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LEE KUAN YEW SCHOLARSHIP
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The occupational therapy assistant program holds the belief that all people have the right to live life to its fullest, and to engage in all occupations that meet their wants and needs. Humans are active beings whose development over time is influenced by the use of meaningful and goal-directed activities. Through the use of meaningful and goal directed activities along with humans’ innate capacity for intrinsic motivation and ability to adapt, humans are able to influence their physical, mental, and spiritual health and well-being as well as their social and physical environments.
Just as occupations are influenced by temporal and cultural contexts, so too is the profession of occupational therapy. While the profession continues to uphold its central belief in the therapeutic value of everyday occupations, the profession also embraces the need to constantly develop new knowledge and approaches that support the use of occupation to elicit maximum functional independence. This evolution of ideas, knowledge, and approaches allows the profession to remain relevant, science-driven, evidence-based, and client-centered in the constantly changing landscape of today’s society. Therefore, occupational therapy educational activities and learning experiences must be purposeful and relevant for the student. They must involve active learning and critical inquiry in a collaborative environment that promotes teamwork and respect for the individual.
Students who have successfully completed the OTA Program at Arkansas State University will be able to:
- Demonstrate professional practice through the use of scientific and creative technologies that increase accessibility for clients.
- Articulate how occupational performance influences health, wellness and quality of life across the lifespan and describe the professional practices used to support these outcomes.
- Articulate and demonstrate the scope of the occupational therapy assistant’s professional practice in clinical and societal environments.
- Demonstrate professional practice through person-first language that communicates respect of person, ability level and environment.
- Demonstrate professional preparation through entry-level clinical competency for the use of scientific and creative technology throughout the therapeutic process to support client’s occupational performance.
- Demonstrate professional preparation through entry-level competency for the planning, implementation, documentation and advocacy of occupational therapy services across varied clinical and societal environments.
- Demonstrate core practice knowledge through the safe and effective use of scientific and creative technology.
- Use core practice knowledge and clinical reasoning to consider client factors, performance skills and performance patterns during the therapeutic process to support the participation and occupational performance of the individual.
- Demonstrate core knowledge about sociocultural contexts and how they influence the occupational therapy process.
- Utilize foundational knowledge and core practice knowledge through the use of scientific and creative technology to promote the health, wellness and the occupationalperformance of the client.
- Articulate how foundational knowledge supports the historical and theoretical development of occupational therapy services and the unique scope of the occupational therapy assistant.
Curriculum Design Overview
The Arkansas State (A-State) Occupational Therapy Associate (OTA) curriculum is organized by three domains and four threads with twelve educational goals that comprehensively measure students’ learning according to Bloom’s revised taxonomy (Anderson et al., 2001). The educational goals reflect the process of expansion of prerequisite foundational knowledge and skills to skilled knowledge that specifically supports the entry-level (core) occupational therapy assistant in professional practice. Graduates from the A-State OTA program are required to demonstrate, articulate and utilize core professional knowledge to develop, create and implement client-centered therapeutic activities that facilitate occupational performance. Students will demonstrate safe and effective use of scientific and creative technology across a variety of clinical and social contexts to support accessibility and participation throughout the human lifespan. Experiential learning is emphasized throughout coursework as students learn by doing, discussing, and through the dynamic process of clinical reasoning and constructive feedback (Dewey, 1916, 1938; Hutchings, Huber, and Ciccone, 2011; Mattingly and Fleming, 1994; Rabow and Hill, 1994; Schon, 1984). Through this process, the student is ultimately able to utilize metacognitive skills to identify their own strengths and weaknesses on their journey to becoming OT practitioners, and to develop skills for lifelong learning. This multi-faceted approach to learning is organized through three domains: Occupational Performance, Scientific and Creative Technology, and Practical Experience in Clinical and Societal Contexts (operationalized as follows); and four threads as follows: Foundational Knowledge and Skills, Core Practice Knowledge, Professional Preparation, and Professional Practice.
