The source of professional confidence in occupational therapy students

Introduction: While undergraduate training in South Africa places an emphasis on ensuring the competence of occupational therapy graduates, very little attention has been paid to exploring their professional confidence, despite the fact that this has been highlighted as an issue for students. The foundation for professional confidence is laid during student years, and is influenced by a number of determinants, which this study aimed to identify. Methods and material: Qualitative methodology was used with a purposive sample of nineteen final year occupational therapy students. Students were invited to participate voluntarily in focus group interviews and/or submit their reflective journal. Five lecturers and six clinical supervisors at the University concerned also participated in focus group interviews. Deductive thematic analysis of the data was undertaken. Results: Two broad themes emerged. The first theme, external determinants, included clinical experience, relationships with peers, staff and patients, and the changing environment in which they worked. The second theme, internal determinants, included certain identified personal characteristics and influencers. The external and internal sources of professional confidence beliefs were either within the control of the student, or the lecturer/clinical supervisor or the profession. Discussion: A number of recommendations ranging from re-thinking clinical practical and supervision are made. These findings have implications for student selection, teaching methodology and experiences, and the professional identity of the profession. Greater formal emphasis needs to be placed on confidence building during the undergraduate experience. KEY WORDS: Professional confidence. Occupational therapy students. Occupational therapy education. Clinical practical. Reflective journaling. Supervision.