APPENDIX 13.1 WORLD FEDERATION OF OCCUPATIONAL THERAPISTS ENTRY LEVEL COMPETENCIES FOR OCCUPATIONAL THERAPISTS

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1 APPENDIX 13.1 WORLD FEDERATION OF OCCUPATIONAL THERAPISTS ENTRY LEVEL COMPETENCIES FOR OCCUPATIONAL THERAPISTS APPENDIX 13.1 FORMS PART OF THE APPENDICES FOR THE 28 TH COUNCIL MEETING MINUTES CM2008: Appendix 13.1: Publication: WFOT Entry Level Competencies for Occupational Therapists 170

2 Appendix 13.1 WORLD FEDERATION OF OCCUPATIONAL THERAPISTS ENTRY LEVEL COMPETENCIES FOR OCCUPATIONAL THERAPISTS Standards & Quality Programme Project Team chaired by Thelma Burnett (Australian Delegate) September

3 Copyright and Photocopying Publication compilation The World Federation of Occupational Therapists. All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means without the prior permission in writing from the copyright holder. The World Federation of Occupational Therapists grants no license to publish, communicate, modify, commercialise, reproduce, transmit or alter this material in any way. For reproduction or use of the WFOT's copyright material in any way, permission must be sought from the WFOT Executive Management Team via the Secretariat. That permission, if given, will be subject to conditions that will include a requirement that the copyright owner's name and interest in the material be acknowledged when the material is reproduced or quoted, either in whole or in part. No permission to reproduce or use the WFOT's copyright material, other than that expressly stated, is to be implied by the availability of that material in published form. For further information, please contact: WFOT Secretariat PO Box 30 Forrestfield Western Australia 6058 Australia Fax: admin@wfot.org.au Website The World Federation of Occupational Therapists 3

4 Contents: PART 1: INTRODUCTION AND BACKGROUND... 5 Purpose of the Entry-Level Competencies... 5 Definition... 5 A Brief History of the Entry-Level Competencies... 5 International Context of Entry-Level Competencies... 6 PART 2: OCCUPATIONAL THERAPY COMPETENCIES... 8 ENOTHE/ COTEC... 8 Canada... 9 Australia United Kingdom Ireland New Zealand PART 3: ENTRY-LEVEL COMPETENCIES FOR OCCUPATIONAL THERAPY Philosophy and Purpose WFOT Minimum Standards for Education and Entry-Level Competencies Framework for Entry-Level Competencies Using the Competency Framework as a Career Path Application of the Entry-Level Competency Framework in WFOT Member Countries The World Federation of Occupational Therapists 4

5 PART 1: INTRODUCTION AND BACKGROUND Purpose of the Entry-Level Competencies This document identifies a framework for entry-level competencies for the practice of occupational therapy. The aim of the document is to inform occupational therapists, education providers, governments, consumers and others of the competencies that entry-level occupational therapists should demonstrate. The competency framework can be used to assist and guide the development and monitoring of occupational therapy practice competencies within WFOT member countries; competencies that are specific to practice in that country. In this context, entry-level refers to graduate entry-level competencies that relate to the successful completion of an occupational therapy undergraduate/entry-level course 1. By promoting the development of uniform competencies, this document will help to develop and promote a standard of excellence in occupational therapy practice. Definition The following definitions 2 have been used to define competency for the purpose of this document. A unit of competency is a discrete component within a standard and reflects significant major functions. Elements of competency constitute the building blocks of the unit of competency and, as such, continue the description of the key purpose of the unit itself. They describe in outcome terms the lowest logical, identifiable and discrete subgroupings of actions and knowledge which a person requires to fulfil the unit of competency. Elements subdivide the unit into manageable and meaningful components that are observable in workplace performance. Elements provide the context for performance criteria and the range of variables in which the competency is observed. A Brief History of the Entry-Level Competencies Over time requests have been received from occupational therapists, WFOT member countries and other stakeholders, for WFOT entry-level competencies to be documented. A number of member countries have existing documents (or are developing standards) that describe entry-level competencies specific to that country. Within the Revised WFOT Minimum Standards for the Education of Occupational Therapists (2002) the identification of knowledge, skills and attitudes (the components that form a competency) were described to guide the goals of educational programs. The WFOT Entry-level Competencies document has built on the competencies identified in the Minimum Standards for Education of Occupational Therapists. This document provides consensus about what constitutes the core elements of competent practice as an occupational therapist. These core elements have been developed into a framework. This document relates to the WFOT priorities 3 to: 1 Entry-level in some countries is at the completion of a post-baccalaureate (graduate) degree 2 OT AUSTRALIA 1994 Australian Competency Standards for Entry-Level Occupational Therapists The World Federation of Occupational Therapists 5

