I thought it would be beneficial to provide the steps to take in order to obtain an OT license, since most of us will be taking the certification exam and applying for a license. We are allowed to practice before taking the NBSOT exam, but OTs practicing under a temporary license are required to have supervision by a licensed OT. A student who has graduated from an accredited OT program, but has not passed the certification exam, may practice under a temporary license. However, they must practice under the supervision of a licensed OT in both the evaluation process and the intervention process. To obtain a license, these are the steps that are required: Graduate from an accredited OT or OTA educational program, complete fieldwork requirements, apply for and pass the NBCOT® Certification Examination, and apply for a license and pay a fee for each state/jurisdiction in which you wish to practice.

This article was interesting to read because it discussed the importance of professionalism and becoming successful within your first job. Several interviews with rehabilitation directors and other experienced healthcare professionals took place to discuss information about landing your first job. One of the individuals stated that it usually takes about six to eight months to learn a new role so it is important to stay in one setting or at one job for at least a year. Also, jumping from job to job does not demonstrate stability when an organization is looking into hiring you. Some of the directors recommend staying at a job for at least two years before you decide that you want to leave. For practitioners looking into going into the acute care setting, make sure you have a good general knowledge of various diagnoses because you will see a variety of diagnoses. It is also important for new graduates to look into jobs at organizations with a mentorship program. In this situation, you are assigned a mentor in which you can ask questions and learn from someone who has been in the game and really understands what is expected of the employees at the organization.

This article is from the American Journal of Occupational Therapy. I felt that it went along with our discussion about becoming fieldwork educators in the future. This study researches the effectiveness of case studies that influence clinical reasoning vs, typical educational case studies. This study goes into depth about clinical reasoning and how it influences educational experiences of students. The research participants, OT students, were asked to complete intervention plans based on client needs and in response to both the medical model of clinical reasoning and paper case study educational methods of learning. Information was qualitatively reviewed to analyze the intervention plans and videotaped discussions were used to guide clinical reasoning process/learning experience. The results showed that clinical reasoning case studies, compared to traditional case studies, promoted three main themes including increased quality of intervention plans, participant confidence levels in treatment plans, and enhanced understanding of the clinical reasoning process. This study is important for FEs and educators to increase clinical reasoning process of students as well as interventions for clients.

This website summarizes the benefits of implementing evidence-based practice in the healthcare setting. This process may involve conducting research within the healthcare setting but it does not necessarily mean a healthcare professional has to be directly involved in conducting research. It can also mean to understand the latest evidence from research and use it to guide patient care to provide the best possible outcomes. Some of the benefits include a higher quality care that is supported by evidence and improved healthcare outcomes. This article also reports that healthcare professionals will also have increased confidence when making decisions and using critical thinking because their decisions will be supported. Using EBP may also reduce costs in healthcare because it is more effective and efficient. Insurance companies are also more likely to support practices that are evidence-based. It is important to understand the benefits of implementing EBP in occupational therapy because practitioners will be more likely to implement these supported practices if they understand the benefits.

Self-initiation, exploration, and free play are vital parts of growing up and learning for children. Children with physical disabilities may be deprived of normal play opportunities and hindered during this vital part of growing up. This can lead to disturbances in psychosocial health in children, also known as a second disability that decreases potential for independent behavior and performance. This interesting article describes the important role that occupational therapists have to increase independence and opportunities for children with physical disabilities. OT practitioners should consider a variety of factors when addressing needs of these children to influence play activities. These include considering the uniqueness of each child, understanding their capabilities, positively influencing parent-child and peer relationships, considering role of other caregivers, adapting toys and materials, and modifying the environment or the setting to promote success and play situations.

Documentation is extremely important in the OT profession, and is necessary whenever professional services are provided to a client. The AOTA standard's of practice state that, "an OT practitioner should document OT services and abide by the time frames, format, and standards established by practice settings, governmental agencies, payers, AOTA documents, and external accreditation agencies." This document is based on the AOTA framework and describes and defines the various components of documentation so that OT practitioners have a clearer idea of what documents are and how they can be used to document client services. I believe this document will be beneficial to us as we begin to start our jobs as practitioners and will assist us in the documentation process.

