Digital technology: Document and define to strengthen emerging practice

Carolyn Murray, Australian Occupational Therapy Journal

Digital technologies have been with Australians since the early 1990s and the term ‘digital divide’, which captures inequalities between those who use technology and those who do not, was first coined in 1995 (Dijk, 2019). Since then, there have been exponential advancements in digital technology, which have transformed both occupations and how they are performed (Liddle, 2023). For example, communicating and connecting with others can now occur through multiple methods, compared with the limited options pre-1990s. As such, there are also changes in occupational performance challenges, such as difficulty using a smartphone.

Dijk (2019) describes the ‘digital divide’ metaphor as simplistic; not fully representing the complexities of social, economic, and cultural inequalities related to digital technology. In a recent editorial in the Australian Occupational Therapy Journal (AOTJ), Liddle (2023) proposed that occupational therapists have a key role and responsibility in ensuring digital inclusion and the prevention of digital exclusion for the people and communities that we work with. This role is recognised through one of the behaviours in our Australian Occupational Therapy Competency Standards

(Occupational Therapy Board of Australia, 2018) being to “maintain knowledge of relevant resources and technologies and maintain digital literacy for practice” (p. 7).

Given our grounding in occupational performance, it is imperative that occupational therapists are actively contributing to discourse related to motivation, physical access, skills, and usage of digital technology (Dijk, 2019). Given the complexities surrounding digital literacy, this discourse will be strengthened through collaboration with our information and communication technology and health and social policy colleagues already exploring this space (Dijk, 2019). A scan of papers related to digital technology over the last ten years within the AOTJ shows publications related to digital technology within three broad themes.

1. Digital literacy of occupational therapy students

There was agreement that occupational therapy students cannot be assumed to have the required digital literacy skills to study and practice (Hills et al., 2016), and there is a need for deliberately designed curriculum to address this core skill (McKinstry et al., 2020).

2. Use of technology to improve efficiency in or provide evidence for therapy outcomes

Research was published across practice areas of hand therapy (Cutler et al., 2018), stroke rehabilitation (Emmerson et al., 2018; Flynn et al., 2019; Hsu et al., 2019), and home assessment (Sim et al., 2015). Overall, technology was found to have benefits in therapy efficiency and outcomes (Cutler et al., 2018; Hsu et al., 2019), but there were concerns about resourcing, leadership and client suitability (Flynn et al., 2019). Furthermore, qualitative perceptions of benefits did not always align with quantitative outcome measures (Emmerson et al., 2018).

3. A user-focused approach to technology for equality and advocacy (Liddle, 2023; Liddle et al., 2022)

Partnering with those people experiencing the occupational performance challenges will establish clarity around needs and ultimately lead to meaningful outcomes (Liddle et al., 2022). Awareness of the complexities of digital inclusion can be enhanced by greater co-design and community led approaches to addressing the digital divide (Liddle, 2023).

Occupational therapists have always been known for their capacity to adapt to different trends in society (Gilbert Hunt, 2017) and there is no doubt that Australian occupational therapists are confidently and adeptly addressing the growing digital needs among the communities in which they work. The next step is to document this practice through research of all designs (including co-design and partnership). Doing so will develop knowledge of how the digital divide manifests within the context of occupational performance. This will also enable us to consolidate our roles and responsibilities (Liddle, 2023) and define, control, and shape our practice with digital technology.