6 Increase and maintain the awareness, understanding and use of the services of occupational therapists by government, employers and the wider community through collaborative action. Develop and promote a standard of excellence in occupational therapy practice. Ensure the ongoing development and quality education and research of occupational therapists worldwide. International Context of Entry-Level Competencies The recognition of the worldwide trend toward shorter hospital stays, increased acuity of care and the enhanced role of the multidisciplinary team and for health services in the home or as community based care is timely to the development of entry-level competencies for occupational therapists. These trends are accompanied by an identified world-wide shortage of health professionals. Figure 1a gives a context through which to view the competency areas. The components (context, generic competencies, specific competencies and settings) are drawn from the Revised WFOT Minimum Standards for the Education of Occupational Therapists. Figure 1a. The components in context Context in which services will be provided Generic Competencies - Identified in competencies framework Specific Competencies match each national need and environment Settings where the service will be provided Nature of local health needs Local health and related systems Relevant health giving occupations Program philosophy and purpose Knowledge Skills Attitudes Person-occupationenvironment relationship Therapeutic and professional relationships Occupational therapy process Professional reasoning and behaviour Context of professional practice Community Hospital Private and public practice Tele-practice Education Recreation Research Other e.g. Policy, industry Figure 1b is a diagrammatic representation of the components, showing a layered effect from a background context, through specific settings, generic competencies and a final or top layer of specific competencies in a specialty area. 3 WFOT Strategic Plan The World Federation of Occupational Therapists 6

7 Figure 1b. Diagrammatic representation of the components CONTEXT SETTINGS GENERIC COMPETENCIES SPECIFIC COMPETENCIES The World Federation of Occupational Therapists 7

8 PART 2: OCCUPATIONAL THERAPY COMPETENCIES A number of WFOT member associations and/or their regulatory bodies have existing documents that underpin competencies for entry-level occupational therapists in their countries. Many of these documents have been drawn on in the development of the current standards. In this context, the WFOT Entry-level Competencies document provides an overarching guide or framework for WFOT member countries. The framework provides a common link between similar documents in member countries and does not replace or take the place of country-specific documents. The following are examples of the development of competency standards in some WFOT member countries and regional occupational therapy networks. ENOTHE/ COTEC 4 Tuning, supported by European Commission, is an overall project involving disciplines within higher education in Europe (and now also Latin America) ( The aim of Tuning is to contribute significantly to the elaboration of a framework of comparable and compatible qualifications in each of the (potential) signatory countries of the Bologna Declaration (1999) and the subsequent Bologna Process, which should be described in terms of workload, level, learning outcomes, competencies and profile. Note here the use of the word Tuning, which emphasizes that the aim of the project is to tune in educational programs, to develop mutual understanding, and not to enforce rigid adherence to a common European prototype. The Tuning Occupational Therapy Project Group of representatives from the European Network of Occupational Therapy in Higher Education (ENOTHE) and the Council of Occupational Therapists for the European Countries (COTEC) has developed a publication Reference Point for the Design and Delivery of Degree Programmes in Occupational Therapy (Tuning Occupational Therapy Project Group 2008, available through ENOTHE-office) including a description of occupational therapy profile, competencies and three cycle level descriptors for occupational therapy education (bachelor, master and doctoral). The process of developing the competencies followed a defined Tuning methodology involving collaboration with European educators (ENOTHE) and practitioners (COTEC) as well as other stakeholders (occupational therapy occupational therapy students, clients and employers). The work was externally validated under the support of European Commission by a group of experts in Brussels June 2007 which concluded with strong support for the document. The Tuning project defines competencies as a dynamic combination of cognitive and metacognitive skills, knowledge and understanding, interpersonal, intellectual and practical skills, and ethical values. Competencies describe what an occupational therapy does but are on a continuum and can be developed throughout a person s professional life. Tuning defines two types of competencies, Generic Competencies described by central Tuning management which are relevant for all disciplines within higher education, and Subject Specific Competencies defined by each discipline. The Tuning Occupational Therapy Project Group defined 35 Occupational Therapy Specific Competencies in six categories in line with the WFOT Minimum Standards: 4 European Network of Occupational Therapy in Higher Education (ENOTHE) and the Council of Occupational Therapists for the European Countries (COTEC) The World Federation of Occupational Therapists 8