otptat.ohio.gov/LinkClick.aspx?fileticket=BcR3d6fGiq0%3D&tabid=68

This document was found at the OTPTATboard website to assist OT practitioners with guidance and collaboration with COTAs. It allows the the OT and the COTA to document a short description about the patient and the OT recommendations so that supervision and communication are maximized. There are other logs available, but this is a good example of monitoring a patient's needs and assists in determining if new goals need to be reinstated, treatments need to be adapted, and if plans need to be changed. Goals and plans are explicitly stated on this document and the OTR and the COTA can effectively manage the patient and their needs.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154286/

This article qualitatively explores the factors that affect and influence clinical reasoning. Twelve OTs working in mental health and physical dysfunction at three different hospitals were interviewed and the data was recorded and transcribed. The results indicated that sociocultural factors, individual attributions, and workplace environment played a role in clinical reasoning. Sociocultural factors such as client values and beliefs, clinician values and beliefs, and individual attitude about the disability contributed to clinical reasoning. Individual attributions such as client attributions (including financial stability and education), and therapist attributions (including level of experience/confidence of the diagnosis/situation, access to tools, knowledge of modern methods of treatment) were also important during clinical reasoning. Workplace environment was also a major factor in clinical reasoning. Lack of knowledge of OT in regards to management of the facility was a major factor in clinical reasoning. Also included in this category was limited resources/access to facilities, which contributed to clinical reasoning. The article reports that it is important to understand the factors that affect clinical reasoning because this plays a role in the level of care of the patient. Facilities should recognize the importance of these factors to maximize resources and opportunities to maximize the care and services for the patient.

http://ajot.aota.org/article.aspx?articleid=1865751
This article, found in AJOT, describes the use of the clinical model "CELIBATE" to problem-solve through an ethical dilemma. The method of using CELIBATE guides a clinician to solving an ethical dilemma using 10 steps. These steps include: identifying the problem, identifying facts, naming parties that our effected, identifying nature of the problem, examining potential ethical dilemmas, weighing legal dilemmas, questioning if more info is needed to solve the dilemma, brainstorming actions, analyzing steps, and choosing a course of action. The original method of CELIBATE was used for practicing clinicians but this article explores its application with research-related dilemmas. The dilemma occurred during a phone interview for a large epidemiological study. The participant shared information that suggested evidence of physical and mental elder abuse in a nursing home. The article goes through each step of CELIBATE and uses this model as a logical approach to solve the dilemma. The article also discusses ways in which the model could be improved for research related cases, specifically the order of the steps when evaluating the situation. Using the CELIBATE model is beneficial when thinking about and addressing an ethical dilemma because it assists individuals with examining various aspects of the situation and guiding the individual with making a reasonable decision.

Individuals experiencing mental health disorders are susceptible to impairments in occupational functioning due to decreased concentration, memory, thought processes, insight, judgement, decision-making, reality orientation, regulating emotions, understanding perception, motivation, and psycho-motor activity. This is a quantitative study out of the South American Journal of Occupation Therapy that studied the effects of slow vs. fast tempo of music on symptoms of psychosis during occupation. There were 160 individuals with diagnosed psychological disorders in a psych hospital in South Africa. The subjects participated in a leatherwork activity while listening to either fast paced/upbeat music or low tempo/slow music. Attention/focus, ability to follow instructions, directedness towards the activity, and motivation were measured in groups of individuals who had psycho-motor agitation or psycho-motor inhibition psychosis. The study found that listening to music during an activity has the ability to improve all three variables in both agitation and inhibited-motor psychosis. Fast-paced tempo significantly improves attention in individuals with inhibited motor-psychosis. The ability to follow instructions improved in both fast and slow tempo music for both agitated and inhibited individuals. Directedness and motivation did not significantly improve in any of the groups. This study indicates that music can improve the ability to perform occupations and activities in individuals with mental health disorders. Music is very individualized and it may be difficult for OT practitioners to work with groups of individuals when introducing music. IT is important for an OT to gather a good understanding of a patient's preferences and determine if they would be a good candidate for the use of music during therapy. More research is recommended in this area to further determine the effects of music on occupation in this population.

http://otpotential.com/

Here is a website that has a variety of helpful resources for OTs and OT students that may be helpful. It is a blog that was created by an OT and contains a variety of resources including job interviews, student debt, apps for cognitive assessments, links to various blogs that revolve around OT, and interviews of different OTs in different settings. I particularly enjoyed the section titled "Nail your OT Job Interview". It is written by an OT and she discusses different questions that could be asked at an OT job interview as well as questions that the interviewee should ask about the facility. This website has a lot of different resources and links that could be useful now and in the future!