APPENDIX 13.1
WORLD FEDERATION OF OCCUPATIONAL THERAPISTS
ENTRY LEVEL COMPETENCIES FOR
OCCUPATIONAL THERAPISTS
APPENDIX 13.1 FORMS PART OF THE APPENDICES FOR THE
28TH COUNCIL MEETING MINUTES
CM2008: Appendix 13.1: Publication: WFOT Entry Level Competencies for Occupational Therapists
170
Appendix 13.1
WORLD FEDERATION OF
OCCUPATIONAL THERAPISTS
ENTRY LEVEL COMPETENCIES FOR
OCCUPATIONAL THERAPISTS
Standards & Quality Programme
Project Team chaired by Thelma Burnett (Australian Delegate)
September 2008
2
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For further information, please contact:
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© The World Federation of Occupational Therapists
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Contents:
PART 1: INTRODUCTION AND BACKGROUND ............................................ 5
Purpose of the Entry-Level Competencies ................................................... 5
Definition ...................................................................................................... 5
A Brief History of the Entry-Level Competencies.......................................... 5
International Context of Entry-Level Competencies ..................................... 6
PART 2: OCCUPATIONAL THERAPY COMPETENCIES ............................... 8
ENOTHE/ COTEC ........................................................................................ 8
Canada ......................................................................................................... 9
Australia ..................................................................................................... 10
United Kingdom .......................................................................................... 10
Ireland ........................................................................................................ 11
New Zealand .............................................................................................. 11
PART 3: ENTRY-LEVEL COMPETENCIES FOR OCCUPATIONAL
THERAPY ...................................................................................................... 12
Philosophy and Purpose ............................................................................ 12
WFOT Minimum Standards for Education and Entry-Level Competencies
................................................................................................................ 12
Framework for Entry-Level Competencies .............................................. 12
Using the Competency Framework as a Career Path ............................. 13
Application of the Entry-Level Competency Framework in WFOT Member
Countries .................................................................................................... 15
© The World Federation of Occupational Therapists
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PART 1: INTRODUCTION AND BACKGROUND
Purpose of the Entry-Level Competencies
This document identifies a framework for entry-level competencies for the practice of
occupational therapy. The aim of the document is to inform occupational therapists,
education providers, governments, consumers and others of the competencies that
entry-level occupational therapists should demonstrate. The competency framework
can be used to assist and guide the development and monitoring of occupational
therapy practice competencies within WFOT member countries; competencies that
are specific to practice in that country.
In this context, “entry-level” refers to graduate entry-level competencies that relate to
the successful completion of an occupational therapy undergraduate/entry-level
course 1. By promoting the development of uniform competencies, this document will
help to develop and promote a standard of excellence in occupational therapy
practice.
Definition
The following definitions 2 have been used to define competency for the purpose of
this document.
•
A unit of competency is a discrete component within a standard and reflects
significant major functions.
•
Elements of competency constitute the building blocks of the unit of
competency and, as such, continue the description of the key purpose of the
unit itself. They describe in outcome terms the lowest logical, identifiable and
discrete subgroupings of actions and knowledge which a person requires to
fulfil the unit of competency. Elements subdivide the unit into manageable
and meaningful components that are observable in workplace performance.
Elements provide the context for performance criteria and the range of
variables in which the competency is observed.
A Brief History of the Entry-Level Competencies
Over time requests have been received from occupational therapists, WFOT member
countries and other stakeholders, for WFOT entry-level competencies to be
documented. A number of member countries have existing documents (or are
developing standards) that describe entry-level competencies specific to that country.
Within the Revised WFOT Minimum Standards for the Education of Occupational
Therapists (2002) the identification of knowledge, skills and attitudes (the
components that form a competency) were described to guide the goals of
educational programs. The WFOT Entry-level Competencies document has built on
the competencies identified in the Minimum Standards for Education of Occupational
Therapists.
This document provides consensus about what constitutes the core elements of
competent practice as an occupational therapist. These core elements have been
developed into a framework.