Three Curriculum Design Domains:
- Occupational Performance: Occupational performance (OP) is synonymous to the term function and operationalized as the point when the person, the environment, and the person's occupation intersect to support the tasks, activities, and roles that define that person as an individual (Baum & Law, 1997). OP is a unique outcome to OT and reflects the summation of the OT process.
- Scientific and Creative Technology: The use of low-tech and high-tech materials, media, and devices in order to acquire knowledge. For example, utilizing a periodical database to find research articles on a specific intervention technique (e.g., constraint-induced movement therapy). Scientific and creative technology is both a method of providing multisensory learning experiences as well as a key support for occupational therapist throughout the creation and implementation of evidenced-based practice in the ever-increasing technology driven society of the 21st century. For example, reviewing evidenced-based databases to identify evidenced information about biomedical strategies to teach individuals with multiple sclerosis an energy conservation intervention and including a Fitbit or other biomedical device to support the client in tracking her/his daily exertion, merges both scientific and creative technology to support individuals in their daily life.
- Practical Experience in Clinical and Societal Environments: The use of experiential learning opportunities within clinical and community settings that enhance classroom learning by providing a context for core practice knowledge and professional preparation to be applied. These experiential learning opportunities may provide insight on specific practice settings, the specific client factors of a group or population, or cultural or societal influences and issues specific to groups of people within our region. For example, based information collected by the Pew Research Center that references 2011 US Census Bureau data, 6% of the population residing in Arkansas is of Hispanic origin, with a median age of 23. Of those who are Hispanic, 38% live in poverty (http://www.pewhispanic.org/states/state/ar/). Students will have the opportunity to explore the effect personal contextual factors such as these have on occupational performance, health literacy, and access to services.
Four Curriculum Design Threads:
- Foundational Knowledge and Skills: Includes concepts, facts, principles, processes or procedures that provide a body of knowledge upon which to build professional and clinical skills. Foundational knowledge might be an understanding of human development or the symptoms associated with a particular condition. For example, in Human Anatomy and Physiology I (BIO 2203, 2201), students gain knowledge about body systems and structures that supports the ability to understand applied kinesiology concepts presented in Technology and Skills I (OTA 2033) related to manual muscle testing and range of motion exercises. Foundational skills include knowledge of how to perform a specific set of activities or behaviors. For example, proficiency with written communication skills attained in Composition I and II (ENG 1003, 1013) support learning effective and professional written documentation methods in Fundamentals of OT Practice (OTA 2013). Students will draw from their Foundational Knowledge and Skills as they develop understanding of concepts covered in Core Practice Knowledge.
- Core Practice Knowledge: Includes concepts, facts, principles, processes or procedures specific to the practice of occupational therapy that form the foundation of clinical skill development, and support the student’s development of clinical reasoning skills within the Occupational Therapy Practice Framework: Domain and Process, 3rd ed., ([Framework III], AOTA, 2014).
- Professional Preparation: Includes utilization and application of clinical and professional skill concepts, principles, processes or procedures in order to develop the student’s ability to interpret the meaning and relevance of practice knowledge. Learning experiences at this level incorporate simulated clinical environments and experiences within the context of a clinical or professional setting that facilitate the transition from learner to practitioner.
- Professional Practice: Professional practice further deepens the student’s understanding of the role and scope of the occupational therapy assistant and the field of occupational therapy at a metacognitive level, by increasing awareness of emerging areas of practice in occupational therapy, the need for client advocacy, as well as advocacy for the value of the discipline of occupational therapy in improving health and wellness for specific populations. Understanding occupational performance within the greater context of our sociocultural environment is a primary focus. Experiences in professional practice also facilitate the discovery of individual strengths, weaknesses, and aspects of professional identity formation as the student becomes an entry level clinician.
