2012-practice-analysis-executive-otr.pdf

2012 Practice Analysis of the Occupational Therapist Registered

Executive Summary

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CONTENTS

Executive Summary

Review of existing test content outline 7

Panel of subject matter experts 7

Validation survey development 8

Survey process 9

Demographics, education and practice experiences 9-16

Task and domain analysis findings 17

Assignment of weights to test content outline 18

Summary 19

Appendix 1 - Validated domain, task & knowledge statements comprising the OTR test blueprint

23-29

Tables & Figures

Table 1: Ethnicity of OTR survey respondents 9

Table 2: Number and percentage of OTR respondents by employment status at their primary OT practice location

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Table 3: Number and percentage of OTR respondents by proportion of work hours spent communicating in a language other than English at their primary OT practice location

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Table 4: Number and percentage of OTR respondents providing services across diagnostic categories

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Table 5: Test blueprint for the OTR examination 19

Figure 1: Proportion of respondents by areas of practice for primary OT employment 11

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About NBCOT

The National Board for Certification in Occupational Therapy, Inc. (NBCOT®) is the

national certification body for occupational therapy professionals in the United States.

The Mission of NBCOT is to serve the public interest by advancing client care and

professional practice through evidence-based certification standards and the validation

of knowledge essential for effective practice in occupational therapy.

Currently, 50 states, Guam, Puerto Rico and the District of Columbia require NBCOT

initial certification for occupational therapy state regulation, (i.e., licensing).

NBCOT certification programs are accredited by the American National Standards

Institute (ANSI) and the National Commission for Certifying Agencies (NCCA). NBCOT

is a member of the Institute for Credentialing Excellence (ICE).

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National Board for Certification in Occupational Therapy, Inc. (NBCOT®) is a not-for-profit certifying body for individuals with education and experience in the practice of occupational therapy. As with other certification programs, the NBCOT’s program aims to establish that individuals have the knowledge necessary to perform tasks critical for the safe and competent practice as an entry-level occupational therapist practicing under U.S. jurisdiction.

In 2012, the NBCOT began the process of reviewing the test blueprint for the NBCOT Occupational Therapist Registered (OTR®) Examination. The NBCOT worked with Castle Worldwide, Inc., a certification and licensure design, development, and administrative service company, to ensure that its certificate examinations meet guidelines and standards for examination development (e.g., Standards for Educational and Psychological Testing, American Educational Research Association, 1999; Uniform Guidelines on Employee Selection Procedures, EEOC, 1978).

A number of steps were undertaken for the analysis of the practice requirements for newly certified occupational therapists. First, feedback was obtained from the existing NBCOT examination item writers, exam development personnel, and a review of feedback from candidates and other persons to identify task areas on the existing occupational therapist test content outline that were no longer current or duplicated in other areas of the outline. A panel of subject matter experts (SMEs) was then assembled. The panel reviewed the existing material and feedback, establishing a revised

test content outline that consisted of important occupational therapy activities to be assessed. The outline was incorporated into a survey sent to a sample of entry-level occupational therapists to validate the panel’s work. A final panel of SMEs was assembled to assign the proportion of items to the content areas.

Review of the existing test content outline

The existing test content outline developed in the 2007 practice analysis study consists of 17 tasks in four domains.

A review of candidate comments and discussions with test and exam development personnel identified areas of improvement in the test content outline. Based on these comments and feedback, NBCOT constructed a revised test content outline.

Panel of subject matter experts

In September 2012, a 10-member panel of SMEs was assembled to review and revise an outline of the areas of practice required for competent performance as a newly certified occupational therapist. The panel members worked with or supervised the practice of recently certified occupational therapists or had been certified within the last two to three years. Panel members represented varied practice settings and a variety of geographic areas in the United States. Ethnicity and gender make-up of the panel was representative of the larger certificant population.

NBCOT’s program aims to establish that individuals have the knowledge necessary to perform tasks critical for the safe and competent practice as an entry-level occupational therapist

Executive Summary

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The panel members initially reviewed the revised practice analysis test content outline prepared by NBCOT. Based on this review and their own experiences, the panel members established a test content outline consisting of nine core tasks in four domains of practice.

The panel also developed a series of critical knowledge statements for each task, producing a total of 60 knowledge statements.

Validation survey development

A total of 73 occupational therapist statements - four domains, nine tasks, and 60 knowledge statements - were incorporated into an online practice analysis validation survey. The survey also included a number of questions about participants’ education, practice experiences, and demographics. The entire survey was conducted online. For the tasks, and knowledge statements, survey participants were provided an opportunity to identify critical elements of practice that had not been captured by the proposed content outline.

