Occupational Therapy is Whole Person Health with Michele Tilstra

Dr. Michele Tilstra, inaugural program director of the Occupational Therapy doctoral program, celebrates the launch of the program (January 2026), discusses the structure and unique flexibility of the program, and gives the audience an inside look into her own journey. 

To learn more about UWS, visit https://www.uws.edu. 

Transcript

SPEAKER_01 0:05

Occupational therapy is part of the healthcare profession. A lot of times we're paired up with speech therapy, our physical therapy, and rehab facilities, but we kind of collaborate in actually a lot of different settings. But we help people of all ages live life to the fullest.

SPEAKER_00 0:21

Greetings, everyone. Welcome to the University of Western States podcast. Located here in Portland, Oregon, and online, University of Western States offers a world-class integrated healthcare education focusing on the whole person. We provide an evidence-informed approach to health and wellness. For more information about UWS, visit us online at www.us.edu. My name is Nathan Long, president of the university. Today I am so pleased to be joined by Dr. Michelle Tilstra, our inaugural program director for our brand Spankinou Doctor of Occupational Therapy program. It is such a pleasure to have, after a lot of work, a lot of uh conversations, meetings, coming to campus, trying to figure out how this is all going to come together, and Dr. Tilstra hanging through it all and doing such a good job and cultivating a great faculty, we are on our way. So, Dr. Tilstra, welcome to the podcast.

SPEAKER_01 1:26

Thank you so much. I'm excited to be able to join you. It's definitely been an adventure.

SPEAKER_00 1:30

It has been. I'm sure we'll get into a little bit of that today. So let's get right to it. Your background, how did you get into the occupational therapy profession? And what were some pivotal moments for you and why?

SPEAKER_01 1:44

So occupational therapy, originally, uh like many people, they actually don't know what that is. So I originally just wanted to go into healthcare, knew that I wanted to help people. So I started volunteering. And in a children's hospital, I was originally exposed to occupational therapy. And I thought it was so fascinating because there were such a variety of things that the therapists were doing with all the kids that they were seeing. And I just loved that they were working on some of the therapists were working on sitting skills and playing with the children. Others were working on feeding, dressing, being able to go to school. So just a lot of variety and kind of addressing whatever that child needed at the moment. And I just I was fascinated by that kind of looking at the whole person instead of just a disability. But hey, what are we doing to help somebody maximize their independence?

SPEAKER_00 2:35

Very cool. So when you say you don't you didn't quite know what occupational therapy was, I remember when I first heard about it, I thought, is this something that you do for help finding help, getting a job, like occupation? And and I and I I'm ashamed to say I think I was much older than one would think when I figured it out. But maybe for our general audience, could you talk about what exactly is occupational therapy and why it's important to the health sciences and health sciences education?

SPEAKER_01 3:13

Yes. And if you become an occupational therapist, you will answer this question every day of your life. So I would say your occupation is whatever you do in your day. That's the simplest way to explain occupations. So if you think of from the time you wake up, actually sleeping is an occupation. So sleeping, and then from the time you wake up till the time you go to bed, all the different activities you do in your day, those are considered your daily occupations. And so occupational therapy is part of the healthcare profession. A lot of times we're paired up with speech therapy or physical therapy and rehab facilities, but we kind of collaborate in actually a lot of different settings. But we help people of all ages live life to the fullest. Occupation is our meaningful activities in our daily life. Another example that a lot of times people don't even realize that OTs work with are neonatal population. So that's their whole life is around being able to sleep, be in a proper position to breathe, and being able to eat. And so that's what OT works on with those, with that population. And then all the way up to the geriatric population that sometimes we're working on dressing, bathing, toileting, being able to feed themselves. Usually it's something like they've had a stroke or some kind of neurological problem that's caused some of those declines in functioning. So we just look at whatever that function is, and that's what we want to maximize.

SPEAKER_00 4:40

Oh, that's really interesting. And so how why would you say that occupational therapy is critical in the health sciences in general?

