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The mission of the COTBC

…is to protect the public by

regulating, advocating and

advancing safe, ethical and

quality occupational therapy

practice in British Columbia.

Summer 2011 Contents

Message from the Board Chair– Carol Williams 2

Introducing Your New Board Members 3Registrar’s reflections:

– Duty to Report — Worth the Call 4Update on the ContinuingCompetence Program

– Advancing Quality OccupationalTherapy Care in B.C. 6

Moving From There To Here– Coming to Work as an

Occupational Therapist in B.C. 8Competence Check

– Opening New Doors – Telepractice 10College Connections

– ACOTRO Harmonization Project 14Legislation update

– Reporting Fitness to Drive 15AGM Notice 16

New Edition of Essential CompetenciesAddresses NonClinical WorkEssential Competencies of Practice forOccupational Therapists in Canada wasrecently revised by the Association ofCanadian Occupational Therapy RegulatoryOrganizations (ACOTRO). This third editionreflects changes to occupational therapypractice over the past few years with moreexplicit descriptions of the competenciesrelated to interprofessional practice,teamwork, and collaboration. Occupationaltherapists whose work extends beyonddirect client care will also find competenciesthat address other roles. ACOTROrecognizes that developing competenciesthat are inclusive of all occupationaltherapists recognizes that public protectionis dependent on a profession that supportsand monitors the competence of all itsmembers, regardless of their present roles(Essential competencies 3rd ed., 2011).

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In looking back over an extremely busy, productive and interesting second year as Chair of the COTBC Board, with an increased understanding that has come from the passage of timeand close personal involvement, I realize that I now better appreciate the way in which theBoard functions in fulfilling its complex role of supporting the College. If one wanted tosummarize the strategic plan of the board, in simple terms, it could be said to both set andguide organizational direction; to ensure that the necessary resources are available; tomonitor performance and, perhaps most importantly of all, to make certain that the bestinterests of the general public are being served and protected.

Carol Williams, Chair

Taking this latter point one step further: if a laypersonwere to ask me in what manner the role of the Boardsupports and oversees the best interests of the general public, how would I best answer?I would summarize it as follows:

First and foremost, ensuring theprofessional competence of all our practicing registrants.

Following on from the above: theexacting and ever evolving establishmentand monitoring of entry-to-practicestandards ensuring only competent andqualified individuals are registered withthe College and can call themselvesoccupational therapists.

The investigation into any complaints raised about the practice or capability of registered members.

To further explain to this hypothetical laypersonthe manner in which this is achieved, I would goon to explain how the Health Professions Actprovides that one third of the COTBC Board mustbe public members. The College Bylaws require sixelected registrant members and three appointedpublic board members. The public membershaving no personal background in the profession— a requirement both shrewd and subtle — laying,as it does, a solid foundation for open, objective,and unbiased input. Inevitably, the varyingbackgrounds, professions and life experiences ofthese three public Board members can only serveto enhance and expand the overall vision andperspective of the Board as an entity. With thepassage of time and close interaction with the

professional expertise of the six registrantmembers, the public board members are absorbed

into what becomes an effective, closelyknit team which is well suited to its roleof oversight and guidance.

My hypothetical layperson — obviously a person with a keen and inquisitive mind — might well now ask what a typical Board meeting entails. How would I best answer that?

First and foremost, we listen. We listento what our registrants are telling us. We deliberate; we do our utmost tomake decisions representing the bestinterests of the College and itsregistrants, but ultimately decisions are

made in accordance with the Health Professions Actand our mandate to protect the public.

What are the Board’s key initiatives for the currentyear? They could best be summarized as follows:

Revisions to the College Bylaws and developmentof the Continuing Competence Program. The pathof self-regulation has led the Board to approve thesecond element of the Continuing CompetenceProgram. In developing the ContinuingCompetence Exam to monitor the continued safe,ethical and effective practice by occupationaltherapists, we recognize that self-regulation isparamount in protection of the public. The committee, registrants, staff and consultantscontinue to address the challenges of bringing theexam to fruition in 2014 and ensuring it testsfairly the diversity of everyday occupationaltherapy practices. From my point of view as a

message from the chair

From my point of view as amember of thepublic, I amconfident knowingthat we willreceive care forour specific needsby a competentoccupationaltherapist.

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Introducing Your New Board MembersThe following occupational therapists began their terms at the end of January 2011. Manythanks to Heather Gillespie, Jeff Boniface and Tanya Boudier who served on the Collegeboard for multiple terms and passed their responsibilities on at the January Board meeting.

Andrea Bowden, VictoriaAfter completing a BSc(Psych)at the University of Victoria in1999 and a BSc(OT) from theUniversity of British Columbiain 2002, Andrea has worked inacute care and private practicesettings in both Victoria andthe Lower Mainland. Andreacurrently works for the Vancouver Island HealthAuthority (VIHA). Previously a Clinical Educatorand a Coordinator of Rehabilitation Services,Andrea recently joined VIHA’s ProfessionalPractice group as a Practice Consultant. In thisrole she is part of a team that supports learningand performance in the organization.

