Page 1 of 14 OT 9542 Evaluating Occupation in Context School of Occupational Therapy Faculty of Health Sciences OT9542 Evaluating Occupation in Context

t Winter Term 2012 Instructors: Donna Dennis Office: Room 2564, Elborn College Phone: ext. 87588 Email: ddennis2@uwo.ca Office Hours: By appointment Jessie Wilson Office: Room 2577, Elborn College Phone: (519) 402-5278 Email: jhow2@uwo.ca Office Hours: By appointment Teaching Assistant Lisa Cossy Office Hours: By appointment. Email : lcossy@uwo.ca Class Schedule: Tuesdays and Thursdays from 9:30-12:30 in 1543 for lectures and 1534 for most labs. Course Description: Students will learn to examine human occupation and occupational participation, in contexts across the lifespan. Students will learn evaluation tools, methods of information gathering, such as observing, interviewing, measuring, and documenting occupational performance and barriers to participation. Course Content: The following evaluations of occupational performance in the context or environment in which the occupation takes place will be introduced in this course and will include the following: 1. Knowledge of contextual and environmental factors for occupational participation supporting well being and physical, cognitive and social health. 2. Concepts and strategies in evaluating and assessing occupational performance, occupational disruption, occupational participation of person resources and environmental demands. 3. Knowledge and application of processes for evaluating occupational performance of children in school, home and play contexts. (e.g. including a range of developmental

Page 2 of 14 OT 9542 Evaluating Occupation in Context

4. Knowledge and application of processes for evaluating occupational performance and

5.

6.

7. 8. 9.

disruption of adolescents in community, school, and social contexts. (e.g. including a range of occupational and independent living assessments). Knowledge and application of processes for evaluating and monitoring occupational performance, risk assessments and occupational disruption of adults in work contexts. (e.g. including a battery of assessments such as Functional Capacity Assessments (FCAs), Job Demands Analysis (JDA), Physical Demands Analysis (PDA), vocational assessments, readiness to work assessments). Knowledge and application of processes for evaluating and monitoring occupational performance, risk assessments and occupational disruption of older adults in the home and community contexts. (e.g. including a range of community mobility assessments, independent and safe living assessments, assessments of social occupation, driving and transportation safety assessments, capacity assessments, activities of daily living assessments, stroke/cognitive assessments, leisure assessments, home assessments, fear of falls assessments). Concepts in using evidence and clinical reasoning in choosing and conducting assessments as well as documenting results. Concepts in using clinical reasoning to synthesize and compare assessment results to identify clients ability, readiness to progress. Concepts in interpreting standardized assessments and tools including the review and application of concepts of reliability and validity.

Professional Perspectives: In the foreground, this course will introduce human occupation, occupational science, and health and rehabilitation science perspectives that are central to evaluating a person and that persons resources. The demands, barriers and resources in environments will be integrated into the material such that the person is perceived within the context of specific surrounding influences. In the background, this course will integrate and apply concepts of evidence-based practice, professional reasoning and client-centred practice to evaluation. These perspectives will be integrated in cases so students can appreciate these concepts in assessment and evaluation of occupational performance for people with physical health problems. Client Populations: y Childrens performance of primary occupations and contexts play and school. y Adults performance of primary occupations and contexts work and volunteer: life sustaining. y Older adults occupations including, but not exclusive to; leisure, work and activities of daily living will be evaluated as will be the characteristics of the environment in which these occupations occur.

Page 3 of 14 OT 9542 Evaluating Occupation in Context Objectives and Learning Outcomes: Competent student in enabling occupation; a. Function effectively as a client-centred expert in occupation, occupational performance, and occupational engagement. The student will explore, define and demonstrate an integrated
understanding of the influences of environments on occupation, health, social / occupational identity and well-being. The student will demonstrate an understanding of how to advocate for assessment and for client needs relevant to assessing and enabling occupational performance.

b. Recognize the limits of person expertise. The student will demonstrate an understanding of how to prioritize client assessments. c. Perform a complete and appropriate assessment of occupational performance. The student will: explore, define, demonstrate knowledge and abilities to assess,
evaluate barriers and facilitators of occupational disruption, occupational participation, performance, competence, and prevention of disability in context.

d. Apply core expertise and professional reasoning.