Domain 1: Scientific and Creative Technology. The first domain in the curriculum begins with students acquiring the necessary and foundational scientific and technological knowledge and skills needed for future practice-related courses. Prerequisite courses, such as Human Anatomy and Physiology I with Lab (BIO 2203, BIO 2201), Intro to Computer Sciences (CS 1013), and College Algebra (MATH 1023) support the development of technical assessment and intervention skills, such as applying range of motion techniques, interpreting data from an assessment, or documenting services using an electronic medical record system. This domain feeds through the introductory didactic and laboratory coursework in which occupational therapy theoretical and conceptual references are directly influential in the teaching of students. The methods of delivery for this domain of the program include a multitude of independent and group-based research projects, class discussions, guest lectures, fieldtrips, presentations, reflection logs, quizzes, games, and hands-on experiences, that employ multiple forms of technology and media and emphasize the versatility utilizing technological skills as well as creativity in environmental modifications, adaptation of activities, grading skill level through adaptation of the environment task, or occupation and how this enhances occupational performance. Students learn to utilize a variety of forms of scientific and creative technology to support the clinical use technology and skills in practical experiences to support clients in achieving optimal occupational performance. The OTA courses that address this theme are Fundamentals of Treatment (OTA 2103), Technology Skills Training (OTA 2033), and Technology Skills Training II (OTA 2093). Lab based clinical courses such as Technology Skills Training I (OTA 2033) and Technology Skills Training II (OTA 2093) emphasize the use of both low and high tech components to performing environmental modification, improving access to daily routines and activities, and creative ways to use technology in motivating and engaging the client, as well as more recent advances in technology aimed at improving client’s occupational performance skills and patterns. For example, in Technology Skills II (OTA 2093), students are introduced to a driving simulator to improve driving skills for clients with a variety of client factors.
Fieldwork Level IA (OTA 2071) and Fieldwork Level IB (OTA 2081) also incorporate technological skills by requiring the student to apply and utilize their understanding of scientific technology to become efficient and accurate in the clinical setting, such as completing effective chart reviews and various types of goal writing and documentation strategies utilizing digital documentation systems. Level II Fieldwork Experiences (OTA 2115 and 2125) carry skills-based instruction into the clinical setting, as students work to gain specific skills based knowledge in each of their assigned clinical sites.
Domain 2: Occupational Performance. This second curricular domain creates a foundation for understanding the role that occupation plays in the health and well-being of every individual. The course Emergence of OT Science (OTA 2023) lays the foundation for the concepts that occupational performance is built upon. Concurrently, students have the opportunity to apply theoretical knowledge from the history, theory, and frames of reference they have discussed in Emergence of OT Science (OTA 2023) to studying and implementing the Framework III (AOTA, 2014), and analyzing occupational performance through activity analysis, adaptation, and environmental modification in the Fundamentals of OT Practice course (OTA 2013). Additionally, students develop an understanding of a variety of conditions that can result in disability and limitations in occupational performance in the course Disease to Practice (OTA 2043), which provides foundational knowledge that later supports core practice. In OTA in Behavioral Health (OTA 2103), Adult Practice for the OTA (OTA 2053), and Pediatrics for the OTA (OTA 2063), students are able to apply concepts of occupational performance to a variety of client populations. The methods of delivery for this curricular domain are similar to that of the first curricular domain and are addressed through independent and group-based research projects, fieldtrips and laboratory experiences; in research papers, class discussions, and guest lectures; and learning by clinical reasoning and feedback through presentations, reflection logs, quizzes, games, and lab practical experiences.
This domain begins to overlap the third domain Practical experiences in Clinical and Societal Contexts through the fall and spring semesters in order to provide essential experiences that further solidify concepts around occupational performance. For example, in Behavioral Health for the OTA (OTA 2103), students are assigned to ride public transportation and go through the application process to obtain food stamps, in order to gain an understanding of elements such as stigma, literacy, environmental barriers, and their impact on occupational performance. Students receive exposure to the practice of addressing occupational performance during Level IA and Level IB Fieldwork courses (OTA 2071 and 2081) with specific emphasis in Level IB Fieldwork on applying ethical principles to concepts of occupational performance. A variety of delivery methods will be used to give students these essential experiences, such as practice of these skills in simulated laboratory environment, expert clinician-led training and practical experience in an actual clinical environment, and mentoring of students by faculty and clinicians in their area of expertise.
