#OTalk 26th Nov 2019 – Driving After a Stroke

The RCOT Specialist Section Neurological Practice (SSNP) Stroke Forum welcomes you to the #OTalk on driving after stroke and invites you to participate in a tweet chat on driving following stroke. The chat will include the meaning of driving to us, the assessment of driving ability, methods of rehabilitation, and adjusting to life without returning to drive.

Driving is an occupation that, to many of us, represents a means of independence. This can include the independence to travel to work, to visit our family and friends, to support our everyday lives such as travelling to the supermarket, and to undertake our leisure activities. Much of our domestic and social lives are supported by us being able to drive and losing this ability would be highly likely to significantly impact on our lives.

In the UK, following a stroke, people are not permitted to drive for at least one month. After this time, people must not drive if there are enduring physical and cognitive limitations. Doctors may give the go-ahead for returning to driving if they consider that the person’s abilities are adequate. When there is uncertainty around a person’s abilities, a referral may be made to a driving assessment service where the person will be tested with a combination of physical and cognitive assessments and an on-road test.

As stroke is a condition where varying degrees of recovery is possible, rehabilitation may be a means to improve a person’s ability to increase the chance of returning to drive. Rehabilitation to improve independence in most occupations usually includes the practice of that occupation, but this is not possible with driving as people cannot legally drive before being assessed as competent. Thus, occupational therapy must depend on indirect methods of assessment and rehabilitation towards an outcome that is not guaranteed of returning to drive.

Please consider the following questions:

  1. What does the occupation of driving mean to you?
  2. How do you determine whether somebody can resume driving following the first month after stroke or whether testing at an official assessment service is required?
  3. How do you rehabilitate a person’s driving?
  4. How can occupational therapy help those who do not return to driving?

We hope the conversation resulting from the above questions will help us to understand different perspectives on driving after stroke and to discover methods which occupational therapists use to assess driving ability, to provide rehabilitation and to work towards developing alternatives to driving.


#OTalk 19th Nov 2019 Sex work and Occupational Therapy.

This week Rachel Rules ‪@_rachelOT and ‬ ‪ Rebecca Twinley‬ ‪@RebeccaTwinley‬ will be leading the chat,  here is what she had to say…

Sex work holds a ‘provocative place in the social psyche’(McCray, Wesely, & Rasche, 2011), yet sex work is a more commonplace role than society recognises. It is predicted that 40-42 million people engage in sex as work globally (Fondation Scelles, 2016), however, there are complications in making this estimate due to the covert nature of sex workand the actual amount is likely much higher. Sex workers are a diverse community from a range of socioeconomic backgrounds – this community encompasses women, men, transgender and gender-diverse individuals – and ways of engaging in sex as work are equally as varied.

In the search for Occupational Therapy literature related to this community of people, it was found that there is a dearth of research from an occupational perspective. Though, Ecklund, Arana, Henning, Lopez, Patel and Varnell’s (2018) phenomenological study explores the facilitators and barriers to occupational participation for six female exotic dancers leaving the sex industry and recognises the role of the Occupational Therapist in working with this population.

When considering the promotion of health through occupation, the stigma that sex workers face can greatly contribute to marginalisation and alienation in society (Open Society Foundations, 2019). This can affect access to health care services and if a person chooses to leave sex work, future working roles.

When considering the lives of sex workers as occupational beings, it is useful to consider the concept of the ‘dark side of occupation’ (Twinley, 2013), in exploring the unexplored and ensuring that people and their occupations are not ‘censored’ or ‘condemned’.

The aim of this #OTalk is simply to encourage thinking about Occupational Therapists’ knowledge, pre-conceptions andabilities in working holistically with sex workers.

This #Otalk differs, in that I have invited the sex workers of twitter to engage in the latter part of the talk, in the hope of capturing their experiences of accessing mainstream healthand social care services and to learn how we can improve our services and approach.

1. What is your current knowledge and understanding of sex as work?

2. Do you believe that discussing sex work is within your remit as an Occupational Therapist?

3. Are you aware of any non-mainstream or sex worker specific services in your community that you could signpost sex workers to, if they wished to access them?