Angenita Gerbracht, Prince RupertAngenita returns to theCOTBC Board this year,having served previously as amember and chair from 2003-2005, as well as a member andchair of the Quality AssuranceCommittee. A practicingoccupational therapist since1987, she also works as theRehab Manager at Prince Rupert RegionalHospital. Angenita’s past experience covers manypractice settings: home and community care,acute care and outpatient occupational therapy.

As a manager she has successfully advocated for occupational therapy services to remotecommunities for adults and children. She hasfostered a supportive work environment wherecolleagues are encouraged to deliver evidence-based programs that meet the needs of theircommunity. Angenita has returned to the Boardto help manage the challenges that lie ahead for occupational therapists in maintaining andenhancing their competency when serving thepublic in a changing health care climate.

Darlene Russell, PentictonWith close to 20 years ofexperience in clinical settingsincluding acute care,community, residential,mental health and privatepractice, Darlene brings a widepractice lens to the Board. She is currently a professionalpractice leader for the Interior Health Authority,having worked in management for over fouryears. Darlene graduated from the University of Alberta in 1991 and obtained her Master ofRehabilitation Science from the University ofBritish Columbia in 2009. She has served on the COTBC Registration Committee for the past two years. ■

member of the public, I am confident knowingthat we will receive care for our specific needs by a competent occupational therapist.

And what would be my parting words and actions to this layperson?

I would give them a copy of You and YourOccupational Therapist to reinforce how the

College ensures quality occupational therapycare. I would end by saying: I can’t say enoughabout the high standards set by the Registrar KathyCorbett and the support of the staff as well as thededication and commitment of the Board. We workwell together and it has been a very enjoyable twoyears as Chair. ■

New Online Resource Available Soon

The Quality Assurance Committee is pleased toannounce a new online resource to supportoccupational therapists in applying the COTBCcode of ethics in practice. Ethics in Everyday

Practice is the first of three chapters. Watch youremail inbox or check the COTBC website(www.cotbc.org) for the launch.

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registrar’s reflections

Duty to Report —Worth a Call

Kathy Corbett, Registrar

From time to time, registrants of either COTBC or another health profession collegecontact the Registrar to discuss concerns about an occupational therapist’s practice or conduct, wondering if he/she should or are obligated to report their colleague to theCollege. Sometimes the caller needs assistance in understanding the expectations forpractice (standards) and conduct (ethical code) to frame their concern; sometimes, thecaller just needs to know what would happen if a concern was reported and what mighthappen (complaint process); and other times, the caller is ready to report and needsinformation on how to proceed. While not an easy call to make, callers relate that thereason for the call is the overriding concern for the client’s well-being.

A Legal and Ethical ResponsibilityIn B.C., the Health Professions Act (the “Act”) sets out a legal duty for occupationaltherapists to report in situations wherethere are reasonable grounds to believethat the health professional is notpracticing competently or his/her abilityto practice is impaired and may pose asignificant risk to the public. The Act[s. 32.1(b)] provides that mental orphysical ailments, an emotionaldisturbance or an addiction to alcoholor drugs may impair the ability topractice. The Act also requiresoccupational therapists to report any sexual misconduct of a healthprofessional. Registrants should also be aware that employers have anobligation under the Health ProfessionsAct to report to the College when aregistrant’s employment is terminated,suspended or restrictions placed on theirwork as a result of impaired orincompetent practice.

Duty to report is also an ethical responsibility.Every client has the right to safe, competent and ethicaloccupational therapy services is one of the values in our Code of Ethics. Section 4(5) of the Code

underscores the ethical responsibility forreporting: Report unsafe, incompetent or unethical

care, including boundary violations, to the appropriate authority. Our Code also recognizes the responsibilities ofoccupational therapists to “assist theircolleagues to recognize and take correctiveaction to address potential unsafe,incompetent or unethical care” (Section8.3). In essence, the client has the rightand we have the obligation to assistcolleagues and/or to report.

Deciding to Take ActionThe obligation to take action is shared by all health professionals and theiremployers under the Health ProfessionsAct. Ultimately any report will have to be in writing to the college. However,there are some logical steps to follow that can assist in a thoughtful and fairprocess in considering a report to a college.Similar to the College of Registered Nurses

of B.C.'s Duty to Report standard, the followingprocess is recommended:

• Define the Behaviour

Frame your concerns by asking whether theregistrant is failing to provide competent care,

…sometimes, the caller just needs toknow whatwould happen if a concern was reportedand what might happen(complaintprocess); andother times, the caller isready to reportand needsinformation onhow to proceed.

and in what way? What ethical standard orcompetency has been potentially breached? Isthis a pattern and/or has the health professionalbeen unwilling or unable to recognize or correctthe behaviour? What harm has occurred and/orare clients likely to be harmed in the future?

You may also find it helpful to contact thecollege to gather more information, such as theexpectations for practice or conduct or for moreinformation on your duty to report.

