Self-Assessment Tool for Occupational Therapists in Manitoba -CLINICAL PRACTICE- Based on the Essential Competencies of Practice for Occupational Therapists in Canada, 3 rd Edition, 2011 as well as on references to specific standards and guidelines for Manitoba Occupational Therapy practice. Name: Date: Instructions: Essential competencies are listed below along with associated action statements. Review each statement, reflecting on your current practice. After reflecting, indicate whether the statement accurately reflects your current practice, is an area requiring work or growth or is not applicable to your practice. The examples provided are to help you define and interpret the competency stated. All examples may not be relevant to your practice; however the competency may still apply to your practice. Many of the examples are drawn from COTM s standards and Practice Guidelines. Use the results from this self-assessment to assist you to complete your annual professional development plan. 1. Define your role, including any changes to your practice and/or setting since your last selfassessment. Text Box#1: Practice role and changes since last Self-assessment 1.2 Practices within scope of professional and personal limitations and abilities. 2. I am aware of, and refer to COTM s standards and guidelines for practice (e.g., Occupational Therapy Consultation to Third Parties, Client Records in Occupational Therapy Practice, Assignment and Supervision in Occupational Therapy Practice, Informed Consent in Occupational Therapy Practice as well as the COTM Code of Ethics, COTM Bylaws, The OT Act and OT Regulation) 3. I only perform procedures / activities that I have the authority to perform. 4. 5. I reflect on my own abilities, knowledge and skills and practice within my roles and responsibilities (e.g. develop technical skills as necessary, refer to other team members). I understand my role may overlap with other professionals and take steps to manage this overlap within the expectations of my practice setting (e.g., speak with manager, engage in inter-professional collaboration). Adapted with permission from: Self Assessment Tool for Occupational Therapists in Ontario (COTO, 2011)
1.3 Adheres to the Code of Ethics recognized by the provincial regulatory organization. 6. 7. I inform my client and other professionals of my title (Occupational Therapist), use appropriate professional credentials (OT Reg. (MB)) and provide the means of contacting COTM, on request. I maintain appropriate relationships and boundaries: I recognize the power imbalance inherent in professional therapeutic relationships and maintain appropriate professional boundaries (COTM Code of Ethics, 2010) I act in the best interest of the client to maintain trust, and do not exploit the professional relationship for any personal, physical, emotional, financial, social or sexual gain (COTM Code of Ethics, 2010) I reflect on how my personal and professional behaviours contribute to the work environment, and work to address behaviours that negatively impact on a trusting and respectful practice environment. (COTM Code of Ethics, 2010) I recognize the presence of coercion and work to minimize its impact. (COTM Code of Ethics, 2010) 1.4 Applies ethical frameworks to solve ethical situations. 8. I am aware of and respond appropriately to specific situation(s) denoting ethical issues encountered in practice including when I am required to report unsafe, unethical and/or incompetent practice, specifically: Reporting of unethical behaviour or unsafe practice to the appropriate parties (e.g., an employer, manager, supervisor, or COTM). Duty to report belief that a child is or might be in need of protection or that a representation, material or recording is, or might be, child pornography (18(1) and 18(1.0.1) of the Child and Family Services Act). Duty to report belief that another member (OT) is suffering from a physical or mental condition or disorder of a nature or to an extent that the member is unfit to continue to practise or that the member's practice should be restricted (64(1) of the Occupational Therapists Act). Duty to report abuse of persons in care (3(1) of the Protection for Persons in Care Act). Duty to protect vulnerable person from abuse or neglect and to report abuse or neglect of vulnerable persons (2.2 and 21(1) of the Vulnerable Persons Living with a Mental Disability Act). Page 2 of 10
1.5 Demonstrates professional integrity. 9. I demonstrate professional integrity by considering the impact of my own values and beliefs and those of my clients, interprofessional team and other stakeholders (e.g. sensitivity to diversity, religion, power imbalance, age, gender, cultural beliefs, ability, etc.) 10. I am alert to and effectively manage perceived and actual conflicts of interest by communicating openly and honestly in a clear and caring manner and respecting the clients right to comprehensive OT services as per the Code of Ethics (COTM, 2010). 11. List specific examples from your practice that demonstrate the 4 competencies above. Text Box#2: Specific practice examples for Assumes Professional Responsibility 2.1 Demonstrates sound professional judgment and clinical reasoning in decision-making. 12. When providing client services I apply critical thinking and reasoning to my decision making process by: Demonstrating evidence- based problem solving and judgment to address client needs Integrating previous learning, experience and professional knowledge in daily practice Integrating the complexity of client issues, needs and goals into services provided Considering and prioritizing information collected during the screening and assessment process to determines services 2.2. Engages in a reflective and evaluative approach to practice that integrates findings into practice. 13. I seek input from other health professionals related to client services (e.g., refer to others during discharge planning, refer to other services, seek input during the course of treatment, etc.). 14. I adjust, limit / modify or discontinue services when necessary. Page 3 of 10
