Essential Competencies Required

 

Below is information related to the Essential Competencies required during the study of Occupational Therapy.

Preamble
This policy incorporates expectations outlined in The Council of Ontario Faculties of Medicine (COFM) Policy Document: Essential Skills and Abilities Required for the Study of Medicine (November 2003), Competency Based Fieldwork Evaluation For Occupational Therapists (Bossers, A., Miller, L., Polatajko, H., Hartley, M., 2002) and Essential Competencies of Practice for Occupational Therapists in Canada (2nd Edition, June 2003).

 

III – 1.1 Rationale
“Occupational Therapists have legal and public recognition as self-regulating professionals under the Regulated Health Professions Act (1991). A profession has a unique body of knowledge, common terminology, techniques and models. It establishes core values, ethics, and standards of practice. A self-regulating profession holds each member accountable to practice according to these expectations.” (Prescribed Regulatory Education Program, College of Occupational Therapists of Ontario (COTO), January 2005).

 

“The Essential Competencies of Practice for Occupational Therapists in Canada (2nd Edition, June 2003), is a foundational document established by occupational therapists. It describes the core knowledge, skills and abilities that all therapists need to demonstrate throughout their careers. Occupational therapists have agreed on both clinical and professional competencies that are required to provide safe, ethical and effective service to clients.” (Prescribed Regulatory Education Program, COTO, January 2005).

 

During their course of studies, students must develop and demonstrate proficiency in the essential competencies required for the practice of occupational therapy outlined in the table below. These competencies were first measured through the Department’s admission process. They are expected to develop throughout the program to prepare the students for self-regulated practice as occupational therapists. Post-graduation, in order to practice, students must pass the licensure examinations of the Canadian Association of Occupational Therapists (CAOT) and register with the College of Occupational Therapists (COTO) in order to be eligible to practice occupational therapy in Ontario. Because of the comprehensive, additive and integrative nature of the curriculum, students are normally expected to complete their course of study within two years (COFM Policy Document, November 2003). This policy does not preclude students requiring special accommodations during their course of study due to a disability. However, upon graduation, all students must be able to meet the expectations for practice, as outlined in the table under the section entitled, Essential Competencies: Expectations for the Practice of Occupational Therapy in Ontario.

 

The seven essential OT competencies are described in a table format below presented in two columns. The left column outlines the essential competencies required during the study of occupational therapy at the University of Toronto. The expectations and terminology in this column are consistent with the measures used during clinical fieldwork evaluations (Competency Based Fieldwork Evaluation for Occupational Therapists, 2002). The right column describes the essential competencies required of practicing occupational therapists in Ontario. These expectations and terminology are consistent with that of the College of Occupational Therapists of Ontario (Prescribed Regulatory Education Program, COTO, January 2005).

 

III – 1.2 Essential Competencies Table

 

Essential Competencies Required during the STUDY of Occupational Therapy at the University of TorontoEssential Competencies – expectations for the PRACTICE of Occupational Therapy in Ontario (Requirements upon graduation)
1. Professional Interactions

Students are required to meet all professional standards of behaviour outlined in the Student Code of Conduct (June 2005). These behaviours are expected in all aspects of the professional program, regardless of setting.

Students are evaluated specifically in the fieldwork setting using the following criteria:

- Adheres to ethical and legal practice standards
- Centers on client/client group needs
- Follows through on commitments; shows respect for clients, colleagues and the profession
- Contributes effectively as a team player
- Motivates others
- Fosters trust and respect as a professional
- Builds collaborative working relationships
- Deals effectively with obstacles and opposition
- Acts with professional integrity
- Gives and receives feedback effectively
(Competency Based Fieldwork Evaluation for Occupational Therapists, 2002)
1. Assumes Professional Responsibility

OTs are personally responsible to know and apply the requirements and accountabilities of the profession. (Prescribed Regulatory Education Program, COTO, January 2005, p. 5)

Specific professional responsibilities include:

- “Protecting the Public: An occupational therapist’s primary responsibility as a professional is to the public (your clients and society).
- Ethics: The Code of Ethics reviews your responsibilities to the public and to the profession.
- Maintaining Competence: You need to keep your knowledge and skills up-to-date for each interaction with a client.
- Integrity: This concept overlaps with ethical practice. It includes respecting clients’ dignity and privacy, diversity and values. It also means recognizing your position of power (inherent in your role as a professional) and, therefore maintaining professional boundaries. Another aspect of this competency is recognizing and avoiding conflicts of interest.” (p. 6).
2. Practice Knowledge

Students must obtain a minimum grade of 70% in all courses and a minimum cumulative average of 73% at the end of each year, as well as successfully complete a minimum of 1,000 hours of learning in a clinical practice environment.