This document relates to the WFOT priorities 3 to:
1
Entry-level in some countries is at the completion of a post-baccalaureate (graduate) degree
2
OT AUSTRALIA 1994 Australian Competency Standards for Entry-Level Occupational Therapists
© The World Federation of Occupational Therapists
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•
Increase and maintain the awareness, understanding and use of the services
of occupational therapists by government, employers and the wider
community through collaborative action.
•
Develop and promote a standard of excellence in occupational therapy
practice.
•
Ensure the ongoing development and quality education and research of
occupational therapists worldwide.
International Context of Entry-Level Competencies
The recognition of the worldwide trend toward shorter hospital stays, increased acuity
of care and the enhanced role of the multidisciplinary team and for health services in
the home or as community based care is timely to the development of entry-level
competencies for occupational therapists. These trends are accompanied by an
identified world-wide shortage of health professionals.
Figure 1a gives a context through which to view the competency areas. The
components (context, generic competencies, specific competencies and settings) are
drawn from the Revised WFOT Minimum Standards for the Education of
Occupational Therapists.
Figure 1a. The components in context
Context in which
services will be
provided
• Nature of local
health needs
• Local health and
related systems
• Relevant health
giving occupations
• Program philosophy
and purpose
Generic
Competencies
- Identified in
competencies
framework
• Knowledge
• Skills
• Attitudes
Specific Competencies –
match each national need
and environment
• Person-occupationenvironment relationship
• Therapeutic and
professional relationships
• Occupational therapy
process
• Professional reasoning
and behaviour
• Context of professional
practice
Settings – where the
service will be
provided
•
•
•
•
•
•
•
•
Community
Hospital
Private and
public practice
Tele-practice
Education
Recreation
Research
Other e.g. Policy,
industry
Figure 1b is a diagrammatic representation of the components, showing a layered
effect from a background context, through specific settings, generic competencies
and a final or top ‘layer’ of specific competencies in a specialty area.
3
WFOT Strategic Plan 2007-2012
© The World Federation of Occupational Therapists
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Figure 1b. Diagrammatic representation of the components
CONTEXT
SETTINGS
GENERIC
COMPETENCIES
SPECIFIC
COMPETENCIES
© The World Federation of Occupational Therapists
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PART 2: OCCUPATIONAL THERAPY COMPETENCIES
A number of WFOT member associations and/or their regulatory bodies have
existing documents that underpin competencies for entry-level occupational
therapists in their countries. Many of these documents have been drawn on in the
development of the current standards.
In this context, the WFOT Entry-level Competencies document provides an
overarching guide or framework for WFOT member countries. The framework
provides a common link between similar documents in member countries and does
not replace or take the place of country-specific documents.
The following are examples of the development of competency standards in some
WFOT member countries and regional occupational therapy networks.
ENOTHE/ COTEC 4
Tuning, supported by European Commission, is an overall project involving
disciplines within higher education in Europe (and now also Latin America)
(http://unideusto.org/tuning/). The aim of Tuning is to contribute significantly to the
elaboration of a framework of comparable and compatible qualifications in each of
the (potential) signatory countries of the Bologna Declaration (1999) and the
subsequent Bologna Process, which should be described in terms of workload, level,
learning outcomes, competencies and profile. Note here the use of the word Tuning,
which emphasizes that the aim of the project is to ‘tune – in’ educational programs, to
develop mutual understanding, and not to enforce rigid adherence to a common
European prototype.
The Tuning Occupational Therapy Project Group of representatives from the
European Network of Occupational Therapy in Higher Education (ENOTHE) and the
Council of Occupational Therapists for the European Countries (COTEC) has
developed a publication Reference Point for the Design and Delivery of Degree
Programmes in Occupational Therapy (Tuning Occupational Therapy Project Group
2008, available through ENOTHE-office) including a description of occupational
therapy profile, competencies and three cycle level descriptors for occupational
therapy education (bachelor, master and doctoral).