9 Knowledge of Occupational Therapy (5) Occupational Therapy process and professional reasoning (9) Professional relationships and partnerships (5) Professional autonomy and accountability (5) Research and development in occupational therapy/science (6) Management and promotion of occupational therapy (5) The Generic and Occupational Therapy Specific Competencies are translated into 19 European languages and available at ENOTHE web ( These Generic and Occupational Therapy Specific Competencies are accompanied by Cycle Level Descriptors which are defined as broad expected learning outcomes of each of the tree cycles (bachelor, master and doctor degree), where the first cycle (bachelor) describe entry-level into practice (Tuning Occupational Therapy Group 2008) Canada 5 The Essential Competencies of Practice for Occupational Therapists in Canada, 2 nd Edition developed by the Association of Canadian Occupational Therapy Regulatory Organisations, outlines the essential competencies required for an occupational therapist to practice in any province in Canada. The Essential Competencies Framework outlines the competencies and performance indicators as: Assumes professional responsibility Demonstrates practice knowledge Utilises a practice process Thinks critically Communicates effectively Engages in professional development Manages the practice environment The Canadian Association of Occupational Therapists has also published the Profile of Occupational Therapy Practice in Canada: 2007, which describes the key competencies for the occupational therapist as a competent professional in relation to seven roles. Involvement in all seven roles is not equal, as not all roles may be part of everyday practice. The roles required in any situation are influenced by, and depend on, who the client is (i.e. individuals, groups, communities, or populations), where the work is being done, and what the client needs. The roles include: Expert in enabling occupation Professionals Communicators Scholarly practitioner Collaborator Change agent Practice manager 5 The Essential Competencies of Practice for Occupational Therapists in Canada, 2 nd Edition, The World Federation of Occupational Therapists 9

10 These two Canadian competency documents complement each other such that the Essential Competencies Framework document a minimum practice standard and the Profile describes competencies for entry to practice to the advanced extended scope practitioner. Australia 6 Competency standards in Australia include the Australian Competency Standards for Entry-Level Occupational Therapists. This document groups entry-level competencies into 7 units: Professional attitudes and behaviour Roles, performance and functional level of individuals and groups Implementation of individual and group interventions Evaluation of occupational therapy programs Documentation and dissemination of professional information Professional education Management of occupational therapy practice These Standards are currently being revised with the vision of developing a set of competency standards for entry-level occupational therapists which reflects contemporary and future occupational therapy practice in Australia. Another set of Australian occupational therapy standards, the Australian Competency Standards for Occupational Therapists in Mental Health identifies specific competencies in mental health as: Facilitate occupational development Work with teams Develop and maintain collaborative partnerships Undertake and support systems advocacy Undertake evaluation and research activities Manage professional practice Maintain professional development United Kingdom 7 The United Kingdom s regulatory body, the Health Professions Council, has published a suite of Standards of Proficiencies for a range of professions. The outline for the Occupational Therapists Standards of Proficiency is: 1. Expectations of a health professional 1a. Professional autonomy and accountability 1b. Professional relationships 2. The skills required for the application of practice 2a. Identification and assessment of health and social care needs 2b. Formulation and delivery of plans and strategies for meeting health and social care needs 2c. Critical evaluation of the impact of, or response to, the registrant s actions 3. Knowledge, understanding and skills 6 Occupational Therapy Competencies in Australia (various) 7 Occupational Therapists Standards of Proficiency United Kingdom Health Professions Council The World Federation of Occupational Therapists 10

11 Ireland 8 The identification of competencies of an occupational therapist on graduation has been the first project that the Therapy Project Office has focussed on. The completed framework identifies six areas of competence: Relationship of occupation to health and welfare Therapeutic and professional relationships The Occupational Therapy process Professional reasoning and behaviour The context of professional practice Practice knowledge and skills New Zealand The primary function of the Competencies for Registration as an Occupational Therapist 9 is to specify the entry-level competencies, which all occupational therapists must meet in order to be registered and practise in New Zealand. The core competency areas are: Implementation of occupational therapy Safe, ethical, legal practice Culturally safe practice Communication Management of self and people Management of environment and resources Continuing professional development United States of America The accreditation standards for educational programs for the occupational therapists delineate expected learning outcomes to ensure that graduates have achieved entrylevel competence as a generalist who can respond to the changing and dynamic nature of contemporary health and human services delivery systems that require occupational therapists to possess basic skills as a direct care provider, consultant, educator, manager, researcher and advocate for the profession and the consumer. Competence must be demonstrated in the following areas: Foundation Requirements Basic Tenants Occupational Therapy Occupational Therapy Theoretical Perspectives Screening, Evaluation and Referral Intervention, Plan Formulation and Intervention Context of Service Delivery Research Professional Ethics, Values and Responsibilities 8 AOTI Therapy Project Office A collaborative initiative between the professional bodies for Occupational Therapy, Physiotherapy and Speech and Language Therapy 9 Competencies for Registration as an Occupational Therapist. New Zealand Occupational Therapy Board, November The World Federation of Occupational Therapists 11