Students are evaluated specifically in the fieldwork setting using the following criteria:

- Has the theoretical knowledge and technical expertise to serve clients/client groups, colleagues, the agency, and the profession
- Utilizes evidence-based knowledge
- Knows the parameters of the profession
- Understands the core values and vision of the profession
(Competency Based Fieldwork Evaluation for Occupational Therapists, 2002)
2. Demonstrates Practice Knowledge

Practice knowledge includes two broad categories: clinical knowledge and skills, and knowledge of the context in which you practice… The practice context includes the legislation that applies in your setting… (as well as) the economic, social or cultural environment in which clients live. (Prescribed Regulatory Education Program, COTO, January 2005, pp. 7-8)
3. Facilitates Change with a Practice Process

As a student, utilizing a practice process would involve the development of a clear, thoughtful and organized approach to your learning, assignments and group studies, and your interactions with others in the program.

Students are evaluated specifically in the fieldwork setting using the following criteria:

- Facilitates and manages change in others
- Establishes a therapeutic relationship
- Practices in a safe manner
- Collaboratively identifies goals
- Advocates and consults
- Practices in a client-centred manner
- Based on sound theory and good evidence, appropriately:

1. assesses needs
2. reports assessment results
3. makes referrals and plans interventions that are outcome based
4. carries out the intervention plan
5. monitors and modifies the intervention plans and enacts the closure of the intervention
6. plans discharge and follow-up
(Competency Based Fieldwork Evaluation for Occupational Therapists, 2002)
3. Utilizes a Practice Process

The OT’s practice process…is a clearly defined, systematic, organized approach to providing service from the first contact with a potential client through to discharge. The OT’s practice process should ensure fair, consistent and equitable service to all his/her clients and that he/she cover all the necessary issues within the established role or scope. (Prescribed Regulatory Education Program, COTO, January 2005, p. 8)
4. Clinical Reasoning

The expression of critical thinking skills will be evident in students’ presentation of evidenced-based learning on a daily basis. Students will also use these skills in examining their own developing professional identities and reflecting upon learning needs and strengths.

Students are evaluated specifically in the fieldwork setting using the following criteria:

- Demonstrates analytical thinking
- Demonstrates conceptual thinking
- Demonstrates good judgment and sound decision making
- Utilizes good problem solving
- Demonstrates reasoning based on evidence
(Competency Based Fieldwork Evaluation for Occupational Therapists, 2002)
4. Thinks Critically

Decisions supported by critical thinking are based on a sound rationale that considers client factors, the environmental context and occupational factors...There should be a clear evidenced-based and logical process that links all aspects of OT service…. A therapist who demonstrates critical thinking also evaluates whether goals have been accomplished with an efficient use of resources. (Prescribed Regulatory Education Program, COTO, January 2005, p. 10)

5. Communication

All forms of communication (e.g. verbal, non-verbal, emails, written in class, written anonymously on evaluation forms…) in the program must demonstrate the professional qualities outlined in the Student Code of Conduct (June, 2005).