• Decide on the Appropriate Course of Action

Review the relevant sections of the Actto determine whether your concernmeets the obligation to report to thecollege. Contact the registrar (or theperson at the particular college thatdeals with complaints) to discuss yourconcern. He or she will assist you withthe best course of action and nextsteps to take.

Consider whether you can discussyour concerns directly with theregistrant or with a manager or theperson to whom you normally reportworkplace concerns. Discussion and feedbackwith your colleague (or your manager) mayresolve the concerns and you may not need totake any further action. Document yourconcerns and any action taken.

If the report is about sexual misconduct, contactthe Registrar as soon as possible. Note: concernsabout sexual misconduct based on informationfrom a client require you to obtain consent fromthe client before making the report.

• Report to the Regulatory Body

Before you submit a formal report, contact the health professional’s college to discusswhat is required in the report and the nextsteps. The report will have to be in writing tothe registrar. Be clear about your concerns andas specific as possible and include any actionsthat may have been taken. Be informed aboutthe next steps in the process as the college

moves forward to investigate theconcerns in a fair and transparent manner.

Keep a Patient Safety PerspectiveKeeping in mind that clients/patients/residents have a right to safe andethical services delivered by competentprofessionals, registrants might bestsituate their duty to report obligationswithin the patient safety perspective.Patient safety not only focuses onestablishing health care systems andprocesses which minimize error andadverse events, but also centers on the professionalism and competence of individual practitioners. Keep a

prevention-oriented approach to both yourown practice and the practice of yourcolleagues. Learn to address concerns of acolleague in a respectful but direct way using a patient safety/client best interest orientationto your feedback. Consider professionaldevelopment on topics such as giving andreceiving feedback and conflict resolution –early intervention is the safest approach. If in doubt, contact the registrar of the healthprofessional’s college for direction. ■

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Duty to report is alsoan ethicalresponsibility.Every clienthas the rightto safe,competentand ethicaloccupationaltherapyservices

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Development of the Continuing Competence Program continues as new information isgathered and shared among various health professional regulators across Canada. Although different approaches are used, all agree that the prospect of having one’scompetence reviewed raises concerns and anxiety even among the most competent andconfident practitioners. Balancing these concerns with the responsibility and privilege thatcomes with self-regulation is a challenge for the occupational therapy profession.

Government and the public recognize that the profession “knows itself best” andtherefore entrusts the College to establish a Quality Assurance Program (QAP) tosupport and monitor practice. Through this program and other College duties, theprofession fulfills its promise to ensure that people living in B.C. receive safe, ethicaland competent care by registered occupational therapists. A major component of the COTBC QAP is the Continuing Competence Program. Throughout its development the College has made a concerted effort to follow the guiding principles established, of which one is the design of a program which reflects quality, balance, fiscalresponsibility and fairness. The following information reports on the developmentprocess based on these values.

The present COTBC Continuing CompetenceProgram consists of three elements:

1. Competence Maintenance: the bi-annual Self-Assessment and annual ProfessionalDevelopment Plan initiated in 2006.

2. Competence Assessment: the key features case-based examination currently under development.

3. Competence Improvement: a customizedprogram designed to help the individualoccupational therapist bring their practice up to the standard set by the profession.

Competence Maintenance ReviewAs reported in the Summer 2010 issue of InStep, self-assessment as a means of judging one’s competence isflawed due to our tendency to ignore our weaknessesand concentrate on improving those competencies inwhich we already excel (Regehr & Eva, 2005; Regehr& Mylopoulos, 2008). Given this, the COTBC Boardapproved the recommendation from the Continuing

Competence Committee to review other methodsthrough which B.C. occupational therapists couldgather and/or receive information to help inform theircompetence maintenance or enhancement activities.This review has begun, and will continue in 2012.

Competence Assessment DevelopmentNow known as the Continuing Competence Exam, this element of the program was announcedin October 2009. Since then the ContinuingCompetence Committee has proceeded to developa blueprint to identify aspects of competence thatwill be included in the exam. The final blueprintwill be completed this Fall. The draft blueprintincludes three dimensions:

1. Key regulatory topics (e.g. consent, conflict of interest).

2. Priority essential competencies.3. Core contexts of occupational

therapy practice.

AdvancingQuality Occupational Therapy Care in B.C.

Update on the Continuing Competence ProgramMary Clark

Policy Development

The COTBC Board has started to review policiesrecommended by the Continuing CompetenceCommittee, with the following approved over the past year.

1. Recognizing that competence varies withdiverse approaches to practice and practicesettings, occupational therapists will be askedto demonstrate competence in one of thefollowing four practice areas:1. Adult and Older Adult – Physical Health2. Adult and Older Adult – Neurological Health3. Adult and Older Adult – Mental Health4. Child and Youth Health

This information was validated through a surveysent to all registrants in April 2010, with 283responses received. Of those who identified theirprimary role as direct service provision 98%indicated a high degree of confidence in theirability to demonstrate their competence in atleast one of the four proposed context categories.

