Supplementary File II.xlsx Data from Member Checking Interviews

Generalist occupational therapists provide hand rehabilitation in challenging settings due to the scarcity of specialist hand therapists. This study aimed to describe the experiences of generalist occupational therapists in South Africa to identify their support and development needs, and propose interventions to address these.<br>This qualitative descriptive instrumental case study design involved six purposively sampled occupational therapists delivering hand therapy in a generalist capacity. Data from in-depth interviews and fieldnotes were analysed using reflexive thematic analysis. Within- and cross-case analysis was undertaken.<br>Vignettes illustrate within-case findings and cross-case findings generated five themes. <i>Stressful and satisfying </i>captured an experience that was both challenging and rewarding. <i>Learning journey</i> communicates participants’ learning trajectories and <i>rising to the challenge </i>articulates enablers of responding to the demand for hand therapy. <i>Traversing system and service change</i> explains the complex and transient nature of the systems and services in which participants functioned<i>. </i>Finally, <i>once upon a hand injury</i> illustrates the lived realities of patients and the practice complexities that therapists navigate.<br>Generalist occupational therapists are integral to extending access to hand therapy in South Africa. Individual-level strategies, team and human resource strategies, education, physical resources, and system and service-level strategies should be considered for capacity strengthening