SPEAKER_01 4:50

That's a great question. I primarily I think because we seem to be the gap fillers as far as we look at each patient in a holistic manner. So we're not focused, even though I might see in my credentials that I'm a certified hand therapist, which means I've done a lot of extra training in upper extremity rehab. But let's say somebody comes in with a traumatic hand injury. I'm not just looking at what's going on with their hand. I'm asking them, how are you sleeping? How's it going at home? Are you getting along with your wife now that you're home all the time and your wife's not used to you being home all the time? How's that going? Trying to look at the whole, again, a holistic perspective of that client and then helping them maximize whatever it is that their personal goals are. So again, we fill in some of those different gaps that get left behind, unfortunately, in some of the other healthcare industries.

SPEAKER_00 5:44

Which really points to the importance of being a part of an integrated healthcare team, right? As the occupational therapist. Yeah, yeah, yeah. That's very critical. So you've you were brought in a couple years ago to University of Western States uh before I got here. And you've been in the in this swimming in the sea of a lot of ambiguity, and now you've gotten to the point of greater clarity, especially as giving birth to a new program, as I call it in any way, is always difficult. It's a journey. But now we're on the way to launching this program officially in January of 2026. And you and your faculty team members have developed what I think is just a phenomenal program. I just put together a brief for our faculty and staff that comes out later today using a lot of your language that you put together. So, in terms of the University of Western States occupational therapy program, what is its distinctive nature and what are some of the elements there that might be more appealing to a student considering UWS and maybe some other institutions, all of them good, but it's just right, the modalities and all of that. And then how does this tie into that whole person health experience that UWS is that we're so fond of trumpeting out there?

SPEAKER_01 7:07

Yes, absolutely. Whole person health, honestly, is the definition of occupational therapy. So it's a great partnership to from the very beginning, honestly. That was a very easy place for me as the developing person to try to develop a curriculum that aligns with that whole person health because it just speaks OT language right there. But I would say, as far as now that the program is developed and we were looking at curriculum and all the different course lineup, I can really say confidently that we're promoting physical, mental, emotional wellness. We're making sure that there are student supports built in from day one. Actually, even in the orientation after interview process, we're having student supports and meetings and things like that to make sure that students are really ready for grad school to help with that transition. So really taking to heart that whole person health, meaning, yes, we're training our students to do that for clients, but we also consider our students in that whole person health. We want them to be able to do things, encourage them to do things socially, make sure that they're staying active physically while they're in grad school. That can be a great time that sometimes people get very focused on academics and then forget to take care of those other things. So if anything, we actually emphasize that you need to still do these other things because they're important to your mental well-being. So much so that we are requiring some counseling sessions as part of the program because we feel like if you can get in on the ground floor with exploring maybe where are some specific stressors in your life and have some supports there, I think that's going to only help you with that transition to grad school. But then also with our whole curriculum design, we've designed it in an accelerated format, which means that it can be completed in two years, which is pretty phenomenal for a doctorate degree. I wish it was around when I was going through it, definitely was not. But and it is primarily asynchronous, which I would say is unique to a lot of OT programs in the country. And that is because we're trying to accommodate people who are working, who have children that they're working around, have life, honestly. And how can we make it as accessible as possible, as efficient, but also graduate competent, proficient occupational therapist? That's really important to me because I still work in the field. I want graduates who can act who I am proud to work beside. So that's really something that that is important to me.

SPEAKER_00 9:46

Again, yeah, no, that's great. I think for a lot of folks out there right now, because all the narrative is on the value of higher education and the value of a degree. And one of the things many of us are working on, and you've cracked the nut, you've solved the code, if you will, is that doctorates have often just taken an inordinate amount of time to finish, and there's a lot of inefficiency and curriculums across all of higher education. So I want to applaud you for that because I think you can still have a very high-quality doctoral experience that is shorter in length, but gets you out into practice faster. And that's what you have ultimately created here, which I think is just fabulous. Yes, it's amazing. And so, along with that, so a student finishes in two years, they've got this very flexible curriculum. And we're gonna get into the pointers in just a moment. But when you say it's asynchronous, that's cool. So a student will be online. But then the next thing is when do I get my in-person experience and what does that look like? Can you describe that a bit?