4. What do you perceive the Occupational Therapy role to be in working with sex workers in your community?

5. The following two questions are directed at people who engage in sex as work – Do you have any experiences to share in accessing ‘mainstream’ health and social careservices (for both physical and mental health)? Do you disclose your work?

6. Is there anything that you think could be improved? What would you like health and social care professionals to know?

Post Chat Updates:

Online Transcript: #OTalk Transcript from www.symplur.com/healthcare-hashtags/OTalk

PDF of transcript: #OTalk 19 Nov 2019

The Numbers

1.579M Impressions
472 Tweets
76 Participants

#OTalk Participants


Eckland, E., Arana, J., Henning, L., Lopez, J., Patel., R. & Varnell, J. (2018) Exploring the role of occupational therapy with women leaving the sex industry. American Journal of Occupational Therapy, 72, 1.

Fondation Scelles (2016) Prostitution. Exploitation, persecution, repression. Retrieved from https://www.fondationscelles.org/pdf/RM4/1_Book_Prostitution_Exploitation_Persecution_Repression_Fondation_Scelles_ENG.pdf

McCray, K., Wesely, J. K., & Rasche, C. E. (2011). Rehab retrospect: Former prostitutes and the (re)construction of deviance. Deviant Behavior, 32(8), 743–768.

Open Society Foundations (2019). Understanding Sex Work in an Open Society. Retrieved from https://www.opensocietyfoundations.org/explainers/understanding-sex-work-open-society

Twinley, R. (2013) The dark side of occupation: a concept for consideration. Australian Occupational Therapy Journal, 60(4), 301-303.


#OTalk 12 November 2019 – How can occupational therapists use digital technology and apps to enhance practice?

This week’s chat will be hosted by #OTalk team member Clarissa (@geekyOT), who works as an occupational therapist on a personality disorder ward in a medium secure forensic unit. After more than 10 years of working in mental health, Clarissa has recently started a new role with the secure messaging app for healthcare professionals, Forward

A few weeks ago, my GP phoned me and asked me to go to Accident & Emergency (A&E). She said that she wanted me to be seen by a specialist, who she had tried to contact via switchboard a few times without success. She assured me that she had written a letter that should help me get seen quicker, and asked me to come to the surgery to pick it up. I explained that the detour would add an hour to my journey, and asked whether she could e-mail me the letter so I could print it out. That wasn’t an option. I asked her to e-mail it to A&E, and, keen to avoid a long journey when I was already feeling unwell, I even offered to phone A&E and ask for their e-mail address. 

Long story short: that didn’t work, and I ended up jumping in an Uber to pick up the printed letter from my GP after all. 

The A&E doctor assessed me and paged a specialist. No response. He tried again. Nothing. 

“This could take a while,” he said, glancing back at the phone on his desk. 

Wishing time away, I scrolled through the apps on my phone. Apps for communication. Apps for productivity. Apps to track all aspects of my health and lifestyle. Make life easier. Save time. And I imagined how much time could have been saved had my GP been able to contact the specialist directly. (As it happens, it would have completely saved me a trip, saved valuable A&E time, and saved me cancelling half a day of sessions with my own patients)

Frustrated with the series of delays, I told the doctor that I’d been for an interview with Forward Health earlier that week. I said that the secure messaging app could have saved us all a lot of time, and explained that he could have sent a detailed message to his colleague (confidential information and all), rather than waiting around for the phone to ring. He asked if it’s secure (it is) and free (yup), and expressed his surprise that he had never heard of it before.

Click here to download the Forward app

This led me to think about how much more efficient and effective I, as an occupational therapist, could be if I had the right technology at my fingertips. The NHS Long Term Plan sets out a vision of digital transformation for the NHS. But, even with my interest in technology, I get so bogged down with the pressures of clinical work that I don’t keep up with new developments. And I’m sure I’m not alone in that. 

So, following on from last week’s research #OTalk about innovation, let’s spend some time this week thinking about practical ways we can use digital technology and apps in our work.

