Running Head: FACTORS INFLUENCING CAREER CHOICE

Factors Influencing Occupational Therapy as a Career Choice: A Qualitative Study

Annie Guiliano, Jennifer Godfrey, Brie Pupp, and Sara Silverberg
Touro University Nevada

FACTORS INFLUENCING CAREER CHOICE

Research Question
The demographics of the United States is changing and according to Joel Kotkin, an
author for the Smithsonian Magazine, the population of America is going to steadily grow in
both size and age between 2015 and 2050 (Kotkin, 2010). As baby boomers gracefully age out of
middle adulthood into their twilight years, the younger working force will also grow in size due
to high fertility rates, immigration, and the original baby boomers children having children of
their own (Kotkin, 2010). In response to this predicted growth, the American Occupational
Therapy Association (AOTA) has developed a component of its Centennial Vision statement to
include a workforce that reflects the diversity of the population (American Occupational Therapy
Association [AOTA], n.d.).
The purpose of this narrative qualitative study will be to discover what personal and
familial experiences influenced or guided first year occupational therapy students at Touro
University Nevada to embark on the study of occupational therapy as a future career. By
researching factors that influence peoples choices of occupational therapy, one can identify
common themes and similar characteristics among those entering their studies of the field of
occupational therapy. These common themes or qualities can be used by AOTA and the field of
occupational therapy towards diversifying the face of its workforce. Researchers anticipate
participants will have been influenced to pursue a career in occupational therapy based on their
personal experiences and, thus, have posed the question regarding what factors influence the
decision to pursue the field of occupational therapy as a career?
Background Literature Review
Most research exploring career development focuses on autonomous exploration in the
decision making process. However, humans do not exist in an insular society. Our beliefs, ideas

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and dreams are often influenced by personal experiences and interpersonal relationships.
Palladino Schultheiss, Kress, Manzi and Glasscock (2001) sought to uncover how interpersonal
relationships are utilized during career exploration and the decision making process and what
role these relationships may play when making difficult career decisions. Palladino et al. (2001),
interviewed fourteen students ranging in age from 18-40 years from a large, public urban
Midwestern university. Palladino et al. (2001) discovered that familial relationships, specifically,
mother, father, and siblings were the most influential component in the career decision making
process as a source of support. Our research team found this discovery relevant as familial
relationships not only serve as a source of support, but often serve as inspiration when pursuing
professional pursuits. Consequently, we utilized their findings to help guide our interview
questions to determine if familial relationships influenced their decision to pursue a career in
occupational therapy.
Rozier, Gilkeson and Hamilton (1992) studied factors influencing first year occupational
therapy students to choose a career in occupational therapy. The researchers conducted a
quantitative study, analyzing two hundred eighteen questionnaires completed by first year
occupational therapy students from four randomly selected occupational therapy programs.
Researchers identified the goal of helping others, job availability, and prestige as the primary
indicators for entry into occupational therapy. Rozier, Gilkeson and Hamilton (1992) conducted
this study twenty three years ago. As occupational therapy has grown and changed as a
profession throughout the years, new factors are expected to have developed.
How Culture Influences Choosing Nursing as a Career, provides a descriptive
interpretation of five different factors that influenced the career choice of thirty-four teenagers
from New Zealand. The researcher included factors such as family, gender, educational, social

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and cultural influences that affected how these individuals saw nursing as a career choice (Pool,
2012). As these factors were a great starting point for data collection, some of these same factors
influenced the choice of what questions the researchers chose for the study of occupational
therapy and what factored into 2016 occupational therapy students of TUN own decision
making process.
According to a study, Factors Influencing the Career Choice of First-Year Occupational
Therapy Students, Craik, Gissane, Douthwaite, & Philip (2001), have identified several trends
and main characteristics that have attracted North American students to occupational therapy.
They found working with people, challenge, and a variety of the profession to be the most
common themes in the questionnaires. The study also cited friends, family and volunteer
experiences as a strong influence for discovery of the profession. Monitoring trends of first year
occupational therapy students can develop insight into factors influencing the discovery and
decisions to go into the profession. This will help identify current trends so that the profession
can target specific areas for recruitment and highlight the reported benefits to create and promote
more diversity within the field. The 2001 study conducted by Craik et al. reflected the current
population of occupational therapist as 90.6% female and 86.6% white. It is important to
understand the current population of occupational therapy students, to use the methods of
recruitment for a more diverse population.
Methodology - General Design of Study
This is a narrative study, in which researchers conducted semi structured open-ended
question interviews in private study rooms. Four researchers conducted separate interviews in
pairs of two on two separate days during lunch at Touro University Nevada. Each group of two
researchers interviewed three subjects and recorded the interview with verbal permission from

