U of T occupational therapy student Heather Moyse participated in the 2006 Winter Olympics as the brakeman for the Canadian women's bobsled team - Canada 1. They missed a bronze medal by less than 1/10th of a second! Her story begins on page 5.
May - June 2006 Volume 8 – Number 3 P h o t o
D a v i d
B u s t o table of contents n
2 10 22 Letter to the Editor Critically Appraised Papers The acculturation of interna- Re: Do people with schizo- tionally educated health phrenia improve equally in professionals in Canada 3 learning to cook in clinic Claudia von Zweck and at home? Editorial 10 • Structured Abstract Mary Clark 11 • Commentary 25 Catherine Vallée Qualification recognition framework underway for 5 support personnel Sense of Doing 14 Donna Klaiman Pushing the boundaries: In memoriam: occupational challenges and Jocelyn Alexander the drive to reach potential 26 Heather Moyse Tal Jarus arrives at UBC CAOT endorsed courses 7 15 27 In touch with assistive 2005-2006 Mid-year report: News from the Foundation technology Claudia von Zweck An occupational therapist’s intellectual property: FAQs 32 Tapas K. Pain 19 Occupational therapy then: Why government relations Stories from our past matter If these walls could talk, Donna Klaiman what would they tell us? Heather McDonald
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 1 Letter to the editor Occupational Therapy Now is published six times a year (bimonthly beginning with January) by the Canadian Association of Occupational Therapists (CAOT). Dear Ms. Clark ence to the treatment of the First I was surprised to read the title Nations people in Canada and also MANAGING EDITOR Mary Clark, BScOT, MDE The Canadian Holocaust- retriev- in how it might be perceived by Tel. (604) 536-4575 (BC) ing our souls. I sympathize with those who feel that the term holo- e-mail: [email protected] the plight of the First Nations caust should be reserved for the COLUMN EDITORS people. However, to use the word atrocities of World War II. This Critically Appraised Papers “Holocaust” is inappropriate. Six information was shared with the Lori Letts, PhD million Jews in addition to hun- author who felt that the term was International Connections Anne Carswell, PhD dreds of gypsies and physically/ appropriate and is used by others In Touch with mentally challenged people were in describing the residential Assistive Technology exterminated, sent to the gas schools and First Nations treat- Elizabeth Steggles, Dip OT chambers. ment in Canada. Sense of Doing Occupational therapist Sincerely Helene J. Polatajko, PhD & Jane A. Davis, MSc Debbie Bauer, CAOT member Mary Clark Tele-occupational therapy Managing Editor, OT Now Lili Liu, PhD and Editor’s Note Masako Miyasaki, PhD Many thanks for your letter of Dear Ms. Clark Watch Your Practice concern. We did consider many The fundamental objection of the Muriel Westmorland, MSc Private Practice Insights definitions of the word holocaust Jewish community to the use of Lorian Kennedy, MScOT in our decision to print the title as this term to describe any genocide written by the author. We found, other than the one which decimat- TRANSLATION De Shakespeare à Molière, that although the term ‘holocaust’ ed the Jewish people can be sum- Services de traduction is most frequently used in refer- marized as follows: ence to World War II, this is not 1. Those who were murdered by COPY EDITOR David Dolsen the only holocaust that has the Nazis were progressively occurred in the history of stripped of their rights, their ON-LINE KEY WORD EDITOR Kathleen Raum mankind. These definitions were humanity and their lives. Even in carefully reviewed in terms of the death they were denied the dignity CAOT EDITORIAL BOARD Chairperson: Catherine Vallée word’s appropriateness in refer- continued on p. 4 Members: Pam Andrews, Emily Etcheverry, Gail Langton,
Anita Unruh & Brenda Vrkljan. 8 1 4
Statements made in contributions to COPYRIGHT Ex-officio: Mary Clark, 4 3
Occupational Therapy Now are made solely Copyright of Occupational Therapy Now is Fern Swedlove 0 0
on the responsibility of the author and held by the Canadian Association of 4 #
CAOT PATRON
unless so stated do not reflect the official Occupational Therapists. Permission must be T
Her Excellency the Right N position of CAOT, and CAOT assumes no obtained in writing from CAOT to photocopy, E
responsibility for such statements. reproduce or reprint any material published Honourable Michaëlle Jean C.C., M E
C.M.M., C.O.M., C.D. E
Occupational Therapy Now encourages dia- in the magazine unless otherwise noted. R
logue on issues affecting occupational thera- There is a per page, per table or figure Governor General of Canada G A
pists and welcomes your participation. charge for commercial use. Individual mem- T CAOT PRESIDENT S bers of CAOT or ACOTUP have permission to O P EDITORIAL RIGHTS RESERVED photocopy up to 100 copies of an article if Diane Méthot A
such copies are distributed without charge D Acceptance of advertisements does not imply CAOT EXECUTIVE DIRECTOR A for educational or consumer information N endorsement by Occupational Therapy Now Claudia von Zweck A nor by the Canadian Association of purposes. C Occupational Therapists. RETURN UNDELIVERABLE Copyright requests may be sent to: CANADIAN ADDRESSES TO: Lisa Sheehan ADVERTISING Canadian Association of Occupational CAOT – CTTC Building Lisa Sheehan Therapists (CAOT) 3400 – 1125 Colonel By Drive Ottawa, Ontario KIS 5R1 CAN (613) 523-2268, ext. 232 CTTC Bldg., Suite 3400 2 3
e-mail: [email protected] 1125 Colonel By Drive E-mail: [email protected] 5 5 Ottawa, ON. Tel. (613) 523-2268 - 1
SUBSCRIPTIONS Tel. (800) 434-CAOT (2268) 8
Canada K1S 5R1 4 1
Linda Charney Fax. (613) 523-2552
Tel. (613) 523-2268, ext. 232 :
(613) 523-2268, ext. 242 Fax. (613) 523-2552 N www.caot.ca • www.otworks.ca S S e-mail: [email protected] e-mail: [email protected] I
2 OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 Editorial Mary Clark
en years ago, when former CJOT Editor reports that challenged the positions of the associ- Geraldine Moore and I presented a paper at ation and shed light on questionable practices of Tthe CAOT Conference in Edmonton, Sue members of other health professions. The result Forwell, the speakers’ introducer, stated that I had was to replace the editors with what the publisher been editor of the National newsletter for over 13 described as “a fresh approach”. years. It threw my entire presentation. Thirteen CMAJ is a peer reviewed medical journal that years – could it have been that long? Well, it was, provides health information to Canadian doctors and now after moving the newsletter to and the public, and which, according to the early Occupational Therapy Now, I’ve pushed it to 23 electronic release on March 16 of an editorial in years and I am in equal disbelief. To grossly the New England Journal of Medicine, is ranked as understate the situation, it’s probably time for a the 5th leading medical journal in the world. In change. addition to peer reviewed research articles, it pub- I’ve always maintained that I have had one of lishes commentaries and news reports. All three the best jobs the profession has offered in Canada. types of articles are quite capable of containing As editor of Occupational Therapy Now, I have information that is contrary to the positions of the had the pleasure of working with both established CMA, so policies concerning editorial independ- and new writers who volunteer their time to write ence require careful consideration. The CMAJ edi- about what matters to them and about what mat- torial board felt that news reporting in the journal ters to the profession. The support that I have is as important as peer reviewed research papers. received from my column editors, the CAOT They placed the two side-by-side. In some ways, National Staff and the CAOT Editorial Board, you could say they popularized their journal. In including the now defunct OT Now Advisory my opinion, they successfully married scholarly Committee, has been outstanding. A special thanks academic writing with acute journalism. Bravo. goes to our translator and colleague Luce Ouellet In doing so they broadened the appeal of the who quietly translates no less than 10,000 words journal, and maintained that it is an important each issue, ensuring that language is not a barrier publication not just for Canadian doctors but also to accessing articles in OT Now. I am leaving at a the Canadian public. The full journal is available very positive time and am happy to pass the red online and thus accessible to anyone with access pen on to my colleague Fern Swedlove, who is to the Internet. It is one of the few, if not the only, transferring her editorial prowess from CJOT to health professional journals to do so in Canada, OT Now. I thank you all very much. and therefore has moved beyond enlightening just Other editors have not been as fortunate. its own to enlightening the public in general. Setting the editorial direction and policies for Unfortunately the CMAJ’s editorial board association publications is not easy. Developing failed to convince the association to move beyond frameworks to ensure editorial independence and serving just its own. The CMA appears to have balancing the public’s right to know with the difficulty with open debate regarding their posi- desire to protect a profession’s reputation, have tions and with responsible journalism that holds been brought to the forefront with the February professionals accountable for unethical practices. firing of the senior editors of the Canadian This shortcoming has drawn international atten- Medical Association Journal (CMAJ). Apparently tion and brought to the forefront the issue of the the Canadian Medical Association (CMA) had been ‘public’s right to know’. Interestingly, the outrage unhappy over published editorials and news over the firings has come from both within and
