Occupational therapy graduates in South Africa are increasingly required to practice in acute mental health settings, yet the extent to which current curricula prepare them adequately remains underexplored. This study examined the competencies required for acute mental health occupational therapy practice through a comparative document analysis of four national and international frameworks: the WFOT Minimum Standards (2016), HPCSA Minimum Standards (2024), WHO Recommendations for Occupational Therapy Practice in Mental Health (2024), and WHO mhGAP Intervention Guide (2016), mapped against the University of KwaZulu-Natal (UKZN) exit-level outcomes (2024). Seven core competency domains were identified across the frameworks. The UKZN outcomes demonstrated strong alignment in cultural competence and interdisciplinary collaboration, partial alignment in recovery-oriented practice, assessment skills, therapeutic use of self, and professional resilience, and confirmed gaps in condition-specific knowledge, risk assessment, trauma-informed care, crisis intervention, and transition planning. These findings demonstrate that acute mental health competency preparation cannot be achieved through alignment with any single regulatory document, including the HPCSA framework. This therefore calls for both urgent curriculum reform and strengthening of accreditation standards across all South African occupational therapy programs.

Managing behavioural and psychological symptoms of dementia (BPSD) demands advanced clinical reasoning, yet traditional teaching often falls short. Virtual Reality 360° (VR360) technology offers immersive learning that may strengthen competence in dementia care. This study explored whether occupational therapy (OT) students' reasoning improved after a VR360 module addressing BPSD such as hoarding, wandering, low mood and daily living challenges. Sixty students (35 female, 25 male; undergraduate and postgraduate) participated. Using a mixed-methods, single-group pre-post design, students completed the Clinical Reasoning Assessment Tool before and after four VR360 scenarios. Large improvements emerged across domains: content (d = 1.94), procedural (d = 2.11) and conceptual (d = 2.08). Qualitative themes highlighted confidence, cue recognition, empathy and personalised care. Findings suggest VR360 is feasible and effective for OT education.

Hand function is a critical determinant of preschool children's participation in everyday occupations. Accurate hand function assessment is vital for guiding interventions, yet assessment practices are highly variable. Despite the abundance of instruments, only a few standardised performance-based tools assess all hand function components. No comprehensive mapping exists of key preschool instrument specifications to guide clinicians and researchers, particularly those working in diverse contexts. The study mapped all published hand function-relevant instruments used with children aged 3-5 years, including pathology-specific measures, proxy-report tools, classification systems, and multidomain developmental assessments. Employing scoping review methodology, 13 databases were searched, and all retrieved sources up to September 2024 were managed on Covidence. Two independent reviewers conducted title, abstract and full-text screenings based on eligibility criteria. The search found 810 sources, with 84 meeting inclusion criteria, identifying 62 instruments. Most were performance-based (n = 46; 74.2%), followed by proxy measures (n = 11), classifications (n = 3) and two unspecified. Over a third targeted children with health conditions, whilst 22 covered both typical and atypical development. Sources from the Global South and LMICs were notably scarce. Performance-based measures were examined in greater depth, with only one addressing all hand function domains. Findings highlight the need for a standardised, culturally adaptable performance-based tool that reflects preschool children's real-world occupations and is applicable across diverse settings. This review offers a structured foundation for developing or adapting such a tool, bridging current gaps in assessment practice in both high- and low-resource environments.