The survey was reviewed by members of NBCOT, Castle, and a subset of the SME panel to ensure fidelity with the panel’s work as well as appropriate survey design.

A total of 73 occupational therapist statements - four domains, nine tasks, and 60 knowledge statements - were incorporated into an online practice analysis validation survey.

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Sample selection

The NBCOT identified a sample of 2,826 currently certified OTRs who had been certified for less than three years as of October 2012.

Contact procedures

The potential respondents were contacted by email on a prescribed schedule. All potential respondents were assured confidentiality regarding their participation and responses. Data was collected and analyzed by Castle and summary results were provided to the NBCOT. The survey was conducted from November 12 through December 5, 2012.

Return rates

Of the 2,826 requests sent, a total of 2,235 respondents started the survey, an overall response rate of 79%. This response rate is similar to experiences with other practice analysis surveys.

Not all individuals responded to every question or provided valid responses; therefore, the total number of responses per question varied. For example, the last knowledge statement was rated by a total of 1,983 respondents, 89% of those who began the survey. Experience with similar surveys shows a completion rate typically between 75% and 85%.

Gender and ethnicity

Eighty-two percent of the 2,235 respondents reported their gender as female, 7 percent reported as male, and 11 percent did not respond. Candidates were asked to report ethnicity by

selecting all applicable categories. Table 1 provides a breakdown of the proportion and number of candidates who selected the options.

Table 1. Ethnicity of OTR survey respondents.

Answer Options Percent Count

American Indian or Alaska Native 0.7% 13

Asian 8.2% 163

Black or African American 3.0% 60

Hispanic/Latino of any race 3.8% 76

Multi-racial 1.6% 31

Native Hawaiian or Other Pacific Islander 0.5% 10

White 80.1% 1,584

Prefer not to answer 4.9% 97

answered question 1,977

skipped question 258

Education

Of the 1,980 respondents who reported their education, 94% reported completing an entry-level master’s degree, 2.6% reported an entry-level doctoral degree, and 3.2% reported an Occupational Therapist Early Determination (OTED) (including internationally educated). A total of 1,942 respondents provided a valid response concerning the year they had completed their occupational therapy education. The majority of respondents reported graduating between 2009 and 2012, with the earliest graduation reported as 19911.

1 Survey respondents were selected based on the timeframe since initial certification. Some respondents may have graduated well before becoming certified.

Validation Survey Process

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Practice

Of the 1,976 respondents who completed the question on current employment, 97% indicated that they were actively working in a position that requires an occupation therapist, less than 1% (20) indicated working in a position other than occupational therapy, and 2.7% (53) reported that they were not currently working. The majority of respondents employed in an OT role were hourly employed, with salaried almost equivalent (Table 2).

Table 2. Number and percentage of OTR respondents by employment status at their primary OT practice location.

The majority who indicated other provided details that were a mix of salaried, contract, self-employed, per diem, and per visit.

Approximately 20% of respondents reported that their primary OT area of practice was skilled nursing, followed by pediatrics (19%) and rehabilitation (17%). Respondents who indicated “other” typically noted a mix of pediatrics, skilled nursing, and rehabilitation. Further breakdowns are provided in Figure 1.

Status Percent Count

Self-employed 2.3% 44

Salaried 41.8% 806

Hourly employed 48.7% 939

Temporary contract 4.2% 82

Other (please specify) 3.1% 59



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Figure 1. Proportion of respondents by areas of practice for primary OT employment.

The average number of hours worked was 37.5 hours per week, with an almost equal split between salaried and hourly employment.

Twenty-nine percent of the respondents indicated that they communicated in languages other than English in their primary OT employment setting. Of the 568 candidates who indicated that they

communicated in languages other than English at their primary OT employment setting, over 70% communicated in Spanish. Table 3 details the proportion of time spent communicating in a language other than English.

Twenty-nine percent of the respondents indicated that they communicated in languages other than English in their primary OT employment setting.

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Table 3. Number and percentage of OTR respondents by proportion of work hours spent communicating in a language other than English at their primary OT practice location.

Respondents were asked to reflect on their caseload and indicate the top three diagnoses from each of six diagnostic categories. Table 4 details the number and percent of respondents who reported providing services across different disorder classifications collected via the survey.