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 3 outside the medical profession. CMAJ was indeed occupational therapists in Canada to support all of successful in developing a loyal audience outside CAOT’s efforts, including encouraging the associa- of its own. tion to continue to explore new ways in which it At CAOT, we have two separate publications. can further increase accessibility to its publica- OT Now is the association’s voice; it publishes tions. CAOT reports, commentaries, practice information I can see the smile developing on those who and the occasional consumer tip. We can’t afford have heard my speech before. You have to forgive reporters and writers, so investigative journalism my passion; in my 23 years I have watched the is out. OT Now frees CJOT to concentrate on profession evolve from discussing the therapeutic scholarly publishing, and whether this scope use of activity to researching the effectiveness of should be broadened may be one of the points interventions that enable occupation. I see the discussed at the upcoming editorial board’s strate- impact of occupational therapy, and believe the gic planning session for CJOT. CAOT actively public has a right to know of its effectiveness and explores and monitors access to its information its challenges. I leave my job undone. There is so including OT Now and CJOT. Increasing access to much to tell, and we must find more ways in our publications, as has CMAJ, is one way to which to do this, well beyond our internal audi- increase the public’s recognition of occupational ence. After all — how can we be client-centred therapy and its role in promoting health and peo- and insular at the same time? ple’s quality of life. It may be time to challenge I anxiously await the next chapter.
Letter to the editor, continued from p. 2
of a grave. Survivors who wish to commemorate States feel if other groups appropriated such terms the death of loved ones have no grave to visit, no as Trail of Tears or such tragic landmarks as headstone to touch. In many cases they lack even Wounded Knee for their own uses? How would a date of death to allow them to utter the Kaddish members of Canada’s First Nations communities prayer. For these individuals, the term “Holocaust” respond to usage of the term Residential School to represents the only graveyard they will ever describe any experience but their own? know. Misuse of that term is therefore seen as improper. The issue, you see, is not solely whether the term Holocaust “fits” other acts of genocide (and there 2. There have been many incidents of genocide in are many who would argue that the Holocaust human history but many of these have been given was unique - or at least unprecedented - in histo- a special identifier by those who grieve. Our ry), but also has to do with sensitivity to the indi- friends in the Roma community refer to their viduals who suffered and died under Nazi terror experiences under the Nazis as the Pourranous and to the larger Jewish community that has been (“The Devouring”). Members of the Ukrainian collectively traumatized by this tragedy. community refer to the deliberate starvation of their people under Stalin as the Holodomar. To Len Rudner bring the matter closer to home, how would mem- National Director of Community Relations bers of the First Nations community in the United Canadian Jewish Congress
4 OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 s e n s e
Pushing the boundaries: occupational challenges and o
the drive to reach potential f
Heather Moyse d o i n
ver the past five months I have undergone antee to become an Olympian. For many people, g an incredible occupational experience. As the chance to become an ‘Olympian’ would win Othe brakeman for the Canadian women’s over anything else, but for me that pitch was not bobsleigh team – Canada 1 – along with my pilot enough. Throughout my athletic career I always Helen Upperton, we ranked second in the world competed for the love of the sport and strived to and placed fourth at the Olympics. In this article I reach occupational mastery in every sport I tried. share my reflections as an Olympian and a future Rugby was my main sport, however as it is not an occupational therapist, with a view of the power Olympic event my goal was the World Cup, which of one’s sense of doing and path to occupational only happens every four years. Simply becoming mastery. an Olympian wasn’t appealing enough for me, This time last year, I was in my first year of because it didn’t seem to be much of a challenge the master’s program in occupational therapy at at the time. I didn’t want it if it was going to be the University of Toronto, and playing rugby for ‘handed’ to me. As well I had other occupational the national senior women’s rugby team. At the dreams. I wanted to work in a developing country same time this year, I was in Italy competing in and had plans to move to Trinidad and Tobago the Olympics. Although I have been involved in that fall. I was going to be developing sporting many different sports over the years, bobsleigh programs for people with disabilities and I ended wasn’t even a part of my vocabulary a year ago; up spending the next two and half years doing however, since I was introduced to it in August it just that. has become a significant part of my occupational The few people who knew about that Olympic repertoire. One might ask why someone would chance respected and understood my decision, leave everything they know and do so well, and however, they still wondered how I would have pick up a relatively random sport that they’ve done in bobsleigh. Although I never once regretted never even seen before. Well, the answer is that my decision, I often wondered too. Opportunities P
h the challenge was such as these rarely come along twice, so when I o t o
too tempting to was approached again this past year, in the sum- D a v
i resist. mer before the 2006 Winter Olympics, I couldn’t d
B
u In the summer say no a second time. It still wasn’t an easy deci- s t o n before the 2002 sion and I endured much internal debate. I had Winter Olympics, enjoyed immensely my first year as a professional a recruiter master’s student, had made some great friends and approached me was excited about becoming an occupational ther- from Bobsleigh apist. In addition, I would have to give up a rugby Canada. It was an tour to France with the National team; I found Olympic year and myself in a complicated situation and had to the first year that rethink my occupational goals. Could I leave the women’s bob- two main occupations that had given me a name sleigh was an and helped define my identity, and enter a world Olympic event. He where I was anonymous, in a sport that I knew pitched to me that nothing about? But… the challenge was too as a sprinter and appealing. Could I learn a new sport? Could I mas- rugby player, I ter it in less than five months? It was a challenge was ideal and that, as an athlete, I found hard, and ultimately potentially would impossible, to resist. I suddenly found myself in a U of T occupational therapy student Heather Moyse (left) with pilot do really well with new environment, with new people, doing a brand Helen Upperton an ‘almost’ guar- new occupation, trying to learn all of the ropes in
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 5 s e n s
e As a future occupational therapist, reflecting on my experiences over the past year,
I’ve realized that people do different occupations for the same reason, o
f or the same occupations for different reasons.