I’d like this to be a space where we can vent about very real frustrations, and also think freely and creatively about future possibilities. Technology is rapidly changing, so let’s not restrict ourselves to what we already know. 

Chat Questions

  • Which apps/digital technology do you already use to support you in your work?
  • What frustrations do you have in practice that could be improved if you had technology that’s fit-for-purpose?
  • What barriers limit the use of technology in your setting?
  • Do you use any apps for your own health/wellbeing/occupational balance?  
  • If you could instantly create any app to improve your work life, what features would it have?

Post Chat Update

The Numbers*

1.411m Impressions
341 Tweets
49 Participants

*Twitter data from the #OTalk hashtag from Tue, November 12th 2019, 8:00PM to Tue, November 12th 2019, 9:00PM (Europe/London) – Symplur

#OTalk Research 5th Nov 2019 – Innovation – Do Occupational Therapists have a role to play?

This talk will be hosted by Dr Karen Bell, R&D Manager, NHS Ayrshire and Arran @RDAyrshire and Jenny Preston @preston_jenny will support on the #OTalk account.

Innovation – Do Occupational Therapists have a role to play?

Health care innovation is defined by NHS Chief Executives as

“An idea, service or product new to the NHS or applied in a way that is new to the NHS which significantly improves the quality of health and care wherever it is applied”.1 

Innovation is part of a complex landscape of drivers to improve the care that health and social care providers deliver. More familiar drivers are quality improvement programmes, NICE guidelines, research and development projects. In the last few years innovation has become a buzz word in the NHS with a number of large scale initiatives such as the Industrial Centre for Artificial Intelligence Research in Digital Diagnostics (ICAIRD) in Scotland. Artificial intelligence to streamline review processes and aid diagnostics along with Precision Medicine are increasingly touted as being the future game changers for the health service. 

However the NHS still faces huge challenges – a shrinking, more elderly workforce, an increasingly frail population with complex multi-morbidities and a drive to deliver care in a home or community environment and the questions remains what role if any can innovation play in tackling these issues and how can staff be involved given the service pressures that they face?

NHS England includes Innovation within Chapter 3 of their NHS Long Term Plan2 with the following commitments:

  • We will speed up the pipeline for developing innovations in the NHS, so that proven and affordable innovations get to patients faster. 
  • Uptake of proven, affordable innovations will be accelerated through a new Medtech funding mandate. 
  • We will invest in spreading innovation between organisations.
  • As UK-led innovations are proven as ‘ready for spread’ in England, we will support their global export through the work of Healthcare UK. 

The Catalyst for Health and Social Care Innovation in Scotland3 is a collaboration between NHS Boards, Integrated Joint Boards and Innovators to develop solutions for service delivery problems. The focus is on identifying priorities that are important, doable, of value and benefit and that there is an opportunity to develop and deliver solutions that can be adopted.

Occupational therapists are no strangers to innovation and routinely demonstrate innovative approaches to practice.  We have considerable experience in the use of technology enabled innovations both in the delivery of care and through environmental adaptation and modification.  Yet at times we don’t recognise our contribution to innovation or indeed acknowledge that our work is innovative.

This #OTalk will facilitate a discussion about what innovation means to occupational therapy research and practice.  In advance of the #OTalk you may wish to consider the following:


What does Innovation mean to you?

How do you feel about Innovation?

What are the limiting factors in developing an innovative workforce?

Do you have time to be innovative?

How likely is your service/practice to adopt innovation?

Post Chat updates:

Online transcript: OTalk Transcript from www.symplur.com/healthcare-hashtags

PDF of transcript: #OTalk 5 Nov 2019

The Numbers

2.196M Impressions
367 Tweets
56 Participants

#OTalk Participants


  1. NHS Chief Executive Innovation Review. Call for evidence and ideas. 2011
  2. NHS England (2019) The NHS Long Term Plan.  Department of Health and Social Care
  3. Catalyst for Health and Social Care Innovation in Scotland Phase One – Summary 2019. Funding, Investment and Partnering for Industry, NHS and Social Care. 

Happy Birthday to us OTalk is eight today! – Two OTalk internships opportunities up for grabs!

