This article discusses the challenge OT is facing to validate and justify its services due to health care reform, funding caps, and decreased access to services. This can be difficult as the core of OT lies in evaluating and treating function, however, due to the wide scope of practice defining and measuring function in a unified way can be difficult. For example there are two widely used ways of looking at function: the top-down and the bottom-up approaches. There is also challenges because some facilities rely on "house assessments" versus utilizing standardized assessments. A more unified method of measuring and defining function needs developed in order to show OTs value across the board.

This document outlines the minimum standards of practice for OTs. It goes through all the requirements for OTs in the areas of education, examination, licensure, responsibilities, screening, evaluation, reevaluation, intervention processes, discharge, and outcomes measurement.

This article discusses the paradigm shift in health care towards evidence based and client centered practice to increase patient outcomes by linking payment to performance. In this type of system it is important to define OTs distinct value so that it does not get pushed out. There needs to be an increase in evidence that shows the efficacy of OT interventions. Overall, there needs to be the development of quality measures so that OTs can evaluate and document their contributions to patient outcomes.

This article discusses evidence based practice and how even with evidence it can be difficulty to incorporate new changes into practice. There are several steps that need to be taken in order to properly incorporate new evidence into practice, such as determining relevance to setting, creating new guidelines, and adopting these new guidelines into practice. Due to several barriers, these changes typically do not take place immediately. Some barriers to adopting new research findings into practice include: profession, legislative, administrative, practitioner, patient/patient family, and value/belief barriers.

In this letter to the editor in AJOT, an OT working in a mental health setting describes the difficulty of proving the effectiveness and cost-effectiveness of OT in mental health. When asked to provide such evidence at her work place, even with the help of some of the prominent mental health OTs she was unable to find enough research. She makes a call for those interested in the mental health profession to begin to do more research in the area in order to protect OTs role in the setting.

This article provides a summary by AOTA's Evidence-Based Practice Project of current evidence available in multiple areas which OT is involved with adults with TBI. By providing a summary of the current evidence available, OTs looking to be involved in research can use this information to create new research questions and see in which areas more evidence is needed to support OT. The areas summarized include arousal and alertness of people in a coma, motor function, cognitive impairment, visual-perceptual impairment, psychosocial/behavioral/emotional impairments, areas of occupation, and social participation.

This is a fact sheet from AOTA which discusses OT's role in community mental health. This is an area in which OTs play an important role as mental health services shift from a a hospital based setting to more community based. It has been shown that OT interventions help to improve outcomes for those living in the community with serious mental illnesses. OT's can help to address the areas of education, work skills, health/wellness, and cognitive remediation and adaption. This document also discusses ways in which OT can help to address community barriers to functioning such as SES, stigma, safety, and housing options.

OT should be science driven and therapists should be able to apply the most up to date evidence to their practice and treatment plans. This resource provided by AOTA helps to breakdown evidence supported interventions that have been shown to improve client outcomes in a variety of different settings/populations. Evidence supported ideas are provided for pediatrics, specifically early childhood, mental health, sensory integration and sensory processing. It is also provided for gerontology, rehabilitation and disability, adults with serious mental illness, and work. This is a good resource if you need a starting point for a treatment plan to give general ideas of EBP.

This resource provides information on how to submit an ethics complaint to AOTA if you believe that someone has violated the OT code of ethics. The complainant must submit supporting document that details the alleged violation including the relationship to violator, when the violation occurred, and what attempts to address the violation were taken. The ethics commission meets once a month to discuss and review ethics complaints. Once reviewed, a final decision can take several months up to a year to be made. During this time, the accused violator can request an appeal to the complaint.

This resource shares 5 simple ways to increase professionalism. These ways include dressing appropriately and having proper hygiene. WHO and the CDC have different guidelines for hygiene so it is important to know and understand the appearance policies for the facility you are interviewing/working for. The use of proper grammar and communication skills in all forms of communication (written or verbal) is essential. It is also important to face challenges head on and to view challenging circumstances as learning opportunities. Always showing respect for others even in times of disagreement will show that you can handle yourself in a professional manner. The final suggestion was to always accept responsibility for mistakes.

This article discusses the ethics behind OTs taking on an advocacy role, both as an advocate for their clients and also empowering clients to advocate for themselves. The OT code of ethics requires OTs to be advocates through the principles of beneficence, justice, and veracity. It is important that OTs understand laws and regulations and how to apply them to clients needs. Understanding this legal language is important as it can dictate who and how we treat. The incorporation of evidence based practice is also essential in advocacy efforts as it adds to credibility and can help strengthen a case for a client and their need for services.

This article discussed how professional judgement, ethics, EBP, and economic constraints are interrelated in OT practice. Each need to be considered during intervention planning, however, some therapists may find this difficulty. A literature review found that overall there is a lack of evidence supporting OT practice and that it can be difficult to integrate research findings into treatment. One question mentioned was should clients be quantified and reduced to variables as each person is unique?. Practitioners need to remember that research provides guidance for interventions, rather than step by step how-tos. It is up to the OT to use their judgment and experience to incorporate it.

This article discussed EPB and some of the ethics surrounding its use. One of the barriers to practitioners using EPB stated in the article was that at times research presents more ambiguity than providing answers. This can be due to the difficulty defining and measuring some aspects of occupational therapy. Some ethical issues brought up included conflict of interests, informed consent especially during the research of a vulnerable population, and bias in research topic selection or support. Overall, OTs are ethically obligated to make sure that their decisions are being made based on the best evidence available.

This 2000 Slagle lecture discusses EBP in OT. The lecture begins by breaking down the 5 levels of evidence used in research as well as provides scenarios for use of EPB. It also stresses the importance of continuing education and staying up to date with the latest research so that you can defend that what you are doing works. The lecture also posed five questions that you can ask yourself to determine if you are being an EBP practitioner: Do I examine what I do by asking clinical questions? Do I take time to track down the best evidence for guidance? Do I appraise evidence or take it at face value? Do I use evidence to do the right thing correctly? and Do I evaluate the impact of the evidence?. The biggest barrier to EBP was described as each individual's own attitude and motivation towards implementing EBP.

This article discusses the general supervision guidelines for OTs and OTAs. It is broken down into four sections which cover general supervision, supervision of OTs and OTAs, roles and responsibilities, and supervision of OT aides. Supervision is defined at a joint effort to establish, maintain, or elevate competence and performance. The article urges OTs to seek mentorship as supervision to maintain competency and increase knowledge. Delegation of tasks to OTAs by OTs should be done with regard to the complexity of the client's needs/the intervention technique, the practice setting, and state/agency requirements.

This article discusses professionalism in OT practice and what it means. Professionalism was broken down into three parts: the heart, mind, and soul. The main point the author stressed is that professionalism is personal and is the responsibility of each individual. The heart was described as the pleasure and pride taken in our work as OTs. The mind is the specialized body of knowledge that makes OT unique. The soul is the authentic and genuine connections with both patients and colleagues. Each of these can be disrupted but it is the individual's responsibility to try and create a solution to further promote the professionalism of OT.

This article discusses three types of clinical reasoning often used with occupational therapy practitioners. These types include scientific, narrative, and pragmatic. The main questions brought up by the authors were what is clinical reasoning and how does it influence practice?, what can we do to increase clinical reasoning skills?, and do views of clinical reasoning work in the reality of practice?. Aspects that influence use of clinical reasoning included the therapists views of OT, therapists life knowledge, ability to carry out treatments, and interest in patients and profession. It is important to understand what types of clinical reasoning are being utilized in particular practice contexts in order to help with the creation of staff and self development models.