Occupational Therapy In Health Care, 25(1):3–6, 2011C© 2011 by Informa Healthcare USA, Inc.Available online at http://informahealthcare.com/othcDOI: 10.3109/07380577.2010.539487

Scholarship of Practice: Reflections on GaryKielhofner’s Legendary Vision for Occupational

Therapy

Renee R. Taylor, PhD

Department of Occupational Therapy, University of Illinois at Chicago, Chicago, Illinois

Professor Gary Kielhofner, laid to rest on September 2, 2010, was a world-renowned educator, researcher, and scholar ardently dedicated to the practiceof occupational therapy and, most importantly, its practitioners. He spent over30 years of his career advancing the field in ways that were fearless, unprecedented,and widely adopted (e.g., Kielhofner, 2002, 2005a). Retrospectively, Kielhofner’scontributions are perhaps best known for being evidence-based and for their directrelevance to assessment and practice outcomes (Kielhofner, Braveman, Levin, &Fogg, 2008; Kielhofner et al., 2004). Over the last decade, Kielhofner has arguedthat the means to achieve evidence to support occupational therapy practice arethrough the application of a set of concepts and methods first coined in 2001 as theScholarship of Practice (Kielhofner, 2001).

The Scholarship of Practice was defined as dialectic between empirical and the-oretical knowledge derived from the practical problems encountered in therapy(Kielhofner, 2005b). Specifically, this approach calls for a commitment to the fol-lowing three actions: (1) conducting research that responds to questions raised inpractice and contributes to answering those questions, (2) developing partnershipswith stakeholders (practitioners) outside the traditional academic department, and(3) creating synergies that address the needs of stakeholders (practitioners) and

Address correspondence to: Renee Taylor, PhD, UIC Department of Occupational Therapy, 1919 W. TaylorSt. (MC 811), Chicago, IL 60612, USA (E-mail: Rtaylor@uic.edu).

3

Occ

up T

her

Hea

lth D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y U

nive

rsity

of

Alb

erta

on

11/2

6/14

For

pers

onal

use

onl

y.

4 Taylor

advance scholarship simultaneously (Hammel, Finlayson, Kielhofner, Helfrich, &Peterson, 2002). In the current healthcare arena, where demands for efficiency inachieving optimal outcomes are an increasing priority, Kielhofner’s efforts to usethese actions to build a knowledge base with direct relevance to practice were notonly timely but also imminently essential (Kielhofner, 2001, 2005b).

Dominant across the basic sciences, the traditional research approach is charac-terized by a top-down, deductive application of the scientific method. According tothis method, a scholar develops a set of ideas, tests them on a restricted and well-characterized sample of individuals, publishes or disseminates the outcomes, andthen expects that stakeholders and, in the case of occupational therapy, practition-ers would adopt and apply the ideas on their own. This assumption that theoreticalknowledge holds all that is necessary to inform practice was referred to as techni-cal rationality (Kielhofner, 2005a). Disillusioned by the lack of carry-over betweenacademia’s emphasis on theory development and the actual methods used by prac-titioners in their everyday work, Kielhofner questioned traditional approaches toknowledge generation in occupational therapy (Kielhofner, 2001, 2005a).

In certain instances, approaches that rely upon technical rationality may be ar-guably translatable for easy implementation. This is true for pharmaceutical agents,assistive devices, or other impairment-focused approaches that are explained andexhibited to practitioners through direct marketing. However, easy applicationsof approaches based on technical rationality are lost in the face of more com-plex, client-centered and occupation-focused approaches popular in the field to-day. Client-centered and occupation-focused approaches espouse their methods asenabling clients to find meaning in occupation, enact their personal narratives, de-velop independent identities, and become empowered (Christiansen, 1999; Clark,1993; Kielhofner, 2008; Kielhofner, 2005a; Law, 1998; Townsend, 1997; Wilcock,2001; Wood, 1998). However, for these approaches to be wholly understood andaccurately executed, they demand a unique approach to education and train-ing. Applications of these dynamic approaches rely on anecdotes, examples, di-rect observations, and practitioners’ interpretations of their own practice to illus-trate the complexities inherent in the therapeutic reasoning that underlies theireffectiveness.

