[OTlist] Expertise
What do you think is OT's expertise? Ron -- Ron Carson MHS, OT -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
Anyone??? - Original Message - From: Ron Carson <[EMAIL PROTECTED]> Sent: Saturday, August 30, 2008 To: OTlist Subj: [OTlist] Expertise RC> What do you think is OT's expertise? RC> Ron RC> -- RC> Ron Carson MHS, OT -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
Before we can say what OT Expertise is we have to define "expertise"... on the web... A capability of a person to perform an operation in a limited domain with exceptional results when compared to others capable of performing the same operation Special skill in or knowledge about a particular topic or activity. Specialized domain knowledge, skills, tricks, shortcuts and rules-of- thumb that provide an ability to rapidly and effectively solve problems within a particular domain. Knowledge and skills gained from both/either training and/or experience, ie, practice wisdom So having defined "expertise" it becomes easier to define OT Expertise---But inclusive of all that is above, it is also about the background of experience to have a "sixth sense" about what you are observing (in the client both passive and interactive) so that your therapeutic actions meld into a response that is knowledge and experience based, intuitive and creative. Being able to keep passionate about not what you know but what you have yet to learn and to emerese yourself in that process for the benefit of colleagues and clients. Susan N. Schriber Orloff, OTR/L CEO/Exec. Director Children's Special Services, LLC Atlanta, GA On Sep 1, 2008, at 7:33 PM, Ron Carson wrote: > Anyone??? > > - Original Message - > From: Ron Carson <[EMAIL PROTECTED]> > Sent: Saturday, August 30, 2008 > To: OTlist > Subj: [OTlist] Expertise > > RC> What do you think is OT's expertise? > > RC> Ron > RC> -- > RC> Ron Carson MHS, OT > > > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
Thanks for the definitions. So, what do members of this list see as OT's expertise Ron -- Ron Carson MHS, OT - Original Message - From: Susan Orloff <[EMAIL PROTECTED]> Sent: Monday, September 01, 2008 To: OTlist@OTnow.com Subj: [OTlist] Expertise SO> Before we can say what OT Expertise is we have to define "expertise"... SO> on the web... SO> A capability of a person to perform an operation in a limited domain SO> with exceptional results when compared to others capable of performing SO> the same operation SO> Special skill in or knowledge about a particular topic or activity. SO> Specialized domain knowledge, skills, tricks, shortcuts and rules-of- SO> thumb that provide an ability to rapidly and effectively solve SO> problems within a particular domain. SO> Knowledge and skills gained from both/either training and/or SO> experience, ie, practice wisdom SO> So having defined "expertise" it becomes easier to define OT SO> Expertise---But inclusive of all that is above, it is also about the SO> background of experience to have a "sixth sense" about what you are SO> observing (in the client both passive and interactive) so that your SO> therapeutic actions meld into a response that is knowledge and SO> experience based, intuitive and creative. SO> Being able to keep passionate about not what you know but what you SO> have yet to learn and to emerese yourself in that process for the SO> benefit of colleagues and clients. SO> Susan N. Schriber Orloff, OTR/L SO> CEO/Exec. Director SO> Children's Special Services, LLC SO> Atlanta, GA SO> On Sep 1, 2008, at 7:33 PM, Ron Carson wrote: >> Anyone??? >> >> - Original Message - >> From: Ron Carson <[EMAIL PROTECTED]> >> Sent: Saturday, August 30, 2008 >> To: OTlist >> Subj: [OTlist] Expertise >> >> RC> What do you think is OT's expertise? >> >> RC> Ron >> RC> -- >> RC> Ron Carson MHS, OT >> >> >> >> >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
I believe that OT are experts in what they do, be it early intervention, geriatrics, driving, hands. It all depends on experience and training. Most important is how does the individual feel about their skills as an OT. Do we as practitioners feel that we are experts in our fields? Would we be able to go into a courtroom as an expert witness, etc. But I do think that we can be experts. Juan C. Turcios On 9/2/08, Ron Carson <[EMAIL PROTECTED]> wrote: > > Thanks for the definitions. > > So, what do members of this list see as OT's expertise > > > Ron > -- > Ron Carson MHS, OT > > - Original Message - > From: Susan Orloff <[EMAIL PROTECTED]> > Sent: Monday, September 01, 2008 > To: OTlist@OTnow.com > Subj: [OTlist] Expertise > > SO> Before we can say what OT Expertise is we have to define "expertise"... > > SO> on the web... > SO> A capability of a person to perform an operation in a limited domain > SO> with exceptional results when compared to others capable of performing > SO> the same operation > > SO> Special skill in or knowledge about a particular topic or activity. > > SO> Specialized domain knowledge, skills, tricks, shortcuts and rules-of- > SO> thumb that provide an ability to rapidly and effectively solve > SO> problems within a particular domain. > > SO> Knowledge and skills gained from both/either training and/or > SO> experience, ie, practice wisdom > > > SO> So having defined "expertise" it becomes easier to define OT > SO> Expertise---But inclusive of all that is above, it is also about the > SO> background of experience to have a "sixth sense" about what you are > SO> observing (in the client both passive and interactive) so that your > SO> therapeutic actions meld into a response that is knowledge and > SO> experience based, intuitive and creative. > > SO> Being able to keep passionate about not what you know but what you > SO> have yet to learn and to emerese yourself in that process for the > SO> benefit of colleagues and clients. > > SO> Susan N. Schriber Orloff, OTR/L > SO> CEO/Exec. Director > SO> Children's Special Services, LLC > SO> Atlanta, GA > > > SO> On Sep 1, 2008, at 7:33 PM, Ron Carson wrote: > > >> Anyone??? > >> > >> - Original Message - > >> From: Ron Carson <[EMAIL PROTECTED]> > >> Sent: Saturday, August 30, 2008 > >> To: OTlist > >> Subj: [OTlist] Expertise > >> > >> RC> What do you think is OT's expertise? > >> > >> RC> Ron > >> RC> -- > >> RC> Ron Carson MHS, OT > >> > >> > >> > >> > >> > >> -- > >> Options? > >> www.otnow.com/mailman/options/otlist_otnow.com > >> > >> Archive? > >> www.mail-archive.com/otlist@otnow.com > > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com > -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