Time Spent Percent Count

1% – 5% 47.3% 283

6% – 25% 32.3% 193

26% – 50% 10.7% 64

51% – 75% 4.7% 28

76% – 100% 5.0% 30

answered question 598

skipped question 1,637

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Table 4. Number and percentage of OTR respondents providing services across diagnostic categories.

Disorders Percent Count

Neurological Disorders

I do not provide services to this diagnostic category. 10.4% 201

Cerebral vascular accident 60.7% 1,173

Traumatic brain injury 26.0% 502

Spinal cord injury 9.4% 181

Multiple sclerosis 4.8% 93

ALS 0.4% 7

Parkinson’s 22.4% 433

Dementia 46.8% 906

Spina bifida 4.9% 94

Cerebral palsy 22.4% 433

Low vision 13.8% 267

Neurogenic back pain 4.5% 87

Complex regional pain syndrome 2.7% 52

Peripheral nerve lesion 1.4% 27

Peripheral neuropathy 14.0% 270




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Developmental Disorders Percent Count


Congenital anomalies 9.4% 180

Developmental delay 42.0% 807

Visual processing deficit 12.7% 243

Fetal alcohol syndrome 2.0% 39

Malnutrition 4.8% 92

Intellectual disability 18.6% 358

Learning disorder 15.6% 299

Sensory integrative disorder 31.7% 608




Musculoskeletal/orthopedic Disorder


Fractures 61.5% 1,178

Upper and/or lower extremity amputations 26.9% 514

Osteoarthritis 42.6% 816

Tendinopathy 4.5% 87

Joint replacements 53.6% 1,026

Sprains/strains 5.3% 102




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Cardiopulmonary Disorders Percent Count


Myocardial infarction 53.5% 1,016

Chronic obstructive pulmonary disease 58.7% 1,114

Congestive heart failure 58.1% 1,103

Tuberculosis 0.3% 5




Psychosocial Dysfunction Disorders


Schizophrenia 16.0% 307

Mood disorders 24.0% 461

Anxiety disorders 41.5% 796

Substance abuse 23.1% 443

Autism spectrum disorders 33.0% 633

Attention deficit hyperactivity disorders 29.7% 571

Behavior disorders 32.1% 616

Personality disorders 6.2% 119




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General Medical/Systemic Disorders Percent Count


HIV/AIDS 2.3% 44

Cancer 37.6% 714

Diabetes 48.6% 921

Rheumatoid arthritis 28.4% 538

Fibromyalgia 4.2% 79

General deconditioning/debilitation 51.9% 984

Burns 3.4% 64

Lymphedema 5.3% 100

Open wounds/decubitis 11.1% 210




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Task and domain analysis findings

To assess the tasks and domains, respondents were asked to rate the criticality and frequency of the concept. Respondents were also asked to rate the knowledge statements on criticality only.

Reliability of ratings

Reliability indices were calculated to assess the capability of the survey to measure the activities relevant to safe and effective practice of newly certified occupational therapists. The scales used had reliability indices above 0.7 for the ratings of domain criticality and frequency, and task criticality and frequency. These reliability indices indicate that the survey is reliably measuring the activities that form the basis for competent occupational therapy practice.

Criticality

Criticality was defined as:

The degree to which a member of the public or other stakeholder would be physically, emotionally, or financially harmed if the OTR failed to perform the described duties competently.

Respondents were asked to rate the criticality of the tasks, domains, and knowledge statements on a 4-point scale from 1 (No Harm) to 4 (A Great Deal of Harm). Average criticality statistics were calculated for each task and domain.

Frequency

Frequency was defined as:

The time that a competent OTR spends performing the described duties.

Respondents were asked to rate the frequency with which they performed the tasks and domains on a 4-point scale from 1 (Rarely) to 4 (Often). Average frequency statistics were calculated for each task and domain.

Importance

Consistent with the Standards for Educational and Psychological Testing (American Educational Research Association, 1999), an importance weight was calculated for each respondent’s ratings of a task or domain. The formula was designed to create an importance weight that was as straightforward as possible and that highlighted the impact of the consequences of failure to perform. By emphasizing criticality, the importance formulation that was used supports the NBCOT’s mission of protecting the public from harm. Average importance statistics were calculated for each task and domain.

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Assessment was also made as to the critical values for the obtained importance weight. A 95% confidence interval (CI) for mean rating was calculated. Following review of the data, none of the tasks were removed from the content outline. See appendix 1 for a complete listing of the validated domain, task and knowledge statements which comprise the OTR test content outline.