The student will explore, define and demonstrate knowledge and theory relevant to assessment and evaluation processes used to understand occupation in context, in the workplace, at home in the community and in school. The student will explore and demonstrate clinical reasoning strategies, for choosing conducting and analyzing assessment and evaluation processes.

e. Synthesize assessment findings and reasoning to develop a targeted action plan. The student will demonstrate professional documentation and evaluation of results of
assessment and evaluation. The student will demonstrate critical appraisal and interpretation of assessment results and findings.

f. Engage in effective dialogue.

The students will apply client-centred approach in communicating assess processes and evaluation of results.

g. Critically evaluate information to support client, service and practice decisions. The student will appraise evidence to support the use of appropriate assessment
an ongoing assessment of occupational performance.

Page 4 of 14 OT 9542 Evaluating Occupation in Context Required CourseTextbooks: 1. Radomski, M.V. & Trombly, C.A. (Eds.) (2008). Occupational therapy for physical dysfunction (6th ed.). Philadelphia: Lippincott Williams & Wilkins. 2. Case-Smith, J. (2010). Occupational therapy for children (6th ed.). St. Louis: Elsevier/Mosby. Recommended: Jacobs, K. (2007). Ergonomics for therapists (3rd ed.). Amsterdam: Elsevier. School of Occupational Therapy Grade Descriptors: Grades will be assigned according to School of Occupational Therapy grade descriptors (Curriculum 2000, revised October 2009): GRADE DESCRIPTORS CONTENT STYLE & MECHANICS A+ y One could not expect better of a y Grammatically correct in every way 90-100 student at this level y No APA reference style errors y Integration of material is critically y Eloquent Exceptional achieved Work y Presents a strong formulation of well presented ideas y Demonstrates exceptional skill or ingenuity in use of relevant concepts y Excellent depth and breadth of research y Sources used intelligently to support position A 80-89 Above Average Work y Demonstrates a thorough knowledge of relevant concepts y Demonstrates some originality or substantial skill in application of the concepts y Evidence of critical insight, freshness of thought, and/or perceptive grasp of subject and its nuances y Good depth and breadth of research y Intelligent use of sources y Work demonstrates a sense of completeness in handling of the topic y Presents clear and interesting ideas y Demonstrates a good grasp of the y Very few grammatical or spelling errors y Very few APA reference style errors y Fluent expression y Good introduction and conclusion y Good transitions y Effective use of headings

B 70-79

y Few grammatical or spelling errors y Clear expression

Page 5 of 14 OT 9542 Evaluating Occupation in Context Work of Good Quality subject y Demonstrates an ability to apply the concepts appropriately y Adequate depth and breadth of research OR good depth or breadth but not both y Careful documentation of the evidence y Contains some interesting ideas y Topic not completely covered y Demonstrates limited understanding or incomplete ability to apply concepts y Incomplete depth or breadth of research y Incomplete documentation of sources y Good introduction and conclusion y Effective use of headings y A few minor errors in APA reference style

C 60-69 Below Average Work

y Ideas are trite, vague, or overly general y Weak or absent grasp of subject y Fails to answer the question posed or Unaccepta address the assignment ble Work y Inability to apply concepts or inappropriate application thereof y Fails to demonstrate relevance of content y Present insignificant or no evidence to support paper y Plagiarism Approved October, 2009. F 0-59

y A number of grammatical and/or spelling errors y At times meaning is ambiguous y Conclusion lacks impact y Some concerns regarding organization/sequence of material y Some errors in citation style y Frequent errors in APA reference style y Frequent grammatical and/or spelling errors y At times meaning is obscured y Content seems disjointed y Lacks conclusion y Inadequate citation of sources y Frequent APA reference errors

Plagiarism: Scholastic offences are taken seriously. Students are expected to read the policy, specifically the definition of what constitutes a Scholastic Offence, at the following Web site: http://www.uwo.ca/univsec/handbook/appeals/scholoff.pdf . Students should also carefully review the section of Plagiarism and Scholastic Discipline in the School of Occupational Therapy Student Handbook. All required papers may be subject to submission for textual similarity review to the commercial plagiarism software under license to the University to detect plagiarism. All papers submitted for such checking will be included as source documents in the reference database for the purpose of detecting plagiarism of papers subsequently submitted to the system. Use of the service is subject to the licensing agreement, currently between The University of Western Ontario and Turnitin.com (http://www.turnitin.com ). Students should retain electronic copies of all assignments until the marked version is returned.