d o i
n a very short period of time – like a baby on wob- At the Olympics, Helen and I set another push-start
g bly legs, learning how to walk for the very first record, breaking the old record by 0.06 seconds, time. and we finished fourth, 0.05 seconds away from a Although I was showing a lot of potential in medal. Fourth place is a tough place to be, but my the beginning, people doubted my ability to trans- race is the first 50 metres. After that point I have fer my testing skills to pushing at the top of a no control over the downtime, so as long as I can track. That made me even more determined. I did- be the fastest in my role, I’ve done my job. n’t put all my previous occupations on the back- Since arriving home many people have asked burner – put my master’s degree on hold, move about my experience at the Olympics, being in an away from friends and family, and jeopardize my environment of occupational mastery. It’s strange. chance to make the Rugby World Cup team – just For spectators, an Olympic medal or a world to play around! I was going to make the experi- record means that you’re the best – a prime indi- ence worthwhile, and prove that I deserved to be cator of occupational mastery. However, I believe there. I’m a fast learner. So why couldn’t I do it? that I’m the same as many world-class athletes Why couldn’t I be the fastest brakeman in the who, although sometimes pleased with their per- world? I really didn’t know much about bob- formances, know that there is always room for sleighing. Therefore, it was the challenge that I improvement. I can always get better and do initially fell in love with, not the sport! more. Although I now hold push-start records at The whole season was a whirlwind, and at five tracks, those are now records to be broken – times a roller-coaster ride with emotions and either by someone else or again by me. I know intensity. Lifting weights was an occupation which that I have accomplished a great deal over the I had never done and never wanted to do. past five months, but maybe that’s what makes an However, I decided that if I really wanted to see elite athlete elite – the drive and determination what I could accomplish in five months, I would never to be ‘just satisfied’ with a performance. commit to doing the full program. At first, it was Maybe that’s what has helped me to ‘master’ the hard to do things in training that were so foreign other occupations in my life, and why I had to me while my team mates were breezing through turned down the ‘almost’ guarantee of being an the workouts. But I was determined to see this Olympian the first time. For me, if it’s not chal- challenge through, and succeeded in posting the lenging, then it’s not as appealing! So, I set the fastest times in the world, setting four new push- bar for each challenge, but once that’s reached, I start records during the World Cup season. I came raise the bar higher. For me, the ultimate chal- to love the sport as well as the challenge, and I no lenge is… how high can I raise the bar? longer felt lost in my new occupation. As a future occupational therapist, reflecting Being at the Olympics was an exclamation on my experiences over the past year, I’ve realized point at the end of a fairly surreal season. This that people do different occupations for the same whole year happened so fast that I’m just now reason, or the same occupations for different rea- beginning to realize what I’ve actually accom- sons. People are driven by various forces, having plished. Throughout the year I was just doing my come from diverse past experiences and, therefore, job, pushing as fast as I could, and somehow I the sense of meaning and purpose of our clients made it. I think I was down-playing the Olympics can vary. By understanding this, it will help us, as for so long to avoid being caught up in all of the occupational therapists, to enable our clients’ distractions – the people and the cameras. I was potential. People need to feel as if they can – a there for the Olympic ‘competition’, not the real sense of doing! Someone once said, “By fac- Olympic ‘Games’, and I just had to stay focused ing our challenges, we discover our potential.” and do my job – push the sled as fast as I possibly Many people thought that I was crazy to start could. Whether we were ranked tenth or second it bobsledding but after five months I competed in wasn’t going to change what needed to be done. the Olympics, so now I know I can!