Detailed practice context descriptions are beingdeveloped to assist occupational therapists to findthe best fit. Those occupational therapists who do not feel their practice falls within any of thesefour areas will be encouraged to participate in the pilot test. Results of the pilot testing willinform improvements to the exam prior to the initial launch.

2. Registrants whose roles and therefore workdoes not require any direct contact withand/or responsibilities to a client will not be required to write the exam. The newlyreleased third edition of the EssentialCompetencies of Practice for OccupationalTherapists in Canada (2011) includes moreinformation regarding what constitutesnonclinical work.

Constructing the Exam

The Exam Development Sub-Committee (EDSC)was appointed in January 2011, and has started itswork on developing cases and questions in thefour practice areas outlined above. In June thefirst Case Construction Session was held inBurnaby, and others will be arranged over the next year. At these sessions, occupationaltherapists provide details of practice scenariosthat can be used by the EDSC in developing casesand questions. By using this information, casesare built that reflect current practice in BC andhelp to build an exam that is fair. The examconstruction also goes under different reviewsand pilot testing, all aimed at producing a qualityassessment. The projected date for the first sittingof the exam was delayed and is now scheduled forearly 2014. The Board approved the recommendationby the Continuing Competence Committee sothat information gleaned from the Self-AssessmentReview can be used to modify, if necessary, thedevelopment of the exam.

Competence ImprovementWork on this third element will begin later in 2012.It will be in place prior to the first sitting of the examand will only apply to those registrants who were notsuccessful in demonstrating their competence in theCompetence Assessment element of the program.

The development of the Continuing CompetenceProgram is guided by Glover Takahashi and Associateswho are experts in the field of measuring competence.Meetings are scheduled for this Fall with researchersin the Faculty of Medicine at the University of BritishColumbia who also have expertise in this area. Thisexemplifies the College’s commitment to developinga program that is based on best practices, and willhelp to inform the challenge of supporting andmonitoring continuing competence. We encourageoccupational therapists to ask questions and attendinformation sessions that will start again this Fall. ■

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2011-2012• Review of the Competence

Maintenance Component (Self-Assessment and ProfessionalDevelopment Plan)

• Information Sessions and CaseConstruction Sessions heldthroughout B.C.

• Construction of the exam

• Policy development and approval• Ongoing program evaluation

and consultation with experts

2012-2013• Revised Competence

Maintenance Element• Pilot testing of the exam

• Further policy developmentand approval

• Development of the CompetenceImprovement Element

2014• First sitting of the exam• Competence Improvement

Element in place

Timelines and Next Steps

Have you ever wondered what it is like to move to B.C. and work as an OT? Are youinterested in helping an OT from another country integrate into the workforce bysupervising them during their provisional registration period? COTBC is just completing a project that will help facilitate this process.

BackgroundBritish Columbia is the second most populardestination in Canada for internationally educatedoccupational therapists (IEOTs); Ontario is the first(CIHI, 2009). According to the COTBC registrantdata base, as of July 30, 2011 the majority of IEOTsin B.C. came from the United Kingdom, the USA,Australia and South Africa. Smallernumbers of OTs came from India, HongKong, New Zealand and the Philippines.Last year, 27% of new applicants hadreceived their entry-level training fromoutside our country.

Moving to B.C. to work as an OT is acontinuum of steps that starts when theIEOT is in his or her home country andfirst gathering information to considermoving. Along this pathway the IEOTtypically has provisional registration withCOTBC until all of the requirements aremet and full registration is granted.During the provisional registration periodthe IEOT must work (or volunteer) under thesupervision of a fully registered OT. Other OTs inB.C. may also take on various roles such as beingfriends or family offering information, direction and support, or as practice leaders or managersoverseeing them, or as practice leaders or managersoverseeing the recruitment and hiring and staffsupport processes.

IEOT Supports ProjectIn November 2010, COTBC received funding fromthe BC Ministry of Advanced Education andLabour Market Development to explore how IEOTs could be supported while integrating intothe BC workforce. The project team includes threeoccupational therapists: COTBC Deputy Registrar

Susan Mulholland oversees the project,Sandra Bressler is the project managerand Tracy Dietrich is the projectassistant. An Advisory Committee, with representation from the UBCDepartment of Occupational Scienceand Occupational Therapy, theOccupational Therapy Examination & Practice Preparation (OTepp), BCSociety of Occupational Therapists,management, an IEOT and an OTworkplace supervisor, guides the project and ensures that all stakeholderviews are considered.

Progress to DateThe initial phase of this project set out to find out what itis like to come to B.C. as an IEOT, in particular to betterunderstand the workforce integration process with aparticular focus on IEOTs who had applied for provisionalregistration between August 2008 and March 30, 2011.Sixty-six (66) stakeholders involved during the IEOT’sprovisional registration process were interviewed by

Moving From There To Here –Coming to Work as an Occupational Therapistin British Columbia

Susan Mulholland, Deputy Registrar

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During theprovisionalregistrationperiod theIEOT mustwork (orvolunteer)under thesupervision ofa fullyregistered OT.

