Practice Readiness of Newly Qualified Occupational Therapists in United Kingdom.

Occupational therapy (OT) is a regulated healthcare profession and to become a qualified occupational therapist, one must complete an education programme in OT and meet specific entry-to-practice requirements. Newly graduated OT graduates were reported to feel transition to work as overwhelming and were found to have considerable self-doubt and feel not fully prepared for practice. Safe care provision, increased confidence in performance, and positive role transition are identified as outcomes of enhanced practice readiness among graduates. Various stakeholders are involved in the making of practice-ready OTs including the new graduate themselves, workplace colleagues clinical practice facilitators, and university faculty. Yet, focus of much of the existing research is on the challenges of newly qualified OTs. This proposed research aims to build on the existing knowledge of practice readiness of newly qualified OTs and seek to explore multiple stakeholder perspectives including work managers, university faculty, and placement educators through focus group discussions. A qualitative approach using interpretive description methodology will be used to explore the variety of perspectives with regards to practice readiness and its attainment from the standpoint of multiple stakeholders. The wholistic understanding of the process and the range of actions undertaken by multiple stakeholders that are expected to be derived from the findings could be beneficial in identifying current best practices and stimulate development of collaborative initiatives to better prepare newly qualified OTs to practice confidently and efficiently upon graduation.

Occupational therapy (OT) helps people do the everyday activities they need and want to do. To become an OT, you must complete an approved degree and meet professional standards. Even so, many new graduates say the move into their first job feels overwhelming and they often doubt their skills and don’t feel fully ready upon graduation. Being “practice-ready” matters because it supports safer care for patients, greater confidence for new staff, and a smoother start in the role.

This study will listen to everyone involved in preparing new OTs including the new graduates themselves, workplace colleagues and practice educators, and university lecturers. We will hold group discussions to explore what “practice-ready” means, what helps or gets in the way during training and in the workplace, and which actions make the biggest difference.

By bringing these perspectives together, we aim to build a clear, practical picture of how readiness develops and how each group can play its part. The findings will highlight what is already working well and guide joint improvements so that new OTs can provide safe, effective care and feel confident from day one.

This qualitative study used interpretive description, adopting a constructivist perspective to capture diverse stakeholder views and achieve a comprehensive understanding of practice readiness. Purposive sampling was used to recruit information-rich participants between October 2024 and February 2025 via stakeholder group emails and snowball sampling. Four online focus groups (MS Teams) were conducted, one for each subgroup. Newly qualified OTs (n=8), workplace OT managers (n=9), OT university faculty (n=4) and OT practice educators (n=8). Sessions were audio/video recorded, transcribed verbatim with pseudonyms, and recordings deleted post-analysis. Data were analysed thematically within the interpretive description approach integrating themes with disciplinary knowledge. The research adhered to epistemological and methodological congruence. Reflexivity was maintained through journaling, transparency of researcher positioning, dual coding of data, and member checking with participants.

Key findings
Three themes emerged across the focus groups:
• Practice-ready vs profession-ready: Full practice readiness at graduation is unrealistic; readiness develops post-graduation through experience, reflection, and ongoing learning. Managers report gaps in practical skills and confidence, with consequences for distress, attrition, and supervision/resource pressures.
• Developmental trajectory shaped by variability: Readiness builds across pre-university experiences, academic preparation, placements, and workplace induction, with substantial variability at each stage. Differences in curricula, practical training opportunities and placement quality yield uneven readiness
• Individual learner characteristics such as maturity and prior life experiences that influence the evolution of practice readiness.
Participants also identified some insights for practice-ready education:
o Address gaps in foundational biomedical knowledge (anatomy/physiology), hands-on skills (manual handling, equipment use), and theory-to-practice application.
o Increase simulation-based learning, involve people who access services, new graduates, and clinicians in teaching, embed digital literacy/emerging technologies, strengthen skills training.
o Placement learning: Placements are pivotal yet inconsistent. Improve through structured supervision, clearer pre-placement guidance, and cross-institution collaboration to standardise outcomes and address capacity constraints.
o Life experience, maturity, apprenticeship routes, international background and neurodiversity shape readiness; one-size-fits-all undergraduate approaches are insufficient. Adopt differentiated teaching, assessment, and support.
o Intentional, stakeholder-informed curriculum design and standardised placement experiences are key to enhancing NQOTs’ practice readiness and smoothing transition to professional practice.

Recommendations and conclusion
The main conclusion from the research is that expectations at the point of graduation is only towards profession readiness and not practice readiness and substantial variability across curricula and placements contributes to uneven preparedness for practice. Key recommendations include:
• Co-development of a minimum competency framework, such as a “Day-one OT” profile may provide programs with clearer educational targets and offer workplaces a consistent benchmark for induction and support.
• Rebalancing curricula toward practice-centered learning and structuring placements intentionally with standardized expectations and mandatory exposure to core practice settings
• Tailoring education pathways to learner profiles through differentiated tracks and/or modules
• Tracking graduate outcomes for two years might improve continuous curriculum refinement and support strategies.
• Formalizing stakeholder collaboration to keep the education system responsive to evolving needs