Canadian Journal of Occupational Therapy: A Reflection of Professional Growth

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1 Canadian Journal of Occupational Therapy: A Reflection of Professional Growth Marilyn Ernest Abstract The Canadian Journal of Occupational therapy (CJOT) is the only Canadian refereed professional publication reflecting the views and professional development of occupational therapists in Canada. A study of all issues of CJOT published during three five-year periods was carried out to see if CJOT could be said to be improving in terms of reflecting professional trends. Some areas eamined were quantity of articles, type of articles, references, authors and citations. It was found that although CJOT did reflect professional growth in many areas, there were a number of areas needing improvement before CJOT could be considered to be the primary professional publication for occupational therapists in Canada. Since 1933 the Canadian Jou rnal of Occupational Therapy (CJOT) has been publishing not only the policies of the Canadian Association of Occupational Therapists but also information of interest and value for the development of the profession. In this author's opinion, interest and value have a direct relationship to content quality. Thus, this study was carried out to see if, over the years, content quality has improved and to see if some areas of the professional literature strengths and weaknesses, as reflected in CJOT publications, could be identified. Review of the Literature A study evaluating content quality was carried out by Ottenbacher and Short (1982) in which they categorized articles appearing in the American Journal of Occupational therapy over a ten year They emphasized their finding that the number of desc riptive articles had decreased while quasi-eperimental articles had increased in number over the years. According to these authors, the profession can only benefit from the increase in quality research being carried out by occupational therapists and the results published in a professional journal. Further emphasis on the importance of and need for research was made by Hathaway (1974), O'Shea (1974), and Hunter (1976). An increase in the number of research articles was thus accepted as one indicator of improved quality of content in CJOT. According to Ottenbacher et al (1982:81), "although it is sometimes advantageous for fields to use the research data and procedures from related disciples, it is also necessary for individual fields to develop their own data basis". Therefore, if improvement in content quality in CJOT has taken place, one would epect to find that CJOT authors are increasingly referring to occupational therapy references rather than nonoccupational therapy references. Marilyn Ernest, M.A., O.T.(C), Associate Professor, Program in Occupational Therapy, The University of Weste rn Ontario, London, Ontario N6A 5C1. DECEMBER/DECEMBRE 1983 The importance of the eistence of references in an article cannot be underestimated. The use of a review of the literature early in a study was strongly emphasized by Ernest, Burton and Keenleyside (1978). An author listing references has looked beyond his/her own knowledge base in order to synthesize information and report new knowledge. Articles without references could indicate either that the author has produced an entirely unique idea or that the author has risked missing previous knowledge which could have been of value. An eamination of CJOT articles showing a decrease in the number of articles without references would then indicate an improvement in the value and quality of CJOT articles. According to Boshier and Pickard (1979:35), "... research should become more structured on prior knowledge... (and) as the discipline emerges, researchers will place increasing reliance on concepts and processes developed by other scholars in the discipline". An improvement in CJOT content quality would thus be evident if it was found that authors built on their own knowledge (i.e. had multiple publications) or if authors built on or cited work carried out by other occupational According to Boshier et al (1979) and Broad and Wade (1983), citation counts by others (not self-citations) are used in education, psychology, and medicine to measure the impact of individual author-researchers within a profession. An eamination of citation counts could thus be used to see if CJOT publications have improved in terms of identifying an increasing number of occupational therapists who are having an impact on the profession. Method It was felt that if improvement in content quality of CJOT eisted, it would be found by comparing the content of all issues published in three five-year periods: ; ; and CJOT content such as the Idea Echange, advertisements and professional reports can be considered to be of value to readers. However, the principle articles 165