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phone, with a smaller number participating intwo focus groups. A diversity of perspectives wasgathered from 40 IEOTs, 12 OTs who supervisedthem 7 professional practice leaders or managers,and 7 key informants.

The information gathered in these interviews iscurrently being analysed to identify gaps andchallenges and what ingredients tend to result insuccess stories for the IEOTs. In particular, the projectfocused on the COTBC registration process includingsupervision during the work integration or provisionalregistration phase. The project assistant also did anextensive scan to identify resources that wouldpotentially help to fill some of the gaps or address the challenges. These resources include literature,websites, organisations, and courses offered face-to-face or via distance. Some resources mostly benefitIEOTs while others may be helpful to the OTssupervising or working with the IEOTs and managersinvolved. This activity continues as new resources areidentified and will be used to enhance the presentCOTBC website information.

How Can You Be Involved?The information gathered in the interviews tells us that OTs working in B.C. can facilitate theworkforce integration process at many of the stepsalong the pathway. A simple way to help is to linkIEOTs to resources such as those websites listedbelow as well as to other OTs in the community.Supervising an IEOT during provisional registrationand taking time to provide timely and constructivefeedback when needed is also greatly appreciated.

Resources for IEOTs and SupervisorsCOTBC (www.cotbc.org) in the “Working as an OT in BC” section.

BCSOT (www.bcsot.org) lists various resources including upcoming courses and Special Interest Groups.

CAOT (www.caot.ca) provides information and resources specific to the NationalOccupational Therapy Certification Exam(NOTCE) chat rooms as well as informationabout upcoming courses and the Canadian OT conference.

Go Canada OT – the IEOT Portal(www.gocanadaot.com) helps IEOTs understand working in Canada and in the different provinces.

OTepp (www.otepp.ca) is a free program to help internationally educated OTs write the NOTCE and integrate into the workforce.You need to register directly with them if you wish to participate.

Health Match BC (www.healthmatchbc.org)assists in the recruitment of healthprofessionals on behalf of BC’s publicly-fundedhealth care facilities.

Skills Connect (www.skillsconnect.ca) mayprovide support and funding to assist IEOTsentering BC.

Kwantlen Polytechnic University(www.kwantlen.bc.ca) offers a course onProfessional Communications forInternationally Educated Health Professionals(IEHP). For more information contact:iehp@kwantlen.ca.

Canadian Immigrant Newsletter(www.canadianimmigrant.ca) provides generalinformation about immigrating to Canada. ■

Provisional Registration

The majority of IEOTs are registered in theprovisional category when they first come toBC. All provisional registrants, whether IEOTs orCanadian trained, are required to work underthe supervision of a fully registered OT. The vastmajority of IEOTs in this category are waiting towrite and pass the next available sitting of theNational Occupational Therapy Exam (NOTCE),formerly known as the CAOT exam. Lesscommon are IEOTs who do not meet thecurrency hour requirements of having workedas an OT for 600 hours in the last 3 years or1000 hours in the last 5 years. These individualsmust participate in a more structured supervised

evaluation process known as a CompetenceConfirmation Practicum (previously called a Re-Entry Practicum). The purpose of thispracticum is to confirm that the OT has thenecessary skills and abilities to return toindependent practice. The practicum may bedone as a volunteer or in a paid work position.Regardless of the circumstance, all of these OTsmust have provisional registration to work,volunteer or call themselves an OT.

ReferenceCanadian Institute for Health Information.(December, 2009). Occupational therapists inCanada, 2008. Ottawa ON: Author.

Practice QuestionsAt COTBC, we receive questions from OTs asking if they can use technology to provide services toclients who are living within or outside of B.C. For example:

I am an occupational therapist in private practice in Kamloops. I would like to offer services via Skype to clients living throughout the province. How can I do this?

I work for a Vancouver rehab company that is consideringexpanding to offer services in Alberta. My proposedintervention is a one-time telephone screeningassessment with prospective clients. Is this possible?

What Do I Need to Think About?Although technology can provide an attractiveoption for efficient, timely and often affordablemethods for OTs to increase public access toservices, several key issues must first be understoodand considered.

Geography & Regulation

It is critical to understand where the occupationaltherapy service is occurring. Is it in B.C. where theOT is currently registered or is it where the client isreceiving services? At COTBC, we believe that theservice is being delivered where the client isreceiving it. This has important implications when

considering using telepractice to work with clientsliving outside of B.C.; it cannot be assumed thatpractice is the same from province to province orin other countries. Therefore the OT is responsiblefor contacting the other jurisdiction to confirmthe scope and standards of practice and to alsomake arrangements as necessary for registration(COTO, 2001). For example, the OT in Vancouverconsidering delivering services to clients in Albertawould first need to contact the regulatory body inthat province prior to initiating any occupationaltherapy services.