In this vein, Kielhofner (2005a) advocated for an inductive, participatory ap-proach to the generation of knowledge. According to this approach, occupationaltherapy knowledge is derived directly from stakeholders’ (i.e., practitioners’) ef-forts to achieve change or solve a problem in an embedded practice context(Balcazar et al., 2003; Bradbury & Reason, 2001; David, Zakus, & Lysack, 1998;Suarez-Balcazar & Harper, 2003). Advocates of participatory approaches demandthat researchers relinquish control of the research process in order to allow stake-holders to decide, for example, what questions are studied, how data are collected,and how findings will be interpreted and utilized.

In his seminal keynote at the World Federation of Occupational Therapy con-ference in Stockholm, Sweden, Kielhofner (2002) first described how these con-cepts might be applied within the field of occupational therapy. From that point,as an educator, researcher, and scholar, Kielhofner not only espoused the egalitar-ian and participatory ideals behind the Scholarship of Practice but also religiouslyapplied them within his own work. He announced a personal transformation in

Occ

up T

her

Hea

lth D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y U

nive

rsity

of

Alb

erta

on

11/2

6/14

For

pers

onal

use

onl

y.

Gary Kielhofner’s Legendary Vision for Occupational Therapy 5

his approach to teaching, researching, and disseminating concepts and tools fromthe Model of Human Occupation (MOHO) (Kielhofner, 2002, 2005a), the mostwidely used client-centered, occupation-focused conceptual practice model in thefield (Lee, 2010). His admission that his scholarship had not always been drivenby the concerns and questions from practitioners was both humble and laden withintegrity.

Together with his colleagues, Kielhofner continued to be ardent in his focus onachieving an open and mutual dialogue with occupational therapy practitionersfrom around the world. Through countless conversations, observations, and solici-tations for critical feedback about the model from practitioners, Kielhofner learnedto scrutinize and strengthen MOHO concepts, assessments, and intervention pack-ages. He became intimately familiar with the practical problems facing cliniciansand their unique approaches to therapeutic reasoning and assessment.

Kielhofner’s scholarship approach (2002, 2005a) in partnership with clinicianscontinues today throughout the world as evidenced by the dynamic interactionswithin the MOHO Clearinghouse at the University of Illinois in Chicago (Taylor,Fisher, & Kielhofner, 2005) and through the United Kingdom Center for Out-comes Research and Education (UK CORE) in Edinburgh, Scotland (Forsyth,Summerfield-Mann, & Kielhofner, 2005). His work to develop, support, and en-hance the concept of the Scholarship of Practice is timeless in its relevance. Fur-thermore, its applicability to the many clinical, educational, and other professionaldilemmas present in the field today are critically needed to meet the demands of the21st-century occupational therapy practice. It is truly my hope that these conceptswill continue to be taught and embraced widely by instructors, students, practition-ers, and other occupational therapy partners for decades to come. If we heed theseimportant ideas, there is ample evidence to believe that the application of the Schol-arship of Practice will continue to have a positive impact on the present and futureoccupational therapy education, research, and practice.

ABOUT THE AUTHORS

Renee R. Taylor, PhD, Department of Occupational Therapy, University of Illinoisat Chicago, Chicago, Illinois.

REFERENCES

Balcazar, F.E., Taylor, R.R., Kielhofner, G., Tamley, K., Benziger, T., & Carlin, N. (2004). Par-ticipatory action research (PAR). In L.A. Jason, C.B. Keys, Y. Suarez-Balcazar, & R.R.Taylor (Eds.) Participatory Community Research. Washington, DC: American PsychologicalAssociation.

