Date of Award

August 2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Educational Foundations & Research

First Advisor

Steven LeMire

Abstract

Since its inception in 1917, the field of occupational therapy has maintained a pronounced gender imbalance, with females comprising the vast majority of practitioners despite major historical shifts in healthcare delivery. This dissertation examines how occupational therapist (OT) and occupational therapy assistant (OTA) students perceive gender and how these perceptions influence their academic experiences and future professional roles.

Using a multi-study design, this dissertation integrates qualitative and quantitative approaches across three articles. In article 1, focus groups were employed with doctoral OT students (N=30) and revealed five central themes: the value of gender diversity for learning, a nurturing and supportive female-dominant educational climate, concerns regarding respect (particularly among female students), distinctive experiences of gender minority students, and the overarching belief that professional identity transcends gender. While students valued the relational strengths of the profession, findings highlighted persistent challenges related to perceived legitimacy, gender expectations, and minority status.

Article 2 utilized survey methodology with OT doctoral students (N=108) across six Midwestern universities to examine gender-based differences in academic experiences. Results indicated generally high levels of rapport, respect, and perceived value of gender diversity across all students, with minimal statistically significant differences by gender. However, gender-related challenges emerged most prominently in clinical contexts, particularly in interactions with clients, and students reported less positive views of how well the profession addresses gender issues as they progressed through the program. These findings suggest that increased clinical exposure heightens awareness of gender dynamics.

Article 3 extended this analysis to OTA students (N=47) and demonstrated similarly positive perceptions of rapport, respect, and the benefits of gender diversity, with limited evidence of overt gender-based differential treatment. A key finding was that second-year students reported significantly stronger recognition of the importance of gender diversity compared to first-year students, indicating developmental growth in awareness. Despite these strengths, reduced perceived responsiveness to nonbinary student needs points to an important gap in inclusivity efforts.

Collectively, these findings demonstrate that gender both enriches and complicates occupational therapy education. While the profession’s female-dominant culture fosters supportive and relational learning environments, it also introduces nuanced challenges related to respect, minority experiences, and inclusivity. This dissertation highlights the need for intentional educational strategies, including increased representation, targeted mentorship, and expanded gender-inclusive practices, to better support all students and strengthen the future occupational therapy workforce.

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