Transfer of Learning in Occupational Therapy

What is Transfer of Learning?

Occupational therapists promote learning using different strategies. One often used concept that clients learn is the transfer of learning. Transfer of learning concepts and its documentation is also used among the interdisciplinary team such as with speech-language pathologists and physical therapists.

Transfer of learning is defined as the “generalization of skill when the learner is able to spontaneously perform the task in different environments
.[1]Pendleton, H. M., & Schultz-Krohn, W. (2017). Pedretti’s Occupational therapy-e-book: Practice skills for physical dysfunction. Elsevier Health Sciences.

Case Study Example

Let’s say a client is having difficulty with scanning to left after a right-sided stroke. The client is said to be exhibiting left inattention in which they perceive the world differently and ignore the left side of their visual field. This poses both safety concerns and occupational performance difficulties.

The occupational therapy practitioner and the client collaboratively set a goal to increase attention to the left for their occupations of gardening. However, working with gardening as a therapeutic activity may be unsafe at the moment – there are trip hazards, slip hazards, and plants may pose a danger themselves such as thorns. If the client were to miss objects on their left, they could potentially be harmed.

So the OTP begins the transfer of learning training by promoting left attention at the bedside with the treatment team. This may begin passively with rearranging the bed and chair so that the doorway is on the left to promote more attention to the left side. The telephone is also placed on the left as is the radio.

For the first OT session, the OTP works with self-feeding as it is noted by staff that the client does not finish the food on the left side of the plate. The OT uses both a combined adaptive compensatory and a remedial cognitive strategy. The OT places bright red tape to the left of the plate to promote a left scanning and search pattern. Cognitively, the OT prompts and cues the client to remember to “look left”. Soon enough, the client (motivated by food and finishing all of the food) remembers to scan left with minimal cues. However, as the patient is assisted to the toilet, they forget to look left again. So there is no transfer of learning to scan left with toileting from self-feeding at this point.

The OT now remembers a better strategy to promote left scanning of the environment using a “lighthouse light” pattern to look left in hopes of promoting transfer with metaphors. The client now remembers to look left more often, especially when walking and mobilizing for an activity. After mastering toileting safely by looking left, the client is ready to practice walking to the garden (to get to the garden). With minimal cues from the OT, the client occasionally forgets to look left to look for signs to the community garden. In the next session, the client needs no cues and is independent with left scanning.

At this point, the client is said to have transferred their learning to the skill of left scanning to decrease their left inattention. When the client reaches the garden to pick fruit off the fruit trees, they independently self-initiate left-scanning. The OTP documents that the client has “transferred the skill” of left scanning independently because they demonstrated and generalized the same skill in many different environments – at bedside for eating, in the bathroom, in the hallway on the way to the garden, and ultimately in the garden.

References

References
1 Pendleton, H. M., & Schultz-Krohn, W. (2017). Pedretti’s Occupational therapy-e-book: Practice skills for physical dysfunction. Elsevier Health Sciences.
Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.