The Knowledge We Hold: Exploring Occupational Therapy's Epistemic Identity and the Balance Between Evidence and Practice
Bibliographic record
Abstract
[Formula: see text]Aliki ThomasOccupational therapy has long drawn strength from its ability to integrate diverse forms of knowledge, scientific evidence, clinical expertise, patient narratives, and embodied wisdom. This lectureship explores the profession's epistemic identity: how we develop, validate, and apply knowledge in practice, and how this identity enables us to respond to complex health and social challenges. Drawing on historical and contemporary case examples, the author examines the evolution of occupational therapy knowledge, tracing shifts from intuitive, relational care to evidence-based models and toward today's epistemically pluralistic landscape. She argues that occupational therapy is not only shaped by multiple forms of knowledge but also functions as an epistemic community, one that holds authoritative, policy-relevant knowledge and contributes meaningfully to interdisciplinary networks. This identity positions occupational therapists to influence care models, policy directions, and systems transformation. However, our influence depends on epistemic humility, strategic collaboration, and a commitment to bridging research, practice, and lived experience. The author then outlines three key calls to action: (1) strengthening our knowledge base through pluralism and reflexivity; (2) amplifying our collective voice by clarifying professional identity and reducing fragmentation; and (3) increasing our policy influence through purposeful collaboration and leadership. In rapidly evolving healthcare environments, occupational therapy must assert its role not only in delivering services, but in stewarding integrated, context-sensitive knowledge that drives equity, participation, and justice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.044 | 0.069 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.042 | 0.130 |
| Scholarly communication | 0.041 | 0.029 |
| Open science | 0.004 | 0.029 |
| Research integrity | 0.009 | 0.011 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".