15. List specific examples from your practice that demonstrate the 2 competencies above. Text Box#3: Specific practice examples for Thinks Critically 3.1. Uses current occupational therapy theory in day-to-day practice. 16. 17. I apply knowledge from current information and literature regarding theories, models and practice approaches., (i.e. general scientific knowledge such as anatomy, neurophysiology, etc.) I integrate current knowledge of OT theory, models and evidence into practice (e.g., specific evidence-based theory and models related to OT practice). 18. List specific examples from your practice that demonstrate the competency above. Text Box#4: Specific practice examples for Demonstrates Practice Knowledge 4.1 Clarifies the role of occupation and enablement when initiating services. 19. 20. Prior to accepting the referral I screen it to determine the appropriateness for service for example: Review and confirm accuracy/currency of information provided in the referral; Distinguish the client from other stakeholders and determine if there are any conflicts of interest (e.g. dual relationship, competing interests); and Determine if any established inclusion or exclusion criteria for the assessment/service apply.(e.g. program eligibility criteria, regulations) I clarify expectations of services with the client and stakeholders (e.g., assessment only, frequency / duration of visits, reason for referral, funding source / fees). Page 4 of 10
4.2 Demonstrates a systematic client-centered approach to enabling occupation. 21. I demonstrate a client-centered approach by: Engaging in a collaborative approach with the client Confirming clients understanding of services to be provided and (if possible) coming to an agreement Allowing the client to identify issues, concerns, expectations and priorities Allowing time for the client to consider the risks and consequences of options presented related to services to be provided 4.3 Ensures informed consent prior to and throughout service provision. 22. 23. 24. 25. I provide complete and accurate information to enable the client to make an informed decision regarding the need for, and nature of, occupational therapy services, including information about the anticipated benefits and risks of accepting or refusing such services. Code of Ethics (COTM, 2010) I obtain and document informed consent for occupational therapy services orally or in writing including instances of when it is implied. I recognize that persons have the right to refuse or withdraw consent for care or treatment at any time. Code of Ethics (COTM, 2010) I ensure informed consent is provided by the appropriate person (e.g., capable client or alternative-decision maker as described in the Practice Guideline: Informed Consent in Occupational Therapy Practice (COTM, 2006) and the Code of Ethics (COTM, 2010). I obtain informed consent for occupational therapy services provided by those under my supervision, such as students and support personnel. Code of Ethics (COTM, 2010) 4.4 Assesses occupational performance, engagement, and enablement needs of client. 26. Within the OT service mandate I assess occupational performance (selfcare, productivity, and leisure, expectation, and goals) related to the person (cognitive, affective, meaning, values, physical) and the environment by: Identifying the occupational performance issues to be assessed based on information gathered; and Selecting a theoretical approach and related assessment methods and tools that are appropriate for the client (age, diagnosis, environment etc.). Page 5 of 10
4.5 Develops client-centered plan with client, interprofessional team members, and other stakeholders. 27. I develop client-centered plans in collaboration with the client, team and stakeholders by: Integrating client wants and needs into all aspects of planning. Identifying the client s priorities for occupational issues and goals. Analyzing factors which impact on occupational performance and engagement issues.(e.g. physical, cultural, social, institutional, and environmental) Analyzing and proposing options to increase inclusion and accessibility in the client s environment when appropriate (e.g. cultural, institutional, physical, social factors) Developing realistic, measurable, understandable targeted outcomes/goals consistent with the client s values and life goals. Planning for needed service delivery, which considers limits or constraints on the various service delivery methods (e.g. resources, support personnel, time, equipment, environment, frequency and duration of service, etc.). Referring to additional services as appropriate (e.g. funding, equipment, community services, other professional services, social agencies, etc.). 4.6 Implements plan for occupational therapy services. 28. I implement a client-specific plan, in collaboration with the client and stakeholders, which may include recommendations, direct service and/or consultation. 4.7 Monitors plan to modify in a timely and appropriate manner. 29. I regularly re-assess client s progress and modify the plan accordingly (modify / change recommendations, change discharge plans, goals, or outcomes). 30. List specific examples from your practice that demonstrate the 7 competencies above. Text Box#5: Specific practice examples for Utilizes an OT Practice Process to Enable Occupation Page 6 of 10
5.1 Communicates effectively with the client, interprofessional team members, and other stakeholders using client-centered principles that address physical, social, cultural or other barriers to communication. 31. I communicate effectively with clients, team members, and other stakeholders by: Delivering information in a respectful, thoughtful, and in an understandable manner. Using strategies that empower communication (prompting client to ask questions, use of adaptive technology, team meetings, etc.) Identifying barriers to communication (language, literacy, hearing, culture) and use strategies to address these barriers. 5.3 Maintains confidentiality and security in the sharing, transmission, storage, and management of information. 