The process of developing the competencies followed a defined Tuning methodology
involving collaboration with European educators (ENOTHE) and practitioners
(COTEC) as well as other stakeholders (occupational therapy occupational therapy
students, clients and employers). The work was externally validated under the
support of European Commission by a group of experts in Brussels June 2007 which
concluded with strong support for the document.
The Tuning project defines competencies as a dynamic combination of cognitive and
metacognitive skills, knowledge and understanding, interpersonal, intellectual and
practical skills, and ethical values. Competencies describe what an occupational
therapy does but are on a continuum and can be developed throughout a person’s
professional life. Tuning defines two types of competencies, Generic Competencies
described by central Tuning management which are relevant for all disciplines within
higher education, and Subject Specific Competencies defined by each discipline. The
Tuning Occupational Therapy Project Group defined 35 Occupational Therapy
Specific Competencies in six categories in line with the WFOT Minimum Standards:
4
European Network of Occupational Therapy in Higher Education (ENOTHE) and the Council of
Occupational Therapists for the European Countries (COTEC)
© The World Federation of Occupational Therapists
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•
•
•
•
•
•
Knowledge of Occupational Therapy (5)
Occupational Therapy process and professional reasoning (9)
Professional relationships and partnerships (5)
Professional autonomy and accountability (5)
Research and development in occupational therapy/science (6)
Management and promotion of occupational therapy (5)
The Generic and Occupational Therapy Specific Competencies are translated into 19
European languages and available at ENOTHE web (http://www.enothe.hva.nl/)
These Generic and Occupational Therapy Specific Competencies are accompanied
by Cycle Level Descriptors which are defined as broad expected learning outcomes
of each of the tree cycles (bachelor, master and doctor degree), where the first cycle
(bachelor) describe entry-level into practice (Tuning Occupational Therapy Group
2008)
Canada 5
The Essential Competencies of Practice for Occupational Therapists in Canada, 2nd
Edition developed by the Association of Canadian Occupational Therapy Regulatory
Organisations, outlines the essential competencies required for an occupational
therapist to practice in any province in Canada.
The Essential Competencies Framework outlines the competencies and performance
indicators as:
• Assumes professional responsibility
• Demonstrates practice knowledge
• Utilises a practice process
• Thinks critically
• Communicates effectively
• Engages in professional development
• Manages the practice environment
The Canadian Association of Occupational Therapists has also published the Profile
of Occupational Therapy Practice in Canada: 2007, which describes the key
competencies for the occupational therapist as a competent professional in relation
to seven roles. Involvement in all seven roles is not equal, as not all roles may be
part of everyday practice. The roles required in any situation are influenced by, and
depend on, who the client is (i.e. individuals, groups, communities, or populations),
where the work is being done, and what the client needs. The roles include:
• Expert in enabling occupation
• Professionals
• Communicators
• Scholarly practitioner
• Collaborator
• Change agent
• Practice manager
5
The Essential Competencies of Practice for Occupational Therapists in Canada, 2nd Edition, 2001.
© The World Federation of Occupational Therapists
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These two Canadian competency documents complement each other such that the
Essential Competencies Framework document a minimum practice standard and the
Profile describes competencies for entry to practice to the advanced extended scope
practitioner.
Australia 6
Competency standards in Australia include the Australian Competency Standards for
Entry-Level Occupational Therapists. This document groups entry-level
competencies into 7 units:
• Professional attitudes and behaviour
• Roles, performance and functional level of individuals and groups
• Implementation of individual and group interventions
• Evaluation of occupational therapy programs
• Documentation and dissemination of professional information
• Professional education
• Management of occupational therapy practice
These Standards are currently being revised with the vision of developing a set of
competency standards for entry-level occupational therapists which reflects
contemporary and future occupational therapy practice in Australia.