Liability

Occupational therapists need to check with their carrier to clarify if their professional liabilityinsurance will cover the intended telepracticeservices. In particular, Canadian therapists need toremember to pay attention to liability insurancewhen clients are located outside of Canada. Thelaws in other countries may be different and someinsurance coverage entirely adequate for Canadamay either not cover or be inadequate for activitiesdeemed to occur, for example in the United States(COTO, 2001). Confirmation with your carrier ofthe extent of your insurance coverage outside ofB.C. is recommended.

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competence check

Opening New Doors – Telepractice Susan Mulholland, Deputy Registrar

Technology is changing at a rapid pace and there are a growing number of communicationoptions available for keeping in touch with people. Technology is decreasing geographicbarriers and increasing how services, such as occupational therapy, can be delivered.

Telepractice, also referred to by various other names such as telehealth, telerehab, tele-occupational therapy or telemedicine, can be broadly defined as the use ofcommunication technology to provide health-related information or services over short or long distances. Telepractice may include the exchange of patient information or providingassessment or therapeutic interventions to clients. Various technologies and methods maybe used ranging from simple to complex including the telephone, email or online chat, as well as telephone or web-based videoconferencing (CAOT, 2011).

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Using Technology

When deciding how to best deliver services, the technology options will need to be evaluatedfrom the perspective of safety, security, quality,reliability and acceptability, to both the OT as a health provider as well as the client. The OT needs to be confident that the delivery of services through the use of technology will notcompromise the standard of care and therapy(NIFTE, 2003). For example, when consideringusing video-conferencing to provide psychosocialsupport to a client, does the picture accuratelydisplay the client’s face and skin tone to enable theOT to be able to read and respond appropriately tofacial expressions revealing that the client is upset?

As with any piece of equipment, the OT needs tobe knowledgeable and skilled in its use as well asaware of potential risks and limitations and howto mitigate these. Multi-tasking is a realityinherent to telepractice, and that means beingable to provide quality care at the same time asmanipulating the technology (NIFTE, 2003). For example, can you use the technology and still stay focused on the client?

An OT is responsible for ensuring that theproposed technology matches the client’s skills,abilities and needs and to ensure he or she isprovided with an appropriate orientation andtraining. The time needed for a client to becomefamiliar with the technology will need to be takeninto consideration when planning sessions.

Collecting and Using Information

When using technology therapists’ fundamentalresponsibilities to their clients remain the same.The standards that apply to more traditionalforms of communication (written paper, face-to-face) must also be applied to communication

facilitated through the use of technologies. It iscritical to consider issues around consent, securityand storage and to have documented policies andprocesses in place. For further details please referto the COTBC practice guideline Collecting,recording and protecting client information and theCollege Bylaws available in the COTBC onlineLibrary at www.cotbc.org.

It is important to consider the degree of complexitythat technology may introduce when determiningprocesses related to collecting, recording andprotecting client information. For example,clarification will be needed to determine who,where and how video-conferencing recordingswill be stored and who would potentially haveaccess to them.

To Stay InformedTechnology and occupational therapy practice are constantly evolving. This article has tried toaddress some of the key areas to be considered as well as hopefully stimulate awareness anddiscussion. Please watch the COTBC website for updates or contact the College if you havespecific questions. ■

References

Canadian Association of Occupational Therapists [CAOT]. (2011). Position statement:Tele-occupational therapy and e-occupational therapy.Ottawa, ON: Author.

College of Occupational Therapists of Ontario[COTO]. (2001). Telepractice: Information foroccupational therapists providing telehealth services.Toronto, ON: Author.

National Initiative for Telehealth [NIFTE].(September, 2003). National initiative for telehealthframework of guidelines. Ottawa, ON: Author.

Watch for the release of the 2nd edition of thepractice guideline: Supervising Support Personnel.This document will replace the original documentAssigning of Service Components to UnregulatedSupport Personnel published in March 2004.

The new guideline was updated by theStandards Committee with an expandedsection on supervision as well as the additionof a practice expectations checklist.

Revised Practice Guideline on Supervision Coming Soon

The Essential competencies (3rd ed.) isorganized into the following seven units:

1. Assumes Professional Responsibility2. Thinks Critically3. Demonstrates Practice Knowledge4. Utilizes an Occupational Therapy Process

to Enable Occupation5. Communicates and Collaborates Effectively6. Engages in Professional Development7. Manages Own Practice and Advocates

within Systems

The competencies that describe nonclinical workdo not include Units 3 and 4. They concentrate onthe knowledge, skills and abilities required foreffective development, delivery, oversight and/orimprovement of systems and services, as opposedto clinical practice. However occupationaltherapists with many roles may draw upon bothsets of competencies to accurately reflect theirdaily work. For example, practice leaders whocarry a caseload may apply competencies from allunits and pull specific competencies that addresstheir management roles such as qualityimprovement.