As students progress through the spring semester, the delivery of content increasingly focuses on case-based application of occupational performance concepts, applying information regarding the influence of client factors and context, and the ability to clearly affect occupational performance outcomes through various treatment approaches. In the application phase, students practice obtaining an occupational profile, administering commonly used formal and informal assessments, implementing commonly used therapeutic intervention techniques, and documenting the therapeutic process for various client populations. By the end of the spring semester coursework, students have received multiple group and individual experiences and are ready to receive professional feedback about their clinical reasoning skills in the Level IIA and Level IIB fieldwork courses (OTA 2115 and 2125).
Domain 3: Practical Experience in Clinical and Societal Settings. The third and last curricular domain is the culmination of coursework in occupational performance and scientific and creative technology, in which the dimension of knowledge deepens, with the ability to apply core practice and foundational knowledge in a meaningful and relevant context. This domain involves a mixture of clinical fieldwork level I and II experiences. These fieldwork experiences are assigned to meet the current and emerging community needs, as well as classroom-based instruction for further development. Level I fieldwork experiences are integrated into the curriculum and occur simultaneously with the population being addressed. In the first semester, for instance, students take OTA in Behavioral Health (OTA 2103), which is a combined lecture and lab course that utilizes discussion, practical group therapy exercises and activities, and presentations, to prepare students for clinical practice in psychosocial settings. At the same time students have their Level IA fieldwork experience where they are able observe clients who are experiencing mental health challenges within the context of a mental health practice setting. This dovetailed approach provides experiential learning to the Behavioral Health coursework. Likewise, in the second semester students take Adult Practice for the OTA (OTA 2053) and Pediatrics for the OTA (OTA 2063) courses which prepare them for clinical practice in the adult physical disability and pediatric practice settings. Concurrently students have their Level IB fieldwork experience (OTA 2081) which consists of students going to either a pediatric or adult setting for one week. During each level I fieldwork experience students will have the opportunity to practice inter-professional communication skills, apply ethical principles to real therapeutic situations, and observe the patient-practitioner interaction. Upon returning from the Level I fieldwork experiences, students will be engaged in activities that lend to processing the events of the week and relating them to concepts such as improving the occupational performance of the clients they observed, examining the therapeutic relationship between provider and client, and receiving feedback on clinical documentation, as well as professional behaviors.
Both level II fieldwork experiences are placed at the end of the curriculum as an experiential culmination to the prior knowledge, technological skills and practice skills students gained from prior courses. These experiences consist of more hands-on, competency-based learning experiences. Students grow in both their mastery of knowledge and skills they will use in practice as entry-level clinicians, and in professional behaviors that are required to be effective in the entry level clinician role. In addition to working with and getting feedback from other occupational therapy practitioners, students will also have an opportunity to process experiences they have during fieldwork with peers and program faculty via the online Blackboard discussion portion of the course. This expands on the student’s ability to utilize technology to express clinical reasoning in a written format, explore application of OT process to specific groups or populations, receive peer feedback on therapeutic skills and behaviors, and engage in relevant discussions as they prepare to take the certification exam.
The occupational therapy assistant program has organized its curriculum around four threads which run throughout the curriculum and utilize the concepts from Bloom’s revised taxonomy (Anderson et al., 2001) to gradually increase in depth and complexity of skill, as well as level of application in clinical settings. These threads are: Foundational Knowledge and Skills, Core Practice Knowledge, Professional Preparation, and Professional Practice. Students progress from obtaining knowledge about the body and mind, human pathology, occupational therapy history, theory, and OT domain and process, to effectively utilizing this knowledge in lab based and clinical settings, and finally, to being able to incorporate understanding of professional and clinical skills into a real clinic setting.