Bradbury, H., & Reason, P. (2001). Conclusion: Broadening the bandwidth of validity: Issues andchoice-points for improving the quality of action research. In P. Reason, & H. Bradbury (Eds.)Handbook of Action Research: Participative inquiry and practice. London: Sage.

Christiansen, C. (1999). Defining lives: Occupational identity: An essay on competence, coher-ence, and the creation of meaning. American Journal of Occupational Therapy, 53, 547–558.

Clark, F. (1993). Occupation embedded in a real life: Interweaving occupational science and oc-cupational therapy. American Journal of Occupational Therapy, 47, 1067–1077.

David, J., Zakus, L., & Lysack, C.L. (1998). Revisiting community participation. Health Policyand Planning, 13 (1), 1–12.

Occ

up T

her

Hea

lth D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y U

nive

rsity

of

Alb

erta

on

11/2

6/14

For

pers

onal

use

onl

y.

6 Taylor

Forsyth, K., Summerfield-Mann, L., & Kielhofner, G. (2005). Scholarship of practice: makingoccupation-focused, theory-driven, evidence-based practice a reality. British Journal of Occu-pational Therapy, 68(6), 260–268.

Hammel, J., Finlayson, M., Kielhofner, G., Helfrich, C., & Peterson, E. (2002). Educating schol-ars of practice: An approach to preparing tomorrow’s researchers. Occupational Therapy inHealth Care, 15(1/2), 157–176.

Kielhofner, G. (2001). A scholarship of practice. Paper presented at the American OccupationalTherapy Foundation Colloquium and Tea at the American Occupational Therapy AssociationConference, Philadelphia, PA.

Kielhofner, G. (2002). Scholarship and practice: Bridging the divide. Keynote presented at theWorld Federation of Occupational Therapy Conference, Stockholm, Sweden.

Kielhofner, G. (2005a). Scholarship and practice: Bridging the divide. American Journal of Oc-cupational Therapy, 59, 231–239.

Kielhofner, G. (2005b). A scholarship of practice: Creating discourse between theory, research,and practice. Occupational Therapy in Health Care, 19(1/2), 7–16.

Kielhofner, G. (2008). Model of human occupation: Theory and application. Philadelphia, PA:Lippincott, Williams, & Wilkins (Wolters Kluwer Business).

Kielhofner, G., Braveman, B., Finlayson, M., Paul-Ward, A., Goldbaum, L., & Goldstein, K.(2004). Outcomes of a vocational program for persons with AIDS. American Journal of Oc-cupational Therapy, 58, 64–72.

Kielhofner, G., Braveman, B., Levin, M., & Fogg, L. (2008). A controlled study of services toenhance productive participation among persons with HIV/AIDS. American Journal of Oc-cupational Therapy, 62(1), 45–62.

Law, M., Ed. (1998). Client-centered occupational therapy. Thorofare, NJ: Slack.Lee, J. (2010). Achieving best practice: A review of evidence linked to occupation-focused prac-

tice models. Occupational Therapy in Health Care, 24(3), 206–222.Suarez-Balcazar, Y., & Harper, G. (Eds.). (2003). Participatory and empowerment evaluation:

Multiple benefits. New York: Haworth.Taylor, R. R., Fisher, G., & Kielhofner, G. (2005). Synthesizing research, education, and practice

according to the scholarship of practice model: Two faculty examples. Occupational Therapyin Health Care, 19(1–2), 107–122.

Townsend, E. (1997). Occupation: Potential for personal and social transformation. Journal ofOccupational Science, 4, 18–28.

Wilcock, A.A. (2001). Occupational science: The key to broadening horizons. British Journal ofOccupational Therapy, 4(2), 56–61.

Wood, W. (1998). It is jump time for occupational therapy. American Journal of OccupationalTherapy, 52, 403–411.

Received: November 3, 2010Revised: November 9, 2010

Accepted: November 9, 2010

Occ

up T

her

Hea

lth D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y U

nive

rsity

of

Alb

erta

on

11/2

6/14

For

pers

onal

use

onl

y.