Assignment of weights to test content outline

In January 2013, a nine-member panel of SMEs experienced in item writing was assembled to assign the proportion of items to each domain assessed by the validated test content outline.

The webinar meeting consisted of three rounds of review of the test content outline. For each round, the panel members were asked to independently determine the percentage of items they felt should be allocated to each of the domain areas. Following each round, a discussion was held to review overall average, highest/lowest ratings, and how the ratings and average reflects the OTR content outline. Participants were asked to revisit the purpose of the meeting and talk about how the ratings support concepts. Domain 4 was identified as an area where much of the knowledge is infused throughout the other domains in the document. The proportion of items assigned to each domain was established as 17% for Domain 1, 28% for Domain 2, 45% for Domain 3, and 10% for Domain 4 – see table 5 for details.

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Table 5. Test blueprint for the OTR examination.

OTR Domain Descriptions Percent of exam

Domain 01Acquire information regarding factors that influence occupational performance throughout the occupational therapy process.

17%

Domain 02Formulate conclusions regarding client needs and priorities to develop and monitor an intervention plan throughout the occupational therapy process.

28%

Domain 03 Select interventions for managing a client-centered plan throughout the occupational therapy process. 45%

Domain 04 Manage and direct occupational therapy services to promote quality in practice. 10%

Summary

The 2012-13 occupational therapist practice analysis study used well-established methods to describe and validate the practice of newly certified occupational therapists in North America. This included:

a. A review of existing test content material.

b. SME knowledge. c. A large scale survey.

Respondents to the 2012 NBCOT occupational therapist practice analysis survey validated the tasks and domains appropriate for inclusion on a certification exam for entry-level occupational therapists. The representativeness and reliability of the survey instrument were very good. In addition, there was evidence to support the validity of the domain, task, and knowledge statements.

Based on the final SME panel deliberations and the validated test content outline, the final proposed test content outline consists of nine tasks in four areas of domain practice, with 60 associated knowledge statements. Additionally, the proportion of items assigned to each domain area was established for the OTR examination. Based on evidence, the findings of this study can be used to evaluate and support an entry-level occupational therapist certification examination. This test content outline will guide NBCOT examination construction for the OTR examinations beginning 2014.

Based on evidence, the findings of this study can be used to evaluate and support an entry-level occupational therapist certification examination.

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References

Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, p. 297-334.

De Champlain, A. F., Cuddy, M. M., & LaDuca, T. (2007). Examining Contextual Effects in a Job Analysis: An Application of Dual Scaling. Educational Measurement: Issues and Practice, 26(3), p. 3-11.

Equal Employment Opportunity Commission (EEOC), U.S. Civil Service Commission, U.S. Department of Labor, and U.S. Department of Justice. (1978). Uniform Guidelines on Employee Selection Procedures. Federal Register, 43 (166), p. 38290-38315.

Joint Committee on Standards for Educational and Psychological Testing (American Educational Research Association, American Psychological Association, National Council on Measurement in Education) (1999). Standards for Educational and Psychological Testing. Washington, D.C.: AERA.

National Council of State Boards of Nursing (NCSBN). (2009). The 2008 RN Practice Analysis: Linking the NCLEX-RN® Examination to Practice. (Research Brief Vol. 36). Chicago: Anne Wendt.

Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric Theory (3rd ed.). New York: McGraw-Hill.

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Appendix 1

Validated domain, task and knowledge statements comprising the OTR test blueprint

Domains are specified in bold with a two-digit number, tasks are grouped under each domain (four-digit number), and the tasks’ associated knowledge statements are listed with a six-digit number.

Code Description

DOMAIN 1

01 Acquire information regarding factors that influence occupational performance throughout the occupational therapy process.

0101

Acquire information about a client’s functional skills, roles, context, and prioritized needs through the use of available resources and standardized and non-standardized assessments in order to develop an occupational profile.

010101 Normal development and function across the lifespan

010102Expected patterns, progressions, and prognoses associated with conditions that limit occupational performance (e.g., stages of disease, secondary complications, outcomes)

010103 Processes and procedures for acquiring client information (e.g., client records, observation, interview, occupational profile)

010104 Administration, scoring, purpose, indications, advantages, and limitations of standardized and non-standardized screening and assessment tools

010105 Influence of client factors, context, and environment on habits, routines, roles, and rituals

010106 Methods for recognizing and responding to typical and atypical physiological, cognitive, and behavioral conditions

0102Analyze evidence obtained from the occupational profile to identify factors that influence a client’s occupational performance.