Thread 1: Foundational Knowledge and Skills: Students will cover concepts related to understanding the human being, both in terms of body systems, structures and functions, but also in terms of pathology, social and cognitive factors, and performance of occupations, through the prerequisite biology and psychology coursework (see table below). Foundational Knowledge and Skills continue to be taught through Disease to Practice (OTA 2023), in which students apply their understanding of body function and structure to identifying the impact of pathology on the human body and mind. This provides a firm knowledge base for understanding the Framework III (AOTA, 2014) in terms of processes and procedures for considering client factors, which are introduced through Emergence of OT Science (OTA 2043) and Fundamentals of OT Practice (OTA 2013). As core practice knowledge is introduced in Emergence of OT Science with guiding principles of occupational therapy practice and frames of reference, discussion of the process and application of frames to client cases will be introduced in Fundamentals for OT Practice, progressing through activity analysis to understanding environmental and contextual impact on occupational performance. Students will rely on their foundational knowledge of the human body and mind, as well as skills associated with abstract thinking and written communication, in order to successfully move from identification, to understanding, and then to application and utilization of the process and concepts in the Framework III (AOTA, 2014). A similar process occurs in Technology Skills I (OTA 2033), in which students utilize their understanding of human body structure and function, abstract thinking, math calculation skills, written communication skills, and problem solving skills to master specific clinical skills and techniques related to assessment and intervention in physical dysfunction, such as manual muscle testing, range of motion, and transfers. The courses have been designed to take advantage of instructional methods that promote multisensory interaction with and learning of course content through modeling, case based analysis, laboratory experiences, and role playing and simulation.
Thread 2: Core Practice Knowledge emerges in the curriculum with understanding of occupational therapy theory, history and process and how it informs the intervention process in Emergence of OT Science (OTA 2023) and is carried throughout the first semester curriculum, both in terms of conceptual knowledge and skills-based procedures and processes. Occupation becomes a cornerstone of understanding the human spirit, as students are exposed to a multitude of case-based, observation based, and informative guest lectures from those who have experienced the benefits of occupational therapy. In the first semester, Disease to Practice (OTA 2043) builds on Foundational Knowledge of the human body and by developing an understanding of the effects of pathology on the body and mind in terms of occupational performance. This knowledge continues to deepen in complexity as technology skills based courses introduce the basic principles of adaptation, modification and mobility in an applied, practical format. Core Practice skills continue to develop through population and lifespan focused coursework that further develop understanding of the basic principles and processes related to practice as they pertain to population specific health issues, practice settings, and reimbursement models. Students learn through Behavioral Health for the OTA, Pediatrics for the OTA, and Adult Practice for the OTA, the impact of development, of sociocultural factors, and psychosocial factors on occupational performance, as well as associated assessments and interventions. Learning through practical experiences is a key component for nearly all of the courses in the curriculum, however, towards the end of the fall semester and into the spring semester, assessment becomes more focused on the student’s ability to apply and utilize the knowledge they have in new, creative or complex ways. In the spring semester, culminating projects that require application of knowledge from the beginning of the curriculum become more frequent. Additionally, lab based courses during the spring semester, such as Pediatrics for the OTA (OTA 2063) and Tech Skills Training II (OTA 2093) regularly incorporate real clients into the classroom and lab practical experience, in order to enhance the meaning and relevance of didactic curriculum, which further embeds the third and fourth curricular threads into the learning process.
Thread 3: Professional Preparation: This thread is evident in the beginning of fall semester related specifically to developing professional behaviors. Fieldwork Level IA (OTA 2071), which is focused on developing a professional identity by becoming more self-aware. A concerted effort is made to engage the student in a process of self-discovery that brings them from more concrete knowledge of behavior to a metacognitive stage in which they begin to actively self-monitor their own professional behavior. The concepts of therapeutic use of self are subsequently introduced, with delivery of instruction centered on activities designed to create a sense of self awareness in the therapeutic environment that builds into mindful empathy, and important skill in interpersonal reasoning (Taylor, 2008), along with opportunities to reflect, discuss, and build personal goals around performance. As the Level IA Fieldwork experience is focused on psychosocial settings, the emphasis on self-discovery and reflection propels the student into a deeper understanding of the power of the therapeutic relationship in terms of occupational performance.