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each subject. A Sony Microcassette tape recorder was utilized to record interviews and
transcribed by the Sony Microcassette-Transcriber M-2000 transcription machine.
During interviews, researchers orientated the participants to the interview process and
explained the intent of the interview as well. Researchers demonstrated undivided attention and
sought clarification when needed, asking probing questions to keep the interview engaging.
Researchers created a bank of questions to ask during the interview based off literature reviews
and the research question (see Appendix A). One researcher with transcription experience,
transcribed all recordings verbatim after the completion of all six interviews. Transcriptions were
documented on a word document and transmitted via email to the remaining researchers. The
researchers altered participants names and anybody mentioned in the interview to protect their
identity and maintain confidentiality.
Information on Participants
To recruit participants for interviews, an email was sent to the 2016 cohort of
occupational therapy students on January 7th, 2015. Seven people responded to volunteer as
interviewees. The first six were approached to set up an interview time and day. The seventh
person was kept as an alternate in case any of the first six were unavailable, changed their mind,
or canceled. The seventh person was also kept as an alternate in case saturation levels were not
reached with the first six and an interview needed to be conducted to collect more data.
Participants included in the research population were all female and close in age range.
Four of the participants were 22 years old and the other two were 23 years old. Fictitious names
were assigned to each participant or person named in interviews to protect their identity and
ensure confidentiality. Participants came from similar undergraduate backgrounds. Two
participants received a Bachelors of Science in Kinesiology and one other in Exercise Sports

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Science. Two participants received a Bachelors of Science in Human Development and Family
Studies, one with an emphasis on Child and Adolescent Development. The final participant
received a Bachelors of Science in Recreational Therapy.
Data Collection
The interviews were conducted during lunch on Monday, January 12, 2015 and Tuesday,
January 13, 2015. The researchers split into two pairs of interviewers and interviewed three
individuals each. The interviews were conducted in a (private) quiet room away from any
distractions or others that may make the interviewee feel uncomfortable. The interview sessions
were recorded with a Sony Microcassette player so the data collected could be transcribed
verbatim. One of the researchers transcribed all six interview sessions using a transcription
machine.
Thematic Analysis
Data Analysis
We composed a semi-structured interview with open-ended questions. Questions were
designed to assess what influences had the most impact on participants decision to pursue a
career in occupational therapy. A list of questions can be found in the appendix. Questions
sought to determine if familial, life experiences, or a combination of both influenced professional
pursuits. To help ensure trustworthiness, interviews were conducted in pairs, with one person
serving as the interviewer and one person serving as the observer. At times, the observer probed
for clarification but generally observed the process and provided feedback to the interviewer
upon interview completion.

FACTORS INFLUENCING CAREER CHOICE

Transcription of interviews
A Sony Microcassette recording device was utilized for documentation to ensure
transcription accuracy. Transcription was conducted at a later time by a researcher with prior
transcription experience using the Sony Microcassette-Transcriber M-2000.
Triangulation
Preliminary analysis was conducted on the first set of interviews by three researchers
simultaneously to identify any preliminary categories. Utilizing axial and open coding, six
domains were identified and coded at that time. The team met during two additional sessions to
re-evaluate prior findings and evaluate the remaining interviews. One additional domain was
identified and coded during subsequent sessions. Throughout this process, researchers
independently identified content appropriate for individual domains and collectively argued the
validity of these assignments. Cross analysis was conducted for each interview at the completion
of its review by the team. Upon completion of evaluation, researchers collectively identified
three primary emergent themes and six sub themes.
Themes and Subthemes
Based on participants responses, three primary themes and six sub themes emerged. The
three primary themes with subthemes in parenthesis include: relationships (familial and
nonfamilial), experiences (work and personal), and professional satisfaction (helping profession,
financial stability and versatility).
Relationships. This category included participant narratives describing relational
influences impacting career choices. As reported by Palladino et al. (2001), familial relationships
play a significant role in the career decision making process. Our results confirmed these
findings, but also point to outside sources of support and influence in the process. Our interviews