Thanks Juan! What is the PROFESSION's expertise. Ron -- Ron Carson MHS, OT - Original Message - From: Juan Turcios <[EMAIL PROTECTED]> Sent: Tuesday, September 02, 2008 To: OTlist@otnow.com Subj: [OTlist] Expertise JT> I believe that OT are experts in what they do, be it early intervention, JT> geriatrics, driving, hands. It all depends on experience and training. Most JT> important is how does the individual feel about their skills as an OT. Do we JT> as practitioners feel that we are experts in our fields? Would we be able to JT> go into a courtroom as an expert witness, etc. But I do think that we can be JT> experts. Juan C. Turcios JT> On 9/2/08, Ron Carson <[EMAIL PROTECTED]> wrote: >> >> Thanks for the definitions. >> >> So, what do members of this list see as OT's expertise >> >> >> Ron >> -- >> Ron Carson MHS, OT >> >> - Original Message - >> From: Susan Orloff <[EMAIL PROTECTED]> >> Sent: Monday, September 01, 2008 >> To: OTlist@OTnow.com >> Subj: [OTlist] Expertise >> >> SO> Before we can say what OT Expertise is we have to define "expertise"... >> >> SO> on the web... >> SO> A capability of a person to perform an operation in a limited domain >> SO> with exceptional results when compared to others capable of performing >> SO> the same operation >> >> SO> Special skill in or knowledge about a particular topic or activity. >> >> SO> Specialized domain knowledge, skills, tricks, shortcuts and rules-of- >> SO> thumb that provide an ability to rapidly and effectively solve >> SO> problems within a particular domain. >> >> SO> Knowledge and skills gained from both/either training and/or >> SO> experience, ie, practice wisdom >> >> >> SO> So having defined "expertise" it becomes easier to define OT >> SO> Expertise---But inclusive of all that is above, it is also about the >> SO> background of experience to have a "sixth sense" about what you are >> SO> observing (in the client both passive and interactive) so that your >> SO> therapeutic actions meld into a response that is knowledge and >> SO> experience based, intuitive and creative. >> >> SO> Being able to keep passionate about not what you know but what you >> SO> have yet to learn and to emerese yourself in that process for the >> SO> benefit of colleagues and clients. >> >> SO> Susan N. Schriber Orloff, OTR/L >> SO> CEO/Exec. Director >> SO> Children's Special Services, LLC >> SO> Atlanta, GA >> >> >> SO> On Sep 1, 2008, at 7:33 PM, Ron Carson wrote: >> >> >> Anyone??? >> >> >> >> - Original Message - >> >> From: Ron Carson <[EMAIL PROTECTED]> >> >> Sent: Saturday, August 30, 2008 >> >> To: OTlist >> >> Subj: [OTlist] Expertise >> >> >> >> RC> What do you think is OT's expertise? >> >> >> >> RC> Ron >> >> RC> -- >> >> RC> Ron Carson MHS, OT >> >> >> >> >> >> >> >> >> >> >> >> -- >> >> Options? >> >> www.otnow.com/mailman/options/otlist_otnow.com >> >> >> >> Archive? >> >> www.mail-archive.com/otlist@otnow.com >> >> >> >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com >> -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
Anything that the person does or thinks is important, hence occupation. --- On Mon, 9/1/08, Ron Carson <[EMAIL PROTECTED]> wrote: From: Ron Carson <[EMAIL PROTECTED]> Subject: Re: [OTlist] Expertise To: "Ron Carson" Date: Monday, September 1, 2008, 4:33 PM Anyone??? - Original Message - From: Ron Carson <[EMAIL PROTECTED]> Sent: Saturday, August 30, 2008 To: OTlist Subj: [OTlist] Expertise RC> What do you think is OT's expertise? RC> Ron RC> -- RC> Ron Carson MHS, OT -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
when you put it like that it can be difficult to answer. As we all know we treat in a wide variety of environments so the professions expertise is difficult to answer like that. But when you look at the individual and their experience as an OT then you can more or less say that you are an expert. But being an expert or claiming that you are an expert in an area, to me, sais that you poses extra education and experience in that area. I have been an OT for 10 yrs and have done a lot of geriatrics( stc/ltc, and home health), EI, DOE, and lately i have been specializing in driving, but i do not consider myself an expert in any of the above mentioned. But i have met OT that are experts in their field like Susan Pierce is an expert in driving. Then to that question i will ask about our counterpart professions like PT or ST. They would also fall under the same realm as ours. What is their professions expertise. It's very difficult to answer. Juan On 9/2/08, Ron Carson <[EMAIL PROTECTED]> wrote: > > Thanks Juan! > > What is the PROFESSION's expertise. > > Ron > -- > Ron Carson MHS, OT > > - Original Message - > From: Juan Turcios <[EMAIL PROTECTED]> > Sent: Tuesday, September 02, 2008 > To: OTlist@otnow.com > Subj: [OTlist] Expertise > > JT> I believe that OT are experts in what they do, be it early > intervention, > JT> geriatrics, driving, hands. It all depends on experience and training. > Most > JT> important is how does the individual feel about their skills as an OT. > Do we > JT> as practitioners feel that we are experts in our fields? Would we be > able to > JT> go into a courtroom as an expert witness, etc. But I do think that we > can be > JT> experts. Juan C. Turcios > > JT> On 9/2/08, Ron Carson <[EMAIL PROTECTED]> wrote: > >> > >> Thanks for the definitions. > >> > >> So, what do members of this list see as OT's expertise > >> > >> > >> Ron > >> -- > >> Ron Carson MHS, OT > >> > >> - Original Message - > >> From: Susan Orloff <[EMAIL PROTECTED]> > >> Sent: Monday, September 01, 2008 > >> To: OTlist@OTnow.com > >> Subj: [OTlist] Expertise > >> > >> SO> Before we can say what OT Expertise is we have to define > "expertise"... > >> > >> SO> on the web... > >> SO> A capability of a person to perform an operation in a limited domain > >> SO> with exceptional results when compared to others capable of > performing > >> SO> the same operation > >> > >> SO> Special skill in or knowledge about