Intro to Occupational Therapy, Ch.6-7

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The three categories of personnel who deliver occupational therapy services
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Occupational Therapist, Occupational Therapist Assistant, Occupational Therapist Aide
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Occupational Therapist Aide
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Does not receive special training before working in the field, they receive on the job training
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Occupational Therapy Personnel
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Personnel, including ot students and aides, who deliver occupational therapy services.
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Occupational Therapy Practitioner
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Individual who is initially certified to practice as either an OT or OTA, or licensed or regulated by a state, district, commonwealth, or territory of the United States to practice as an OT or OTA and who has not had that certification, license, or regulation revoked due to disciplinary action.
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The Accreditation Council for Occupational Therapy Education (ACOTE)
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regulates entry-leval education for both OT and OTA programs in the United States.
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The standards are reviewed
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every 5 years
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OT and OTA programs must follow whose procedures to become accredited and to maitain accreditation
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ACOTE
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ACOTE
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Accreditation Council for Occupational Therapy Education
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What does Accreditation mean
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minimal educational standards recommended by the profession have been met and the school has received formal approval by ACOTE
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What does Accreditation ensure
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graduates of the program are qualified to take the national certification examination
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Professional requirements for OT and OTA’s
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Learn curriculum in occupational therapy principles, practices, and processes.
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Fieldwork
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practical experience
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The purpose of fieldwork is to
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provides students with the opportunity to apply the knowledge learned in the classroom to practice in the clinical setting
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Frequently OT and OTA students are scheduled to complete fieldwork
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at the same time
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Level I fieldwork is completed
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Concurrently with the academic coursework
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The purpose of Level I fieldwork is to
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introduce the student to the profession and to the various applications and interventions
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Level II fieldwork for OT’s is a minimum of
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24 weeks full-time
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Level II fieldwork for OTA’s is a minimum of
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16 weeks full-time
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Level II fieldwork is designed to
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Provide students with supervised, hands-on clinical training.
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By the end of Level II fieldwork, students are
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expected to be functioning as entry-level practitioners
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In what year did it become required for an OT to have a Master’s Degree
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2007
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Doctor of Occupational Therapy degree is a
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Clinical or practice-based doctorate that focuses on the development of sophisticated practice competencies
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In what year were OTA’s required to take the certification exam
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1977
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OTA’s are eligible to take the certification exam once they
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Complete 2 years of post-secondary education in an accredited program, successfully have completed Level I and Level II fieldwork experiences, and have obtained an Associates Degree (science or arts)
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Programs for OTA’s typically focus less on theory and more on
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the “doing” aspects of the field, such as methods and procedures used in occupational therapy
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Certification
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Acknowledgement that a individual has the qualifications to be an entry-level practitioner
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OTR
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Registered Occupational Therapist
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COTA
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Certified Occupational Therapist Assistant
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The national certification exam is administered by the
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National Board for Certification of Occupational Therapy (NBCOT)
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In some states, instead of sitting for national certification, candidates take the
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state exam for certifiation
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If you do not pass the certification test the first time you may
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retake the test but you must pay for each attempt
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What are the two official levels of professionals in the field of occupational therapy
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OT and OTA’s
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AOTA Mission
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Advance the quality, availability, use and support of occupational therapy through standard setting, advocacy, education, and research on behalf of its members and the public.
