This thesis investigated the supervisory process between occupational therapy students and practice educators during practice placements. It explored the strategies and techniques used by both students and practitioners to facilitate students' learning and to develop their ability to reflect on practice. Few studies have investigated this topic specifically in relation to occupational therapy students, revealing a gap in relation to the reality of what actually occurs during supervision sessions. The researcher argued that observation of supervision sessions should provide accurate, detailed accounts of the content, structure and format of the sessions with clear analysis of the techniques/strategies being adopted. A case study approach was used to enable the researcher to gain a unique insight into the real life supervisory relationships between occupational therapy students and their practice educators, involving a number of methods of data collection: focus groups, questionnaires, observations and audio- recordings of 20 supervision sessions. The major themes to emerge from the focus groups and questionnaires showed the importance of effective interpersonal skills in fostering a partnership approach that encouraged students to take responsibility for their own learning. Interpretive analysis of the audio-recordings identified various techniques used by practice educators such as probing questions, sharing accounts of their own reflections, and giving constructive feedback. However, the findings also revealed areas for improvement. Although each practice educator had their own style of supervision and all endeavoured to assist their student with their professional and personal development, they did so with varying degrees of effectiveness. Examples of good practice were demonstrated in relation to the effective supervision of students on placement, but it was shown that the preparation of students and practice educators could be enhanced and further strengthened to ensure that both parties fully appreciate the purpose and benefits of effective supervision and their roles within that process. IX Abbreviations ACE AHP APPLE COT CPD DHSS PS HEFCE HEI HPC IPE UK WFOT Accreditation of Clinical Educators Allied Health Professions Accreditation of Practice Placement Educators College of Occupational Therapists Continuous Professional Development Department of Health and Social Services and Public Safety Higher Education Funding Council Higher Education Institutions Health Professions Council Inter-Professional Education United Kingdom World Federation of Occupational Therapists.

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Changes in health and social care present exciting opportunities for occupational therapists to expand their practice into innovative settings. To prepare graduates for these opportunities, placement experiences must reflect current trends in practice. Role-emerging placements are increasingly being used to help students develop the skills, knowledge and attributes needed to become the therapists of tomorrow. Whilst the literature on role-emerging placements is increasing, studies have tended to be general placement evaluations, with limited studies exploring students' experiences in detail. No studies have explored the influence of role-emerging placements on graduates' professional practice and identity. This study adopted a phenomenological design to gain a deeper understanding of how occupational therapy students experience and ascribe meaning to role-emerging placements and the ways in which such placements influence their professional practice and identity once qualified. In-depth initial interviews were carried out with five MSc pre-registration occupational therapy students within one month of having undertaken a role-emerging placement. Follow-up interviews were carried out six months after the students had graduated and gained employment. Interviews were audio taped, transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Key findings reveal that the role-emerging placements acted as a strong catalyst for the students' ontological development. Through engaging in challenging and autonomous learning experiences, they developed deeper insights of who they were becoming as professionals. This led to a professional identity that was of their own making. Having to continually reflect on and verbalise the core essence and contribution of occupational therapy, students developed clarity of understanding about the uniqueness of the profession. This is an important finding in light of the historical difficulty occupational therapists have had articulating their unique role and professional identity. Once qualified, participants had mixed experiences concerning the extent to which they were able to sustain this identity and enact practice in a way that was meaningful to them. A significant finding was the difficulty that graduates experienced working in NHS settings where the nature of occupational therapy practice restricted their ability to work in a way that was congruent with the professional way of being that they had developed during their placement. Consideration therefore needs to be given to the nature of occupational therapy practice in traditional settings. Recommendation is made for role-emerging placements to be made compulsory for all occupational therapy students to assist them in their ontological development and prepare them more effectively for practice. Further research into the long-term influence of such placements, in particular on graduates' practice and identity, is required.

The aim of this study was to examine, understand and conceptualise the critical thinking and clinical reasoning adopted by new graduate occupational therapists as they enter the workforce to become newly autonomous practitioners. The study obtained the perspectives of new graduates, their supervisors and service managers on the means by which critical thinking and clinical reasoning develop to meet the expectations of employers. Factors which impeded the transition between new graduate and autonomous practitioner were identified and explored. Ethical approval was obtained to conduct the study. The study adopted a qualitative phenomenological research approach; Interpretative Phenomenological Analysis (IPA), which informed framing, data gathering and analysis. Semi-structured interviews were conducted with new graduates (n=6), supervisors (n=7) and managers (n=7) from multiple sites within one National Health Service Board. Interviews were transcribed verbatim from audio-recordings. The findings indicate that new graduates are expected to develop critical thinking and clinical reasoning in a manner that might challenge traditional conceptualisations of the transitioning process. A phenomenon, historically named the “shock of practice”, was reflected on by therapists in each phase of the study and adaptive and mal-adaptive responses to this in the thinking and behaviour of new graduates was identified. The clinical supervisor-supervisee relationship appeared to be the key source of support, and the supervisor the most significant knowledge resource, for new graduates. This relationship was supplemented by both peer support and Preceptorship. Discharge planning was a significant source of anxiety and development of an algorithm to support this process is proposed. Recommendations for further research and theoretical implications for practice and undergraduate education are discussed.