Another set of Australian occupational therapy standards, the Australian Competency
Standards for Occupational Therapists in Mental Health identifies specific
competencies in mental health as:
• Facilitate occupational development
• Work with teams
• Develop and maintain collaborative partnerships
• Undertake and support systems advocacy
• Undertake evaluation and research activities
• Manage professional practice
• Maintain professional development
United Kingdom 7
The United Kingdom’s regulatory body, the Health Professions Council, has
published a suite of Standards of Proficiencies for a range of professions. The outline
for the Occupational Therapists Standards of Proficiency is:
1. Expectations of a health professional
1a. Professional autonomy and accountability
1b. Professional relationships
2. The skills required for the application of practice
2a. Identification and assessment of health and social care needs
2b. Formulation and delivery of plans and strategies for meeting health and social
care needs
2c. Critical evaluation of the impact of, or response to, the registrant’s actions
3. Knowledge, understanding and skills
6
7
Occupational Therapy Competencies in Australia (various)
Occupational Therapists Standards of Proficiency United Kingdom Health Professions Council
© The World Federation of Occupational Therapists
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Ireland8
The identification of competencies of an occupational therapist on graduation has
been the first project that the Therapy Project Office has focussed on. The completed
framework identifies six areas of competence:
• Relationship of occupation to health and welfare
• Therapeutic and professional relationships
• The Occupational Therapy process
• Professional reasoning and behaviour
• The context of professional practice
• Practice knowledge and skills
New Zealand
The primary function of the Competencies for Registration as an Occupational
Therapist 9 is to specify the entry-level competencies, which all occupational
therapists must meet in order to be registered and practise in New Zealand. The core
competency areas are:
• Implementation of occupational therapy
• Safe, ethical, legal practice
• Culturally safe practice
• Communication
• Management of self and people
• Management of environment and resources
• Continuing professional development
United States of America
The accreditation standards for educational programs for the occupational therapists
delineate expected learning outcomes to ensure that graduates have achieved entrylevel competence as a generalist who can respond to the changing and dynamic
nature of contemporary health and human services delivery systems that require
occupational therapists to possess basic skills as a direct care provider, consultant,
educator, manager, researcher and advocate for the profession and the consumer.
Competence must be demonstrated in the following areas:
• Foundation Requirements
• Basic Tenants Occupational Therapy
• Occupational Therapy Theoretical Perspectives
• Screening, Evaluation and Referral
• Intervention, Plan Formulation and Intervention
• Context of Service Delivery
• Research
• Professional Ethics, Values and Responsibilities
8
AOTI Therapy Project Office – A collaborative initiative between the professional bodies for
Occupational Therapy, Physiotherapy and Speech and Language Therapy
9
Competencies for Registration as an Occupational Therapist. New Zealand Occupational Therapy
Board, November 2000.
© The World Federation of Occupational Therapists
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PART 3: ENTRY-LEVEL
OCCUPATIONAL THERAPY
COMPETENCIES
FOR
Philosophy and Purpose
WFOT Minimum Standards for Education and Entry-Level Competencies
Similar to the World Federation of Occupational Therapists Revised Minimum
Standards for the Education of Occupational Therapists 2002, the entry-level
competencies reflect the common issues and values that underpin the profession of
occupational therapy.
The Minimum Standards for Education outline 5 areas of competence:
•
The person-occupation-environment relationship and its relationship to health
•
Therapeutic and professional relationships
•
An occupational therapy process
•
Professional reasoning and behaviour
•
The context of professional practice
The particular knowledge, skills and attitudes in the 5 areas of competency will be
determined by:
•
The nature of the local health needs including prevention of disability
•
The local health, welfare, disability and legislative systems
•
Locally relevant health giving occupations
Framework for Entry-Level Competencies
The framework that has been identified for the entry-level competencies therefore
uses the areas of competence as identified in the WFOT Minimum Education
Standards. As a framework this leaves the specific competencies for each area of
competence, knowledge, skills and attitudes to be determined and developed in each
country or geographic region.
Figure 2 defines the placement of the entry-level competencies in the career of an
occupational therapist. The initial step into the profession following undergraduate/
entry-level education is being increasingly recognised as a separate career stage,
leading to the requirement for entry-level competency standards to be documented.
© The World Federation of Occupational Therapists
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Figure 2.