010201 Therapeutic application of theoretical approaches, models of practice, and frames of reference

010202 Activity analysis in relation to the occupational profile, practice setting, and stage of occupational therapy process

010203 Internal and external influences on occupational performance (e.g., environment, context, condition, medication, other therapies)

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DOMAIN 2

02Formulate conclusions regarding client needs and priorities to develop and monitor an intervention plan throughout the occupational therapy process.

0201

Analyze and interpret standardized and non-standardized assessment results, using information obtained about the client’s current condition, context, and priorities in order to develop and manage client-centered intervention plans.

020101 Methods for analyzing results from screening and assessments

020102

Integration of screening and assessment results with client occupational profile, client condition, expected outcomes, and level of service delivery to develop a targeted action plan, monitor progress, and reassess the plan

020103Methods for determining program development and client advocacy needs (e.g., aging in place, falls prevention, health and wellness programs, community support groups, inservices)

0202

Collaborate with the client, the client’s relevant others, occupational therapy colleagues, and other professionals and staff, using a client-centered approach to manage occupational therapy services guided by evidence and principles of best practice.

020201 Interprofessional roles, responsibilities, and care coordination (e.g., referral to and consultation with other services)

020202

Management of collaborative client-centered intervention and transition plans based on client skills, abilities, and expected outcomes in relation to level of service delivery, frequency and duration of intervention, and available resources (includes communication with family, caregiver, and relevant others)

020203Prioritization of goals based on client skills, abilities, and expected outcomes in relation to level of service delivery and frequency and duration of intervention (e.g., expected length of stay, transition plan)

Code Description

25

DOMAIN 3

03 Select interventions for managing a client-centered plan throughout the occupational therapy process.

0301

Manage interventions for the infant, child, or adolescent client, using clinical reasoning, the intervention plan, and best practice standards consistent with pediatric condition(s) and typical developmental milestones (e.g., motor, sensory, psychosocial, and cognitive) in order to support participation within areas of occupation.

030101 Influence of pediatric condition(s) and typical developmental milestones on areas of occupation

030102 Intervention activities for supporting participation in occupations based on current sensory, cognitive, motor, and psychosocial skills and abilities

030103Intervention methods for facilitating or inhibiting sensory, motor, or perceptual processing based on pediatric condition(s), tasks, and environmental demands

030104Intervention methods for improving range of motion, strength, and activity tolerance based on pediatric condition(s) in order to promote occupational performance

030105 Group facilitation methods appropriate to pediatric condition(s) and developmental level

030106Splint design and fabrication, and types, functions, and use of orthotic and prosthetic devices based on pediatric condition(s) and task demands

030107 Assistive technology, adaptive devices, and durable medical equipment based on pediatric condition(s), task, and environmental demands

030108 Methods for adapting intervention techniques, activities, and environments in response to behaviors and developmental needs

030109 Intervention methods for enabling feeding and eating skills based on pediatric condition(s) and developmental level

030110 Transfer and positioning techniques based on pediatric condition(s), task, and environmental demands

030111 Prevocational and vocational interventions that support transition planning

Code Description

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030112 Seating options, positioning devices, and mobility systems based on pediatric condition(s), developmental level, and environmental demands

030113Environmental modifications for maximizing accessibility and mobility within various contexts based on pediatric condition(s), developmental level, and task demands

030114Methods for adapting or grading an activity, task, or an environment based on pediatric condition(s), developmental needs, and task demands

030115

Methods and techniques for promoting the continuation of the interventions within multiple contexts based on current pediatric condition(s), developmental level, and expected outcomes (e.g., home program, caregiver instructions, teacher consultation)

0302

Manage interventions for the young, middle-aged, or older adult client, using clinical reasoning, the intervention plan, and best practice standards consistent with general medical, neurological, and musculoskeletal condition(s) in order to achieve functional outcomes within areas of occupation.