6 OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 i n
t o u c
An occupational therapist’s intellectual h
property: FAQs w i t
Tapas K. Pain h
a s s i s t i v
ccupational therapists are creative by same internal resources for handling intellectual e
design, and as enablers of occupational property as Rigby, placing them at an informa- t
Oengagement they often develop innovative tional disadvantage. This article aims to answer e
assistive technology (and other intellectual proper- some frequently asked questions (FAQs) that arise, c
ty) within a clinical setting. However, commercial- specifically geared toward intellectual property h
izing that intellectual property, with seamless rein- issues for occupational therapists. n
tegration into a clinical setting, remains an often- o How can assistive technology created in a clinic be insurmountable obstacle for most occupational l therapists primarily because of the lack of publicly protected from commercial theft? o accessible “how-to” information and support. Patents protect functional aspects of inventions g Some occupational therapists, like Patty Rigby (either products or methods) for 20 years from the y of Bloorview Kids Rehab (formerly Bloorview date of the filing of an application (assuming the Macmillan Children’s Centre), are fortunate enough patent is actually granted) (Canadian Intellectual to have internal support in this area with access to Property Office (CIPO), 2004). In Canada, methods engineers, like Steve Ryan, who are more experi- of medical treatment generally are not patentable enced in such commercial ventures1, and commit- but diagnostic methods are. To be patentable, an tees focused on researching and answering invention must be: i) novel; ii) useful (i.e., solve a 2 inevitable questions that arise. Recently, Rigby and known problem); and iii) non-obvious in light of Ryan (2005) described their experience in the com- that which is already publicly known. Patents are mercialization of their Embrace™ Pelvic Positioner. national in scope, and country-specific. Industry In an interview with this author, Rigby explained Canada provides facilities for filing national that as part of that project, patent applications and applications under the they were required to explore Patent Cooperation Treaty (facilitating filing in Tapas K. Pain, MSc commercial prospects for their multiple foreign jurisdictions including the United (Phm), LLB, a proud pelvic positioner. In doing so, States, Asia, Europe, Australia and others). member of CAOT and a Rigby was able to delegate If the technology is not patentable, are there other founding partner of certain aspects of the project, Pain & Ceballos LLP, is forms of protection? including arranging for ade- In certain instances where products are not a patent and trade- quate protection of their inno- mark lawyer, licenced patentable, they may be eligible for protection by vation, disclosure to third par- industrial design (CIPO, 2003) (also known as in Canada and the ties, locating commercial United States, and can ‘design patent’). Registered industrial designs are prospects, assignment of their good for ten years from the date of registration be reached for ques- rights (under the terms of tions at 905-851-8542 but are limited to protecting shape, configuration, Bloorview’s intellectual prop- and ornamentation, whereas patents protect or 1-866-282-2570 erty policy), and subsequent extension 221, or by licensing concerns (for 1 e-mail at Bloorview). Mr. Ryan’s experience includes being named in five other patents and design registrations. [email protected] Most occupational thera- 2 A proper discussion of the concept of obviousness is beyond the pists do not have access to the scope of this paper.
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 7 i n
t o u
c Assistive technology can get to market by individual development, h licence, or sale to third parties.
w i t h functionality. Alternatively, depending on the Do I sell or licence the technology, and where does
a technology and the manner in which it is used the money go?
s and disclosed, it may be suitable for protection by Assistive technology can get to market by individ-
s trade-secret. ual development, licence, or sale to third parties. i
s Individual development requires tenacity, know-
t How can disclosure of the technology be made how, a detailed business plan, and usually signifi- i safely? v cant investment capital. Under a licence, a licens-
e Disclosure to commercial prospectors can be: 1) ee pays royalties to a licensor for ongoing usage
unconditional; 2) subsequent to a non-disclosure and exploitation of a patented technology (or t (or secrecy) agreement; or 3) subsequent to filing
e trade-secret). The royalties can be directed in sev- a patent application. The first method of disclo-
c eral ways, including stimulating further research sure is not recommended, and the second and h and development, funding and expanding clinical third are reasonably effective at deterring both n practices, or rewarding investors, thereby creating short and long-term commercial misappropriation o a desirable future investment environment. A sale (infringement). In the third, if a patent is issued, l typically transfers all rights (including patents), is o the deterrence level increases, and is generally the a one-time event, and leaves the seller without g most effective of these three methods. Patents recourse subsequent to the sale. y offer nationwide relief against infringers whereas non-disclosure agreements must be enforced on a How is the technology brought back to clinical province-by-province basis (and are generally practice after sale or licence? more problematic). This question is often the most significant for health-care practitioners. Commercialization and What’s in a name? exploitation of therapeutic technologies does not Consumers (including therapists) tend to identify necessarily mean the technology becomes unavail- products and services by brand (i.e., trade-marks). able to the originating therapist, originating clinic, For example, the word “Embrace” in Embrace or the public. Even when technologies are sold, it Pelvic Positioner and the acronym EPP arguably is possible to obtain and implement non-exclusive act as trade-marks, allowing therapists to distin- perpetual royalty-free licences in exchange, per- guish this brand from another, and identify the mitting continual clinical and public access. Such commercial source of this product as (depending reversionary interests should be negotiated and on the agreement involved) BodyTech NW of detailed early in any commercial dealing to avoid Seattle, WA, Patty Rigby and Steve Ryan of significant and expensive conflict. The cost of Toronto, Ontario, Bloorview Kids Rehab, or the including this feature in a larger commercial deal 3 University of Toronto. The value of a trade-mark, can be negligible. when properly grown and nurtured, often can overshadow the value of a patent (consider for Where do we go from here? example the trade-mark IBM™ and then try to list Protection of intellectual property is only the first from memory ten patents owned by IBM™). Trade- step to successful commercialization, and there- mark registrations are federal in scope, relatively after the therapist’s choice of direction is governed inexpensive, and can be renewed perpetually largely by entrepreneurial will and/or an employ- (CIPO, 2005). er’s intellectual property policy, if applicable.
3 Supra note 1. en by tax considerations. Even where incorporation is selected, 4 Incorporation is not necessary, and is normally done to limit per- therapists and clinics are not obligated to incorporate as a not- sonal liability, offer a structured investment environment, raise for-profit corporation. Corporate structures tend to have higher capital, and reduce tax liability. Entities can be incorporated fed- profitability, overhead, visibility, monetary liability and accounta- erally or provincially, and often the choice of jurisdiction is driv- bility (to shareholders, banks and government).
8 OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 i n
t o u c h
Some of the questions and answers above assume w
that the therapist in question has no desire to i leave a clinical setting. Where a therapist does t h choose to leave, other questions inevitably arise, 4 such as: “Must I incorporate a company?” ; “What a
should be included in a supplier and distributor s agreement?”; “Do I have to register for a goods s i and services tax (GST) number?”; “What are my s product liability issues?”; and “Should I carry t i insurance?”. Answers to these and other inevitable v questions are beyond the scope of this paper, and e should always be sought from experienced legal t
and business counsel. e
References c
Canadian Intellectual Property Office. (2005). A guide to trade- h
marks. Retrieved March 16, 2006, from n http://strategis.gc.ca/sc_mrksv/cipo/tm/tmguide-e.pdf o http://strategis.gc.ca/sc_mrksv/cipo/patents/patguide-e.pdf l
Canadian Intellectual Property Office. (2003). A guide to industrial o
designs. Retrieved March 16, 2006, from g http://strategis.gc.ca/sc_mrksv/cipo/id/idguide-e.pdf y Rigby, P., & Ryan S. (2005). From concept to distribution: Developing a new positioning device. Occupational Therapy Now, 7(1), 8.