SPEAKER_01 10:54

Yeah, that's a great question because occupational therapy is a hands-on profession. So we cannot do a hundred percent of the curriculum asynchronously, meaning just recorded lectures or videos or things that you're doing on your own. There actually needs to be time when you're putting hands on stimulated patients, real patients, other faculty students to be able to get the true feel of what we're trying to make sure that the true feel of the skills that we're trying to teach. And sometimes this, it's just a matter of actually feeling it. And so when we'll have students come to campus to Portland for one week a semester during their first year of the program. And then the second year, they're actually out on full-time clinicals. And so they do a 12-week level two field work for one semester, another level two field work for a second semester, and then 14 weeks of a capstone experience. And that's all required by the accreditation standards as well. So you gain a lot of experience that way. That's where you get that hands-on experience.

SPEAKER_00 11:57

So when you say clinical, do you all choose where I go? Like I'm thinking, I've got kids and I've got they gotta go to school and I've got work uh a few days a week. What do I do with that? And then what about this capstone? Can you describe those a little bit?

SPEAKER_01 12:15

Sure. Yeah, those are great questions. So the there's different phases of field work. So we'll start with a level one fieldwork that is integrated into that first year program that I was talking about. And so we you will accomplish that level one field work when you come to campus during that week. It's built into the week that you're there. And either you will be at a community-based center, we will bring patients into our university, into our lab, or we also have some simulated patients that we've are training, actually in the process of training right now, or faculty. So you'll have all kinds of different experiences for those level ones. So, with that, you don't really have a whole lot to say with that because um it has to align with the content that we're teaching at the moment, kind of thing. And we also have to prove that all of those experiences are equal for all students. That's one of those touchy standards. So that's a way that we can ensure that. For level two field work, those can be done in your hometown. So we have right now, as of today, we have fieldwork agreements in 41 different states. And Dr. Natasha Smet is our academic fieldwork coordinator, and she's amazing with her networking. She knows so many people, and she has built quite a network of fieldwork educators already, and it's continuing to build that. And so as students register for courses and we get them into the program and we're knowing where they live, and if that is their preference, is to stay in their area, then she will be diligently searching for sites that are within a reasonable driving distance. I have plenty of students though, of course, as you mentioned before, I don't know that I live in Ohio. So I've had students that like, I don't want to do my field work at home. I want to go to Florida or Texas or the Virgin Islands because that's an American island. And we can send we I we actually have a clinical fieldwork site at the Virgin Islands. So sometimes students take that opportunity, they get an Airbnb for three months and they go travel somewhere and pick a state or somewhere that they want to go. So that's a way to do that as well.

SPEAKER_00 14:21

I I think I may do the OTD program just to do the Virgin Islands. That sounds amazing.

SPEAKER_01 14:27

I I would like to go supervise that.

SPEAKER_00 14:30

Yeah, I have a doctorate, it's not an OD OT doctorate, but if you could I could supervise, I'll do it. Yeah, no, that's really fabulous. I think that level of flexibility speaks to the program, what you've created. And certainly, I think to ACOT, props to them for being willing and open to understand the importance around accessibility. And ACOTE for our guests is the accrediting body for the occupational therapy programs that are out there. Yeah.