We are 8 today!!  Where did the time go as part of our celebrations we are recruiting one OT student intern and one Qualified or Retired Occupational Therapist intern to join our team.


#OTalk is a community that welcomes students alongside practitioners and academics, recognising the vital role students can play in bringing fresh knowledge, innovation and enthusiasm to the community.  To foster this collaboration, in 2015 #OTalk introduced the position of Student Digital Leader.

This year we also want to open up the opportunity for a qualified or retired Occupational Therapists . These Intern roles offers the opportunity to become involved in the running of #OTalk for 6-12 months whilst receiving mentoring in digital leadership from the team.

Being part of the #OTalk team allows you to be creative, innovate and work as part of team. As a Intern these are some of the activities you could be involved in and be responsible for during your internship:

OTalk Project. As part of your internship we hope you would be able to contribute in an innovative way to the #OTalk community by undertaking some form of project. This will be agreed between yourself and the rest of the OTalk team after you join the team.

 OTalk Website – Transcript posting. To support the team in posting blog transcripts on the blog posts within 48 hours of a chat and sharing this with the #OTalk community on the social media platforms.

 OTalk Facebook. To monitor the facebook page, replying to comments and ensuring blogs have been shared within other relevant pages and groups (e.g. 4OT groups and Student Occupational Therapy groups/pages)

 OTalk Twitter – Promoting. To regularly tweet from OTalk and personal accounts to promote the chats and other related activities.

OTalk Twitter – Follows. To review follows on the OTalk Twitter account, block spam accounts and to follow back/create lists for the OTalk account.

 OTalk Twitter – Hosting. To host a minimum of one chat during the internship and to support an additional two chats with guest hosts (Training will be provided – more can be hosted as desired).

Promoting OTalk. To take and create opportunities to promote #OTalk and the benefits of professional social media use within university populations and regional/geographical networks.

 OTalk Experience Summary. Along with the OTalk crew,  write up an account of the experience of interning for publication.  This can be done in a range of ways and we are open to finding new and creative ways to share this experience Our first intern Kelly did this by displaying a poster at #COT2016 and our second Kirstie wrote a piece with Kelly for OTNews. Our last intern Caroline also Worte a reflection for OT news.

 OTalk Development, including becoming a charity.  Engagement in online team meetings to review chat effectiveness, suggest future development and feedback on the relevance of OTalk.  This year we would like to register as a charity, and be able to raise some funding, to help support OTalk, including the costs of running the website, and the team attending events to promote OTalk.

Interns ideally need to be:

  • UK or Ireland based
  • Excellent communicators
  • Familiar with the use of twitter
  • Familiar with the use of gmail, google calendars and google drive
  • Familiar with the use of skype
  • Familiar with wordpress blog editing dashboard
  • Able to create PDFs of transcripts and certificates
  • Available on Tuesday nights between 8pm – 9pm at least once a month
  • Available for 30 minutes on Thursday or Fridays to post chat transcript
  • Able to access the Internet and have a laptop/smartphone that will enable blog editing and twitter/Facebook access.
  • Passionate about the occupational therapy profession
  • Promoters of the positive application of social networking for professional development
  • Responsible and professional in their use of social media (social media accounts of applicants will be reviewed as part of the application process)
  • Engaging with CPD on a regular basis
  • Knowledge of setting up a charity and managing donations.

Training to use the relevant software will be provided so please still apply if you meet most of the outline above.

If you are interested in this position please send the following information to otalk.occhat@gmail.com:

A personal statement of no more than 500 words demonstrating your suitability for the internship.

A Biography of between 100-200 words (that includes your name and university/ area of work and a link to your LinkedIn profile) [Write this as if you are introducing yourself to the OTalk Community on the blog].

Your skype username.

The name and e-mail of a referee who can be contacted if you are invited to interview.

Please direct any queries to the our email or DM us on Twitter at @OTalk_

The closing date for applications is Tuesday 26th November 2019 at 23:59.

Shortlisted applicants will be invited to a skype interview in December and will invited to a Skype interview in January 2020.