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AOTA directs its efforts to
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1)assure the quality of occupational therapy services, 2) improve consumer access to health care services, and 3) promote the professional development of its members
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Benefits or membership in professional organizations
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helps OT practitioners become informed, provides professional development, publishes research information for the profession, sponsors continuing education activities, provides resources for information
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AOTA is responsible for
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ensuring the delivery of quality occupational therapy services
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In what year did American Occupational Therapy Certification Board change name
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National Board for Certification Occupational Therapy in 1996
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When was the certified only category created
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1980
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In what year did ACOTE mandate that OTA programs be established in junior colleges
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1965
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What is it called when the program undergoes a site visit to maintain accreditation
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Report of self study
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Roles
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specify positions or sets of stipulated job related responsibilities – each role carries w/ it specific expectations for job performance and responsibilities – ability to function: educational prep., professional boundaries, and responsibilities and prior experience in role – most people in working in organizations have multiple roles
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Relationship
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connection of differ. roles to one another comb. of roles and relationships defines expectations in organizations and clarifies interactions
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Direct Client Care
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role most commonly assumed by OT practitioner who is just entering field
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ROLE: Practitioner-OT
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-PROVIDES QUALITY OCCUPATIONAL THERAPY SERVICES , includes evaluation,intervention, program planning and implementation, discharge – service provision: direct, monitored, and consultative approaches
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ROLE: Practitioner-OTA
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Provides quality occupational therapy services to assigned individual’s under supervision of an OT
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ROLE: Educator (CONSUMER,PEER)
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Develops and provides educational offering or training related to occupational therapy to consumer,peer, and community individuals or groups
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ROLE: Fieldwork educator -practice setting
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Manages LEVEL 1 OR 2 Fieldwork in a practice setting. Provides OT students w/ opportunities to practice and carry out practitioner
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ROLE: Supervisor
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Manages OVERALL DAILY OPERATION of occupational therapy services in defined practice areas
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ROLE: Administrator (practice setting)
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Manages department, program, services, or agency providing OT SERVICES
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ROLE: Consultant
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Provides OT consultation to individuals, groups, or organizations
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ROLE: Academic Fieldwork Coordinator
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Manages student fieldwork program w/in academic setting
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ROLE: Faculty
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Provides formal academic education for OT or OTA students
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ROLE: Academic Program Director
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Manages the educational program for OT or OTA students
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ROLE: Researcher/Scholar
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Performs scholarly work of the profession includes: examining, developing, refining, and evaluating profession’s body of knowledge, theoretical base, and philosophical foundations
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ROLE: Entrepreneur
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Partially or fully self-employed individuals who provide occupational therapy services
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Career Development
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Career of OT progresses, he or she may wish to advance w/in service delivery or transition into a role outside of service delivery Develops 3 ways: Vertical movement, Horizontal movement Maturation
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Vertical move within a setting,
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practitioner moves up in the organization to progressively higher positions ex: move from fieldwork educator to department superivisior
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Horizontal Move (across settings)
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Involve an expert clinician transitioning to the role of a clinical instructor in a university setting
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Maturation within a role
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maturation of individual w/in specific role from entry level to intermediate, to advanced level ex: entry level clinician to advanced clinician specialist
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3 levels of performance
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Entry Intermediate Advanced
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Entry level practitioner
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expected to be responsible for and accountable in professional activities related to role -in states w/ licensure laws: entry level practice defined by licensure law and supporting regulations major focuses: – development of skills -socialization in the expectations related to organization, peer, and profession – Acceptance of responsibilities and accountability for role-relevant professional activities is expected
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Intermediate level practitioner
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increased responsibility and typically pursues specialization in a particular area of practice -increased independence -mastery of basic role functions -ability to respond to situations based on previous experience -participation in the education of personnel
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Advanced level practitioner
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considered an expert, or a resource in the respective role -refinement of specialized skills – understanding of complex issues affecting role functions
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The 5 AOTA Standards for Continuing Competence
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Standard 1. Knowledge Standard 2. Critical Reasoning Standard 3. Interpersonal Abilities Standard 4. Performance Skills Standard 5. Ethical Reasoning
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Knowledge Standard
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Occupational therapists and occupational therapy assistants shall demonstrate understanding and comprehension of the information required for the multiple roles and responsibilities they assume. The individual must demonstrate: • mastery of the core of occupational therapy as it is applied in the multiple responsibilities assumed • expertise associated with primary responsibilities • integration of relevant evidence, literature, and epidemiological data related to primary responsibilities and to the consumer population(s) served • integration of current Association documents and legislative, legal, and regulatory issues into practice.
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Critical Reasoning
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Occupational therapists and occupational therapy assistants shall employ reasoning processes to make sound judgments and decisions. The individual must demonstrate: • deductive and inductive reasoning in making decisions specific to roles and responsibilities • problem-solving skills necessary to carry out responsibilities • the ability to analyze occupational performance as influenced by environmental factors • the ability to reflect on one’s own practice • management and synthesis of information from a variety of sources in support of making decisions • application of evidence, research findings, and outcome data in making decisions.