Importance of ContextAlthough Essential competencies (3rd ed.) sets thestandard for developing entry to practice andcontinuing competence requirements, it needs tobe interpreted within the context and authority ofeach provincial regulatory organization. Likewise,the individual occupational therapist has theresponsibility for applying these competencieswithin their practice and their various roles. It is expected that the vast majority of thecompetencies will be applicable in most contexts,but in the event that this is not possible areasonable explanation should be available.

Process for RevisionsThe revisions to Essential competencies (2nd ed.)and the development of the competencies fornonclinical work involved a collaborative andsystematic process. It began with a

comprehensive environmental scan anddocument analysis, followed by consultationswith key informants as the competencies werereviewed and revised. A field consultation using anational survey of occupational therapists was alsodone to validate the content and construct of thisedition. Additionally, focus groups were used as

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New Edition of Essential CompetenciesAddresses NonClinical Work …continued from front cover

Download the Essential Competencies of Practicefor Occupational Therapists in Canada, 3rd edition

and the Methodology Supplement from the libraryon the COTBC website.

needed. The project was guided by a diverse groupof experts on the Steering Group and AdvisoryGroup that included members from ACOTRO, theAssociation of Canadian Occupational TherapyUniversity Programs (ACOTUP), and the CanadianAssociation of Occupational Therapists (CAOT) aswell as other experts external to occupationaltherapy (Essential competencies 3rd ed., 2011).

Other UpdatesIn addition to the development of thecompetencies for nonclinical work, the following additions and/or revisions were made:

• A definition of competence and a descriptionof the elements of competence.

• A description of the competencies foroccupational therapists with nonclinical work.

• An overview of the approach used for theEssential competencies (3rd ed.) and that used for the Profile of Occupational Therapy Practice in Canada, 2007.

• Fine-tuning of areas that were redundant in the previous edition.

• A more explicit description of thecompetencies related to interprofessional

practice, teamwork, and collaboration inoccupational therapy.

• A more explicit inclusion of the competenciesrelated to client safety in occupationaltherapy practice.

• Adjustments to reflect other changes inpractice context, such as health humanresources and culture. (Essential competencies3rd ed., 2011).

Essential competencies (3rd ed.) describes theknowledge, skills, and abilities that are requiredfor occupational therapists to provide safe ethicaland effective services, and for some occupationaltherapists, the development, delivery, oversightand/or improvement of systems and services. With this third edition, occupational therapistsnow have an expanded repertoire of competencieswhich more accurately reflect the diversity of the profession. ■

Reference

Association of Canadian Occupational TherapyRegulatory Organizations [ACOTRO]. 2011.Essential competencies of practice for occupationaltherapists in Canada (3rd ed.). Toronto, ON: Author.

Keeping all your contact information up to date is a critical component of registration. It is yourresponsibility to ensure your contact informationis accurate and current. Up-to-date contactinformation ensures College mailings are receivedin a timely manner. Also, COTBC is required underthe Health Professions Act to maintain a publicregister. Information on the status of yourregistration is available to the public by contactingthe College. The Act mandates that the registerinclude the registrant’s name, business address andbusiness telephone number.

The College provides members of the public withyour registration status, business address andbusiness telephone number when requests forinformation are received. If you are self-employed,be advised that business contact information(even if it is the same as your personal contactinformation) is disclosed on the public register.

Please update your information online or provideit in writing via mail, fax or email message toregistration@cotbc.org. ■

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Address change – let us know!

college connections

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Last year just over $2 million was awarded by the Government of Canada’s ForeignCredential Recognition Program, Human Resources and Skills Development Canada(HRSDC) for the Association of Canadian Occupational Therapy RegulatoryOrganizations (ACOTRO) Harmonization Project. Spearheaded by COTBC, this projectwill complete the final phase of a Pan-Canadian initiative aimed at implementing acommon assessment approach for the assessment and qualification recognition ofinternationally educated occupational therapists. Building on Phase I and Phase II,highlights of this project include implementing harmonized policies for assessments forEnglish language fluency and academic credentials; pilot testing and implementation ofthe profession-specific tools developed in Phase II – the Profession Specific CredentialAssessment and the Competence Assessment Tool; and mapping of the regulatoryEssential competencies of practice for occupational therapists, 3rd edition to theNational Occupational Therapy Certification Exam Blueprint.

The project is supported by a full-time projectmanager, Rita Parikh who joinedCOTBC in late February 2011. Aproject council made up of theregistrars from the Ontario, NovaScotia and B.C. colleges providesoversight of the project. For each ofthe project components, steeringcommittees and advisory groupswill be struck to provide directionand guidance.

COTBC registration statisticsreinforce this province’s relianceon occupational therapists movingto British Columbia from other provinces andcountries to meet its occupational therapy

workforce demands. Through collaboration in thisproject, COTBC and its fellowregulatory colleges across thecountry are better positionedto have consistent and fairqualification recognitionprocesses and create supportsnecessary for successfulregistration of internationallyeducated occupational therapists.