12 PART 3: ENTRY-LEVEL COMPETENCIES FOR OCCUPATIONAL THERAPY Philosophy and Purpose WFOT Minimum Standards for Education and Entry-Level Competencies Similar to the World Federation of Occupational Therapists Revised Minimum Standards for the Education of Occupational Therapists 2002, the entry-level competencies reflect the common issues and values that underpin the profession of occupational therapy. The Minimum Standards for Education outline 5 areas of competence: The person-occupation-environment relationship and its relationship to health Therapeutic and professional relationships An occupational therapy process Professional reasoning and behaviour The context of professional practice The particular knowledge, skills and attitudes in the 5 areas of competency will be determined by: The nature of the local health needs including prevention of disability The local health, welfare, disability and legislative systems Locally relevant health giving occupations Framework for Entry-Level Competencies The framework that has been identified for the entry-level competencies therefore uses the areas of competence as identified in the WFOT Minimum Education Standards. As a framework this leaves the specific competencies for each area of competence, knowledge, skills and attitudes to be determined and developed in each country or geographic region. Figure 2 defines the placement of the entry-level competencies in the career of an occupational therapist. The initial step into the profession following undergraduate/ entry-level education is being increasingly recognised as a separate career stage, leading to the requirement for entry-level competency standards to be documented. The World Federation of Occupational Therapists 12

13 Figure 2. Framework for Entry-level Competencies EXPERT EDUCATION SPECIALIST CONTINUING PROFESSIONAL DEVELOPMENT ENTRY LEVEL BASELINE COMPETENCIES WFOT MINIMUM STANDARDS FOR OCCUPATIONAL THERAPY EDUCATION The review in Part 2 of current Occupational Therapy competency standards in a range of WFOT member countries has shown some common groupings for standards. These have been further grouped or divided into two areas: 1. Expectations of an Occupational Therapist; and 2. Application of practice. The groupings for standards in these two areas are: 1. Expectations of an Occupational Therapist: 1.1. Governance, autonomy and accountability 1.2. Professional relationships 1.3. Professional management 2. Application of practice: 2.1 Underpinning knowledge, understanding and skills 2.2 Patient/client assessment and treatment implementation and evaluation Using the Competency Framework as a Career Path Figure 3 gives a diagrammatic representation of the entry-level competency framework as part of the building that is an occupational therapists career path. From the review of existing WFOT member country standards in Part 2, areas for specific standards in each group and area have been identified. These areas and groups form the framework for the entry-level competency standards. The World Federation of Occupational Therapists 13

14 Figure 3. The Framework Components Extended Scope Specialty Areas of Practice Enhanced Practice and Skills DEVELOPING ROLES Governance, autonomy and accountability Professional relationships Professional management Underpinning knowledge, understanding and skills Patient/client assessment and treatment implementation and evaluation Expectations of an Occupational Therapist Application of practice ENTRY-LEVEL COMPETENCIES Person-occupationenvironment relationship and relationship to health Nature of local health needs Therapeutic and professional relationships ENTRY-LEVEL EDUCATION Local health, welfare, disability and legislative systems Occupational Therapy process Professional reasoning and behaviour Locally relevant health giving occupations Context of professional practice Programme philosophy and purpose KNOWLEDGE SKILLS ATTITUDES Areas of the framework are: Expectations of an Occupational Therapist: Governance, autonomy and accountability Patient safety including risk assessment, clinical decision-making, standards and protocols and clinical pathways Recognition of communication and reporting structures Individual accountability and responsibility Legislation including statutory registration and WFOT requirements Professional relationships Roles in teams and in workplace Professional networks Professional management Patient needs and community needs assessment The World Federation of Occupational Therapists 14

15 Management of caseload and throughput Audit, reflection and review of practice Application of practice: Underpinning knowledge, understanding and skills Theory in frame of reference Ongoing learning that involves continuing professional development as a planned process Patient/client assessment and treatment implementation and evaluation Identification and assessment of health and social care needs Assessment processes Formation of plan using assessment data Delivery of service using the plan Evaluation and modification of treatment Application of the Entry-Level Competency Framework in WFOT Member Countries The WFOT Entry-Level Competencies Framework is a guide for WFOT member countries to assess competencies for therapists entering the profession following training and graduation. It does not replace or take the place of country-specific documents. Instead it provides a common link between similar documents in member countries. As therapists move between countries it is essential to have a framework that ensures a level or structure for competencies at entry-level to the profession. It is also essential that these competencies are linked to the WFOT Minimum Standards for Education; the Standards that form a basis for the education of occupational therapists throughout the world. The use of this document and the framework will differ, depending whether a member country has existing competency standards. WFOT member countries that have existing competency standards should review their documents to ensure that the competencies for entry-level therapists are consistent with the framework. The context/format should be specific to country requirements. For WFOT member countries that are yet to develop competency standards: The WFOT Entry-Level Competencies Framework should be used as a basis for the development of entry-level competency standards specific to the member country Existing documents such as those in Part 2 can be used as a guide, with appropriate permission and/or acknowledgement of the country/regional network that has developed the standards The World Federation of Occupational Therapists 15