SPEAKER_01 14:58

And you asked earlier about the capstone process. And I would say that's extremely flexible as well, because the whole process for that actually starts in the very second semester where you're building you're learning about research and building on those skills, but you you will already start brainstorming what is the area that you are most interested in because you actually develop or the student will actually develop their passion project, I guess would be a good name for it, if something that there sticks out to them, either they want to learn more about or they're very interested in. And that's where they do a research project. They select a site again in their own local community. And those are can be like a homeless shelter or a women's transitional housing. We've had students do it. We've had them do it in like a veterans' home, pediatric centers. There's Down syndrome, outpatient area play centers where I've had students do capstones. I've had them do them at universities, working with the disability coordinators at the universities. So it's just, it's it's really open to what the student is interested in and passionate about. And then that's where Dr. Dan Martin, who is our doctoral capstone coordinator, comes alongside the students and helps to guide them, get them to the point where they're ready to go out and do that capstone project during their very last semester.

SPEAKER_00 16:18

How very cool. Okay, that's terrific. So now as we think about student going into a doctoral program, I go back to my old days and how panicked and anxious I was. Like, I'm not smart enough, I'm not good. Then I overcorrected and then I thought I knew everything, and I got I had to figure that all out. And but when I first got in, I was really nervous about doctoral work. And I think a lot of our students who come into doctoral programs are very anxious about is it doable? How do I ensure I'm successful? It is a big investment. There's no two ways to about it. It there's an upfront cost and an ongoing cost to that. What are a few key pointers that you would give to students in terms of being successful in their pursuit of a doctorate in occupational therapy?

SPEAKER_01 17:17

Schedule, schedule. That's number one, no one, two, and three, probably. But and what I mean by that is you schedule in the time that you're going to study, you schedule in your readings, you schedule in your social time as I already talked about it, you schedule in your exercise so that you because if you don't schedule it in, I promise you it will not happen. Yeah because you get overwhelmed with other things. And so it's better if you get it at the front, at the very forefront of each semester. I always encourage students to sit down with all their syllabi and and schedule it out. From personal experience, I will tell you though, that can be very overwhelming and you might need to take a moment afterwards, take a break. But then after that, you take it one day at a time, one week at a time, because you've already scheduled it out for the semester. The other part I always tell my students is you, this is your opportunity to be the sponge. And what I mean is everywhere you go, every opportunity that is provided to you during school, during community, whatever it is, absorb as much information as you possibly can because that is when people are wanting to pour in to you. And so you just want to absorb that and ask as many questions, be ready to learn.

SPEAKER_00 18:34

What great advice. Yeah. I think, boy, if I had you, that would have helped a lot. Seriously, it's like someone saying that early on would have been super helpful. And I do think one thing gave have given advice to doc students on in the past, regardless of the discipline, is don't hesitate to read in advance. If you're if you've got a heavy load around anatomy and physiology or in pharmacology or whatever it is, feel free to like take the extra time to immerse yourself, even if it's just skimming and reading through books and trying to get a grasp of what you're about to go through or and experience as an as a way to just seed the ground on all that. So really great advice, Dr. Tilser. Appreciate that. So I'm thinking, okay, this sounds like a really good opportunity. I'm gonna apply for the UWS occupational therapy program. I get in, I love my faculty, I love the program, I'm gonna graduate. What do I do with this degree? You've alluded to some options that people have, but where does a student go to practice after they've finished?

SPEAKER_01 19:53

Um great question, and that is pretty much anywhere they can imagine. There's probably been an OT or should be an OT, but that's a different advocacy thing. But primarily hospitals, any uh any type of outpatient clinics, and that would be a pediatric clinic, it can be an outpatient adult rehab center, it can be a mental health clinic. So all across the spectrum with that. Schools employ quite a few occupational therapists, early intervention centers where they go into the homes and work with kids in that zero to three age range, skilled nursing. I worked in home health for eight years. I think that's a really great place to do occupational therapy because it brings it all right into the house. You're adapting things on the fly with what the patient has at the moment, trying to get them as functional as they possibly can. And then academia, that's the other area or research. So actually, there's another one, and that would be like policy and advocacy. I've known a lot of OTs that have gone into that. And then there's things where you may not be called an occupational therapist, but you're still using your skills. And that's in a lot of the community-based centers where again you could be doing advocacy, you could be directing a nonprofit, doing research types of things. Um, so it can be whatever you create it to be. A lot of our students or my past students have gotten job offers from their field works or capstone experiences because that opens a lot of doors for them. And if you think of it, it's almost like a three-month trial to see if you like it and if the facility likes you. And so a lot of times that's where job offers come from too.