This project also underscoreseach ACOTRO member’scommitment to ongoingregulatory cooperation and

collaboration for quality occupational therapyregulation in Canada. ■

ACOTRO Update

Spearheaded by COTBC, this project will complete the final phase of a Pan-Canadian initiative aimed at implementing a commonassessment approach for the assessment andqualification recognition of internationally educatedoccupational therapists.

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Changes to Health Care (Consent) and Care Facility (Admissions) Act in ForceThe Ministry of Health has provided several resources which are now posted on theCOTBC website to assist occupational therapists in learning about the changes tohealth care consent and advance care planning in B.C., effective September 1, 2011.

The changes include the formalization of AdvanceDirectives as a binding legal document that allowsa capable adult to provide consent or refusal tohealth care in advance of a time when the caremay be needed. The new laws also allow capableadults to appoint a representative using anoptional form without having to visit a lawyer or a notary public.

The Health Providers Guide to Consent to Health Carehas been updated to reflect the addition ofadvance directive and will help OTs to understandthe legal requirements for securing valid consentor refusal for health care for an adult.

Please review the documents found in the COTBCLibrary (under Legislative Updates) and if youhave any questions, contact the registrar at:kcorbett@cotbc.org. ■

Many occupational therapists are aware of the change to the B.C. Motor Vehicle Actamended in June 2010. The relevant section for registrants was the amendment toSection 230: Report of Medical Condition or Impairment. Occupational therapists wereadded to the list of healthcare practitioners who have a duty and authority to reportunder the Act about concerns of a person’s fitness to drive as a result of a medicalcondition or impairment. This amendment also specifies the medical conditions andimpairments that affect someone’s ability to drive and must be reported to theSuperintendent of Motor Vehicles.Registrants should be aware that the amendmentsto Section 230 are still not in force as the regulations,developed by the B.C. Office of the Superintendentof Motor Vehicles (OSMV) are not yet finalized bythe Ministry of Public Safety and Solicitor General.The OSMV has confirmed the approval of theregulations is delayed now until January 2012.OSMV reassured the College that once theregulations are approved, there is a plannedtransition period of six months for bringing them into force. In the Fall COTBC will work

with OSMV to establish an occupational therapists’working group to assist with the transition to thenew regulations.

Registrants will be informed as soon as there is any news about the release of the regulations and theamendments brought into force. In the meantime,occupational therapists may wish to reviewDelivery of Services Relating to the Use of MotorVehicles: Guide for Occupational Therapistspublished by the Quebec OT association and available on the COTBC website. ■

Occupational Therapists Duty to Report DriverFitness Concerns – An Update

legislation updates

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Official Publication of the

College of Occupational

Therapists of British Columbia

Suite 219-645 Fort StreetVictoria, B.C.V8W 1G2

Telephone 250-386-6822

Toll Free in B.C. 866-386-6822

Fax 250-383-4144

General Email info@cotbc.org

Registration registration@cotbc.org

Web www.cotbc.org

2011 Board MembersPublic members

Carol Williams, ChairSherry BakerVila Nova Carvalho

Occupational therapistsDiane Graham, Vice ChairAndrea BowdenNaz ChowAngenita GerbrachtDarlene RussellHelen Turner

StaffKathy CorbettRegistrar

Susan MullhollandDeputy Registrar

Mary ClarkCommunications Director & Projects Coordinator

Jill LangridgeExecutive Assistant

Darlene HayReceptionist and Administrative Assistant

college calendar

Notice of COTBC Annual General MeetingCOTBC is pleased to provide notice to both registrants and the general public of the College’s 11th Annual General Meeting (AGM)

Saturday, October 29 @ 2011 11:45am

Location: Coast Coal Harbour Hotel, 1180 West Hastings Street, Vancouver, BC.

Pre-AGM Session @ 9:30am

Regulatory Topic: Professionalboundaries – is there an “app” for that?

Maintaining professional boundaries iscritical because they define the limits andresponsibilities of how you interact withclients. Crossing these boundaries is a slippery slope that can lead to anuncomfortable situation at best…or in a worst-case scenario to an event that harms the client. This interactive session will provide you with information about professional boundaries as well as an opportunity to explore how to apply some strategies for managing these situations.

Watch for more details on the AGM events and our Annual Report that will be posted on our website in mid-September.

We look forward to seeing you there!

COTBC Board Meetings

October 28, 2011 (Vancouver)January 28, 2012 (Vancouver)

Registrants are welcome at all boardmeetings. Please email Jill Langridgeat: jlangridge@cotbc.org if you wish to attend.

Information Sessions on ContinuingCompetence Exam

If you would like College staff topresent in your area, please let usknow. A minimum of 15 OTs ispreferred (but not necessary). Thesesessions can be combined with

discussions on other regulatory orpractice topics with the registrar.Email kcorbett@cotbc.org for furtherinformation.

UBC OS&OT Program CapstoneConference

Organized by the graduating class withpresentations of their research andkeynote addresses by Dr. Helene Polatajko,Min Trevor Kyi and Dr. Bill Miller.

Cost: free

August 31, 2011 Vancouver PublicLibrary. Register at:http://www.capstoneconference.ca