Page 6 of 14 OT 9542 Evaluating Occupation in Context Language Proficiency: Each student granted admission to Western must be proficient in spoken and written English. Students must demonstrate the ability to write clearly and correctly. Work presented in English in any subject at any level, which shows a lack of proficiency in English and is, therefore, unacceptable for academic credit, will either be failed or, at the discretion of instructors of OT 9542, returned to the student for revision to a literate level. Good Grammar: Poor grammar matters academically, but it also projects an unprofessional image in professional writing. Remember that what may slide by in informal conversation is not necessarily acceptable in written language. Grammar checking programs may be helpful, but they may not catch all errors. If writing is a real problem for you, the Student Development Centre offers an excellent Effective Writing Program. Accommodation for Students with Disabilities (if required): At the beginning of each term, it is the students responsibility to contact the Services for Students with Disabilities Office to arrange for the appropriate forms to be sent to each course instructor in the School of Occupational Therapy for special accommodations. Accommodations cannot be granted without the appropriate documentation. Attendance: In accordance with School of Occupational Therapy standards, students are expected to attend all classes and labs. An instructor may refuse to admit late students to a class or lab. 100% attendance is expected for all classes and labs. This is consistent with the professionalism expected in the program. Should a student have an unavoidable absence, the instructor(s) affected should be notified as soon as possible, and before the start of the class or lab. Because material covered in classes and labs is generally not available from textbooks, students are responsible to obtain material covered from a classmate. In case of a surprise quiz or in-class assignment, students who are absent will receive a grade of zero, unless appropriate medical documentation is submitted and/or university reporting protocol is followed. If a students attendance is judged unacceptable, permission to write the final test or submit the final assignment may be withheld, which could result in failure of the course. Any student who is absent frequently will be reported to the Director of the School. On the recommendation of the instructor, the student can be disciplined within the acceptable bounds of the academe. Use of Technology During Classes: The School of Occupational Therapy supports the appropriate use of technology during classes. Laptops may be used for taking notes, or following previously uploaded material from Web-CT (OWL). Computers should not be used for purposes unrelated to class. Please turn off cell phones and other communication devices during class. If you need to be available in an urgent situation, please use vibrate or silent mode. Privacy: In order to respect privacy, graded assignments will only be returned directly to the student concerned. Individual grades will be posted to Web-CT (OWL), where they are secure. Grades

Page 7 of 14 OT 9542 Evaluating Occupation in Context will only be shared over e-mail if absolutely necessary and only with written permission from the student. Note that faculty may not release a final grade, but you will be provided with your marks for each component on which you are evaluated during this course. Assignments: All assignments must be submitted in class. A penalty of 5% (of the maximum possible mark) per day will be applied to papers handed in 1-5 days late. No papers will be accepted for marking after 4 pm on the 5th day (weekends included) following the due date. Extensions may be granted at the discretion of the instructors in consultation with the Director, only on medical or compassionate grounds. Please request extensions as far before the due date as possible. Students should retain electronic copies of all assignments until the marked version is returned. Faxed or e-mailed assignments will not be marked. Professional Behaviour in Class: Students are expected to demonstrate exemplary professional behaviour and respect for others in class. Address all instructors, lecturers, clients or client partners (including fellow students) with dignity and respect and fully demonstrate a client centered approach to learning and interacting with others. Some examples of disrespect include: being late for class or late returning from breaks, side conversations during lectures, wearing hats with visors that cover your face, wearing sunglasses, having laptops open when guest lecturers are speaking. Students are expected to voluntarily assist in room and equipment management to ensure that rooms are restored to proper order after use and that equipment is returned and stored. Participation and Preparation for Class: 1) This course uses experiential learning to develop abilities to perform assessments and measures of occupational performance. Guest lecturers and possibly clients, will be engaged to support and contextualize learning through experience as well as understanding approaches to evaluation of occupational performance and demands in context. This approach also requires independent learning of students in labs to learn how to perform assessments and to interpret results of evaluations that will inform interventions. 2) This course also includes student dialogue and sharing of knowledge. A seminar like format will be used to engage students in critically examining issues in occupational therapy relevant to the occupational therapy process of assessment of the person in context. This format is highly dependent upon student participation and contribution. Core readings are specified for each session so that there is common basis for scholarly discussion. All students are required to reflect upon and present ideas relevant to the course content; develop and clearly convey insights; synthesize and critique readings. Students will be expected to share and build knowledge through active participation and dialogue in class. This approach requires students to offer insights and knowledge gained from other classes and to share this with other students. 3) Cases will be used in this class to integrate the knowledge and contextualize the application of knowledge relevant to the objectives of this course.