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 9 c a p s
– Declarative title: Do people with
c
r schizophrenia improve equally in learning i t
i to cook in a clinic and at home? c a l l y
a Structured Abstract Outcome Measures: Cognitive level of participants
p Summary of Duncombe, L. W. (2004) Comparing to their matched pair was measured with the Allen Cognitive Level Screen (ACLS-90) administered by p learning of cooking in home and clinic for people the principal investigator. Cooking skill was r with schizophrenia. American Journal of a Occupational Therapy, 58(3), 272-278. (Prepared assessed using the Kitchen Task Assessment-
i Modified (KTA-M) both before and after the inter-
s by CAPs Advisory Group Member) vention. The KTA-M was developed in a previous e
d Research Objective: The purpose of this study was study by the author. It combined the cooked pud- ding task of the Kitchen Task Assessment (KTA; to compare learning of cooking skills in two con-
p texts (home compared to clinic) for individuals Baum & Edwards, 1993) with a scoring system to
a with long-term schizophrenia. evaluate cooking performance adapted from the
p Rabideau Kitchen Evaluation Revised (Neistadt,
e Design: Quasi-experimental design with pre and 1991). Each one of the 40 steps of the task was
r post measures. scored on a six point ordinal scale of 0-5. A total s score was obtained with 200 representing maximal Setting: The cooking lessons were held either in a independence. Face validity, and interrater and clinic setting or in the home environment. The test-retest reliability of the KTA-M were demon- clinic setting was a classroom with a kitchen on a strated in an earlier pilot study by the author. quiet floor of a university building. Minimal dis- tractions existed and the environment remained Intervention: Each participant was seen individual- calm and organised. Since most participants lived ly four times, on a weekly basis, in the designated in group homes, the kitchens of those environ- site by a research associate blind to the study pur- ments were described as cluttered with equipment pose. During the first session, the KTA-M was and supplies. On many occasions staff and other administered. Afterwards, the cooking lesson residents interrupted the cooking sessions, which began, emphasizing the aspects of cooking may have affected the attitude or the focus of the required to perform the cooked pudding task. Each participants. participant received a handout listing ten steps necessary for cooking simple food (such as wash- Participants: The forty-four participants were peo- ing hands before cooking). Each guideline was ple who received the diagnosis of nonparanoid discussed with references to the cooked pudding schizophrenia (n=19) or schizoaffective disorder task. During the second session, participants made (n=25) at least five years prior to the beginning of a sandwich, emphasizing seven of the ten guide- the study. All participants showed negative symp- lines. The third session was dedicated to learn how toms of schizophrenia. The age range of the par- to cook ramen soup and integrating all the cook- ticipants was 27-62 years, with a mean age of ing guidelines. Finally, at the fourth session, the 45.5 years (SD=8.5). Most participants were men KTA-M was administered a second time to meas- (n=26). Most (n=38) lived in one of 12 group ure change. homes; the remaining six lived in supported apart- ments. All participants could access a kitchen. Main Findings: One significant difference was Twenty-five had cooked or, at the time of the found at baseline between participants in the two study, were preparing some of their own meals, groups: the home group mean score on the KTA-M while 19 had minimal exposure or experience in was significantly higher than of the clinic group cooking. Participants were matched on cognitive (t=-2.07, df =42, p<0.026). Participants in both level; one of each pair was randomly assigned to groups scored significantly higher on the KTA-M either a clinic or home cooking group, with the after cooking lessons (t = 5.57, df = 21, p< 0.0001 other assigned to the remaining group. for the clinic group; t=7.81, df = 21, p< 0.0002 for
10 OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 c a p s
– Participate in the online discussion of this paper.
Beginning June 15, 2006 c Click on CAPS at www.caot.ca r i t i c a l l y the home group). The author asserts that this dif- raised the question of the role of the context: does a ference reflects the learning of the cooking skill. A that difference reflect the supporting role of a p greater variability was observed in the clinic familiar environment or can it be explained by p group, as the participants with the two lowest other unaccountable differences between the two r
KTA-M scores were assigned to this group. groups? Were the lowest scores observed in the a
Participants with initial lower KTA-M had signifi- clinic group due to the unfamiliarity of the clinic i cantly more change in KTA-M than individuals setting or are they artifacts of randomization? s e with initially high KTA-M scores (t= -3.39, df = Learning new skills in the home was not better d 37, p<0.001). There were no statistically signifi- than learning in the clinic for people with schizo-
cant differences in scores on KTA-M between the phrenia in this study. Further research on the p
two groups based on where the learning took effect of context on learning for people with cog- a
place (b = -1.8, df = 42, p<0.23). nitive dysfunction and schizophrenia is recom- p
mended. e
Conclusions: Participants assigned to the home r environment performed better initially than the Contact details of authors of appraised paper: s clinic group. This finding is interesting in light of Linda Duncombe, Sargent College of Health and the clinical observation that interruptions and dis- Rehabilitation Sciences, Occupational Therapy tractions in the home environment should have Department, Boston University, Boston, USA: made the learning process more challenging. This E-mail address: [email protected] Commentary on Duncombe (2004)
his study focuses on a very relevant aspect the application or performance of skills in the rel- of occupational therapy interventions for evant environment (Anthony, Cohen, Farkas & Tpeople with schizophrenia: how and where Gagne, 2002). While learning relates to the capaci- skills must be taught to ensure better functional ty of the person to acquire a skill, performance outcomes. The author demonstrated a good inte- conveys how the individual uses this skill in the gration of how cognitive processes may affect real life context (Goldstein, 1981). Generalization learning in individuals with schizophrenia, as was of the learning in a real-life context remains a apparent in the literature review, the sampling challenge for most psychoeducation and skill strategy and the intervention protocol. Duncombe training programs (Anthony et al., 2002; Deleu & was also quite transparent and thorough in the Lalonde, 1999), hence the need for teaching skills description of the research protocol and the limi- in the environment where they will be used tations of the study. Despite the quality of this (Corrigan, 2003; Test & Stein, 2000). Even if the paper, one may be perplexed by a few aspects of author wanted to examine the impact of the con- the study, notably the choice of outcome meas- text on the learning of cooking skills, the ultimate ures, the differences between the two groups and test lies in the ability of the person to apply those how this research informs clinical practice. skills on a day-to-day basis. No efforts were made to gather complementary data describing how the Measurement Issues learning was reflected in participants’ occupation- Duncombe wanted to measure the learning of al performance. cooking skills. The acquisition or learning of skills is demonstrated and measured more easily than continued on page 12
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 11 c a p s
– One could argue that the KTA-M measures strictly a cooking task and
