Social and Academic Belonging: Developing an Ecological Belonging Program for Occupational Therapy Students.

Importance: Occupational therapy students can experience a lack of social and academic belonging during their education, affecting their well-being and confidence. There is a lack of evidence-based programs to increase social and academic belonging.

Objective: To explore experiences of belonging and adversity among entry-level occupational therapy doctorate (OTD) graduate students and develop an ecological belonging program to address the findings.

Design: Qualitative descriptive methodology with a constructivist paradigm.

Setting: An entry-level OTD program at an urban research university.

Participants: Forty-one entry-level OTD students were recruited from a 3-yr graduate program.

Outcomes and measures: A semistructured interview guide.

Results: Students at different stages in the entry-level OTD program participated in focus groups (n = 41). Themes illustrated that students experienced a lack of social and academic belonging at three program time points related to specific struggles they encountered. Themes included making friends, balancing school and personal life, questioning whether they belonged in occupational therapy, whether they would succeed in fieldwork, and how to excel as an entry-level practitioner. A three-session, evidence-based ecological belonging program, Supporting Hardiness and Inclusion for New Endeavors (SHINE), was developed from focus group findings.

Conclusions and relevance: Occupational therapy students experience a lack of social and academic belonging and often feel alone in their struggles throughout graduate school. Evidence-based programs can be tailored and implemented to address this adversity. Educators can support students at key transition points to normalize adversity and encourage success. Plain-Language Summary: This study explored the experiences of belonging and adversity among entry-level occupational therapy doctorate students. The study aimed to develop a program to normalize challenges and address self-doubt among students. Focus groups revealed that students often question their career path and experience feelings of self-doubt, especially during key transitions. These concerns extended to clinical settings, both as students and as future clinicians. The findings informed the development of an evidence-based, ecological belonging program focused on building confidence, belonging, and strategies to overcome self-doubt, helping students develop resilience for success in education and future practice.