a particular topic or activity. > >> > >> SO> Specialized domain knowledge, skills, tricks, shortcuts and > rules-of- > >> SO> thumb that provide an ability to rapidly and effectively solve > >> SO> problems within a particular domain. > >> > >> SO> Knowledge and skills gained from both/either training and/or > >> SO> experience, ie, practice wisdom > >> > >> > >> SO> So having defined "expertise" it becomes easier to define OT > >> SO> Expertise---But inclusive of all that is above, it is also about the > >> SO> background of experience to have a "sixth sense" about what you are > >> SO> observing (in the client both passive and interactive) so that your > >> SO> therapeutic actions meld into a response that is knowledge and > >> SO> experience based, intuitive and creative. > >> > >> SO> Being able to keep passionate about not what you know but what you > >> SO> have yet to learn and to emerese yourself in that process for the > >> SO> benefit of colleagues and clients. > >> > >> SO> Susan N. Schriber Orloff, OTR/L > >> SO> CEO/Exec. Director > >> SO> Children's Special Services, LLC > >> SO> Atlanta, GA > >> > >> > >> SO> On Sep 1, 2008, at 7:33 PM, Ron Carson wrote: > >> > >> >> Anyone??? > >> >> > >> >> - Original Message - > >> >> From: Ron Carson <[EMAIL PROTECTED]> > >> >> Sent: Saturday, August 30, 2008 > >> >> To: OTlist > >> >> Subj: [OTlist] Expertise > >> >> > >> >> RC> What do you think is OT's expertise? > >> >> > >> >> RC> Ron > >> >> RC> -- > >> >> RC> Ron Carson MHS, OT > >> >> > >> >> > >> >> > >> >> > >> >> > >> >> -- > >> >> Options? > >> >> www.otnow.com/mailman/options/otlist_otnow.com > >> >> > >> >> Archive? > >> >> www.mail-archive.com/otlist@otnow.com > >> > >> > >> > >> > >> -- > >> Options? > >> www.otnow.com/mailman/options/otlist_otnow.com > >> > >> Archive? > >> www.mail-archive.com/otlist@otnow.com > >> > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com > -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
Defining the profession's expertise is difficult, for sure. One of the reasons I chose OT as a profession is the infinite array of "career paths" within the one "profession." It is often one of the things I discuss when talking to others about my joy in my career. Personally, I have "specialized" in pediatrics and autism. I would consider myself an expert in that area. I have dabbled in stroke and orthopedic rehab. Although I would consider myself COMPETENT and CONFIDENT in my skills to effectively help those patients return to their base occupation, I by no means would consider myself an EXPERT. So, to answer the question. I will choose to define OT's expertise in the same manner I explain OT to those who need educating :) What an OT does (therefore my perspective of our expertise as a profession) is to return someoneANYONEto their daily occupations. Whether it be a child, whose occupational role is to play and learn, or be it a older man s/p CVA whose daily occupations include making the same PB&J sandwich everyday, like he has for the past 15 years. OUR job is to facilitate the return to or begin to engage in meaningful, functional occupations of life. When I transitioned from peds to adults people in my life had a hard time understanding why people who had a stroke would need to swing and play. I realized that my explanation of OT had been specific in my previous career, but lacking in the overall explanation of my profession. It seems like explaining the idea and theory of occupation has better educated those in my life who are not OTs!! Bottom line. (and being a long time lurker, I believe this will be the answer you are looking for, Ron:) ) Our professional expertise is (drumroll, please) OCCUPATION!!!Whatever that means to the patient or client, it is our role to facilitate that, in whatever means is appropriate, effective and meaningfult to that person. Phew. longwinded for a first time responder!! Kelly, OTR On Wed, Sep 3, 2008 at 7:30 AM, Juan Turcios <[EMAIL PROTECTED]> wrote: > when you put it like that it can be difficult to answer. As we all know we > treat in a wide variety of environments so the professions expertise is > difficult to answer like that. But when you look at the individual and > their > experience as an OT then you can more or less say that you are an expert. > But being an expert or claiming that you are an expert in an area, to me, > sais that you poses extra education and experience in that area. I have > been > an OT for 10 yrs and have done a lot of geriatrics( stc/ltc, and home > health), EI, DOE, and lately i have been specializing in driving, but i do > not consider myself an expert in any of the above mentioned. But i have met > OT that are experts in their field like Susan Pierce is an expert in > driving. Then to that question i will ask about our counterpart professions > like PT or ST. They would also fall under the same realm as ours. What is > their professions expertise. It's very difficult to answer. > Juan > > > On 9/2/08, Ron Carson <[EMAIL PROTECTED]> wrote: > > > > Thanks Juan! > > > > What is the PROFESSION's expertise. > > > > Ron > > -- > > Ron Carson MHS, OT > > > > - Original Message - > > From: Juan Turcios <[EMAIL PROTECTED]> > > Sent: Tuesday, September 02, 2008 > > To: OTlist@otnow.com > > Subj: [OTlist] Expertise > > > > JT> I believe that OT are experts in what they do, be it early > > intervention, > > JT> geriatrics, driving, hands. It all depends on experience and > training. > > Most > > JT> important is how does the individual feel about their skills as an > OT. > > Do we > > JT> as practitioners feel that we are experts in our fields? Would we be > > able to > > JT> go into a courtroom as an expert witness, etc. But I do think that we > > can be > > JT> experts. Juan C. Turcios > > > > JT> On 9/2/08, Ron Carson <[EMAIL PROTECTED]> wrote: > > >> > > >> Thanks for the definitions. > > >> > > >> So, what do members of this list see as OT's expertise > > >> > > >> > > >> Ron > > >> -- > > >> Ron Carson MHS, OT > > >> > > >> - Original Message - > > >> From: Susan Orloff <[EMAIL PROTECTED]> > > >> Sent: Monday, September 01, 2008 > > >> To: OTlist@OTnow.com > > >> Subj: [OTlist] Expertise > > >> > > >> SO> Before we can say what OT Expertise is we have to define > > "expertise"...
Re: [OTlist] Expertise
Occupational task analysis. The rest is down hill from there. Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Audra Ray Sent: Wednesday, September 03, 2008 4:09 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Expertise Anything that the person does or thinks is important, hence occupation. --- On Mon, 9/1/08, Ron Carson <[EMAIL PROTECTED]> wrote: From: Ron Carson <[EMAIL PROTECTED]> Subject: Re: [OTlist] Expertise To: "Ron Carson" Date: Monday, September 1, 2008, 4:33 PM Anyone??? - Original Message - From: Ron Carson <[EMAIL PROTECTED]> Sent: Saturday, August 30, 2008 To: OTlist Subj: [OTlist] Expertise RC> What do you think is OT's expertise? RC> Ron RC> -- RC> Ron Carson MHS, OT -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Expertise
Hello Kelly: Yes, I was hoping that someone define's OT expertise as occupation. And thank you so VERY much for responding. I totally agree that better understanding the theoretical underpinning of occupation allows for better articulation of the profession. And better articulation leaves little doubt in the patient's mind as to what/why we are different. Ron -- Ron Carson MHS, OT - Original Message - From: Kelly Hunt <[EMAIL PROTECTED]> Sent: Thursday, September 04, 2008 To: OTlist@otnow.com Subj: [OTlist] Expertise KH> Bottom line. (and being a long time lurker, I believe this will be the KH> answer you are looking for, Ron:) ) KH> Our professional expertise is (drumroll, please) KH> OCCUPATION!!!Whatever that means to the patient or KH> client, it is our role to facilitate that, in whatever means is appropriate, KH> effective and meaningfult to that person. KH> Phew. longwinded for a first time responder!! KH> Kelly, OTR -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Ron and all, While defining expertise for OTs as being "Occupation" seems to fill the void of a professional identitity crisis. To be an "expert" as a profession should be more than just about what we "believe in" or what we "hold dear". These beliefs, values, and assumptions are a philosophical ideology (Theory) which has great usefulness in forming a professional identity but what about the role facts and evidence in refining our practices? What if facts and evidence refute our belief about the use of Occupation in certain situations?...will we refine our beliefs and practices? Currently it seems as though practices can neither be fully confirmed or refuted When we make these judgements about what is good OT and not-good OT shouldn't we also have an scientific method of establishing what does work and refine our practice from that data. Shouldn't all theories be tested and questioned and proven?...or at least a tendency or trend be established? Granted it is very hard work to find information that supports and validates completely certain practices, please steer me in the direction of some good research and outcomes that shows that Occupation is a powerful tool, process, method, to achieve functional outcomesI know that we all believe in Occupation but is that enough? This kind of information would validate our practices and confirm us as experts. We are not alone in this disconnection between theory and objective evidence. The lack of evidence and science in practice is a problem for not only OT, but PT, MDs, pharmacology and countless other health-related professions. It feels good to believe but I want more specifics for my work in Geriatric Rehab. Sincerely, Brent Cheyne OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Ron and all, While I love OT as a profession, I remain open-minded to doing what is proven to work, If Occupation is all that we believe it to be, it will become evident when studied...a good idea it won't die. We owe it to our clients to confirm objectively what gets results and meet their goals and discard what doesn't. Food for thought "Men who have excessive faith in their theories or ideas are not only ill prepared for making discoveries: they also make very poor observations. Of necessity, they observe with a preconceived idea, and when they devise an experiment, they can see, in its results,only a confirmation of their theory. In this way they distort observation and often neglect very impotant facts because they do not further their aim. But it happens further quite naturally that men who believe too firmly in their theories, do not believe enough in the theories of others. So the dominant idea of these despisers of their fellows is to find others' theories faulty and try to contradict them. The difficulty for science is still the same." Claude Bernard, "An Introduction to the Study of Experimental Medicine,1865 Sincerely Brent Cheyne OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Brent, the issue of research supporting practice is very valid. I don't have a good reply other than to follow up with your sentiments that OT is NOT alone in the lack of evidence supporting practice. At this point, I must confess a small secret. I do not like research; I don't like doing it or reading it. I KNOW it's important but I am just NOT a research man. As such, I tend to never focus on the research question(s) that you mention, but maybe I should. Maybe someone else on the list has a better answer. None the less, thanks for taking time to write. Ron -- Ron Carson MHS, OT - Original Message - From: Brent Cheyne <[EMAIL PROTECTED]> Sent: Sunday, September 07, 2008 To: otlist@otnow.com Subj: [OTlist] expertise BC> Ron and all, BC> While defining expertise for OTs as being "Occupation" seems BC> to fill the void of a professional identitity crisis. To be an BC> "expert" as a profession should be more than just about what we BC> "believe in" or what we "hold dear". These beliefs, values, and BC> assumptions are a philosophical ideology (Theory) which has great BC> usefulness in forming a professional identity but what about the BC> role facts and evidence in refining our practices? What if facts BC> and evidence refute our belief about the use of Occupation in BC> certain situations?...will we refine our beliefs and practices? BC> Currently it seems as though practices can neither be fully confirmed or refuted BC> When we make these judgements about what is good OT and BC> not-good OT shouldn't we also have an scientific method of BC> establishing what does work and refine our practice from that BC> data. Shouldn't all theories be tested and questioned and BC> proven?...or at least a tendency or trend be established? BC> Granted it is very hard work to find information that BC> supports and validates completely certain practices, please steer BC> me in the direction of some good research and outcomes that shows BC> that Occupation is a powerful tool, process, method, to achieve BC> functional outcomesI know that we all believe in Occupation BC> but is that enough? This kind of information would validate our BC> practices and confirm us as experts. We are not alone in this BC> disconnection between theory and objective evidence. The lack of BC> evidence and science in practice is a problem for not only OT, but BC> PT, MDs, pharmacology and countless other health-related professions. BC> It feels good to believe but I want more specifics for my work in Geriatric Rehab. BC> Sincerely, BC> Brent Cheyne OTR/L BC> BC> -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Brent, are you suggesting that ALL your interventions are based on evidence? I also want to add that medicine deals with diseases affecting people. OT deals with people affected by diseases. Researching what affects a disease process is vastly different than what affects a person with a disease. Plus, I wonder what the occupational science people are doing? Ron -- Ron Carson MHS, OT - Original Message - From: Brent Cheyne <[EMAIL PROTECTED]> Sent: Sunday, September 07, 2008 To: otlist@otnow.com Subj: [OTlist] expertise BC> Ron and all, BC> While I love OT as a profession, I remain open-minded to doing BC> what is proven to work, If Occupation is all that we believe it to BC> be, it will become evident when studied...a good idea it won't BC> die. We owe it to our clients to confirm objectively what gets BC> results and meet their goals and discard what doesn't. BC> Food for thought BC> "Men who have excessive faith in their theories or ideas are not only BC> ill prepared for making discoveries: they also make very poor BC> observations. Of necessity, they observe with a preconceived idea, BC> and when they devise an experiment, they can see, in its BC> results,only a confirmation of their theory. In this way they distort BC> observation and often neglect very impotant facts because they do not further BC> their aim. But it happens further quite naturally that men who believe BC> too firmly in their theories, do not believe BC> enough in the theories of others. BC> So the dominant idea of these despisers of their fellows is to find BC> others' theories faulty and try to contradict them. The difficulty BC> for science is still the same." BC> Claude Bernard, "An Introduction to the Study of Experimental Medicine,1865 BC> BC> Sincerely Brent Cheyne OTR/L BC> -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Well ELderly Study. Made the cover of JAMA the year it came out> Date: Mon, 8 Sep 2008 09:20:35 -0400> From: [EMAIL PROTECTED]> To: OTlist@OTnow.com> Subject: Re: [OTlist] expertise> > I would suggest the COPM as you mentioned, Ron. And the study done at USC with the geriatric population...can't remember the name.> > > Neal C. Luther,OTR/L> Rehab Program Coordinator> Advanced Home Care> 1-336-878-8824 xt 3205> [EMAIL PROTECTED]> > Home Care is our Business...Caring is our Specialty> > > > The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-Original Message-> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ron Carson> Sent: Sunday, September 07, 2008 7:14 PM> To: Brent Cheyne> Subject: Re: [OTlist] expertise> > Brent, the issue of research supporting practice is very valid. I> don't have a good reply other than to follow up with your sentiments> that OT is NOT alone in the lack of evidence supporting practice.> > At this point, I must confess a small secret. I do not like research;> I don't like doing it or reading it. I KNOW it's important but I am> just NOT a research man. As such, I tend to never focus on the> research question(s) that you mention, but maybe I should.> > Maybe someone else on the list has a better answer. None the less,> thanks for taking time to write.> > Ron> --> Ron Carson MHS, OT> > - Original Message -> From: Brent Cheyne <[EMAIL PROTECTED]>> Sent: Sunday, September 07, 2008> To: otlist@otnow.com > Subj: [OTlist] expertise> > BC> Ron and all,> BC> While defining expertise for OTs as being "Occupation" seems> BC> to fill the void of a professional identitity crisis. To be an> BC> "expert" as a profession should be more than just about what we> BC> "believe in" or what we "hold dear". These beliefs, values, and> BC> assumptions are a philosophical ideology (Theory) which has great> BC> usefulness in forming a professional identity but what about the> BC> role facts and evidence in refining our practices? What if facts> BC> and evidence refute our belief about the use of Occupation in> BC> certain situations?...will we refine our beliefs and practices?> BC> Currently it seems as though practices can neither be fully confirmed or refuted> BC> When we make these judgements about what is good OT and> BC> not-good OT shouldn't we also have an scientific method of> BC> establishing what does work and refine our practice from that> BC> data. Shouldn't all theories be tested and questioned and> BC> proven?...or at least a tendency or trend be established?> BC> Granted it is very hard work to find information that> BC> supports and validates completely certain practices, please steer> BC> me in the direction of some good research and outcomes that shows> BC> that Occupation is a powerful tool, process, method, to achieve> BC> functional outcomesI know that we all believe in Occupation> BC> but is that enough? This kind of information would validate our> BC> practices and confirm us as experts. We are not alone in this> BC> disconnection between theory and objective evidence. The lack of> BC> evidence and science in practice is a problem for not only OT, but> BC> PT, MDs, pharmacology and countless other health-related professions.> BC> It feels good to believe but I want more specifics for my work in Geriatric Rehab.> BC> Sincerely,> BC> Brent Cheyne OTR/L> BC> > > > BC> > > > > -- > Options?> www.otnow.com/mailman/options/otlist_otnow.com> > Archive?> www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Ron and all, I definately can't say that all my interventions are evidence-based but it is a goal of mine like to trend towards being better able to find info that supports my area of practice. RIght now there no incentive from my employer or medicare or even my patients to show evidence..at least for now. They mainly want functional results. Some of the results come from occupation-based treatment and some definately don't...it's a mix based on my patient interests, goals, and on my clincal experience of what will work or could work. But that is as far as I can go to call myself an expert at what I do. I don't have any independent objective data the says "this way of proceding is proven to work in this situation". If I had more of a connection professionally to what is done out there in research to what I did in practice I might feel more confident about ruling out certain practices and including others. Even just a tendency or trend for practice would be nice. And I know this kind of data exists in small amounts in our profession but like you, I don't have a lot of time or interest to dig it all up and incorporate it into practice.. Hopefully I can overcome my own laziness and complaceny in practice to get more evidence based and science-driven. But until that time I'm very hesitant to commit to any level of expertise or judge the practices of others as deficient. All in all, we (OTs) know deep down that occupation is essential to well-being but how does this idea translate into a meaningful practice in our society? Sincerely Brent Cheyne OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Great Quote! Global Warming, anyone? Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Brent Cheyne Sent: Sunday, September 07, 2008 6:44 PM To: otlist@otnow.com Subject: Re: [OTlist] expertise Ron and all, While I love OT as a profession, I remain open-minded to doing what is proven to work, If Occupation is all that we believe it to be, it will become evident when studied...a good idea it won't die. We owe it to our clients to confirm objectively what gets results and meet their goals and discard what doesn't. Food for thought "Men who have excessive faith in their theories or ideas are not only ill prepared for making discoveries: they also make very poor observations. Of necessity, they observe with a preconceived idea, and when they devise an experiment, they can see, in its results,only a confirmation of their theory. In this way they distort observation and often neglect very impotant facts because they do not further their aim. But it happens further quite naturally that men who believe too firmly in their theories, do not believe enough in the theories of others. So the dominant idea of these despisers of their fellows is to find others' theories faulty and try to contradict them. The difficulty for science is still the same." Claude Bernard, "An Introduction to the Study of Experimental Medicine,1865 Sincerely Brent Cheyne OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
I would suggest the COPM as you mentioned, Ron. And the study done at USC with the geriatric population...can't remember the name. Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ron Carson Sent: Sunday, September 07, 2008 7:14 PM To: Brent Cheyne Subject: Re: [OTlist] expertise Brent, the issue of research supporting practice is very valid. I don't have a good reply other than to follow up with your sentiments that OT is NOT alone in the lack of evidence supporting practice. At this point, I must confess a small secret. I do not like research; I don't like doing it or reading it. I KNOW it's important but I am just NOT a research man. As such, I tend to never focus on the research question(s) that you mention, but maybe I should. Maybe someone else on the list has a better answer. None the less, thanks for taking time to write. Ron -- Ron Carson MHS, OT - Original Message - From: Brent Cheyne <[EMAIL PROTECTED]> Sent: Sunday, September 07, 2008 To: otlist@otnow.com Subj: [OTlist] expertise BC> Ron and all, BC> While defining expertise for OTs as being "Occupation" seems BC> to fill the void of a professional identitity crisis. To be an BC> "expert" as a profession should be more than just about what we BC> "believe in" or what we "hold dear". These beliefs, values, and BC> assumptions are a philosophical ideology (Theory) which has great BC> usefulness in forming a professional identity but what about the BC> role facts and evidence in refining our practices? What if facts BC> and evidence refute our belief about the use of Occupation in BC> certain situations?...will we refine our beliefs and practices? BC> Currently it seems as though practices can neither be fully confirmed or refuted BC> When we make these judgements about what is good OT and BC> not-good OT shouldn't we also have an scientific method of BC> establishing what does work and refine our practice from that BC> data. Shouldn't all theories be tested and questioned and BC> proven?...or at least a tendency or trend be established? BC>Granted it is very hard work to find information that BC> supports and validates completely certain practices, please steer BC> me in the direction of some good research and outcomes that shows BC> that Occupation is a powerful tool, process, method, to achieve BC> functional outcomesI know that we all believe in Occupation BC> but is that enough? This kind of information would validate our BC> practices and confirm us as experts. We are not alone in this BC> disconnection between theory and objective evidence. The lack of BC> evidence and science in practice is a problem for not only OT, but BC> PT, MDs, pharmacology and countless other health-related professions. BC> It feels good to believe but I want more specifics for my work in Geriatric Rehab. BC> Sincerely, BC> Brent Cheyne OTR/L BC> BC> -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Just did a huge lit review on this topic for my dissertation - the literature documents a very interesting phenomenon, where all kinds of health professionals (MDs, nurses, OT, PT, SLP, and numerous others), when asked, typically express a positive attitude towards research and evidence-based practice (think it's necessary, think it will advance their profession, improve client care, etc), but other than in certain pockets, the vast majority do not use evidence based practice, even when there is evidence available. In the literature, EBP is described as including things like searching for evidence, reading and appraising the literature, applying research findings to practice, conducting any kind of research on one's own practice, and/or being involved in clinical studies. This is not only consistent across the health professions, it is consistent across time, going back from the 1980s to the present. Hopefully as more contemporary students, who are being taught more EBP skills, enter the work force, this may change, but there is also some intriguing evidence that suggests that health professionals say what they think they are supposed to say about EBP, but really don't think that using and/or creating research evidence is important, or an integral part of their role... Ron, at least you are being honest about it! What do others think? Sue Ordinetz *** REPLY SEPARATOR *** On 9/7/2008 at 7:14 PM Ron Carson wrote: > >At this point, I must confess a small secret. I do not like research; >I don't like doing it or reading it. I KNOW it's important but I am >just NOT a research man. As such, I tend to never focus on the >research question(s) that you mention, but maybe I should. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Sue...thanks for the discussion...Having been an OT for 20 years I have to say that EBP has not always been the focus and I tended to do what I was taught in school and field work and what has worked for me in the past but I have started progressing to more review of articles and seeing what is out there to confirm what I am doing...I am really enjoying this! I am now in school for my MS in gerotology and I have learned more about research and how to really do it...having a BS in OT, research was not a component in my learningI think it is really exciting to focus on EBPI have also consulted with a PT coworker/manager of mine regarding modalities. I know a controversial topic probably, but he is getting a phD in PT and he has done much research on electrical modalities and the evidence does not show that it "works".( if I understand him correctly). I plan to do more research on this and have chosen to continue with manual type therapy of course with function and not modalities in my practice. I do not plan to progress towards certification as I had planned to doI love hands on therapy. By the way, I do tend to write ST goals for prerequisite skills with function of course reflected in the same goal...I do plan to relook this.I don't do cookbook evals so my evals are never the same...the goals always are specific to my patient so I can't say I do it all the timethanks for the reminder of what we really need to focus on Ron...I appreciate and gain alot from this OT list...thank you! Lisa Sloan, OTR/L --- On Mon, 9/8/08, Sue O <[EMAIL PROTECTED]> wrote: From: Sue O <[EMAIL PROTECTED]> Subject: Re: [OTlist] expertise To: OTlist@OTnow.com Date: Monday, September 8, 2008, 7:32 PM Just did a huge lit review on this topic for my dissertation - the literature documents a very interesting phenomenon, where all kinds of health professionals (MDs, nurses, OT, PT, SLP, and numerous others), when asked, typically express a positive attitude towards research and evidence-based practice (think it's necessary, think it will advance their profession, improve client care, etc), but other than in certain pockets, the vast majority do not use evidence based practice, even when there is evidence available. In the literature, EBP is described as including things like searching for evidence, reading and appraising the literature, applying research findings to practice, conducting any kind of research on one's own practice, and/or being involved in clinical studies. This is not only consistent across the health professions, it is consistent across time, going back from the 1980s to the present. Hopefully as more contemporary students, who are being taught more EBP skills, enter the work force, this may change, but there is also some intriguing evidence that suggests that health professionals say what they think they are supposed to say about EBP, but really don't think that using and/or creating research evidence is important, or an integral part of their role... Ron, at least you are being honest about it! What do others think? Sue Ordinetz *** REPLY SEPARATOR *** On 9/7/2008 at 7:14 PM Ron Carson wrote: > >At this point, I must confess a small secret. I do not like research; >I don't like doing it or reading it. I KNOW it's important but I am >just NOT a research man. As such, I tend to never focus on the >research question(s) that you mention, but maybe I should. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Hi Sue, Ron and all: I have been reading these posts with great interest. Sue, I am working on my Ph D and leaning toward choosing for my dissertation topic the evolution of clinical reasoning in established therapists. In other words, how do we move people out of the mode of only doing what they saw during FW or learned in school toward a more dynamic occupation based, as well as, evidence based practice. One thing I learned that has helped me over the years feel less intimidated is to not just equate EBP with research alone. In my doctoral work, I have been taught that there are several componets to EBP: best available research, clinical expertise and the preferences of the clients. Though they are not all equally weighted, the weaving of these three variables is what should guide our clinical reasoning. An EBP practitioner should be able to answer the question "why did you decide to do that?" in regard to any OT intervention. Of course it would be great if we could pull out excellent examples of randomized control trials (RCT) that upheld OT interventions as effective, but we are not there yet, nor is it likley that the types of questions generated by OT will fit the RCT . However, there is increasingly more literature out there that does support what we do if we look for it. 'OT Seeker' is an excellent resource for a good place to start looking for reserach around various topics. The clinical expertise piece comes in when we don't just do what we've always done (often mistaken for "expertise"), but rather, collect our own data within our own practice settings. This doesn't have to be a huge formal undertaking, it can be as simple as tracking informally what ever it is you want to evaluate over time (which can be a baby step toward collaborating on a more formal research program in the future). For example, years ago when I worked in rehab, I began tracking Allen Cognitive Level scores on patients who had been admitted after hip surgery. It didn't take long to see a trend in the scores of people who had surgery as a result of a fall (lower) versus those who had elected the surgery (higher). This information informed my "expertise", and helped direct my inteventions. The protocal at the hospital back then was to put every hip patient on the same clinical pathway of teaching use of dressing equipment and compensation, strategies which were often to hard for the fairly cogntively impaired patient. I focused instead on caregiver education and environmental modification to support engagement in occupation. Back then, many of my fellow OTs however simply did the same things over and over with every hip patient, then got frustrated when some didn't learn or couldn't remember what they had been taught. Regarding patient/client preferences, this isn't to imply that we only do what clients want ( I have had many a home care client ask me to give them a back massage because the PT's I worked with did that-very appropriately- but its not OT so I don't offer that intervention). Rather, what we need to do is always take into account the clients preferences whenever possible. I give as many choices as I can within the intervention I select and let the client direct. EBP is an evolving process. I agree that there have been many changes in entry level OT education, and the goal is to graduate practitioners who can go into a practice setting and make use of the best available information in real time (not just what they learned in school) because they know where to look for/ how to evaluate the literature, and who can also contribute both formally and informally to the gathering of "evidence" as defined by the three compnents I described above. Terrianne Jones, MA, OTR/L Faculty University of Minnesota Program in Occupational Therapy --- On Mon, 9/8/08, Sue O <[EMAIL PROTECTED]> wrote: From: Sue O <[EMAIL PROTECTED]> Subject: Re: [OTlist] expertise To: OTlist@OTnow.com Date: Monday, September 8, 2008, 9:32 PM Just did a huge lit review on this topic for my dissertation - the literature documents a very interesting phenomenon, where all kinds of health professionals (MDs, nurses, OT, PT, SLP, and numerous others), when asked, typically express a positive attitude towards research and evidence-based practice (think it's necessary, think it will advance their profession, improve client care, etc), but other than in certain pockets, the vast majority do not use evidence based practice, even when there is evidence available. In the literature, EBP is described as including things like searching for evidence, reading and appraising the literature, applying research findings to practice, conducting any kind of research on one's own practice, and/or being involved in clinical studies. This is not only consistent acro
Re: [OTlist] expertise
To Ron and the OTList> I was glad to see the COPM mentioned more than once in rhe recent discussion as I was born raised and edcuated in Canada and have been taught by some of the designers of the COPM. I need to go back and get a copy of that material and start using it in practice. The OT profession in Canada is strong and dynamic, at least it was when I left 15 years ago. I wonder if some of the problems in practice related to occupation-based treatments are related to the different healthcare system(?) being a single payer system vs our US system which has a lot of big business influences. I have written earlier about what the Medicare PPS system and RUGS classification and Rehab companies have done to OT practice in SNFs..productivity, staffing, etc.. have made it hard to practice in a more ideal OT way. And it has created bad habits for the profession in terms of good occupation-based interentions. Good to hear about some EBP going on our there too...but I know that a great majority of therapist don't really use it at this time including me. But objective validation of practices through science would clarifiy a body of knowledge and level of expertise. If OT is a powerful idea it will be shown through the evidence. \Good Discussion Brent Cheyne OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
Hey Brent, Just curious...what brought you to USA? Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Brent Cheyne Sent: Tuesday, September 09, 2008 3:09 PM To: otlist@otnow.com Subject: Re: [OTlist] expertise To Ron and the OTList> I was glad to see the COPM mentioned more than once in rhe recent discussion as I was born raised and edcuated in Canada and have been taught by some of the designers of the COPM. I need to go back and get a copy of that material and start using it in practice. The OT profession in Canada is strong and dynamic, at least it was when I left 15 years ago. I wonder if some of the problems in practice related to occupation-based treatments are related to the different healthcare system(?) being a single payer system vs our US system which has a lot of big business influences. I have written earlier about what the Medicare PPS system and RUGS classification and Rehab companies have done to OT practice in SNFs..productivity, staffing, etc.. have made it hard to practice in a more ideal OT way. And it has created bad habits for the profession in terms of good occupation-based interentions. Good to hear about some EBP going on our there too...but I know that a great majority of therapist don't really use it at this time including me. But objective validation of practices through science would clarifiy a body of knowledge and level of expertise. If OT is a powerful idea it will be shown through the evidence. \Good Discussion Brent Cheyne OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise
To the list, I was asked why I moved to the USA and the short answer is that I was happy to move to the west coast of Florida right out of college to avoid the cold Canadian winter and I was recruited by a rehab company right on my college campus. There was such a shortage of OT's in the states that I had no trouble getting a work Visa and my employer paid my immigration and moving expenses. That was the good old days in the mid 1990's. I worked with therapist from South Africa, Sweden, Australia, Phillipines, and Great Britain. I was quite an internation experience. When I met my American wife and settled down I became a US citizen and I love the US but I'm shy about suggesting some improvements especially in the healthcare field. Thanks for asking Brent Cheyne OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise, goals, and my 2 cents
Hi all - very interesting discussion. If, by expertise, you mean what differentiates us from other rehab professions, I would say that our expertise is (or should be) facilitating occupational performance. We may include preparatory interventions to accomplish occupational performance goals, but if we stop at the preparatory step, or write our goals to reflect preparatory skills (like strength, ROM, etc.) then we are not doing OCCUPATIONal therapy. I don't write ROM or strength goals, nor do I teach my students to do so either. Once you shift your thinking, it's not that difficult to write goals that reflect occupational performance. I would never start a goal with the performance skill or client factor (increase ROM to do something). That, to me is like describing OT by how it's not like PT. I always start (and end) with occupational performance. Why not simply state as a goal that the client will don pullover clothing (if that is what they identify as the problem), or even something more general like complete self-care tasks requiring overhead reaching (and maybe give a couple of examples), if the physical problem is shoulder ROM? The intervention plan itself will spell out that I might work on ROM or teach the client some self-stretching, but that should not be the goal. I respectfully disagree with those who say that just because something is done by an OT, then it's OT. That mentality has, in my opinion, caused some of the identity problem we now wrestle with. That's like saying I'm a dentist, so if I happen to be good at giving massages, and I choose to give you a massage while you're in the chair, then it is dentistry (I realize my analogy is a bit absurd, but in a way some of what we do isn't that different). We have tried to be all things to all people, and it's taken us away from our roots, which is the power of occupation to promote mental and physical health. Therapists trained during the heavy "medical model" years were taught a more reductionistic perspective. But in the past 10-15 years there has been a decided shift back to a more holistic foundation based on the power of occupation. I really like the language that the Canadian model uses, which is exemplified in the COPM, which asks the client "what things do you need to do, want to do, or are expected to do, that you can't do, don't do, or aren't satisfied with how you do them, due to your (fill in the blank diagnosis, health condition, situation)"? Starting with an assessment like the COPM, it's almost impossible not to be both client centered and occupational based. Once the occupational performance deficits are identified and goals developed, then we can address the "why" and add in the necessary assessment and interventions to address the appropriate performance skills in pursuit of the occupational performance goals. The bottom line, to me, is if there are no occupational performance goals (i.e. the client's condition is not affecting their occupational performance in any meaningful way, as perceived by the client), then OT is not indicated. I know by reading the posts on this topic that some of you will disagree with me - no problem. But as someone who has been teaching OT for the last 11 years and has experienced the shift first hand, I see the handwriting (no pun intended) on the wall. I have tremendously enjoyed the debate and look forward to more! Sue Ordinetz Assistant Professor of Occupational Therapy American International College Springfield MA 01109 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] expertise, goals, and my 2 cents
I could not agree more!! Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Sue O Sent: Monday, September 08, 2008 10:12 PM To: OTlist@OTnow.com Subject: Re: [OTlist] expertise, goals, and my 2 cents Hi all - very interesting discussion. If, by expertise, you mean what differentiates us from other rehab professions, I would say that our expertise is (or should be) facilitating occupational performance. We may include preparatory interventions to accomplish occupational performance goals, but if we stop at the preparatory step, or write our goals to reflect preparatory skills (like strength, ROM, etc.) then we are not doing OCCUPATIONal therapy. I don't write ROM or strength goals, nor do I teach my students to do so either. Once you shift your thinking, it's not that difficult to write goals that reflect occupational performance. I would never start a goal with the performance skill or client factor (increase ROM to do something). That, to me is like describing OT by how it's not like PT. I always start (and end) with occupational performance. Why not simply state as a goal that the client will don pullover clothing (if that is what they identify as the problem), or even something more general like complete self-care tasks requiring overhead reaching (and maybe give a couple of examples), if the physical problem is shoulder ROM? The intervention plan itself will spell out that I might work on ROM or teach the client some self-stretching, but that should not be the goal. I respectfully disagree with those who say that just because something is done by an OT, then it's OT. That mentality has, in my opinion, caused some of the identity problem we now wrestle with. That's like saying I'm a dentist, so if I happen to be good at giving massages, and I choose to give you a massage while you're in the chair, then it is dentistry (I realize my analogy is a bit absurd, but in a way some of what we do isn't that different). We have tried to be all things to all people, and it's taken us away from our roots, which is the power of occupation to promote mental and physical health. Therapists trained during the heavy "medical model" years were taught a more reductionistic perspective. But in the past 10-15 years there has been a decided shift back to a more holistic foundation based on the power of occupation. I really like the language that the Canadian model uses, which is exemplified in the COPM, which asks the client "what things do you need to do, want to do, or are expected to do, that you can't do, don't do, or aren't satisfied with how you do them, due to your (fill in the blank diagnosis, health condition, situation)"? Starting with an assessment like the COPM, it's almost impossible not to be both client centered and occupational based. Once the occupational performance deficits are identified and goals developed, then we can address the "why" and add in the necessary assessment and interventions to address the appropriate performance skills in pursuit of the occupational performance goals. The bottom line, to me, is if there are no occupational performance goals (i.e. the client's condition is not affecting their occupational performance in any meaningful way, as perceived by the client), then OT is not indicated. I know by reading the posts on this topic that some of you will disagree with me - no problem. But as someone who has been teaching OT for the last 11 years and has experienced the shift first hand, I see the handwriting (no pun intended) on the wall. I have tremendously enjoyed the debate and look forward to more! Sue Ordinetz Assistant Professor of Occupational Therapy American International College Springfield MA 01109 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