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uncovered two important relationships that impacted decisions to enter occupational therapy;
familial and nonfamilial. Rachel indicated in the following quote that her experiences with her
sister played a significant role in her decision to pursue a career in occupational therapy:
I had a sister when I was younger, she was a year older than me...couple months in she
started having seizures, so my parents took her to OT, PT, different doctors. They had so
many questions, so many issues like functional and the OT was there for them just to
explain everything. And they didnt know what to do with a child with a disability so the
OT helped them explain everything. But, also like, was there to help Emily in every way
possible.
Oftentimes, our relationships with nonfamilial members serve as inspiration when
identifying a career path. The following quote from Katie demonstrates the influence of
nonfamilial:
My brother, his soccer coach in high school got into a really bad car accident, so (he)
became paralyzed. He used to play soccer and everything and so, Matt was really close to
him. And then, he (the soccer coach) actually started teaching at my high school. And so,
I was his student aid. And I came in and so I got to see like, the things he went through
and I know that was a big part why Matt chose that, to help people. And it kinda, like,
helped me open my eyes too.
These quotes support the findings of Craik et al. (2001) in that familial support is not the
only determining factor in making career choices. Our relationships and experiences with
friends, mentors and teachers also serve as a source of inspiration in the career decision making
process.

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Experiences. Experiences include narratives reflecting work or personal experiences

impacting decisions to pursue a career in occupational therapy. The type of experience
individuals have with others and previous work experiences can influence career options. They
can tell us what we want to pursue, or conversely, what we do not want to pursue.
Work Experience. Megan indicated that her work experiences in day care lead her
occupational therapy:
Working in the day care, it made me realize that I definitely want to work with
kidsthere were a few kids here and there that didnt develop as typically as everyone, I
was drawn to them a lot of the time. Like I could kinda connect with them a lot, I just
wanted to help themsay I could make a bigger impact than a teacher, me myself, I
think I would make a bigger impact as an occupational therapist.
Jamie indicated that her work experiences at her college newspaper helped her identify
what she did not want to pursue and, consequently, encouraged her to investigate other avenues.
It was actually working at the newspaper believe it or not, because I was debating
between journalism and occupational therapy. And I was like I can get a job at the school
newspaper and see if I like it. And it was kinda me discovering I didnt really like
journalism and it spurred me into more discovery of occupational therapy. But, yeah, so
working as an editor in chief at a school newspaper and discovering that I wanted to be
more hands on, wanted to make more of a visible difference and contribution in the world
than just writing, where it was so impersonal. And thats what kind of made me start, ok
lets go back to square one, what can I do? And looking into other careers, and looking
into OT in particular. So it was actually discovering what I didnt want to do instead of
what I wanted to do in undergrad that led me to OT.

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Personal Experiences. Amber demonstrates how her personal experiences with her
brother greatly impacted her decision to pursue a career in occupational therapy.
So I have a brother thats two years older than I am that has Down syndrome. And so Ive
just grown up, his best friends were my best friends and they were often all of the special
ed classroom. So Ive just been exposed to a lot of physical disabilities and
developmental disabilities, and so Im very comfortable working with those people and I
wanted a profession...where I could pursue that. I want to give back to the population that
directly affects my family so I chose Occupational Therapy.
Professional Satisfaction. Pursuing a career that offers professional satisfaction was an
emergent theme in our research. We discovered that participants wanted a career that enables
them to help others, maintain financial security and provide versatility. Participants indicated
they want a career that provides opportunities for both professional and personal fulfillment.
Helping Others. Many respondents chose this field because it enabled them to help
others and give back to their community. The following narratives demonstrate the importance of
helping others to our respondents. Elizabeth indicated she was motivated by the field because of
its holistic approach:
It involves a lot of the things that Im interested in. Helping people in the therapy aspect,
but there is a part of it that really looks into peoples mental status and how they think
and how its going to affect them later in life and since I love both those fields I was like,
oh, its a perfect match.
Amber indicated she was inspired by her own experiences with her family and wanted to
give back to her community:

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I knew I wanted special needs, I knew this population of human services of like helping
people. I want to give back to the population that directly affects my family so I chose
occupational therapy.
Financial Stability. Financial stability was also a determining factor. Katie stated, I was
always leaning towards the health field, because its kind of a stable, I mean like after the
economy... and seeing like how people lost jobs with things that were stable.
Versatility. Many participants indicated the versatility of the field as very appealing.
Diversity in populations served, incorporation of art and science and the flexibility with
scheduling were predominant themes identified. Jamie indicated the incorporation of art and
science was appealing to her.
I always liked science and healthcare, but I didnt want to do blood, and guts, and gore
and be responsible for whether or not people died...it was a good combination of art and
science too...I can [be] an artist and a scientist at the same time.
Amber indicated the diversity of populations served and the flexibility with scheduling as
motivating factors for choosing occupational therapy.
So if I could have my dream schedule. Like Monday, Wednesday, Friday, I am working
with children with autism or Down syndrome with those developmental needs. And then
Tuesday, Thursday Im working with geriatric patients in a psychiatric acute care setting.
Discussion and Implications
Research by Rozier, Gilkeson and Hamilton (1992) indicated that the highest rated factor
for occupational therapy students entering the field of occupational therapy is the goal of helping
others. The students in the present study echoed a similar sentiment. Under the theme of
professional satisfaction, the desire to help others was a prominent expression. Another sub