2 are the primary means of spreading new findings and professional knowledge. Therefore, for each five-year period, principle articles only were eamined in terms of quantity of articles, types of articles, and references. Principle article authorships were eamined to see who was publishing, what they were publishing, multiple publications, self-citations, and other citations. Results and Discussion 1. According to Table 1, the number of articles published in the period increased by an average of one article per issue over the Table 1 Number and type of CJOT articles Articles* No. with 22(39) 57(75) 76(88) No. without 34(61) 19(25) 1(12) No. research Articles 5(8.9) 14(18.4) 21(24.4) * issues/year; issues/year. Although it appears that even more articles per issue were published in the period, it must not be considered an indicator of improvement as this period concided with the introduction of five issues per year instead of four. Therefore, the average number of articles per issue actually decreased compared to the This observation might be accounted for by a new editorial philosophy introduced in the period as described by Rudy (1982): The other trend that has taken place is that in trying to make our journal more professional and scientific, the review board has increased its standards. Thus authors are receiving the results of their publications with some dismay. Instead of being lauded for their effort, they are receiving criticisms... It would appear that the editorial board's efforts to improve the standards of CJOT has temporarily, decreased the number of articles accepted for publications. A second observation in Table 1 relates to the number of articles that contained, or did not contain, references. The number of articles without references decreased markedly over the three time periods from 34 (61%) in the period to 1 (12%) in the The journal thus reflects a significant improvement in the trend for authors to reach beyond themselves for knowledge. It can also be noted from Table 1 that the percentage of research-orientated articles increased. All principle articles were evaluated in terms of whether or not they were "research-oriented" in the field of occupational therapy. The articles were categorized using a modified format adapted from Ottenbacher et al (1982). All articles that could fit their categories of correlational, quasi-eperimental, or true eperimental were classified here as "research" articles. Almost all research articles were correlational and there were no true eperimental articles by occupational therapist. The results show a marked improvement in the number of research articles published in CJOT, ranging from 5 (8.9%) of all articles published in the period to 21 (24.4%) in the Although there is obviously room for improvement here, the data would appear to reflect a trend that more research is being carried out and published in CJOT. No judgements were made as to the quality of the published research. 2. CJOT An assessment of all CJOT article references was made to see where authors looked to for information used as the basis of their articles. Occupational therapy references were defined as all occupational therapy journals and all publications written by or for occupational therapists, including government and professional documents considered to be generally available to Non-occupational therapy references were considered to be all other articles, tets or journals published primarily for or by another profession. Table 2 in CJOT No. non O.T. 129(84.3) 476(77.) 612(7.7) No. O.T. 21(13.7) 118(19.1) 214(24.7) No. to CJOT 3(2) 24(3.9) 4(4.6) As shown in Table 2, the total number of references used by CJOT authors increased significantly from 153 in the period to 866 in the Also noted is that the use of occupational therapy references increased from 13.7% of all references to 166 CJOT VOL. 5 NO. 5

3 24.7% of all references. The journal reflects that although CJOT authors are increasingly reaching out for knowledge, over 75% of all references are still to publications in related disciplines. A further eamination was made as to the etent CJOT publications contributed to the knowledge of CJOT authors. It can be seen that, although there was an improvement in the number of CJOT references used over the five-year periods (3 in the period to 4 in the period), CJOT articles have been used minimally as reference material. One could speculate as to whether this is due to either the small number of articles published covering many areas of interest, the quality of the articles published, the inability of readers to retrieve CJOT articles from computer bases, or a general reluctance of therapists to read CJOT which has been perceived (by reference counts) to be almost irrelevant to them as professionals. In any case, one can question whether or not CJOT and its authors reflect adequately the state of the art of occupational therapy in Canada. 3. Number, Nationality and Affiliation of CJOT Authors An eamination of who has been writing for CJOT over the years produced some interesting observations. Table 3 Number, Nationality and Affiliation of CJOT Authors Authors No. Canadian O.T. Clinician 49(74.2) 83(7.9) 92(66.2) No. Canadian O.T. Faculty 3(4.5) 23(19.7) 37(26.6) No. O.T. Student 1(1.5) 1(.9) 5(3.6) No. American O.T. Authors (%) 1(1.5) 2(1.7) 2(1.4) No. Non O.T. 12(18.2) 8(6.8) 3(2.2) Table 3, indicates that the percentage of Canadian occupational therapy clinician authors has decreased only slightly over the years while there has been a striking increase in the number of occupational therapy faculty authorships. Much of this increase appears to come at the epense of a decrease in the percentage of non-occupational therapy authors from 18.2% in the period to 2.2% in the Considering that occupational therapists are being en- DECEMBER/DÉCEMBRE 1983 couraged to develop their own data bases, this change can only reflect a positive trend for the profession. If we are to develop our own knowledge bases, it will be done by adding new knowledge to previous knowledge. Thus authors who write only one article are not as likely to add to