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Interpersonal Abilities
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Occupational therapists and occupational therapy assistants shall develop and maintain their professional relationships with others within the context of their roles and responsibilities. The individual must demonstrate: • use of effective communication methods that match the abilities, personal factors, learning styles, and therapeutic needs of consumers and others • effective interaction with people from diverse backgrounds • use of feedback from consumers, families, supervisors and colleagues to modify one’s professional behavior • collaboration with consumers, families, and professionals to attain optimal consumer outcomes; • the ability to develop and sustain team relationships to meet identified outcomes.
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What are the 10 roles an OT can hold?
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Educator Fieldwork educator Supervisor Administrator Consultant Academic fieldwork consultant Faculty Academic program director Researcher/scholar Entrepreneur
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Professional Development
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organizing and personally managing a cumulative series of work experiences to add to one’s knowledge, motivation, perspectives, skills, and job performance.
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3 types of Professional Development
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In-service presentations Supervising students Evidence based practice (EBP)
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Importance of lifelong learning/professional development
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To keep pace with changes in technology, research evidence, best practice, delivery mechanisms and regulations. – To avoid consequences such as self-dissatisfaction with performance to employer or client dissatisfaction and potential harm to client
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What is a practitioner’s level of performance based on?
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Work experience Education Professional socialization
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What is the role that an OTA can perform without supervision?
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Activity director
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Where are activity directors typically employed?
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Group homes Institutions for people with mental retardation assisted Living facilities Long term health care
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ROLE: Activity Director
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Responsible for the planning, implementing and documenting an ongoing program of activities that meet the needs of the residents – be aware of and adhere to regulations from Medicare, state health dept. and licensing agencies
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Maintenance Activities
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Provide opportunities for individual to maintain physical cognitive, social, emotional, and spiritual health (exercise groups, games)
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Empowering Activities
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Geared toward promoting self-respect, and offer opportunities for self-expression, personal responsibility and social responsibility (writing newsletter)
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What association developed the service standards?
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AOTA
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Discuss the 4 areas of OT service delivery as described in the standards of practice for occupational therapy
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1) Sceening 2) Evaluation/Reevaluation 3) Intervention 4) Outcomes
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Describe service competency as it relates to OT
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Established for a particular procedure, when two or more practitioners meet the acceptable standard or performance on three successive occasions
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Continuing competence
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a dynamic multidimensional process in which the OT develops and maintains knowledge, performance skills, interpersonal abilities, critical reasoning and ethical reasoning necessary to perform their professional responsibilties…
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Describe the tools that can be used to maintain and document continuing competency
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1) Professional Development Tool (PDT): developed by AOTA to assess learning needs and organized professional growth, identify and pursue prof development, promote quality in the profession, fulfill responsibility for continuing competency 2) Certification renewal with NBCOT 3) Speciality certification: OT/OTAs 4) Board certification: OTs
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Supervision
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a cooperatve process in which two or more people participate in a joint effort to establish, maintain, or elevate a level of competence and performance…
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Identify the practices that contribute to successful supervisory relationships
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Give & receive constructive feedback Communication, actively listening being assertive, tactful & ability to resolve conflict regularly scheduled meetings with an agenda active participation by both supervisor and supervisee
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Client related tasks
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Routine tasks in which the aide may interact with the client but not as the primary service provider of ot…
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Non-client-related tasks
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Preparation of the work area and equipment, clerical tasks and maintenance activities…
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Describe the different types of teams in health care and recognize the importance or interdisciplinary teams
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1) Multi-disciplinary team: variety of disciplines that work together in a common setting 2) Trans-disciplinary team: members cross over professional boundaries & share roles & functions 3) Inter-disciplinary team: Members maintain their own professional roles while using a cooperative approach that is interactive and centered on a common problem to solve
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Multi-disciplinary Team
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Mix of practitioners from multiple disciplines who work together in a common setting by without an interactive relationship
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Trans-disciplinary team
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Members cross over professional boundaries & share roles & functions
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Interdisciplinary Team
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Mix of practitioners from different disciplines who maintain their own professional roles and use a cooperative approach that is very interactive and centered on a common problem to solve
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Speciality Certification
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a credential for OTR’s and OTA’s that indicates advanced knowledge in a particular area of practice examples: driving and community mobility environmental modification feeding eating, swallowing & low vision
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Board Certification
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Certification for the occupational therapist that incorporates more generalized areas of practice that have an established knowledge base in OT Examples: gerontology mental health pediatrics physical rehabilitation
