When does routine work activity become Continuing Professional Development?
Date: 02/02/2016 Host: @trammcpd
This weeks Rachel @OT_rach from OTalk is hosting the chat this is what she has to say,
I have recently listened to an audiobook call ‘Period Power’ by Melissa Hill.
The introduction starts with the following.
‘In my profession as a woman’s health specialist I get asked a lot of questions, questions that my clients have had since they were 13 that they still don’t have an answer for in their 30s. Questions that usually begin with why, such as
Why is my period so painful/short/light/long/heavy?
Why are they so frequent/irregular/rare?
Why have they stopped altogether?
Why do I feel so great one week and so bloody awful the next?
Why is my vagina sore dry/wet/sensitive?
Why does sex hurt sometimes/all the time?
Why don’t I want to have sex?
Why am I so horny?
Why am I so goddamn tired all the time?
Why do I get so bloated that my dress size jumps up two sizes?
Why do I feel anxious/stressed/depressed?
Why am I so full of rage.
The answer to all of these questions is it’s your hormones. ‘
In another chapter she goes on to describe.
Follicular Phase: Menstruation to Ovulation.
Your period and your cycle are a reflection of your overall health and can be affected by little and large life events. Those gallons of wine and platefuls of delicious stinky cheesy cheese you devoured over Christmas, the crazy work project that nearly broke you, the relationship issues that keep you up all night, the death of a loved one, weight gain or loss, travelling, finally quitting smoking, the supplements you been taking, the Yoga class you’ve been going to, the new job that you love, the great sex you’ve been having, – they all have an impact on whether your period is early or late, light or heavy, short or long and painful or pleasurable.
Period Power – Maisie Gill Greentree 2019
What struck me as I listen to this book was how a lot of what she described were occupations that we engage in, and it got me thinking, Do Occupational Therapists routinely assess clients menstrual cycle, it’s affect on functioning and ability to engage in occupations they need to or want to do?
As I listened I tweeted out some of my thinking, got some great responses and had some interesting discussions from the OT community. Including Katie Major @KatieCMajor, who kindly agree to co host this chat.
Below are some questions that I plan to ask during the chat on Tuesday to generate discussion.
Question 1) Do you routinely ask about, assess for or provide interventions relating to your clients menstrual cycle? If so please give examples.
Question 2) From your own experiences of having a menstrual cycle or from knowing someone that does, what impact does it have on engagement in occupations that you need to or want to do?
Question 3) What assessment tools could we use as occupational therapist to understand the impact a clients menstrual cycles may be having on their functioning?
Question 4) What are the possible interventions we could engage our clients in to enable them to manage the occupation of their dealing with their period?
Question 5) What are the possible interventions we could work on with clients to enable them to manage and understand the impact of the menstrual cycle on their ability to engage in occupations?
Loving forward to the chat, Rachel
Host Rachel Booth @OT_rach
Support on OTalk about @helenotuk
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This week’s #OTalk is on the topic of using standardised assessments routinely in practice and will be hosted by Dr Alison Laver-Fawcett (@alisonlaverfaw) from York St John University and Professor Diane Cox (@dianecox61) in the UK.
Here’s what Alison and Diane had to say:
In the early 1990s, as part of her PhD studies, Alison undertook a small survey of occupational therapists to explore their use of standardised and unstandardised assessments with people with neurological diagnoses. Results (n = 29 OTs) indicated that 93% of OT respondents were using informal observation of ADL, rather than standardised assessment, to assess for perceptual deficits (Laver, 1994). Back then there were a limited number of assessments developed by occupational therapists to choose from, but nearly 30 years later many occupational therapists have been involved with the development and evaluation of standardised assessments and we have evidence of their reliability, validity, sensitivity and clinical usefulness. A look through Asher’s (2014) annotated index of occupational therapy assessment tools reveals that occupational therapists now have 100s of tests to choose from, many of which have been developed by occupational therapists. Yet standardised assessments do not appear to be routinely used in all areas of occupational therapy practice. Why is that?
But nearly 20 years later, a survey of 109 Irish occupational therapists (Stapleton and McBreaty, 2009) still found that “..the consistency of [standardised assessment’ use tended to be low. The barriers to a more consistent use of standardised assessments and outcome measures included time restraints, the unsuitability of the available measures and a lack of sensitivity of the available measures to capture the effectiveness of occupational therapy’ (p55).
Whilst, a much larger study of 794 occupational therapists in the USA (Piernik-Yoder and Beck, 2012, p97) found that paediatric occupational therapists used standardised assessments more than colleagues working with adult patients. They reported: ‘With regard to administrating of standardized assessments, 393 (49.5%) respondents reported that the most common modification they make is to administer portions of standardized assessments, whereas 221 (27.9%) indicated they modify the instruction when administering standardized measures. However, 106 (13.4%) respondents specified they administer standardized measures out of the age range for which the measure is intended, and 66 (8.3%) reported they modify test materials.’
Often students returning from placement report that OTs are using an assessment that has been developed ‘in house’ in the service to fit the particular needs of the client group and the service. Or students report a standardised assessment was being using but in a modified form. Why do some OTs need to modify standardised assessments to make them useful in practice?
The College of Occupational Therapists’ (2017) in their ‘Position Statement: Occupational therapists’ use of standardized outcome measures’ encourages the use of standardised measures and states that ‘without accruing data from such sources the evidence-base to support the value of occupational therapy will fail to grow and the profession will be challenged to produce the robust information that will be essential to support future commissioning of occupational therapy services’ (p1.). So why aren’t all occupational therapists using standardised assessments routinely in practice?
Whether you are an experienced researcher, a clinician or a student please join us for this #OTalk twitter chat and share your ideas and experience.
Suggested talking points and discussion questions to focus our chat:
1. What standardised assessments do your use – why do you choose to use this / these assessments?
2. How often do you use standardised assessments in practice?
3. Do you use standardised assessments routinely/regularly in your practice? Why or why not?
4. Did you go on any training to learn to administer any of the standardised assessment
you use – what test was the training for and what did the training comprise?
5. Do you make modifications to standardised assessments? If yes, is this to the
instructions or to the materials or you use a portion of the assessment, or administer it but don’t use the scoring?
6. What are the barriers to implementing standardised assessments in practice?
7. What factors support you to use standardised assessments regularly in your
Asher, I E. (2014) Asher’s Occupational Therapy Assessment Tools: An Annotated Index 4 th ed. Bethesda: American Occupational Therapy Association.
Laver, A J. (1994) The Development of the Structured Observational Test of Function (SOTOF) PhD Thesis. Guildford, University of Surrey.
Piernik-Yoder, P., Beck A (2012) The Use of Standardized Assessments in Occupational Therapy in the United State. Occupational Therapy in Health Care, 26(2–3):97–108.
Stapleton, T., McBreaty, C. (2009) Use of Standardised Assessments and Outcome Measures among a Sample of Irish Occupational Therapists Working with Adults with Physical Disabilities. British Journal of Occupational Therapists, 72 (2) 55-64. Available from: https://journals.sagepub.com/doi/10.1177/030802260907200203 [accessed
Host: Dr Alison Laver-Fawcett (@alisonlaverfaw) and Professor Diane Cox (@dianecox61)
OTalk Support: Rachel @otrach
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This weeks #Otalk is on the topic of “What are the considerations for occupational therapists in practice with regards to paid work for individuals with a learning disability?” and will be hosted by Erin Rolfe (@Erinnnnn14).