What follows is my rationale for not supporting Motion 1. The "Line
Items" refer to the actual text of the Motion.
These are the rationale that I send to my RA Rep and I encourage YOU to
to develop your own rational and send them to YOUR RA Rep. Remember, you
MUST ACT quickly as time is running out.
This information and more is available at:
www.otnow.com/motion1/rationale.html
Thanks,
Ron
==============================< START >=============================
<< LINE ITEMS 17 - 21 >>
Line items state: "The ad hoc committee would include at least one
member representative of the Physical Disabilities Special Interest
Section (PDSIS) Hand Subsection, one practitioner who specializes in
upper extremity rehabilitation, one practitioner in general physical
disabilities rehabilitation, one educator, and a certified hand
therapist recommended by the American Society of Hand Therapists (ASHT)
who is both an ASHT and an AOTA member.
##### RATIONALE AGAINST LINE ITEMS 17 - 21 #####
The Motion recommends that the Ad Hoc committee include 5 members. Of
these 5, only 1 is called from the general phys-dys community. This is
not good representation for non-UE specialists. IF this motion passes,
it should be changed to include equal representation for both UE
specialists and non-UE specialists.
Special interest groups such as the ASHT should not be involved in
general OT education. The ASHT is not concerned with the interests of OT
or OT education.
======================================================
<< LINE ITEMS 17 & 19 (repeat) and 36 & 37 >>
Line items 17 & 19 state: "...one practitioner who specializes in upper
extremity rehabilitation, one practitioner in general physical
disabilities rehabilitation."
Line items 36 & 37 state: "We seek to ensure that entry-level
occupational therapists bring a strong and effective set of practice
skills to the area of physical disabilities and upper-extremity
rehabilitation."
##### RATIONALE AGAINST LINE ITEMS 17 & 19 and 36 & 37 #####
The language of Motion 1 segregates the practice of adult physical
disabilities into "upper extremity rehabilitation" and "general physical
disabilities rehabilitation". This language suggests that UE rehab is a
speciality of general rehab. Entry-level education is designed to
provide basic evaluation and treatment skills for general therapy across
different practice areas. Entry-level practitioners need entry-level
skills, not the skills of an UE specialist.
UE rehab is a specialization, similar to complete decongestive therapy
or wound care, that is carried out by advanced practitioners with years
of experience, not by new grads.
======================================================
<< LINE ITEMS 44 & 45 >>
Line items state: "Adequate knowledge and skills preparation are
essential for the future participation and advancement of OT in physical
disabilities."
##### RATIONALE AGAINST LINE ITEMS 44 & 45 #####
I agree with the above statement but I do not agree with the notion that
increased student training in UE specialization advances our profession
in physical disabilities. Increased training in UE specialization only
serves to advance those OT's who choose specialization in rehab of the
UE. Those OT's who practice in "general physical disabilities
rehabilitation" will not be advanced by development and adherence to
additional core competencies.
If evidence supports that OT students do not have adequate basic science
knowledge to practice in "general physical disabilities rehabilitation",
then additional competencies need developing or educational programs
need to meeting existing competencies for the general rehab setting.
This motion is authored by three CHT's, who are obviously specialized in
the hand#arm. Entry-level education should not be driven towards
specialization, especially towards an an anatomical region which
categorically denies the entire lower half of the human body.
======================================================
<< LINE ITEMS 51 & 54 >>
Line items state: "We are seriously concerned that if core educational
competencies are not established for the treatment of physical
disabilities and upper-extremity rehabilitation, our ability to practice
in these areas will be compromised or lost to other competing allied
health professionals"
##### RATIONALE AGAINST LINE ITEMS 51 & 54 #####
While developing additional UE rehab competencies for entry-level
education will certainly increase UE knowledge and skills, at what cost?
Educational programs have time and man power limitations and can only
deliver so much information. If additional context is required, then
existing (non-specialized) content may be removed.
It is very important that OT students learn basic phys-dys skills, such
as MMT, goniometry, ROM, etc. However, these skills need not be learned
solely for the purpose of UE Specialization. In accordance with AOTA's
Framework, these skill should be learned to increase patient's
occupational performance. As most occupations involve patients' lower
extremities, basic phys-dys skills are equally necessary for the LE.
Motion 1 serves to only improve basic science skills as they relate to
the UE.
======================================================
<< LINE ITEM 65 >>
The line item includes the following Framework goal:
Goal 1. Building the profession’s capacity to fulfill its potential
and mission:
##### RATIONALE AGAINST LINE ITEM 65 #####
The mission of OT is NOT restoring UE function. The mission of OT is
restoring occupation. The "UE Specialization" phenomenon is already too
prevalent in the adult phys-dys community. Our profession needs to move
from this practice pattern by embracing our Framework. Motion 1 takes us
exponentially further from our Framework
The Framework clearly states that OT's expertise is OCCUPATION, not "UE
Rehab". Thus entry-level students should NOT receive excessive training
in UE Rehab. Instead, UE training should be consistent with other
phys-dys training, Specialization in UE Rehab should be left to
individual therapist who desire to work in that practice setting.
======================================================
<< LINE ITEM 78 - 80 >>
Line items include the following excerpt from AOTA's Centennial Vision
"We envision that occupational therapy is a powerful, widely
recognized, science-driven and evidence-based profession with a
globally connected and diverse workforce meeting society's
occupational needs."
##### RATIONALE AGAINST LINE ITEMS 78 - 80 #####
There is very little if anything about "UE specialization" that helps
people meet their occupational needs. By it's very name, UE
specialization is about the upper extremity. True, there are those
patient's whose chief complaint is loss of UE function and when that
function is restored, then so is their occupation. But there are just as
many people who's occupational deprivation far exceeds the loss of UE
function.
Specialization has been defined as "learning more and more about less
and less." Hand therapists, be they OT or PT, exemplify this definition
as they have spent extraordinary time learning about UE rehab. But, the
very nature of their specialization takes them away from the nature of
meeting society's OCCUPATIONAL needs.
======================================================
<< SUMMARY >>
Being an UE Specialist is a choice that individual phys-dys therapists
make. However, if developing OT students receive increased emphasis on
UE training, and especially if the term "UE Rehab" is used, students
will more likely develop the UE therapist mentality that is already too
prevalent in adult phys-dys. So, while new therapists may choose to not
practice as UE specialists, I believe that the motion exponentially
moves the profession of adult phys-dys profession, as a whole, towards
UE specialization, which in my professional opinion is the diametrically
the wrong direction!
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