Exploring facilitators and barriers to effective practice among new graduate occupational therapists working with children and families: A scoping review.
Amanda Barnes, Laura Burritt, Laine B Chilman and 1 others
New graduate OTs working with children consistently report feeling underprepared and overwhelmed, with external mentoring, manageable caseloads, and access to experienced colleagues as the strongest enablers.
The evidence base is thin—13 studies, mostly small qualitative work—so these are reported patterns, not proven solutions.
Key findings
1Across most included studies, new graduates reported feeling underprepared from university for paediatric practice, with specific gaps in feeding intervention, assistive technology assessment, and school-based service delivery.
2Mentoring from someone external to the organisation was consistently described as more valuable than internal supervision, which some graduates perceived as evaluative and which made them reluctant to ask for help.
3Workload pressures, billable-hour targets, and sole-practitioner roles were the most commonly reported barriers, and graduates linked these directly to burnout and leaving their positions.
Still to come
How it was doneWhat they foundWhat it means for OTs
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What it does not show
All 13 included studies were non-experimental (Level III); there were no randomised or quasi-experimental designs, so no causal claims can be made about which support structures actually improve practice. The definition of 'new graduate' varied across studies—less than 1 year, less than 2 years, or less than 3 years—making it hard to know which time window the findings apply to. Only 7 of the 13 studies involved participants working exclusively with paediatric caseloads; the rest included mixed adult and paediatric work, so paediatric-specific findings are diluted. No included study examined how a clinician's gender, culture, or disability status shaped their transition into paediatric practice. The evidence base is geographically concentrated: 7 studies from Australia, 5 from the US, 2 from New Zealand, 1 from Canada.
Declared interests
The authors declare no conflict of interest. No funding source is named in the text provided.
The easy way to misread this
Do not read the consistent reports of mentoring and supervision as evidence that these interventions improve new graduate outcomes. This is a scoping review of 13 mostly small qualitative studies mapping what graduates describe, not a test of whether any particular support structure causes better practice. The authors themselves note the evidence base is limited in strength and scope, and no study in the review compared a support intervention against a control.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →