Manualization of Occupational Therapy Interventions: A Crucial but Overlooked Step in Building Evidence

Manualization of an intervention is an essential component in the implementation of research studies. When collaborating on research teams, manualization gives a template to check for fidelity and thus determine if the intervention is carried out in the way in which it was intended by the program developers. Murphy and Gutman (2012) have outlined essential elements in intervention fidelity that are often absent from study descriptions. For example, within the intervention manual researchers should describe the intervention design to include the number, length, and frequency of intervention sessions. The researchers should explain both the theoretical framework and any clinical guidelines that provided the foundation for the intervention. The manual must also define the “active ingredients” or elements of the intervention proven to be responsible for changes in specific outcomes, often quite complex in intervention research. Careful consideration must be given to the training of individuals who will be implementing the study’s procedures. Implementation training is not only outlined in the manual, but the manual content can also be used for training purposes. Written/electronic intervention manuals can be an important tool to assist in fidelity as they provide a means to articulate the distinct differences of the intervention and ensure outcomes are replicated.

COVID-19 AND THE IMPACT ON OT AND OTA FIELDWORK 

By: Kim Dudzinsk MS, OTR/L & Angela Sampson OTR/L

PANDEMIC, SOCIAL INJUSTICE, COPING AND HOPE Living through Layers of Pandemic and Social Injustice: C ontextualized through Voices of Coping and Hope, Part I

 By:

The Metamorphosis of Identity through the Chrysalis of Fieldwork Education

By: Becky Piazza, OTD, MS, OTR/L, BCPR FLOTEC Academic Fieldwork Coordinator University of St. Augustine for Health Sciences [email protected]

I was recently inspired by Stephen Covey’s internationally acclaimed book, 7 Habits of Highly Effective People (Covey, 2004). In it he states, “Self-growth is tender; it’s holy ground and there’s no greater investment” (Covey, 2004, p. 70). This reminded me of the term reflective practitioner (Adam, Peters, & Chipchase, 2013; Bannigan, & Moores, 2009; Knightbridge, 2019; O’Reilly, & Milner, 2015; Parham, 1984), and the process of self-discovery that educators hope will occur during their OT and OTA students’ level II fieldwork journeys. Self-awareness, self-discovery, and the process of self-reflection are key tenants in identity creation, which in this context, is a level II fieldwork student’s ability to establish a clinical identity as an entry-level prepared practitioner. Quality fieldwork educators are key in this identity transformation from student to occupational therapy practitioner. The maturation process that culminates in successfully passing fieldwork, thus allowing graduation, is only the beginning of the self-growth journey that has just begun for these new practitioners. As fieldwork educators, awareness of our own self-growth equips us to mentor these future colleagues and model compassionate and effective service delivery. Our ability to reflect on our clinical competencies and the identity transformations that continually occur throughout our careers and lived experiences empower our distinct value as occupational therapists. It elevates and inspires human potential within us, our clients, our colleagues, and our students. Allow me to reflect on a recent self-growth journey of my own. This year I chose to say yes to a professional opportunity that required significant self-awareness, self-reflection, and proactivity towards my career as an occupational therapy practitioner; a valued role that I take great pride in, and one that significantly contributes to my self-efficacy and sense of purpose. I said yes to academia after more than 17 years in adult inpatient rehabilitation – an area of clinical practice that will forever remain my first love. This one “big” decision, of saying yes to a new job as an Academic Fieldwork Coordinator (AFWC), was much more than a singular decision made in a one-dimensional context. It required countless smaller, yet just as “big” decisions, whose consequences affected multiple individuals, systems, processes, and relationships across a myriad of environments, both personal and professional. My decision could not be made without an awareness of the occupational disruptions that my self-perceived “big” decision would surely cause in my colleagues’ lived work experiences, as well as in their perceptions of me as their boss. It was a decision that required months of continual assessment, reassessment, reflection, and consideration of my valued roles, habits, routines, goals, co-occupations, relationships, and performance abilities. Ultimately it was a decision that challenged my occupational therapy identity (Laliberte-Rudman, 2002; Laliberte-Rudman & Dennhardt, 2008). The infrastructure of my identity consisted of my many roles: occupational therapist, rehab therapist, neuro therapist, treating clinician, fieldwork educator, student coordinator, clinical education coordinator, supervisor, electronic medical records super-user, colleague, friend, mentor, etc. My occupational participation and performance across these roles, and my ability to meet the activity demands of the many occupations that made up each role, were optimized over time through a process of continuing competency development, life-long learning, and reflective practice. My confidence and competence were symbiotic in these complex, interwoven roles. The more I participated in these roles, the more my clinical occupational identity solidified. These experiences, and the confidence and competence that came from them, afforded me the opportunity to have a “big” decision to make in the first place, however, the juxtaposition of this optimized occupational performance is that it made me doubt my ability to be as effective in a novel role within a new environment, where my identity was less established and secure. Hence, my occupational identity transformation and reconstruction journey began, 18 years after the initial establishment of my clinical identity on level II fieldwork. The truth is, it has been a continual evolution since the day I transitioned from the halls of didactic coursework into the hospital rooms of level II fieldwork, and beyond into clinical practice once I earned those beautiful letters behind my name: OTR/L. I share this to convey that many clinicians go through a similar occupational identity transformation when they consider leaping into what they consider to be the unknown realm of Fieldwork Educator (FWE).

TREATING ACROSS THE LIFE SPAN THROUGH 36 YEARS OF PRACTICE: EMBRACING CHALLENGES, ENHANCING LIVES 2020

MESSAGE FROM THE PRESIDENT

These are unprecedented times that we are living in, as we continue to face a pandemic and social injustices that are pervasive throughout society. As an association, FOTA is here to support our profession by reaching out to occupational therapy practitioners and the community to meet their needs. There have been various meetings, sessions, resources, and initiatives orchestrated by the team of volunteers and our lobbyists to keep everyone abreast of changes and equip you with the tools to navigate these times.

FOTA has been leveraging technology, relationships, and other partnerships to keep everyone connected and equipped with support and information. As the COVID-19 pandemic continues, we have provided resources, activities, and opportunities for practitioners to come together while staying safe and informed. During the month of April in celebration of our profession, FOTA Connect was launched to provide a way for practitioners to communicate, network, and be informed on practice issues. We held 5 consecutive weeks of livestream sessions, with members receiving free continuing education, on the following topics: Telehealth, Entrepreneurship, Advocacy, Leadership, and Financial Planning. Additionally, in light of recent awareness brought to social injustices and racism, FOTA hosted a Listen, Learn, and Lead: Be the Change session, which was an intimate conversation attended by students and practitioners. We will continue to provide such opportunities as a member benefit and seek your assistance to volunteer, join in, and support such initiatives.

Measuring Florida Occupational Therapists’ Interest and Feasibility in Providing Therapy Services to Majority World Nations

“The difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems” -Mahatma Ghandi

The world has become a global society with the ability to achieve an interconnected community. The problem is the world has a global view without global support. Resources are available yet avenues to bring resources abroad in a safe, effective way are scarce. Third world nations, also known as majority world nations or developing world nations, have deficits in care, education, and equipment. Occupational rights are such an integral part of American and European society that the Office of Public Sector Information and the United States Department of Justice have put laws in place for people with disabilities guaranteeing equal access to education, employment, and public buildings and activities. Developed nations have funding that support large amounts of rehabilitation research, development of technology that support mobility, cognition, and sensory while health as a right is very difficult for marginalized populations. Inequitable distribution of health opportunities globally is a major factor in health deficits. It is a joint responsibility of both domestic and external governments to fulfill health rights of majority world citizens (Barugahare & Lie, 2016; Reynolds, 2010). There is a lack of awareness of this need, lack of therapists available to provide services, and lack of safe, economical methods to bring relief to these countries.

Texting: The impact on departmental events to increase student retention

Occupational Therapy education is not unlike other programs of study when it comes to the trials and tribulations of student engagement. College educators and administers are constantly trying to find new ways to improve students’ academic performance and retention. Literature demonstrates that brief psychological interventions in education may have a significant positive impact on performance and retention (Yeager & Walton, 2011). Specifically, brief socialpsychological interventions that focus on the way students think, feel, and believe regarding academics, have been shown to improve educational achievement (Cohen, Garcia, Apfel, & Master, 2006; Walton & Cohen, 2011). At multiple sites and disciplines (e.g., psychology undergraduate students, OTA students), the hypothesis that personalized text messages about departmental activities and resources could increase student retention was tested.

Methods: At orientation, 48 students completed a series of questionnaires, provided their cell phone numbers, and agreed to receive text messages about program events, campus resources, college announcements, as well as selective course announcements. Students were randomly assigned into text message conditions, providing a sample of 20 students in the experimental and control conditions. Both conditions received one text every week, but the experimental group texts included the student name to personalize the information in order to make the student feel identified and like they belonged to the department and the college environment (see Table 1 for an example). The messages were sent from a temporary Skype account to provide information and encourage feelings of belongingness and connectedness to the major and college. Following the 12-week semester, participants were asked to complete an online survey, identical to the ones they completed at orientation. In addition, participants were asked about their intentions to continue their program of study and overall enrollment at the college. Participant schedules were reviewed following the 12-week semester to investigate if they returned to their studies.

FOTA...

Who We Are

The Florida Occupational Therapy Association (FOTA) is an all volunteer organization with the exception of one paid employee. That one employee, which many of you who have contacted the organization already know, is named Janine. She is fantastic at what she does for the organization, handling many of the day to day tasks that administratively need to be addressed. FOTA proudly represents the interest of over 16,000+ occupational therapy practitioners (occupational therapists, occupational therapy assistants, and students). Currently, membership in our organization is approximately 1,000 total members, with half of those members being students (our future practitioners). Of the 500 approximate practitioners, we have 50 or so practitioners who are tasked with running the organization and the scope of its reach. So, you might ask, why all the honesty? Because FOTA believes in transparency and we feel it is important you know who we are and what we do. We also need to be honest in expressing how necessary you are to that definition, as we are all simultaneously co-evolving.

Trauma and Trauma Informed (TI) Approaches to Care:Applications to Occupational Therapy Practice

by Mirtha Montejo Whaley, PhD, MPH, OTR/L

Trauma is widespread and has profound effects that can lead to emotional and physical distress throughout the lifespan. Statistics from the Center for Disease Control and Prevention (CDC) on abuse and violence in the United States indicate the following:

Florida Medicaid Health Care Alert

April 27, 2020

 April 1, 2020 

COVID-19 Update and Resources 
Resource link

Amidst the continuing changes as a result of COVID-19 (coronavirus), I wanted to reach out and update everyone on the most current resources, supports, and activities. As it stands, Governor DeSantis has issued a stay-at-home order for the next 30 days. With April being Occupational Therapy month, FOTA wants to continue and support occupational therapy practitioners and establish a sense of community. 

From AOTA

The Role of Occupational Therapy: Providing Care in a Pandemic

 COVID-19 Update and Resources

March 22, 2020 

FOTA recognizes the impact of Covid-19 (coronavirus) on individuals, families, the nation, and our world as we all adapt to these uncertain times. OT Practitioners across the state of Florida have all been challenged to remain healthy and ensure safe practices to prevent further community spread. As many of you have worked in various sectors or continue to be on the front lines, the influx of executive orders at the local, state, and national level can cause confusion as to what steps to take next. Of the utmost importance is to ensure your safety and that of your family, while following orders to reduce and prevent community spread.

I was recently inspired by Stephen Covey’s internationally acclaimed book, 7 Habits of Highly Effective People (Covey, 2004). In it he states, “Self-growth is tender; it’s holy ground and there’s no greater investment” (Covey, 2004, p. 70). This reminded me of the term reflective practitioner (Adam, Peters, & Chipchase, 2013; Bannigan, & Moores, 2009; Knightbridge, 2019; O’Reilly, & Milner, 2015; Parham, 1984), and the process of self-discovery that educators hope will occur during their OT and OTA students’ level II fieldwork journeys. Self-awareness, self-discovery, and the process of self-reflection are key tenants in identity creation, which in this context, is a level II fieldwork student’s ability to establish a clinical identity as an entry-level prepared practitioner. Quality fieldwork educators are key in this identity transformation from student to occupational therapy practitioner. The maturation process that culminates in successfully passing fieldwork, thus allowing graduation, is only the beginning of the self-growth journey that has just begun for these new practitioners. As fieldwork educators, awareness of our own self-growth equips us to mentor these future colleagues and model compassionate and effective service delivery. Our ability to reflect on our clinical competencies and the identity transformations that continually occur throughout our careers and lived experiences empower our distinct value as occupational therapists. It elevates and inspires human potential within us, our clients, our colleagues, and our students. Allow me to reflect on a recent self-growth journey of my own.

This year I chose to say yes to a professional opportunity that required significant self-awareness, self-reflection, and proactivity towards my career as an occupational therapy practitioner; a valued role that I take great pride in, and one that significantly contributes to my self-efficacy and sense of purpose. I said yes to academia after more than 17 years in adult inpatient rehabilitation – an area of clinical practice that will forever remain my first love. This one “big” decision, of saying yes to a new job as an Academic Fieldwork Coordinator (AFWC), was much more than a singular decision made in a one-dimensional context. It required countless smaller, yet just as “big” decisions, whose consequences affected multiple individuals, systems, processes, and relationships across a myriad of environments, both personal and professional. My decision could not be made without an awareness of the occupational disruptions that my self-perceived “big” decision would surely cause in my colleagues’ lived work experiences, as well as in their perceptions of me as their boss. It was a decision that required months of continual assessment, reassessment, reflection, and consideration of my valued roles, habits, routines, goals, co-occupations, relationships, and performance abilities. Ultimately it was a decision that challenged my occupational therapy identity (Laliberte-Rudman, 2002; Laliberte-Rudman & Dennhardt, 2008).

Trauma and Trauma Informed (TI) Approaches to Care: Applications to Occupational Therapy Practice

Trauma is widespread and has profound effects that can lead to emotional and physical distress throughout the lifespan. Statistics from the Center for Disease Control and Prevention (CDC) on abuse and violence in the United States indicate the following:

Overview

Every Legislative Session, representatives and students from the Florida Occupational Therapy Association travel to Tallahassee to advocate on behalf of the occupational therapy profession. Our firm strategically selects members of the Legislature for FOTA to meet with, based upon the organization’s legislative priorities at the time. In October, during interim committee weeks, FOTA conducted a mini-Hill day focused on increasing Medicaid reimbursement. There is significant work to be done on this issue but starting the conversation in advance helps to build champions for the future.

The 2020 Legislative Session is early this year due to the elections, with the 60-day Session commencing on January 14^th and ending on March 13^th. Due to scheduling, the regular FOTA Hill Day was conducted during the Legislative Session, providing an opportunity for FOTA members to discuss legislation already moving through legislative process.