One type of change is one that doesn’t make an announcement. Neither a press conference nor a rebranding campaign are included. It takes place in a conference room, most likely with lukewarm coffee, where a group of former clinical professionals who are now educators gather and discreetly reevaluate their methods. That’s essentially what has been happening within the doctorate program in occupational therapy at Duke University, and it’s something to be aware of.
Perhaps surprisingly, the story begins with an operations manager. In addition to managing the day-to-day operations of Duke’s OTD program, Lindy Norman was pursuing a doctorate in Higher Education Leadership. Instead of keeping those two worlds apart, she combined them; as part of her dissertation research, she created a three-session faculty development series and tested it with her own colleagues. It’s the kind of thing that seems straightforward until you consider how infrequently it occurs in educational environments.
Anyone who has transitioned from clinical practice into a classroom could quickly identify what Norman discovered through her root cause analysis. Researchers and clinicians are not always trained to explain how they expect others to demonstrate learning. When it comes to the mechanics of instruction, such as rubric design, learning objectives, and precise assessment criteria, faculty in health professions education frequently arrive with deep expertise and very little preparation. These are not glamorous subjects. However, most people don’t want to acknowledge how important they are.
Barbara Hooper, the division chief, helped shape Duke’s OTD program, which had already established itself as a learning community as opposed to a conventional academic hierarchy. Norman’s initiative was made possible by that culture. Without it, a staff member who wanted to train faculty might have faced opposition or courteous indifference. Rather, she found a group of associate professors who were open to changing their own grading procedures.
Assistant professor and Capstone coordinator Cambey Mikush was candid about the impact. She had been uneasy with her own rubrics for years, wondering if students could truly understand the standards she set. She completely redesigned an assessment following Norman’s sessions. Students said they understood what was expected of them. Mikush thought feedback was more significant and grading was simpler. By some standards, it’s a modest result. However, in a field where students from non-traditional educational backgrounds are subtly disadvantaged by unclear assessment criteria, clarity is structural rather than modest.
This place has something worthwhile to sit with. Equity—who enters the field, who advances within it, and who feels seen and supported along the way—has received more attention in the scholarly literature on occupational therapy education. According to a qualitative study that was published in the American Journal of Occupational Therapy, women of color in occupational therapy leadership frequently cited sponsorship, mentorship, and a sense of true inclusion as the factors that enabled them to pursue their careers.
Almost unintentionally, Norman’s pilot tackles the educational aspect of that same issue. Students who lack informal access to faculty and are unable to use social capital to decipher unspoken expectations fall behind when grading criteria are opaque. In this way, more precise rubrics are a silent equity intervention.
Raheleh Ghasseminia, an associate professor, put it simply: students are getting feedback that genuinely aids in their development, and faculty are now developing assessments that feel more transparent and aligned. It’s still early, and three sessions can only go so far, so it remains to be seen if that results in quantifiably better outcomes over time.
However, observing this from the outside, it seems that Duke’s OTD program has discovered something that the larger health professions education community tends to ignore: teaching is a skill in and of itself that requires intentional cultivation, and the most qualified individuals aren’t always the ones with the most senior titles. Sometimes it’s the one who has been observing the most closely the entire time.