c not the ability to cook. r i t i c To match participants in the two groups, the cog- researcher’s focus not on the final score of the a nitive abilities of participants were measured by KTA-M but on the change from the baseline to l
l the ACLS-90. Although there is little evidence of final scores for the two groups. As the author y
its validity, the ACLS-90 is used widely in the U.S. noted, there was a ceiling effect; this means that
a as a gold standard for screening cognitive func- the participants who performed well at baseline
p tioning. Duncombe thoroughly describes how the could not improve their scores as much after the
p outcome measure was chosen. The Kitchen Task intervention. One may wonder to what extent
r Assessment (KTA) (Baum & Edwards, 1993) and their final score is a true reflection of their learn- a the Rabideau Kitchen Evaluation-Revised (RKE-R) ing or compounded by the limitations of the i
s were considered. For the purpose of this commen- assessment tool. In this context, given that the e tary, it is worthwhile to review what those tools possibilities for improvement were different d measure. The KTA measures the cognitive support between the two groups and that they may not
p a person needs to complete a cooking task (Baum have been well captured by the outcome measure,
a & Edwards, 1993; Gitlin, 2005). It never was it remains difficult to conclude anything on the
p intended to be a measure of cooking skills, as effect of the learning environment. Perhaps the
e observations focus on only one activity, and scor- experimental and control group should have been
r ing is related to the executive functioning demon- paired not only on the cognitive level of the par- s strated through that activity. While the RKE-R ticipants but also on their cooking skills. Culture focuses on the assessment of cognitive and per- was not discussed or considered as a variable, ceptual abilities of an individual, it also measures although it may have impacted on cooking per- light meal preparation skills; but primarily, the formance. RKE-R is used to “determine the functional sequencing ability” of the clientele for whom it Intervention Issues was intended originally (Neistadt, 1994, p. 433). It Duncombe never discussed the possible impact of could be argued that the KTA-M cannot assess the similarities between what was taught during effectively occupational performance more than the training program and the task of the KTA-M. the original assessment tools from which it is This may also explain part of the change observed derived. Is it a true reflection of the functional between the baseline and final scores. To reduce outcome for which occupational therapists strive? researcher bias, research associates who participat- One could argue that the KTA-M measures strictly ed in the administration and in the training of a cooking task and not the ability to cook. The participants were blind to the purpose of the summation of the KTA-M items by the author is study. The author, however, fails to control anoth- controversial as there is an increased awareness er source of bias: since the research associates that mathematical operations, like creating a total were aware of the baseline scores, this may have score, are strongly discouraged within an ordinal affected the training they provided, or more scale (Ancelle, 2002; Stein & Cutler, 2001), importantly, the research associates’ final assess- because it cannot be assumed that the differences ment. The question remains: is the change related between scores are equal within or across different to the learning of cooking skills or how the indi- items of the scale. viduals learned to perform better on the next administration of the KTA-M? This issue is of rele- Issues in comparing groups vance to research, but also to practice when thera- Baseline measures of cooking skills demonstrated pists are evaluating outcomes by using a pre and that the control group scores were significantly post intervention tool. How can we best ensure lower than those of the experimental group. Since that we are not “teaching to the test”? the groups were not equivalent at baseline, it makes the comparison between groups more chal- Applications to Research and Practice lenging. This could have been compounded by the Despite those concerns, this article remains rele-
12 OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 c a p s
– One may wonder to what extent their final score is a true reflection of their learning
or compounded by the limitations of the assessment tool. c r i t i vant to research and practice. It demonstrates the Research in Addiction and Mental Health Policy c a challenges involved in the design of research pro- and Services (RAMHPS)-CIHR training program. l
tocols focusing on occupational performance. She may be reached at: [email protected]. l y
Choosing outcome measures and reducing bias are
challenging tasks as researchers strive to develop a References a Ancelle, T. (2002). Statistique épidémiologique. Paris: Maloine. protocol that reflects what practitioners would do p Anthony, W. A., Cohen, M., Farkas, M., & Gagne, C. (2002). in real life without, at the same time, compromis- p Psychiatric Rehabilitation (2nd ed.). Boston: Center for r ing the robustness of their findings. There is a sub- Psychiatric Rehabilitation, Boston University. a stantial consensus that in-vivo learning is prefer- Baum, C., & Edwards, D. F. (1993). Cognitive performance in senile i
able to minimize issues related to generalization dementia of the Alzheimer’s type: The Kitchen Task Assessment. s and transferability of skills, and this article does American Journal of Occupational Therapy, 47(5), 431-436. e not produce sufficient evidence to challenge this Corrigan, P. W. (2003). Towards an integrated, structural model of d belief. The discussion section of the paper alludes psychiatric rehabilitation. Psychiatric Rehabilitation Journal, 26(4), 346-358. p
to considerations in each setting that should be a Deleu, G., & Lalonde, P. (1999). Thérapie psychoéducative. In F.
kept in mind. The study raises some thought pro- Grunberg (Ed.), Psychiatrie clinique: Une approche bio-psycho- p
voking, although ambivalent, results and points sociale - Tome II: Spécialités, traitements, sciences fondamentales e
out the need for continued research. Therapists in et sujets d’intérêt (pp. 1342-1362). Boucherville: Gaëtan Morin. r
practice are encouraged to continue focusing on Gitlin, L. N. (2005). Measuring performance in instrumental activities s interventions to improve functional living skills of daily living. In M. Law, C. M. Baum & W. Dunn (Eds.), Measuring and performance in occupations, including cook- occupational performance: Supporting best practice in occupational ing. The challenge is not only to find the setting therapy (2nd ed., pp. 227-247). Thorofare, NJ: Slack Inc. Goldstein, A. P. (1981). Psychological skill training. New York: that best meets the learning needs of the client, Pergamon Press. but also to identify measures of the functional per- Neistadt, M. E. (1994). A meal preparation treatment protocol for formance of cooking, rather than simply the learn- adults with brain injury. American Journal of Occupational ing of the task without application to everyday Therapy, 48(5), 431-438. occupational performance. Stein, F., & Cutler, S. K. (2001). Clinical research in occupational — Catherine Vallée. Catherine is a PhD candidate therapy (4th ed.). Albany, NY: Delmar. in biomedical sciences at the Université de Test, M. A., & Stein, L. I. (2000). Practical guidelines for the commu- nity treatment of markedly impaired patients. Community Mental Montréal. She is also a teaching associate at the Health Journal, 36(1), 47-60. University of Ottawa and a trainee for the
Interested in reading more CAPs? Column editor Lori Letts and the CAPs Advisory Group have now completed three CAPs. These are available online to CAOT members and also by PDF through CAOT Publications. Email [email protected] with the name of the CAP and issue date.