SPEAKER_00 21:34

Yeah, yeah. And when you think about the investment a student will make in the degree, the salary and the investment do, you know, over time. And granted, you're never able to totally recoup the investment in the first few years. I always try and remind students like you're not going to come out making six figures. Maybe you will, some are lucky, but it it depends on the location and the country and all that kind of stuff. But would you Say that the long-term value of the degree that those can be like if they take out student loans and that type of thing, it's manageable to pay those back over time. And what does that look like? Maybe just from your perspective.

SPEAKER_01 22:13

Absolutely. Again, I wish this was around when I became an OT because I had to go through several going back to school to get to the doctorate level of OT, where now students can do that in, like I said, in this two-year program. And so then if you're paying off those loans, I think that's a definitely a reasonable amount of time to be able to do that. You're making, even at the lowest range, you're still going to be able to live and eat and pay your rent and pay your pay your student loans and be able to do the things, enjoy the things that you want to do. But you can also look at, I would say home health is right now a big payer source. So it depends also not only on where you are in the country, but what population and what setting you're in. Because with home health, you can maximize your income that way. But I don't always recommend that for new grads because you're out by yourself traveling all day. So sometimes a new graduate kind of needs a little bit more mentoring and support. It's something you have to think about over the long term of what you want your career to look like. And if you jump out going, oh, I want all the money, but you don't take the time to get the mentoring and grow in your profession, I think you get stagnant really early.

SPEAKER_00 23:25

Oh, great advice. Yeah, that's really good advice. Before we get into the last couple lightning round questions, if you will, I wanted to throw out a maybe, I don't know if it's a curveball question, but more of a your own personal experience because so often I talk to healthcare providers and faculty members who, you know, they they've really one of the things that keeps them invested is the power of transformation in the patients that they serve. And you had mentioned you were in home health for eight years, which is awesome. And I would imagine kind of difficult work in its own way. What were maybe it what was some inspiring or some an anecdote or two that really spoke to you into like what types of things did you do to help restore someone's occupational well-being or something that stands out to you as a transformational moment for a patient?

SPEAKER_01 24:25

That's good. I've had so many over the years. I don't know why, but the first one that's coming to mind was actually an older gentleman that I worked with, and he unfortunately had a brain tumor, but his mission in life was to be able to fish with his grandchildren before he died. And he was coming in to see to therapy, had he had lost some functioning in his arm. And so we were working on trying to gain that function and practicing fishing, practicing fishing. And then I promised him that we would go fishing, and we did. We ended up going fishing before he was done with therapy. So it was, it was just one of those fun things. I had another, actually, another gentleman that this I don't know if I should advertise, but I live, I when I first graduated, I actually lived in New Orleans and his he wanted to be able to go to the racetracks. And I was a young therapist and said, I've never been to the racetrack. So I'd like you to teach me about the racetracks and what that's involved in. And so it made him so motivated because that was at a time where he could do therapy for six months or so. And then the PT, the OT, which was myself and the patient, we all made a road trip and we went to a racetrack and he taught us all about betting and picking horses and stuff. But it was also about his mobility, his be able to engage in leisure activities that he enjoyed, being able to be internally motivated to do the therapy. Those are things where you see those light bulbs go off in people. And I would say more recently, I work in, I do some mental health right now. And it's with adults and children with a variety of sensory uh concerns. And I had this one gentleman who was struggling in college, actually. He's struggling with organization, staying on top of his skills, but he really didn't recognize that he had some sensory needs. And by introducing him to a variety of fidges and different sensory things that he could do and give him permission, which was interesting, to use them because he had always been told that he couldn't do that or he shouldn't. And it was something to see him be able to come back the next week and say, Dr. Tilstrong, you won't believe what I was able to do by having this down in my backpack and be able to carry this around. Then I was able to pay attention and listen and I was able to take all the notes. I'm like, Yes, that's what it's about. So sometimes it's simple things. It doesn't have to be this big grand thing, but it can be simple things and that it matters what you're doing every day. And so you have to rest on those, I would say.

