Steering forces in learning and role-play: The case of occupational therapy education

In this study, we adopt an ecological perspective (Nardi and O’Day, 1999) supported by language games theory (Wittgenstein, 1958) to explore how digital simulation-games could enrich existing forms of non-digital role-play in the Occupational Therapy education. Our goal is to understand: 1) How non-digital role-play is experienced by students and teachers, 2) Which intended learning is attributed to non-digital role-play, and lastly 3) How could digital simulations contribute to bridge theory and practice in educating healthcare professionals. Therefore, we have engaged in a participatory design process (Ehn, 1988) with Occupational Therapy educations and other partners from the relevant eco-system in Copenhagen and Odense, Denmark. According to our data, non-digital role-play is an established practice within the education, however, teachers and students do not seem to agree on its learning value. This disagreement seems generated by a mismatch in the steering forces leading teachers’ and students’ perspectives on existing role-play practice and the students’ learning hereof. In the teachers’ view, academic knowledge and exams requirements are the primary steering forces of the students’ learning outcome. Interpersonal and professional skills appear instead as steering forces for the students, affecting how they relate to academic knowledge and exams requirements. In this respect, we find that existing role-play practices, which are used to train students to assess a patient’s condition through clinical writing and reflection-in-action, exemplify the dilemma of balancing theory, practice, and relational skills in teaching and learning a profession (Schön, 1987). By clinical writing we mean a skilled note-taking practice (Bowman et al, 2015), resembling ethnography and used by occupational therapists to draft a profile of a patient to be shared with doctors and physiotherapists. In conclusion, we present new insights on the challenges of bridging theory and practice in profession studies, concluding with requirements and reflections on the design of a digital simulation.