Brief occupational therapy increased self-management behaviour in adults with early rheumatoid arthritis but had no effect on functional or health status at two year follow-up. November, 2005
Systematic review of the literature concluded that there is an evidence base for occupational therapy interventions with people aged 60+ living independently in the community. January, 2006
Clinical reporting by occupational therapists and speech pathologists falls short of therapists’ intentions and parental expectations. March, 2006
If you are interested in writing a structured abstract or commentary, please email Lori Letts at: [email protected]
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 13 IN MEMORIAM Tal Jarus appointed as Head of UBC Jocelyn H. Alexander Division of Occupational Therapy 1924-2005
Jocelyn H. Alexander died in The Division of August 2005 after a long and Occupational Therapy interesting life. During WW II is delighted to she served in the Women’s announce that Dr. Tal Royal Canadian Naval Jarus is the new Service (WRCNS), following Head, Division of which she enrolled in the first Occupational Therapy expanded occupational thera- and began her five- py course at the University of year term on Toronto, graduating in 1949. February 16, 2006. During her 40 years of prac- Dr. Jarus has exten- tice Jocelyn worked in sive academic experience in research, teaching, Hamilton, Ottawa, Montreal graduate supervision and administration. and Kingston. While working at Kingston Previously she was Associate Professor and Chair, Psychiatric Hospital she was instrumental in as well as Head of the Graduate Program, in the implementing Anne Mosey’s Recapitulation of Department of Occupational Therapy at Tel Aviv Ontogenesis theory as the framework organizing University in Israel. Dr. Jarus earned a BOT at occupational therapy practice hospital wide. She Hebrew University in Jerusalem, and completed returned to Ottawa in 1973 as head therapist at her MA and PhD within the Department of Ottawa General Hospital (OGH). When the new Occupational Therapy at New York University. OGH was planned, she designed its occupational Dr. Jarus’ primary area of research and gradu- therapy department but elected to stay at the old ate supervision is motor learning with an empha- hospital when it converted to geriatric care (now sis on skill acquisition, retention and generaliza- the Elisabeth Bruyere Health Centre). Joce retired tion. Her other research interests include work and in 1989 and spent many happy years in work-related injuries, and the use of technology in Wakefield, Quebec. occupational therapy. Dr. Jarus’ work appears in Jocelyn practised client-centred therapy long many peer-reviewed journals that include: before the term was coined. She considered diag- American Journal of Occupational Therapy, nosis less important than forging an alliance with Canadian Journal of Occupational Therapy, her clients that encouraged them to be self-reliant Developmental Medicine and Child Neurology, and improve their quality of life. Not only was she Israeli Journal of Occupational Therapy, a sought-after fieldwork supervisor, she was a Occupational Therapy Journal of Research, brilliant mentor to generations of young thera- Physical and Occupational Therapy in Pediatrics, pists, always encouraging them to think for them- Physiotherapy Canada, and Work: A Journal of selves. She was incredibly generous with her time Prevention, Assessment & Rehabilitation. and expertise and was a wonderful role model. Joce was pragmatic, straightforward, wise, well- informed, non-judgmental and compassionate towards all, valuing their uniqueness. The lives of Seeking new column editor all who knew her were enriched, and her family, friends and colleagues sorely miss her. After a few dedicated years, Elizabeth Steggles has To honour her memory a new Young Adult stepped down from her position as column editor Section of the Biblio Wakefield Library is being for In Touch with Assistive Technology. developed. Contact: Glennis Cohen, Biblio Wakefield Library, 20 Valley Drive, Wakefield, If you are interested in this volunteer position, Quebec, J0X 3G0. please email Fern Swedlove: [email protected]
14 OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 2005-2006 mid-year report
CAOT Executive Director Claudia von Zweck
n October of 2006, we marked the tenth ty, and the development of a new occupational anniversary of locating the CAOT National language and models of health. The initiative is I Office in Ottawa by introducing a new strate- led by primary authors Dr. Elizabeth Townsend gic plan. This plan builds on the partnerships we and Dr. Helene Polatajko, in conjunction with a have created in Ottawa to represent our profession national advisory panel. CAOT members will have on national issues and advance our mission of an opportunity to provide input into the develop- promoting excellence in occupational therapy in ment of this new publication through surveys and Canada. Many CAOT activities in the first half of focus groups. As well, a member consultation ses- the 2005-2006 membership year have reached out sion will be hosted at Conference 2006 in to involve our members and other partners in col- Montreal on Thursday June 1, 2006. laborative projects that are directed toward CAOT continues to work on several additional achieving our strategic priorities. The following is new publications to lead occupational therapy in a progress report on our activities. Canada. These publications include an annotated bibliography of research on the Canadian Strategic Priority #1 Occupational Performance Measure as well as the Advance leadership in occupational therapy McGill Ingestive Skills Assessment. Also, the pub- CAOT members have a long history of working lications Functional Capacity Evaluation and together to provide a vision for the conceptual Business in Practice: How to Get There are grounding, processes and outcomes of occupation- planned for publication in 2006. In addition, the al therapy in Canada. In the 1980s this vision was CAOT Membership Committee has developed a articulated in a series of publications produced new ethical decision-making framework and through a partnership between CAOT and Health workbook that will be posted on our web site for Canada. They were combined and published in CAOT members later this year. A revised version 1991 by CAOT as the Occupational Therapy of our Code of Ethics will be available to accom- Guidelines for Client-Centred Practice, which was pany this framework. These documents were followed in 1997 with the introduction of developed using input provided by members and Enabling Occupation: An Occupational Therapy other stakeholders during a professional issue Perspective. All these publications have been inte- forum held in Vancouver in June 2005. gral in guiding Canadian occupational therapy CAOT recognizes Canadian leaders in occupa- practice and are used in many countries around tional therapy through our awards program. A the world. Over the past six months, CAOT has new web site section was created in the fall of been engaged in a process to develop a new publi- 2005 that celebrates the achievements of our past cation which will be complementary to these cur- award winners. All members are invited to join us rent CAOT documents, and will provide a vision in recognizing our newest award winners at our for the future of occupational therapy practice and Awards Ceremony on June 2, 2006 in Montreal. education in Canada. This document will reflect As part of our national occupational therapy the changes that have occurred in the context of awareness campaign, CAOT will be developing a occupational therapy practice in the past decade special consumer issue of OT Now that profiles due to shifts in Canadian health and social policy, leaders in occupational therapy in different areas increased emphasis on evidence and accountabili- including practice, research, education, adminis-
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 15 2005-2006 mid-year report, continued
tration and policy-making. The issue will highlight evidence into practice. With our theme of the achievements of our members and promote the “Evidence and occupation: Building for the diverse career opportunities available to occupa- future”, the conference offers a wide variety of tional therapists in Canada. In addition, CAOT will presentations that highlight the research contribu- be meeting with representatives from the tions of Canadian occupational therapists. CAOT Association of Canadian Occupational Therapy will be hosting a professional issues forum at the University Programs (ACOTUP), the Association of conference on “research without borders”. Eminent Canadian Occupational Therapy Regulatory researchers will be invited to this session to iden- Organizations (ACOTRO), the Canadian tify strategies to support collaborative research in Occupational Therapy Foundation (COTF) and the occupational therapy. A CAOT position statement Professional Alliance of Canada (PAC) in June on clinical practice guidelines in occupational 2006 on the topic of leadership to foster inter- therapy will be published later this year based on organizational efforts to promote and recognize input provided at a 2005 professional issues leaders in occupational therapy. forum.