SPEAKER_00 26:54

I that's powerful. It it seems small, but those minute things that we think are minute are big challenges for people that make such a difference in their lived experience. And I think that's those are actually really beautiful stories. I appreciate you sharing those with us. And I think that's the power and transformation of OT brought to life. So appreciate that very much. That's great. You're welcome. So, in a few words, when you think about University of Western States, what comes to mind for you?

SPEAKER_01 27:31

I guess it's I don't want to be cliche, but I think that whole person health, and I know yes, this is a podcast and we're doing advertising, yay, yay, yay. But that's not really why I'm picking that. It's because I've personally experienced that. Even right after I started working here, I had something going on in my family that I really needed to take a breath, honestly, and take a step back for a little bit and take care of some things that were going on. And I can't tell you the amazing support that the faculty and staff had in that time of my life and recognizing that they really meant that when they were talking about whole person health, that they weren't just saying, oh, we're teaching students. It was about their employees, about faculty, about students. How can we support each other as we're working each day? Yes, I have a job to do. It's a very important job to do, but I also have a life and a family life. And I think that's important for all of us to remember faculty, staff, and students.

SPEAKER_00 28:30

Amen to that. Amen to that. And lastly, what does whole person health mean to you since you brought it up? And I think you you gave one good example, but what does it mean to you in other ways?

SPEAKER_01 28:43

I think it's looking at I'm just pausing because when you first see someone, sometimes you just see that outer, physical, either things that are going on with them, things that are not going on with them, but we all we don't always take the time to get to know that person, to really know where are they coming from, what are their values, what are their cultural beliefs, what are their life experiences? It's been amazing to me to learn more and more about trauma and what people have been through and how that impacts their daily, their entire life, honestly. And how can we take that extra, sometimes it's just extra minutes to get to know someone and before we jump in and make recommendations? I would say that's another thing. Actually, remind my students, especially in the homes, is that this is their home or this is their life. You're coming in as a support to them, not to tell them how to live their life. Yeah, it's to give them suggestions and things. You can't do that if you don't take the time to know them and know all about them and what they value and what they believe and what their goals are. Because that matters.

SPEAKER_00 29:57

It matters so much.

SPEAKER_01 29:59

My goals are not always your goals. Right.

SPEAKER_00 30:02

Yeah, yeah. And often they're not. Yeah, that's right. Dr. Tilster, thank you so much for being here today. We're gonna have you back in the as we get closer to the launch and maybe even right after and do some student interviews with you and Dr. Smith and so on, and looking forward to that. Appreciate your time today. Thank you.

SPEAKER_01 30:23

Well, thank you so much for having me. It's been a great time. I appreciate you taking the time to get to know me.

SPEAKER_00 30:29

Absolutely.

SPEAKER_01 30:29

Sharing our OT, our all about OT and our this amazing curriculum that we're we're so excited to launch.

SPEAKER_00 30:35

That's fabulous. And I'm looking forward to learning more about you in the future. And to our audience, thank you for spending time with us. I encourage you to keep exploring the vast world of health and wellness and all that it offers, helping us lead richer, healthier, and hopefully happier lives. As a reminder, you can find us online at www.us.edu. You can also visit us on social media across all the podcasts and Facebook platforms or Meta, Instagram, LinkedIn, X, etc., you name it, we're there. And for our new OT program, you simply just need to Google UWS OT or UWS Occupational Therapy or UWS Michelle Tilstra. You can probably find us a hundred different ways. We encourage you to look us up, take a peek, and contact Dr. Tilstra when it's easy and when you're able to do it. So with that, I hope you will continue to join me and our guests as we continue to explore the mind, body, and beyond. Signing up for now. Bye.