to be careful not to say that they worked on the patient's ability to walk or Medicare would see that as redundant treatment, since a PT is probably working on getting the patient walking. That is my understanding of this.

That said, I think you're totally right. As future OT's, we'll need to have a thorough understanding of body mechanics to really give our patients the best care. While we are trying to help people achieve optimal participation in meaningful activities, that will sometimes mean we'll be helping them improve their physical functions. Perhaps one thing you could ask yourself as you decide on the best program to fit your needs is what area of OT are you planning to work in? If you work in a hospital or rehab facility, you may need a stronger background in biomechanics. If you will be working in mental health, this might not be as important.

Otherwise, if you like everything else about the program, maybe you could take a few classes they don't offer to give yourself the background you desire. Kinesiology, a gross anatomy class and neuroanatomy are all good ones.

That's my two (more like ten) cents. I look forward to seeing what everyone else has to say one the subject.

 

[lizzo76]

This is a great question and it might be one you ask each program you apply to: how do you integrate both the medical model and community based approach?

I think part of this might come from so many OT's working with PT's and not wanting to tread on their toes, so to speak. I know that in SNF settings, billing can get tricky and overlap between the two causes problems when the company is trying to get paid by Medicare. A PT might focus on walking and an OT might focus on getting the patient to independently get to the bathroom and become proficient in using it and other basic self-care. Getting to the bathroom usually involves walking, so it would be important for the OT to know how to increase a patient's capability to do so. But when they take their notes, they have to be careful not to say that they worked on the patient's ability to walk or Medicare would see that as redundant treatment, since a PT is probably working on getting the patient walking. That is my understanding of this.

That said, I think you're totally right. As future OT's, we'll need to have a thorough understanding of body mechanics to really give our patients the best care. While we are trying to help people achieve optimal participation in meaningful activities, that will sometimes mean we'll be helping them improve their physical functions. Perhaps one thing you could ask yourself as you decide on the best program to fit your needs is what area of OT are you planning to work in? If you work in a hospital or rehab facility, you may need a stronger background in biomechanics. If you will be working in mental health, this might not be as important.

Otherwise, if you like everything else about the program, maybe you could take a few classes they don't offer to give yourself the background you desire. Kinesiology, a gross anatomy class and neuroanatomy are all good ones.

That's my two (more like ten) cents. I look forward to seeing what everyone else has to say one the subject.

Very interesting.... I've seen a lot of programs which don't require a cadaver lab or even neuroanatomy, although most require these (at least neuroanatomy) as a prereq, so you get it at some point. My initial reaction to the question posed by the OP was also that there is a division between PT and OT. I generally think of the PT as being the one who would help the patient to walk again, while the OT is involved in helping the patient to regain abilities in "activities of daily living," often through the use of assistive technology.

At least in my shadowing and reading, I'm seeing OTs being involved in true "rehab" more in the realm of cognitive deficits and fine motor skills, and less in the realm of large muscle groups.

I only applied to one program this year (no word yet) and it does not have anatomy either. It seems a good program otherwise, but is also the only one which is truly feasible for me to attend. But, it's a bit disappointing that it doesn't go so in-depth. The hard science stuff really interests me. I did take a number of neuroscience courses in undergrad and had a pretty good two semesters of anatomy and physiology at the Harvard Extension School, but if possible I might pick up a couple other classes to enhance my knowledge. (If I don't get in this year, then I will definitely do that just to keep sharp.)

I think there's also something to the issue of programs being affiliated with or not affiliated with a hospital. Some are more research-based than others.

 

[mco316]

I have also noticed this. When I first started applying, CSU was my only choice, so I had no idea other schools were embedded with medical schools. CU is our med school in Colo and they have no OT program. My life changed significantly last fall and was suddenly able to apply to schools outside of Colo and found out about the med programs.

When I interviewed USD (So Dakota) and was blown away by their program and how different it was from CSU's. I truly see pros and cons to both approaches. At USD, you are in the med school and take your first year of classes with med and PT students. Anatomy and neuroanatomy, and so forth. It sounded really grueling! Then in your second year you start to do field work and start learning the practical items about working with people. But then at CSU, you are in the field from your first semester, you spend an entire year studying adult/elder care and pediatrics (respectively) and also have a number of practical courses on decision making and evidence-based practice from the first year on. I see that as a more integrated approach, a long term world view of learning (or being able to absorb the OT world view over time) as opposed to taking the theory of OT in large chunks toward the end of the program. Does that make sense?

In the end my decision was financial (in state tuition) and emotional (home, family) and practical (where I intend to practice after school). CSU is highly regarded. I'm not worried about not being prepared. We will spend so much time in field work too, every semester we are in school we are in some level of fieldwork, so I think we'll graduate with a pretty good idea of what the "field" is like. KWIM?

Did you ask CSU about this specifically, being prepared? I know the alum that I shadowed with has very positive feelings about the school and the program.

I hope you are enjoying your visit. I really like Ft. Collins, it's a cool little town with surprisingly a lot to do despite its smaller size. And totally beautiful weather this weekend! My schedule won't allow me to make the drive this weekend/Monday but I wish you luck. Let us know what you decide. 🙂

 

[Elana]

Have you made a decision yet, mco?

It was quite an eye-opening time, and everyone was incredibly genuine and friendly.

 

[mco316]

Yes, Elana, I'm going to CSU. In the end moving 1.5 hours away from my life and roots was far more attractive than anything else. I'm also a resident so it is my least expensive option...

What about you? Did you like the town? You have a choice between a couple of places, right?

 

[Elana]

Hey, can we talk outside of this board? email me at [email protected]

 

[shammster]

I had a similar concern when I visited CSU this past weekend also. I spoke with one of the professors, and he says that a lot of the physiology and anatomy knowledge will be integrated into the courses. He mentioned that we also do get a lot of experience in our fieldwork, which is what truly prepares us for a job after graduation, so I don't think we would be considered any less prepared than any other OT student.

For those of you who are accepting the CSU admission offer, are you guys local or out-of-state? I tried to get a feel for the neighborhoods, but I really don't know what the best housing options are (on-campus or off-campus). I'm coming from California, and would appreciate any advice anyone has. Thanks!

 

[mco316]

Housing is one of my tasks today... I called CSU and was given this webaddress with property mgrs to look for off campus housing. I don't know what you are looking for specifically, but this should help:

http://www.ocssral.colostate.edu/property-management

 

[shammster]

Thanks for the info! I was thinking about one-bedroom places, but that may get very lonely, so possibly looking for a graduate student housemate to share a 2-3 bedroom place if that is less expensive.

 

[Elana]

I ended up speaking to a lot of the current students and it seems as though some people live in Old Town (north of campus) and also a fair amount just west and just east, but most people had a disdain about the south part of fort collins, as it's apparently being built up with cookie-cutter houses and malls...

If I go, I think I'll just use craigslist to try to find some like-minded young people to live with. Some OT students told me they arranged to live with other people in their cohort, but I feel like I'd rather have some space between home and school. Which professors did you meet, Shammster?