Students are evaluated specifically in the fieldwork setting using the following criteria:

- Fosters open communication
- Listens actively
- Speaks clearly and appropriately
- Listens and speaks respectfully
- Manages conflicts with diplomacy
- Provides explanations and/or education that is at an appropriate level for the client
- Writes clearly and appropriately
- Modifies language for the listener
- Uses non-verbal communication appropriately and effectively
(Competency Based Fieldwork Evaluation for Occupational Therapists, 2002)
5. Communicates Effectively

Effective communication requires that OTs consciously identify the various parties with whom they need to communicate…. Effective communication also means considering the methods and styles of communication…. the attitude and approach should demonstrate respect for the information and opinions of others. OTs need to develop strong listening skills and be responsive to other’s perspectives…. Good communication should be timely, complete and accurate. (Prescribed Regulatory Education Program, COTO, January 2005, pp. 11-12)
6. Professional Development

Students are expected to supplement their learning as necessary, to meet the expectations required in each course and clinical placement.
Students are evaluated specifically in the fieldwork setting using the following criteria:

- Demonstrates self-directed learning
- Integrates new learning into practice
- Student tries to identify areas for future growth and sets new levels for personal best
- Adapts to change
- Demonstrates commitment to the profession
- Upholds the core values of the profession
- Demonstrates skills of self-appraisal
(Competency Based Fieldwork Evaluation for Occupational Therapists, 2002)
6. Engages in Professional Development

Professional development is described as an individualized, self-directed and goal-directed process that is focused on your learning needs in the context of your own practice. This enables the OT to keep current and enhance his/her skills in order to provide better service to his/her clients. (Prescribed Regulatory Education Program, COTO, January 2005, pp. 12)
7. Performance Management

Students are expected to manage their own time and responsibilities within the program.

Students are evaluated specifically in the fieldwork setting using the following criteria:

- Self starter; Completes tasks in a time efficient manner, setting priorities effectively
- Demonstrates effective resource utilization and quality management
- Is accountable and responsible
- Teaches/Coaches
- Demonstrates operational and organizational awareness
- Demonstrates leadership (delegates appropriately)
- Seeks assistance and feedback appropriately (responds positively to constructive feedback)
- Demonstrates self-monitoring
- Organizes time and sets priorities effectively
(Competency Based Fieldwork Evaluation for Occupational Therapists, 2002)

In addition, “a student must consistently demonstrate the emotional health required for full utilization of her/his intellectual abilities. The application of good judgement and the prompt completion of all responsibilities …are necessary. The development of mature, sensitive and effective relationships with (clients), families and other members of the health care team are also required. The student must be able to tolerate the physical, emotional and mental demands of the program and function effectively under stress. Adaptability to changing environments and the ability to function in the face of uncertainties that are inherent in the care of (clients) are both necessary.” (COFM Policy Document, Nov. 2003)
7. Manages Practice Environment

OTs need to ensure they are aware of the system in which they practice…. They are also responsible to make sure there are systems in place to ensure consistent, safe, fair and ethical practice. (Prescribed Regulatory Education Program, COTO, January 2005, pp. 14)

 

III – 1.3 Students Requiring Reasonable Accommodation

“Disability” is defined by Section 10 (1) of the Ontario Human Rights Code.

 

[The Universities]…are committed to facilitating the integration of students with disabilities into the University community.  Each student with a disability is entitled to reasonable accommodation that will assist her/him to meet the standards.  Reasonable accommodation will be made to facilitate student’s progress.  However, such accommodation cannot compromise (client) safety and well-being.  Reasonable accommodation may require members of the University community to exercise creativity and flexibility in responding to the needs of students with disabilities, while maintaining the academic and technical standards.  The student with a disability must be able to demonstrate the knowledge and perform the necessary skills independently.  There are a few circumstances in which an intermediary may be appropriate.  However, no disability can be accommodated if the intermediary has to provide cognitive support, substitute for cognitive skills, perform a physical examination and/or in any way supplement clinical judgment.  The appropriateness of an intermediary will be assessed on a case-by-case basis.

 

This policy acknowledges that central to the success of a student with a disability in completing the [OT] program, is her/his responsibility to demonstrate self-reliance and to identify needs requiring accommodation in a timely fashion.” (COFM Policy Document, November 2003)

 

III – 1.4 Evaluation
Student progress will be reviewed at the end of each term during a competency review/marks meeting.  Any competencies not being met will be monitored, and conditions placed on a case-by-case basis.

 

The means of identification and measurement of these essential competencies are integral to this Department’s policies on “Requirements for Standing and Promotion” and “Student Code of Conduct and Guidelines.” Therefore, consequences for students who are unable to meet the expectations for practice upon graduation will be in accordance with the consequences of breaches to either one or both of these policies.