#OTalk 29th October 2019 Yoga and Occupational Therapy

As always the chat will be live on twitter Tuesday 8pm UK time,  you can join in by using #OTalk,  This week Emily Kellett @EmilyKellett7 will be hosting this is what she had to say –

Yoga is becoming more a of ‘buzz word’ within the healthcare community and more frequently being explored by Occupational Therapists. I first found a love for yoga and mindfulness from a personal perspective and couldn’t believe the benefits my body and mind received – I just had to bring it in to my work!

Within my current role I support children and young people who experience significant sensory processing challenges which manifest as behaviours that challenge. Yoga naturally provides lots of yummy sensory information to our bodies including the increase of tactile information, body awareness and gentle movements which supports our central nervous system to reach a ‘calm and alert’ state.

This therefore, leads to better control over our emotions and thought processes through the inter-linking of body, mind and breath which can lead to improved confidence and self-esteem.

The powerful effect yoga has on calming the central nervous system (which is responsible for understanding how to process sensory information) can be transferred off the mat as well to help individuals within their daily lives.

Yoga is defined as a journey of self-discovery and empowerment; bringing the mind, body and soul together. It enables individuals to feel grounded and connected, creating a sense of control, not only over their own body and thoughts, but over situations in their life also which can be hugely empowering.

OT focuses on enabling individuals to engage in meaningful daily activities despite limitations in their physical, sensory and communication abilities. OT’s view individuals holistically, meaning they look at all aspects of their life, what is important to them and what barriers they may be facing which are preventing them from participating in such activities.

Therefore, yoga and OT both place emphasis on the ‘whole’ person and incorporate the use of the mind and body to enable individuals to live their life to the fullest.

Yoga not only develops our physical health by improving our co-ordination, balance, strength alongside our fine and gross motor skills; it also does a world of good for our mental and emotional wellbeing.

It can be done anywhere, by anyone, there is no time limit, expectations, demands or rules. It can be tailored to our individual needs at that time with faster and more energetic poses, as well as calming and more grounding positions.  It can positively impact on our levels of focus, attention, and stress management, as well as supporting an increased understanding of our bodies and knowing how to slow down and relax.

And finally, the big focus on breath in yoga allows our parasympathetic nervous system to come into play and calm our minds and bodies down; preparing us for rest and relaxation as well as supporting our digestion system to work effectively, giving us the nutrients we need to remain healthy!

So stretch, twist, explore and breathe and see how Yoga can benefit you!

The questions I would like to discuss are;

  • How do you think yoga and mindfulness techniques can be incorporated into your OT practice?
  • What are the barriers to introducing yoga and mindfulness as an OT?
  • How do you perceive yoga can influence occupational performance?
  • What evaluative tools would you use to measure the effectiveness of yoga and mindfulness within your OT practice?


Online Transcript

#OTalk Healthcare Social Media Transcript October 29th 2019

The Numbers

651.332K Impressions
132 Tweets
24 Participants
106 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

#OTalk 22nd Oct 2019 – Transition from Clinician to Academic

This week  Bill Wong @BillWongOT his hosting this is what he has to say.

When I started occupational therapy school in 2009, my instructors thought I would be a researcher because of my statistics background. They thought I could be a great person to consult for in developing powerful quantitative evidence based assessments. They thought I could be a great scientist our profession need badly. Little did my former instructors know, I contributed in our profession in other ways even though I just started in academia earlier in 2019.

During my student days, I was not too confident in my clinical abilities. My expertise in autism was still developing. After I had great confidence that I would pass my first placement towards my license in California, I applied to attend the clinical doctorate program at University of Southern California (USC). During the second placement a few months later, I found out that I was conditionally accepted to the program. As I became confident that I would pass that placement, I started reading about past capstone projects on the department’s website. The idea that quickly jumped to my mind was by one of my former instructors- as she developed a course for her capstone project. Then, I asked my network of peers who went through the same program recently. I found out that my preceptor (aka project consultant) can provide remote supervision would only need to supervise me on an as needed basis. Thus, it became a slam-dunk decision for me to do my capstone project on an autism course.