new knowledge as will those who continue questioning, observing, writing, and sharing. This author noted a small but significant increase in the number of authors who have published two or more articles in CJOT over the years. Another encouraging reflection of change is the increase in the number of occupational therapy student authors. This increase may well result in future clinicians being encouraged to produce publishable material. An eamination of the research articles was made to see who was producing the research published in CJOT. One would hope that, for the benefit of the profession, relevant research is being produced by occupational therapists as opposed to non-occupational On the other hand, since many occupational therapists have relatively few skills in statistics and research methodology compared to professionals with graduate education, one would epect therapists to collaborate with these more knowledgeable individuals. Research Art. No. O.T. only Table 4 Research No. Interdisciplinary 1 3 No. non-ot As seen in Table 4, CJOT articles have reflected both a trend for an increase in occupational therapy only authorships and an increase in the number of therapists collaborating with others in interdisciplinary research. Also noted is that very few non-occupational therapy research papers have been accepted for publication in CJOT. Table 5 has reflected a breakdown of the data concerning all research articles published by occupational From , clinicians produced all four research articles. Of the twenty occupational therapy produced research articles in the period, less than half were produced by occupational therapy clinicians alone. The remainder were produced by occupational therapy faculty (5), occupational therapy faculty-clinician collaboration (3), and occupational therapy faculty-non-oc- 167

4 Table 5 O.T Research Articles No. research Articles by 4 11 OT's No. by Clinical OT's No. by OT Faculty No. by Faculty Clinician Collaboration 1 3 No. by OT Faculty and 3 Non OT Collaboration cupational therapy collaboration (3). This would indicate a noticeable trend for occupational therapy faculty to produce research either alone or in collaboration with clinicians and others. This trend could be predicted considering the increasing pressure put on occupational therapy faculty to upgrade their qualifications and "publish or perish". However, the increase in occupational therapy faculty-clinician collaborative research can only be seen as a positive trend for the profession reflected in CJOT. 4. CJOT Citations Author citations are often used as indicators of both growth of knowledge and impact of that knowledge on a profession. One can say then that self-citations indicate that an author is building knowledge based on prior knowledge. CJOT self-citation counts over the fifteenyear period studied indicate a very small but growing number of occupational therapy authors citing their own previous works. In the period, there were two self-citations, in the period three self-citations, and in the period there were fourteen self-citations. CJOT thus reflects a growing tendency for the growth of knowledge based on previous knowledge with the profession. A final area of study involved two questions. First, do CJOT publications reflect that its authors are having an impact on the profession and, secondly, can that impact be credited to CJOT articles? To answer the first question, the thirteen most "prolific" authors in CJOT during the past fifteen years were selected based on the assumption that their multiple publications (3 or more) might well have the greatest impact on the profession. Of the thirteen authors, eleven published primarily in the period and two published primarily in the As well, twelve of the thirteen are, or were, full-time university faculty members, one is manager of a University Hospi- 168 tal occupational therapy department; all thirteen are occupational to these thirteen authors were tabulated to see: (a) if they cross-referenced (had an impact on) each other; (b) if any other CJOT authors referred to (were impacted by) these thirteen authors; (c) if references to these thirteen authors had been taken from CJOT or other publications. REFERRED BY Table 6 Author Citations REFERRED TO AUTHORS BELL BRIDLE 2 BRINTNELL 3 J. BURTON 4 ERNEST 5 FERLAND 6 GILL 7 HACHEY 8 JOBIN 9 O'SHEA io POSTHUMA u SHIMELD 12 WOODSIDE 13 ALL OTHER AUTHORS O XX TOTAL X = CJOT REFERENCES - = OTHER REFERENCES An understanding of the data in Table 6 can be arrived at by using O'Shea as an eample. Bell referred to O'Shea four times and two of these publications were in CJOT. Bridle referred to O'Shea twice, and one of the two references was from CJOT. O'Shea cited herself twice and both publications referred to were in other than CJOT. A variety of "others" cited O'Shea five times with two of the five citations coming from CJOT. By subtracting O'Shea self-citations, O'Shea would then be credited with an impact count of eleven citations. Looking at all thirteen authors this way, it can be seen that they referred to (were impacted by) only si authors within the group of thirteen. As well, only eight of the thirteen were referred to by all other CJOT authors. Therefore, in answer to the first question, CJOT does reflect that, through CJOT publications, at least 8 authors are having an impact on the profession. Considering that there were a total of 322 authors, eight impacting authors are a very few who are using CJOT to reach and influence their colleagues. The 8 authors accounted for 32 of the 44 total citations in Table 6 (not counting self-citations). Of these 32 citations, 16 were from articles published in CJOT while 16 were to other publications. In brief, these 16 citations O XX CJOT VOL. 5 NO. 5 X X