030201 Influence of medical, neurological, and musculoskeletal condition(s) on activity selection and areas of occupation

030202Rehabilitative strategies and procedures specific to medical, neurological, and musculoskeletal condition(s) (e.g., joint protection, work simplification, energy conservation)

030203

Methods and strategies for improving range of motion, strength, and activity tolerance based on general medical, neurological, and musculoskeletal condition(s) in order to promote occupational performance

030204Strategies and procedures for facilitating or inhibiting sensory, motor, and perceptual processing based on general medical, neurological, and musculoskeletal condition(s)

030205Methods for selecting and effectively applying superficial and deep thermal, mechanical, and electrotherapeutic physical agent modalities as an adjunct to participation in an activity

030206Splint design and fabrication, and types, functions, and use of orthotic and prosthetic devices based on general medical, neurological, and musculoskeletal condition(s) and task demands

Code Description

27

030207Assistive technology (i.e., high and low tech), adaptive devices, and durable medical equipment based on client needs and general medical, neurological, and musculoskeletal condition(s)

030208 Intervention methods for enabling feeding and eating skills based on client needs and medical, neurological, and musculoskeletal condition(s)

030209Transfer methods and positioning techniques based on client needs; general medical, neurological, and musculoskeletal condition(s); task; and environmental demands

030210Seating options, positioning devices, and mobility systems based on client needs; medical, neurological, and musculoskeletal condition(s); task; and environmental demands

030211Environmental modifications for maximizing accessibility and mobility within context based on client needs; medical, neurological, and musculoskeletal condition(s); and task demands

030212 Ergonomic principles and universal design for health promotion and injury prevention

030213 Methods for adapting and grading tasks and activities based on client needs and medical, neurological, and musculoskeletal condition(s)

030214Methods and strategies for promoting the continuation of the intervention within context based on medical condition(s) and expected outcomes (e.g., home program, caregiver instructions)

0303

Manage interventions for the young, middle-aged, and older adult client, using clinical reasoning, the intervention plan, and best practice standards consistent with psychosocial, cognitive, and developmental abilities in order to achieve functional outcomes within areas of occupation.

030301 Influence of psychosocial, cognitive, and developmental abilities on areas of occupation

030302 Methods for facilitating groups to enhance participants’ psychosocial, cognitive, and developmental skills

Code Description

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030303

Approaches (e.g., remediation, compensation, prevention) and interventions (e.g., problem solving, medication management, memory strategies) appropriate for psychosocial and cognitive models of practice (e.g., cognitive, behavioral, acquisitional, developmental)

030304 Environmental modifications to enhance community safety and well-being consistent with occupational roles and client needs

030305Assistive technology and adaptive devices to enhance participation in occupation consistent with psychosocial, cognitive, and developmental abilities

030306 Methods for adapting and grading an intervention based on psychosocial, cognitive, and developmental abilities

030307

Methods and techniques for promoting the continuation of the interventions within multiple contexts based on psychosocial, cognitive, and developmental abilities (e.g., home program, caregiver instructions, job coach)

Code Description

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DOMAIN 4

04 Manage and direct occupational therapy services to promote quality in practice.

0401Maintain and enhance competence, using professional development activities relevant to practice, job responsibilities, and regulatory body in order to provide evidence-based services.

040101 Professional development activities

040102 Methods of analyzing and interpreting research and its application to practice

040103 Methods for evaluating, monitoring, and documenting service competency (e.g., self-assessment, peer review)

0402

Manage occupational therapy service provision in accordance with laws, regulations, accreditation guidelines, and facility policies and procedures governing safe and ethical practice in order to protect consumers.

040201 Influence of policies, procedures, and guidelines on service delivery

040202

Licensure laws, federally mandated requirements, and reimbursement policies related to occupational therapy service delivery (e.g., client confidentiality, levels of supervision, plan of care certification/recertification, referral policy)

040203 Methods for incorporating risk management techniques and monitoring safety related to occupational therapy service delivery

040204Methods for applying continuous quality improvement processes and procedures to occupational therapy service delivery (e.g., program evaluation, outcome measures)

040205 Scope of practice and practice standards for occupational therapy (e.g., delegation, supervision, role delineation)

040206Accountability processes and procedures using relevant technology (e.g., documentation guidelines, components of an intervention plan, coding systems, electronic medical records, written documentation)

Code Description

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording, or otherwise) without prior written permission of the copyright owners.

© 2013 National Board for Certification in Occupational Therapy, Inc. ‘NBCOT’ (formerly American Occupational Therapy Certification Board ‘AOTCB®’) is a service and trademark of the National Board for Certification in Occupational Therapy, Inc. ‘OTR®’ is a certification mark of the National Board for Certification in Occupational Therapy, Inc. ‘COTA®’ is a certification mark of the National Board for Certification in Occupational Therapy, Inc.

All marks are registered in the United States of America.

12 S. Summit Avenue, Suite 100Gaithersburg, MD 20877

www.nbcot.org

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