When I met USC OT department’s faculty to verify what I have learned and proposed my initial idea, the department gave me the approval for the course development as a capstone project. As a condition for the academic year, I must acquire teaching experience and read at least 20 related books on autism- notably autobiographies. I was elated because it was a project that would be meaningful to me while increasing my likelihood to successfully complete the clinical doctorate degree. I ended up finding @OTSalfordUni as my preceptor after consulting the #otalk crew 7 years ago.

In 2012, one of my biggest hurdles was public speaking. I had bouts of struggles with doing presentations for OT school. I remembered I told myself, “I need to be good at something. If I want to go far with autism in OT, I must be at least adequate in public speaking. Sure, I can write awesome courses on paper. But, I will stunt my potential if I can’t deliver.

Over the years, I submitted to various OT conferences to build up my confidence. I reflected on my performance of each experience. Over time, my confidence improved. My TEDx Talk at TEDxGrandForks in 2015 was a key building block for my confidence because I could deliver speeches under immense pressure. My TEDx Talk at TEDxYouth@AlamitosBay in 2017 was another building block because it was my first time I had any courage to publicly speak about subjects other than my go-to OT topics in such a high stakes environment.

In late 2018, I decided to apply for a couple faculty positions around Los Angeles OT and OT assistant programs. I was rejected by a masters of OT program. However, I was invited to interview for an OT assistant program. Given that I am autistic, I knew it is important to be as prepared as possible for my interview. Fortunately, I was able to ace the interview even though it was unexpectedly rescheduled. 

Going into this “slow transition” for almost a year now, I have observed a few things.

1. When you guest lecture, you do your lecture and move on. However, when you formally have a class of students for at least one academic term, you need to put them in positions to succeed in the classroom and out in the field.

2. You must learn your institution and department’s academic policies. You must also be aware of rights of students who might require reasonable accommodations. Since I am in the United States, this means I must be aware of Americans with Disabilities Act.

3. If teaching is your secondary job, you must find ways to have it co-exist with your primary job. You need to maintain constant communication with your primary job’s employer regarding teaching schedule.

4. If you are unfamiliar with a prospective uni that you are interested in teaching, taking placement students from that uni can be wonderful opportunities to get more insights to the uni’s courses and culture.

5. Teaching is a small world! News can spread within a department quickly! 2 days after my interview at Stanbridge University’s Los Angeles campus, the placement coordinator from its Irvine campus was aware that I interviewed for an adjunct faculty position! Then, when I went to my first day of orientation at the Irvine campus, I recognized half of the OT faculty from the university because I met them at various conferences over the years!

6. Before I started teaching, @shawnPhippsPhD gave me this advice, “You may have to teach something in a subject that you might be uncomfortable with.” This advice couldn’t ring more true with my teaching assignment this year. To be honest, physical disabilities is one of my worst subjects in OT school. To teach a lab course on this is actually quite a challenge!

7. It has been quite a learning experience for me to grade students! Consistent and fair are qualities students are looking for. Out of the 3 practicals I graded so far, I have 2-4 students requesting me to adjust their grades due to inconsistencies. While I strived for no more of such instances, at least my students appreciated that I try my best to strive to be consistent.

8. It is important to keep professional boundaries between you and your students on social media, as eluded in previous #otalk discussions. I allow my students to follow me on Instagram because the school’s student organization (aka OT society) has an account.

On my final note before my questions, I have come to appreciate my former instructors a lot more. It is not as easy to teach OT subjects as it seems. Academia is more than just teaching a course or understanding university policies, it is also important in building rapport with students and fellow faculty.

Now, here are my questions for everyone-

1. Are you a student or a practitioner? Are you in academia right now?

2. If you are in academia now, what led you to be interested in it? What are some common myths associated with academia?

3. If you are not in academia now, what led you to be away from it? If there are things that could entice you to work in academia in the future, what are they?

4. What are some tips for either practitioners transitioning to academia, or students preparing for their futures in academia?

Post chat updates.

The Numbers

1.205M Impressions
195 Tweets
41 Participants

Online transcript click here

PDF of transcript.  #OTalk Healthcare Social Media Transcript October 22nd 2019

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