32. I maintain confidentiality and security of information when managing, sharing, transmitting and storing information by: Complying with all provincial legislation and professional regulations regarding confidentiality. Collecting and using only that information which is relevant and necessary for quality service delivery. Taking action to safeguard personal information while in the process of collecting, recording, releasing, securing and destroying information. Being explicit with clients regarding the use and disclosure of their information, including how it is used in the context of providing services. Sharing personal health information with others only with the authorized consent of the client, or where failure to disclose would cause significant harm, or if legally required. Recognizing that a duty of confidentiality remains even after the therapist-client relationship has ended. Not abusing access to information by accessing healthcare records, including my own, a family member s, or any other person s, for purposes inconsistent with my professional obligations. Advocating for their clients to receive access to their own healthcare records through a timely and affordable process, when such access is requested. Ensuring secure transmission of information when using email (e.g. referring to employer guidelines) Identifying risks that could lead to a breach of confidentiality and security and act to decrease / limit these risks (e.g. ensuring correct recipient of a fax, proper application of encryption and password protection, USB, mobile devices etc.). Page 7 of 10
5.4 Collaborates with client, interprofessional team and other stakeholders. 33. I collaborate with the client, team members, and stakeholders by: Considering the opinions and perspectives of others Demonstrating flexibility within the team (by consulting and collaborating with, listening to, supporting, and responding to the team) Asking for support and demonstrating leadership when needed 5.5 Works effectively with client, interprofessional team, and other stakeholders to manage positive professional relationships. 34. I work effectively with the client, team and stakeholders by: Demonstrating a sensitivity and adaptability to my approach and considering issues related to diversity and differences (e.g., impact of age, gender, religion, cultural beliefs, sexual orientation, ethnicity, ability, etc.) Demonstrating a willingness to set team goals and priorities Communicating openly and considering other opinions Effectively managing differences / conflicts with others (in a diplomatic manner) 35. List specific examples from your practice that demonstrate the 4 competencies above. Text Box#6: Specific practice examples for Communicates and Collaborates Effectively 6.1 Uses self-evaluation, new learning and evidence in professional development. 36. I conduct a regular assessment of personal learning needs by: Monitoring the impact of changes in practice and areas of responsibility Adjusting the assessment with external information such as performance review, client, peer and supervisor feedback Considering the impact of new sources of knowledge to my practice (e.g. research articles, guidelines, conferences, discussion groups, critical appraisal). Page 8 of 10
6.2 Demonstrates commitment to continuing competence. I maintain knowledge, skills and attitudes needed for efficient effective service and take action by: 37. Providing evidence informed practice Taking action to address deficiencies to enhance practice 38. List specific examples from your practice that demonstrate the 2 competencies above. Text Box#7: Specific practice examples for Engages in Professional Development 7.1. Manages day-to-day processes. 39. I prioritize my time and allocate my OT services by balancing client needs and resources. 40. I recognize personal and professional limits on effective functioning and manage my professional responsibilities accordingly (e.g., I limit or stop work if physically or mentally unable to practice safely and effectively; I monitor the impact of work- life balance on professional responsibilities). 7.2. Manages assignment of service to support personnel, other staff, students, and others under the occupational therapists supervision. 41. I assign appropriate work and manage assignments of services to support personnel, and/or students by: Assigning appropriate work activities as per the COTM Practice Guideline: Assignment and Supervision in Occupational Therapy Practice (COTM, 2006). Orienting the support personnel/ student to the role, duties, and responsibilities. Supporting effectiveness and safety. (e.g. monitoring, fieldwork supervision, supervision, mentoring, teaching, and coaching.) Providing regular feedback and/or evaluation (e.g. learning objectives, evaluation forms, etc.) Page 9 of 10
7.3. Contributes to a practice environment that supports client-centered occupational therapy service, which is safe, ethical, and effective. 42. 43. I participate in established organizational processes, (e.g., workload measurement tool, annual performance review, billing processes, or intake processes) I advocate for consistency between my practice setting policies and the COTM Guidelines when required (e.g., number of years client records are maintained, requirements for client consent, privacy and confidentiality issues) 7.4. Demonstrates commitment for client and provider safety. 44. 45. I integrate safe practices into daily activities (e.g., infection control protocols/standards, seeking assistance with client transfers, verifying accuracy of information, using checklists, investigating mismatches between current situations and the expected state.) I consider high risk clinical situations and manage potential risks related to client and personal safety (e.g., infectious disease issues, mental and physical health of client, the environment in which the services are provided) by: Demonstrating situational awareness by continually observing the whole environment, thinking ahead, and reviewing potential options and consequences; Recognizing safety problems in real-time and responding to correct and prevent them from impacting the client; and Employing safe practices. 7.6. Advocates for the occupational potential, occupational performance, and occupational engagement of clients. 46. I manage the inherent conflict between my advocacy role for my client and the realities of finite services and resources. 47. I advocate appropriately for the role of occupational therapy to clients and the interprofessional team. 48. List specific examples from your practice that demonstrate the 5 competencies above. Text Box#8: Specific practice examples for Manages Own Practice and Advocates Within Systems Page 10 of 10