Clinical skill development moves into professional preparation during the late fall and early spring semesters with increased focus on identifying gaps in knowledge, utilizing research to guide clinical practice, and developing improved ability to give and receive feedback with peers. Several assignments during the spring Pediatrics for the OTA (OTA 2063), course focus on developing dependability, teamwork and cooperation skills through group assignments in which the peers provide rating information on their team members’ performance that becomes included in their overall assignment grade. Lab based practical experiences are also an important part of professional preparation. This process begins with guided case-based learning through whole class instruction, to incorporating case-based, problem based learning assignments completed in a group setting during the beginning of the fall semester, then progressing to individual case-based presentations on intervention in Fundamentals for the OTA (OTA 2013) and Behavioral Health (OTA 2103) at the end of the fall semester. The practical experience curriculum culminates into a full thirty minute individual practical treatment session at the end of the Adult Practice for the OTA course (OTA 2053), just prior to their first Level II Fieldwork experience.
Thread 4:Professional Practice: Opportunities to observe professional practice are initiated in the fall semester with lab based experiences, observations and Level I fieldwork in the psychosocial setting. Each level I Fieldwork experience was integrated with its corresponding didactic course in order to allow students the opportunity to observe how the courses’ content can be applied to clinical practice settings, to provide a contextual framework for the skills and processes they learn. The placement of Level I fieldwork experiences also serves to provide students with real examples to reinforce their learning of course content. During the fall semester, the psychosocial Level I fieldwork experience (OTA 2071) occurs in the same semester with Behavioral Health for the OTA (OTA 2103). Experiences from fieldwork allow for rich dialogue and processing of therapeutic techniques applied in mental health populations during class time. Similarly, the Level I fieldwork experience in spring semester (OTA 2081) can either be with an adult or pediatric placement, allowing for students to share experiences relevant to their coursework and apply knowledge from their lab based courses, Pediatrics for the OTA (OTA 2063), Adult Practice for the OTA (OTA 2053), and Technology Skills Training II (OTA 2093) in a real clinic setting. Both level II fieldwork experiences (OTA 2115 and 2125) have been placed at the end of the curriculum to give students “hands-on” learning experience in a real clinical environment once they have mastered the content of core knowledge and are ready to apply their experiences within a clinical or societal context, with the goal of demonstrating entry level competency in lab based experiences prior to embarking on Level II Fieldwork.
As students move into the beginning of the spring semester, they begin to receive more assessment and feedback pertaining to demonstration of clinical reasoning that promotes occupational performance for the client within a context, with feedback focused on the student’s ability to integrate information and apply elements of a wide variety of knowledge and use of technology into the treatment setting to promote the client’s occupational performance. Fieldwork IB (OTA 2081) coursework continues to develop the student’s professional behaviors, with a focus on delivering feedback on the student’s ability to apply ethical principles to the clinical reasoning and decision making process, incorporating focused self-reflection and self-evaluation, feedback from the instructor, and from the fieldwork educator during clinical experiences. The end of the Level IB course culminates in a self-assessment with a professional development plan and a mock job interview in which students will receive professional feedback from an HR representative as well as feedback from their instructor in order to enhance the self-reflection experience and promote metacognitive learning surrounding both clinical and professional skills. Finally, during Level IIA and IIB Fieldwork experiences (OTA 2115 and 2125), students begin to receive intense and regular feedback from their fieldwork educator, as well as feedback from their instructor and soon to be colleagues in terms of application of concepts to real treatment sessions, self-reflection, and communication skills in a written format using technology.