5 published in CJOT constitute less than 1% of all references used by CJOT authors. Conclusions and Suggestions This study of CJOT publications has suggested both positive and negative professional trends. Positive trends It is apparent that, over the years, therapists are reading more, synthesizing material and applying it to their own knowledge bases. This is reflected in the vast increase in the number of references being used despite a small decrease in the number of articles published. As well, an increasing number of Canadian occupational therapists are gradually building a body of knowledge and creating an impact on the profession generally while non-occupational therapy authorships have declined significantly over the years. As well, all authors found to have an impact on the profession are occupational More research in occupational therapy is being carried out, particularly during the past five years. It is encouraging to note the positive increase in collaborative research between occupational therapy faculty and occupational therapy clinicians. Occupational therapy faculty are finally fulfilling the epectation that they lead the way in creating an impact on the profession. Negative trends It is noted that very few articles per issue are being published, and in relation to the total number of authors, very few authors have written more than one article which could contribute in a cumulative way to increasing professional knowledge. Although authors are citing more, relatively few are influenced by occupational therapy literature and very few are influenced by CJOT. Although the low number of cited authors might initially be felt to reflect negatively on the non-cited authors, it must be emphasized that these are logical rather than discouraging findings. Over the years the relatively few principle articles cover a very wide range of subjects. Thus it might be considered an eception, rather than the epected, when an article lends itself to be referred to by another author. Also, it must be noted that three of the 13 most prolific authors published primarily in French, and this undoubtedly had an impact on the fact that they have rarely, to date, been used as references by other authors. Suggestions Canadian occupational therapists carrying out research supported by Canadian funds, (i.e. financial grants, administrative time, and personnel collaboration) might well consider the possible ethical responsibility of publishing such research findings in CJOT for the benefit of Canadian At the same time the CJOT editorial board should continue to emphasize quality but be innovative in finding ways to encourage both new authors and authors who should be invited to submit additional material to CJOT while non-occupational therapy authorships should be closely scrutinized for content that is considered to be both relevant and not available elsewhere. Once a greater number of quality submissions have been solicited by the editorial board, the board might wish to consider putting three of four principal articles in each issue or, eventually, increasing the number of issues per year. Finally, of interest would be a further study eamining the impact of both CJOT articles and Canadian authors on occupational therapy literature of other countries. This study has shown that CJOT has indicated positive growth trends in the profession. It has also pointed out a number of weaknesses that can, and will, be strengthened with the cooperation and interest of occupational therapists in Canada. REFERENCES Boshier, R. and Pickard, L. Citation patterns of articles published in Adult Education Adult Education, 1979, 3, 35. Broad, W. and Wade, N. "Betrayers of the truth". Equino, May-June, 1983, Ernest, M., Burton, H., and Keenleyside, J. The literature review: an integral part of the research process. Canadian Journal of Occupational Therapy, 1978, 45, Hathaway, E. Research in occupational therapy. Canadian Journal of Occupational Therapy, 1974, 41, Hunter, J. Research and occupational therapy. Canadian Journal of Occupational Therapy, 1976, 43, O'Shea, B. Why research? Canadian Journal of Occupational Therapy, 1974, 41, Ottenbacher, K. and Short, M.A. Publication trends in occupational therapy, The Occupational Therapy Journal of Research, 1982, 2, Rudy, A. Editorial. Canadian Journal of Occupational Therapy, 1982, 49, 115. Résumé La Revue canadienne d'ergothérapie est la seule publication professionnelle qui reflète le développement des ergothérapeutes au Canada. Une étude de tous les numéros parus pendant trois périodes de cinq ans, avait pour but d'établir si la Revue canadienne d'ergothérapie était un indicateur du développement de la profession. Parmi les critères eaminés, se trouvaient la quantité d'articles publiés, le type d'articles, les références, les auteurs, et les citations. On a pu établir que la Revue canadienne d'ergothérapie a bien reflété les progrès professionnels dans plusieurs domaines mais il eiste encore des secteurs qui nécessitent une amélioration avant qu'il soit possible de considérer cette revue comme étant la plus marquante des publications professionnelles pour les ergothérapeutes au Canada. DECEMBER/DÉCEMBRE

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