Hi Terrianne and Joe - I have been following (and participating in) a very lengthy and informative discussion on Motion 1 on the AOTA Phys Dis and Faculty listservs, which has spilled over onto some others, thanks to Ron's advocacy. I realized that the things they are asking for are already included in the accreditation standards for OT education (at an entry level of competence), and have to be taught. As an educator, I have to know the standards well.
The current standards are way more detailed than when any of us were in school (I graduated in 1994 with an entry level masters). There is absolutely no movement to take out any of the sciences, in fact the standards spell out that coursework "must include, but is not limited to, biology, anatomy, physiology, neuroscience, and kinesiology or biomechanics". The old standards only said you had to have courses in the "biological and physical sciences". In addition, there are specific standards on physical agent modalities, feeding & eating, assistive technology, and orthotics, that were never there before. There are specific standards for evaluation and intervention for all the client factors & performance skills (ROM, strength, sensation, motor control, cognition, etc). This is in addition to all the standards that relate to occupational performance, service delivery, research, management, etc. >From what I can gather, the authors of Motion 1 are UE practitioners (mostly CHTs I believe) that have decided that students and new grads aren't competent with the goniometer or UE rehab. They haven't collected any data, only some anecdotes and observations that seem to reflect that they really don't know (or have forgotten) what an entry level OT should be able to do. I'm not saying that every new grad has all the skills they should have, but it's not because we don't teach the stuff. No matter how many competency tests we give (and the students pass) some still go out on fieldwork and act like they've never seen a goniometer, but they are the exception, not the rule. I have opposed Motion 1 for 2 reasons - 1. what they want to establish is redundant and already exists in the standards, and 2. their request has no evidence base. I have no problem with assigning resources to a real problem, but I don't feel the authors have established that there really is a problem. Hope that sheds a little light on the issue, plus my 2 cents. :-) Thanks, Sue Sue Ordinetz, ABD, MEd, MS, OTR/L Assistant Professor of Occupational Therapy American International College 1000 State Street Springfield, MA 01109 *********** REPLY SEPARATOR *********** On 3/18/2008 at 7:38 PM Terrianne Jones wrote: >Joe, if I understand Ron correctly, he is not proposing we get rid of >content related to basic science,anatomy, etc. I believe what he is saying >is that we do need to teach all that stuff, but not to the extent that we >can truly create an advanced practitioner at the entry level of education. > >Terrianne > >Joe Wells <[EMAIL PROTECTED]> wrote: Hi Ron: > >Personally, I do not agree with RA Motion- 1, but can not completely oppose >it either. I believe it is incomplete, and needs some corrections/ >clarifications. I feel that OT education must include basic sciences that >not only include occupational science but also the "whole body" anatomy/ >physiology/ biomechanics and kinesiology versus just for the upper >extremities. I thought this was already the case as in my bachelors >curriculum (90-95) did include all but Occupational Science (which I was >glad to have later for my OTD) until I saw the motion. I agree that >"occupation" is our major domain, but I do not believe that we can truly >facilitate that without knowing the basics of how our physical system works >either (while working with physical disabilities). How do we use exercise >as >"means" to facilitate occupation without actually knowing what structures >you need to work on? What desired effect is intended? How do the >inappropriate use of cones/ dumbbells (that we have either witnessed, heard >of, or personally are guilty of doing at times, either in the name of >occupation or exercise or human performance or whatever else we personally >choose to call them) reflect on our professions competence in physical >rehab already? Please note: these very same props- the cones or dumbbells >could very well be used appropriately in our treatments as well. > >Ron, I hope by opposing this motion you do not mean that OT schools should >stop teaching (or requiring as pre-requisites) basic clinical sciences such >as anatomy, physiology, biomechanics/ kinesiology, pathology, etc.. The OT >Practice Framework states OTs have knowledge of "body structures/ body >functions". How do we intend to get this knowledge when we plan to >eliminate >the required foundation in basic sciences that make us clinicians? As >aspired in our centennial vision, we must be science- driven. Our >treatments/ purpose must be strongly founded in science for us to thrive in >the future. Also, I fear that defeating the motion altogether (if it means >excluding the sciences) may cause insurance companies/ states (e.g. >California) to seek special certification in use of PAM, or further still >to >do other procedures commonly used in physical rehab (how do we do >therapeutic exercises, manual therapies, orthotic management without having >a knowledge of the body structures/ functions)? Please note that currently >under Medicare, Medicaid and other health insurances, "Occupation" as an >unique experience by the client, and as an outcome/ product of our service, >is paid via CPT codes or similar procedural codes that address it either in >a more direct manner, e.g., self-care management training, community >reintegration program, or in a rather indirect manner as with the majority >of the procedures listed under "physical medicine and rehab" codes, e.g., >therapeutic exercises, therapeutic activities, any of the modality codes, >etc.. We need to ensure that we have all "tools" available to us and that >we >are competent in the use of such tools. > >However, I agree that we do not need advanced education but appropriate >basic- level education for competent entry-level general practice. >Advanced education/ training such as the CHT are specializations. This is >true for all fields- PT, MD, DO, DDS, etc. MDs do not learn advance hand >surgical techniques for general practice. We should not seek advanced >professional expertise with entry-level education. The question then is- >does our current curriculum prepare students with adequate skills to enter >the field to practice in physical rehab? > >In my opinion, the motion should be re-written to ensure appropriate >curricula is followed in schools pertaining to basic clinical sciences for >competent entry-level practice in physical rehab (from the motion, it would >seem that we do not have a standard for one already). > > >Joe Wells, OTD, OTR/L > > > > >-----Original Message----- >From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf >Of Ron Carson >Sent: Tuesday, March 18, 2008 3:28 PM >To: OTlist >Subject: [OTlist] More Rationale For Voting Against Motion 1 > >In my opinion, OT is NOT competitive in rehab. It never has been and >never will be IF we try competing with PT, which is what Motion 1 is >trying to do. The skills required for UE rehab are not unique to OT and >in my opinion is not something that we should even strive for. > >In my opinion, OT's are stifling themselves by trying to be UE experts. >First off, being an UE expert is 100% inconsistent with our Framework. >secondly, our UNIQUE contribution to health care is OCCUPATION. >Occupation is our bread and butter and has the potential to BREAK OPEN >our inability to to be highly competitive in physical disabilities. > >The inconsistency between what OT says it does and what is actually does >is killing us. Our feet are standing in quicksand and ever shifting. We >do NOT have a solid base and NEVER will for as long as we are not >consistent with our Framework. > >We should not go around training new therapists and acting like UE >experts if such behavior is NOT supported by our theoretical >foundations. > >Years ago when occupational science was formed, I saw it as a wonderful >opportunity for OT to advance itself. Unfortunately, it is evident that >many, many OT's are still resistant to such science. There are many >sciences more important to OT than basic sciences. OT will never be >respected as having advanced musculo-skeletal knowledge, that is PT; They >are the musculo-skeletal experts. We are burning our bridges if we try >pursuing that profession. We have an opportunity to forge a NEW road >that MAKES PROFOUND DIFFERENCES in our patient's lives, and not just >those patient's with UE deficits. > >Think about all the times you or other therapists have wasted patient's >time and money by doing UE cones, pegs, balloons, etc. I am sure other >professions laugh at us when they see us acting in such manner. Why do >we do this? It's because we have segregated ourselves into UE "experts" >and so that's all we know to do. We need to bust ourselves free from >the shackles of our predecessors and advance ourselves forward towards >the Centennial Vision. Continued specialization in UE rehab is not >advancement, it's a hindrance to our profession and to our patients. > > > > >Ron Carson MHS, OT >www.otnow.com/motion1 > > > >-- >Options? >www.otnow.com/mailman/options/otlist_otnow.com > >Archive? >www.mail-archive.com/[email protected] > >No virus found in this incoming message. >Checked by AVG Free Edition. >Version: 7.5.516 / Virus Database: 269.21.7/1329 - Release Date: 3/14/2008 >12:33 PM > > >No virus found in this outgoing message. >Checked by AVG Free Edition. >Version: 7.5.516 / Virus Database: 269.21.7/1329 - Release Date: 3/14/2008 >12:33 PM > > > >-- >Options? >www.otnow.com/mailman/options/otlist_otnow.com > >Archive? >www.mail-archive.com/[email protected] > > > >--------------------------------- >Looking for last minute shopping deals? Find them fast with Yahoo! 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