Strategic Priority #2 Strategic Priority #3 Foster evidence-based occupational therapy Advocate for occupational therapy as an essential CAOT is involved in several initiatives to support service the development of research and promote evi- CAOT is actively involved with over 35 partner dence-based decision-making in occupational organizations to represent occupational therapy as therapy. For example, CAOT continues to provide an essential service for the health and well-being financial and in-kind support to COTF to foster of Canadians. A wide array of topics is addressed occupational therapy research. In the past year, in these collaborative efforts, ranging from end- our work with COTF has resulted in the develop- of-life care to housing to patient safety and public ment of several new critical reviews, which will be health strategies. A major thrust of our activities disseminated in CAOT publications. has been focused on gaining recognition for the A new column on Critically Appraised Papers value of occupational therapy in primary health (CAPs) was launched in OT Now in the fall of care services. Currently, we are completing work 2005 to help members to identify and use evi- on two large multi-year projects that have resulted dence in their practice. The column is accompa- in the development of a framework for interdisci- nied by a time-limited online discussion of the plinary collaboration in primary health care and a findings on the CAOT web site. Our new OT collaborative mental health charter. Consultations Education Finder on the CAOT web site includes for the development of these documents were held our new CAPs, plus other professional develop- with members in forums across Canada. Revised ment opportunities available to occupational ther- position statements were published on the topics apists in Canada. This past fall CAOT offered sev- of primary health care, home and community care eral continuing education workshops, including and continuing professional education. hands-on sessions to help members search for CAOT launched the “Yes I Can” theme for OT research evidence using resources on the CAOT Month in October 2005. A special issue of OT Now Information Gateway. More of these workshops was developed for OT Month that highlights how will be held in 2006. occupational therapists promote an inclusive soci- Watch for our launch of a new evidence- ety and break down barriers to occupational par- based practice web portal later this spring that ticipation. Other OT Month activities included the will add to our existing online resources. As well, submission of articles to consumer and workplace many sessions at our 2006 Conference will assist journals about occupational therapy and the occupational therapists with integrating research development of resource information and promo-
16 OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 2005-2006 mid-year report, continued
tional items for use by members to advocate for ers. This framework would help occupational ther- occupational therapy. The CAOT Pan-Canadian apists to understand the competency level of sup- Awareness Campaign was introduced during OT port workers when assigning components of their Month with a reception in Ottawa attended by rep- work. In a related project, CAOT is undertaking a resentatives of government and partner organiza- review of the Profile of Occupational Therapy tions. This grassroots strategy involves occupation- Practice in Canada, a document that outlines skills al therapists from across Canada using resources and knowledge needed to practice occupational prepared by CAOT to inform government, policy- therapy in Canada. The Profile serves as the basis makers, funders and referral agencies about what of the certification examination blueprint as well occupational therapists can bring to primary as standards for academic accreditation of univer- health care. sity occupational therapy programs. The revised The initial phase of the new three year Stable, Profile will address the range of skills and knowl- Able and Strong Project is nearing completion. edge needed for occupational therapy practice in This project hopes to demonstrate how occupation- Canada, from support worker to an advanced al therapists can make a difference in community occupational therapist practitioner. development. Peer support resources for seniors The CAOT Workforce Integration Project, who have experienced a fall will be developed and funded by the Government of Canada Foreign tested in pilot sites in Calgary, Prince Edward Credential Recognition Program, is investigating Island and Ottawa. barriers and enablers for international graduates wishing to work in Canada as occupational thera- Strategic Priority #4 pists. Findings of the study will be shared with Develop workforce capacity in occupational therapy members and other stakeholders in consultations CAOT recognizes the importance of health human across Canada later this spring to develop recom- resource planning to ensure access to occupational mendations for future action. The Certification therapy services in Canada. In 2004, CAOT and Examination Committee already has initiated sev- other stakeholders articulated a health human eral changes to the certification exam to ensure resources strategy for occupational therapy. CAOT international graduates are not disadvantaged is working on several components of this strategy. unfairly. Funding was approved in the fall of 2005 An essential element of the human resources for a full plain-language translation of examina- strategy is the development of a consistent source tion items following a successful trial earlier in of data regarding the occupational therapy profes- the year. The number of distractors for each multi- sion. CAOT is one of several data providers ple choice item was reduced recently from five to involved in the development of a database of four and the length of the exam will be shortened, information for occupational therapists in Canada. beginning with the July 2006 sitting. These This project, funded by Health Canada and coordi- changes were made to ensure the exam tests nated by the Canadian Institute for Health knowledge rather than endurance. Our analysis Information, will result in the availability of need- has indicated that these changes will not impact ed data for occupational therapy by 2007. the performance of the exam in evaluating knowl- CAOT also continues to work on the issue of edge areas. caseload guidelines for occupational therapy. Currently, funding is being sought for a project to Strategic Priority #5 follow up on recommendations from the 2005 Advance CAOT as the national occupational therapy CAOT report on caseload guidelines. The CAOT professional association in Canada Board of Directors also approved funding for a CAOT strives to provide valued services and prod- project proposal for a qualifications recognition ucts for members. A number of our CAOT commit- framework for occupational therapy support work- tees have undertaken initiatives to gather input to
OCCUPATIONAL THERAPY NOW . MAY 2006 . VOLUME 8 . 3 17 2005-2006 mid-year report, continued