Framework for Entry-level Competencies
EXPERT
CONTINUING
PROFESSIONAL
DEVELOPMENT
EDUCATION
SPECIALIST
ENTRY LEVEL
BASELINE COMPETENCIES
WFOT MINIMUM STANDARDS FOR
OCCUPATIONAL THERAPY EDUCATION
The review in Part 2 of current Occupational Therapy competency standards in a
range of WFOT member countries has shown some common groupings for
standards. These have been further grouped or divided into two areas:
1.
Expectations of an Occupational Therapist; and
2.
Application of practice.
The groupings for standards in these two areas are:
1. Expectations of an Occupational Therapist:
1.1. Governance, autonomy and accountability
1.2. Professional relationships
1.3. Professional management
2. Application of practice:
2.1 Underpinning knowledge, understanding and skills
2.2 Patient/client assessment and treatment implementation and evaluation
Using the Competency Framework as a Career Path
Figure 3 gives a diagrammatic representation of the entry-level competency
framework as part of the “building” that is an occupational therapists career path.
From the review of existing WFOT member country standards in Part 2, areas for
specific standards in each group and area have been identified. These areas and
groups form the framework for the entry-level competency standards.
© The World Federation of Occupational Therapists
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Figure 3.
The Framework Components
Extended Scope
Specialty Areas of Practice
Enhanced Practice and Skills
Expectations of an Occupational
Therapist
Patient/client assessment and
treatment implementation and
evaluation
Underpinning knowledge,
understanding and skills
Professional management
Professional relationships
Governance, autonomy and
accountability
DEVELOPING ROLES
Application of practice
ENTRY-LEVEL COMPETENCIES
ENTRY-LEVEL EDUCATION
Person-occupationenvironment
relationship and
relationship to
health
Nature of local health
needs
Therapeutic
and
professional
relationships
Occupational
Therapy process
Local health, welfare,
disability and
legislative systems
KNOWLEDGE
Professional
reasoning and
behaviour
Locally relevant health
giving occupations
SKILLS
Context of
professional
practice
Programme
philosophy and
purpose
ATTITUDES
Areas of the framework are:
Expectations of an Occupational Therapist:
Governance, autonomy and accountability
• Patient safety including risk assessment, clinical decision-making, standards
and protocols and clinical pathways
• Recognition of communication and reporting structures
• Individual accountability and responsibility
• Legislation including statutory registration and WFOT requirements
Professional relationships
• Roles in teams and in workplace
• Professional networks
Professional management
• Patient needs and community needs assessment
© The World Federation of Occupational Therapists
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•
•
Management of caseload and throughput
Audit, reflection and review of practice
Application of practice:
Underpinning knowledge, understanding and skills
• Theory in frame of reference
• Ongoing learning that involves continuing professional development as a
planned process
Patient/client assessment and treatment implementation and evaluation
• Identification and assessment of health and social care needs
• Assessment processes
• Formation of plan using assessment data
• Delivery of service using the plan
• Evaluation and modification of treatment
Application of the Entry-Level Competency Framework in WFOT Member
Countries
The WFOT Entry-Level Competencies Framework is a guide for WFOT member
countries to assess competencies for therapists entering the profession following
training and graduation. It does not replace or take the place of country-specific
documents. Instead it provides a common link between similar documents in member
countries.
As therapists move between countries it is essential to have a framework that
ensures a level or structure for competencies at entry-level to the profession. It is
also essential that these competencies are linked to the WFOT Minimum Standards
for Education; the Standards that form a basis for the education of occupational
therapists throughout the world.
The use of this document and the framework will differ, depending whether a
member country has existing competency standards.
WFOT member countries that have existing competency standards should review
their documents to ensure that the competencies for entry-level therapists are
consistent with the framework. The context/format should be specific to country
requirements.
For WFOT member countries that are yet to develop competency standards:
•
The WFOT Entry-Level Competencies Framework should be used as a basis
for the development of entry-level competency standards specific to the
member country
•
Existing documents such as those in Part 2 can be used as a guide, with
appropriate permission and/or acknowledgement of the country/regional
network that has developed the standards
© The World Federation of Occupational Therapists
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