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theme under professional satisfaction was versatility. As one of the students mentioned, she
wanted to combine science and art without the blood and guts.
Nevada is faced with a shortage of occupational therapists. Touro University Nevada has
the only occupational therapy program in the state and many of the students leave after
graduation. Empowered with the knowledge that occupational therapy students are often
attracted to the field because of the emphasis on helping others and versatility, recruiting
measures can be undertaken at Nevadas undergraduate universities in specific complementary
fields of study. Typical fields of study that may share the values of helping others and versatility
are psychology and education. Targeting Nevada State, University Nevada Las Vegas, and
University Nevada Reno may increase the number of students with ties to Nevada increasing the
likelihood that Nevada will benefit from their professional occupational therapy license.
The data gathered in this study was consistent with the research of Palladino et al. (2001).
Relationships are an important influence in the career decision making process. All of our
subjects referenced a relationship (parent, sibling, friend or mentor) as a factor in choosing the
profession of occupational therapy. Teachers and coaches were also mentioned in the interviews
as significant influences.
The Nevada Occupational Therapy Association (NOTA) could provide ample education
about the field of occupational therapy to Nevada high school guidance counselors. Counselors
could then influence students who were determined a good fit for the profession. This technique
could be used to increase the diversity of the face of occupational therapys workforce which
would align with AOTAs Centennial Vision statement.

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Limitations
A limitation of this study is the lack of generalizability based on the small sample size
and the fact that all participants were from a single university. The sample was homogeneous
with respect to gender as well as very close in age. All of the participants were females between
the ages of 22 and 23. Priorities and values alter as people age, along with factors influencing
their decisions. The older perspective was not represented in this study. The male perspective
was not captured in this sample. Males may have different concerns that impact factors in
choosing occupational therapy as a career. The researchers in this study were homogeneous in
gender and close in age range as well. This may have created a bias in interview questions and
direction. The research team split into pairs to conduct the interviews. This affected the
consistency of the interviews. This was also the first qualitative research study for this research
team. Their lack of experience is also considered a limitation.
Recommendation for further research
Further inquiry is needed into the factors influencing the decision to pursue the field of
occupational therapy as a career. Studies that draw from a more diverse sample pool are
recommended to gain information on influences of a population that better reflect the face of the
global population. A larger more representative sample could result in more generalizable
outcomes.

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References
American Occupational Therapy Association. (n.d.). Promote the profession: The brand.
Retrieved January 21, 2015, from http://www.aota.org/AboutAOTA/CentennialVision/Brand.aspx
Craik, C., Gissane, C., Douthwaite, J., & Philip, E. (2001). Factors influencing the career choice
of first-year occupational therapy students. British Journal of Occupational Therapy,
64(3), 114-120.
Kotkin, J. (2010). The changing demographics of America. Smithsonian Magazine. Retrieved
January 30, 2015, from http://www.smithsonianmag.com/40th-anniversary/the-changingdemographics-of-america-538284/?all
Pool, L. (2012). How culture influences choosing nursing as a career. Whitireia Nursing Journal,
(19), 27-42.
Rozier, C., Gilkeson, G., & Hamilton, B. (1992). Why students choose occupational therapy as a
career. American Journal of Occupational Therapy, 46(7), 626-632.
Schultheiss, D. P., Kress, H. M., Manzi, A. J., & Glasscock, J. J. (2001). Relational influences in
career development: A qualitative inquiry. The Counseling Psychologist, 29(2), 214239.doi:10.1177/0011000001292003

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Appendix A
Interview Questions:
Life experiences, interpersonal, family

What attracted you to OT?

What experiences in undergrad led you to apply to an OT program?

Describe a family relationship that lead you to the Occupational Therapy profession.

Tell us about other people in your life that may have influenced your decision.

Have you or anybody in your family received OT services?

Family members that are in the OT profession?

What if any previous career experiences influenced your choice?

What volunteer experiences influenced your decision to go into OT?

How has your childhood SES affected your decision to enter the profession?

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