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Direct or Continuous supervision
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supervising therapist is in the immediate area at all times; required for OT AND OTA students, limited permit holders, ot aides
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Close Supervision
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Daily, direct contact at site work
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Routine Supervision
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Face to Face contact at least every 2 weeks at site of work w/ interim supervision through methods of telecommunication
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General Supervision
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at least monthly face to face contact with the supervisee
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Standard 1, Knowledge
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-shall show understanding of info required for the many roles and responsibilities of a practitioner -mastery of the core of OT as applied to the many responsibilities -Expertise associated with primary responsibilities -integration of relevant evidence, literature and data related to responsibilities and the population served -integration of current association documents, legislative, legal and regulatory issues into practice
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Standard 2, Critical reasoning
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-shall employ reasoning process to make sound judgments and decisions -using deductive and inductive reasoning in making decisions specific to roles and responsibilities -must have problem solving skills -ability to analyze occupational performance influenced by the environment -ability to reflect on ones own practice -management of information from several sources to support decisions
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Standard 3, Interpersonal abilities
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shall develop and maintain professional relationships with others with the context of roles and responsibilities -must use effective communication methods that match the abilities, personal factors, learning styles and therapeutic needs of consumers and others -effective interactions with people from different cultures -use feedback from others to modify ones professional behavior -collaborate with consumers, families and professional to achieve best outcomes
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Standard 4, Performance skills
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-shall demonstrate the expertise, aptitudes, proficiencies and abilities to fulfill roles and responsibilities. -practice grounded in the core of occupational therapy-therapeutic use of self, -therapeutic use of occupations and activities, the consultation and education process to bring about change -use current practice techniques and technologies -always update performance based on current research and literature -utilize quality improvements to prevent practice error and maximize client outcome
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Standard 5, Ethical reasoning
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-shall identify, analyze, and clarify ethical issues or dilemmas to make responsible decisions within the changing context of roles and responsibilities -understand and adhere to the professions code of ethics, other relevant codes of ethics, plus applicable laws and regulations -use of ethical principles and core values to understand complex situations -integrity to make and defend decisions based on ethical reasoning
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Emergency Procedures
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Actions to follow in case of an injury or accident in the clinic.
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Accreditation
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A form of regulation that determines whether an organization or program meets a prescribed standard.
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Documentation
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The process of keeping records on all the aspects of service delivery.
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Outcome measures
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An aspect of program evaluation that evaluates the results of the intervention after the service
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Evidence-based practice
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Basing practice on the best available research.
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4 steps to use Evidence Based Practice (EBP)
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1-forming a clinical question 2-searching literature for evidence 3- appraising evidence for validity and applicability to practice 4- applying evidence to practice- eval outcome
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Program evaluation
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Measuring effectiveness by determining which programs are achieving their goals and objectives and modifying programs accordingly.
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Program Process
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Stages of referral, evaluation, and intervention
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Program Structure
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System in which the services are delivered (staff levels and expertise, equipment, budget, and range of services)
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What must all facilities do
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establish emergency procedures
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What are evaluations/screening composed of
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Information on referral, evaluation data, occupation profile, expected outcomes
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Re-evaluation
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Recommendation for changes to: goals services frequency
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Intervention Document
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Intervention plan Service contacts Progress reports Transition plan
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Outcome documents
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Discharge/discontinuation report
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Intervention Plan
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Document clients goals and ways to approach those goals; duration, frequency, provider
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Service contact document
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interactions between OT and others; client log, time, date, use of time, clients response (calls, mtgs, narrative notes)
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What are progress reports
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Summary of interventions and new data and modifications to plan
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What are transition plans
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client’s progression from one setting to another; info of current status, reason for transition, frame for transition
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What is in a discharge plan
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Discontinue report; Outcomes stage summaries of changes in client’s abilities, Further service info, Follow-up
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Individualized Education Plan (IEP)
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Documentation for third party payers in schools to reflect success in school-federal funding
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What does documentation provide
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Justification for OT interventions

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