Page 8 of 14 OT 9542 Evaluating Occupation in Context 4) Students need to print off materials for which a paper copy is required in class. Handouts of required materials will not be provided. If a document is on OWL and the student can makes notes from that material, on a computer, a paper copy will not be required. 5) In this course, for all in-class lectures and labs, students need to come appropriately dressed. Closed-toed shoes such as running shoes or leather shoes need to be worn for safety and for optimal participation in lab assignments and labs. Students need to wear a tshirt or tank top, and wear shorts or put shorts on for participation in some labs and in-class demonstrations. Students will be physically active in many classes and must have suitable clothes to conduct assessments.. Web-CT: Web-CT Owl, available online at http://webct.uwo.ca/, is being used to deliver readings, individual grades and supplemental educational material. If you have any difficulty with WebCT, contact the ITS Help Desk at 519-661-3800 (83800, then extension #1 on campus), or help.desk@uwo.ca. The Support Centres web-site is http://www.uwo.ca/its/helpdesk. If you are unable to resolve the difficulties, please advise the instructor as soon as possible. Library Support: Marisa Surmacz l is available to provide group teaching to support research for a particular assignment. She can be reached at marisa.surmacz@uwo.ca or by telephone at (519) 6612111, Ext. 80959. Weekly Schedule:

DATE Feb. 7 DD

TOPIC Introduction to OT9542 Standardized vs. Nonstandardized Assessments

READINGS Brown, T. (2012). Assessment, Measurement and Evaluation. In S. Lane & A. Bundy (Eds.), Kids Can Be Kids: A Childhood Occupations Approach (pp. 320-348). Philadelphia: F.A. Davis Company. (copy available in the filing cabinet)

Feb. 9 DD

Clinical Reasoning / Documentation

Mandez & Neufeld, (2003), Clinical Reasoning, CAOT, pp. 10-15. (WebCT) Radomski & Trombly, 6th ed., Chapter 3, Planning, Guiding and Documenting Practice, pp. 41-53.

Feb. 14 JW

Physical Development Assessments with Infants/Young

Lane & Bundy (2012) Chapter 4: Early Intervention pp. 44-62 (copy available in the filing cabinet)

Page 9 of 14 OT 9542 Evaluating Occupation in Context Children Motor Milestones Resource Sheet- (WebCT)

Feb. 16 JW

Physical Development Assessments with Older Children (fine and gross motor)

Hinder, E.A. & Ashburner, J. (2010). Occupationcentred intervention in the school setting. In S. Rodger (Ed.), Occupation-centred practice with children: A practical guide for occupational therapists (227-247). West Sussex: Wiley-Blackwell. (copy available in the filing cabinet) Hoy, M., Egan, M. & Feder, K. (2011). A systematic review of interventions to improve handwriting. Canadian Journal of Occupational Therapy, 78(1), 1325. (copy available in the filing cabinet and link below) Link: http://search.proquest.com.proxy2.lib.uwo.ca:2048/do cview/859014480/fulltextPDF/1349BC5C36E2F5AE7 ED/7?accountid=15115

Feb. 21 JW

Sensory/Perceptual Assessments

Case-Smith, 6th ed., Chapter 12, Visual Perception, pp. 373-403. Shields Bagby, M., Dickie, V. & Baranek, G. (2012). How sensory experiences of children with and without autism affect family occupations. American Journal of Occupational Therapy, 66(1), 78-86. (copy available in the filing cabinet and link below) Link: http://search.proquest.com.proxy2.lib.uwo.ca:2048/do cview/916229322/fulltextPDF/1349B5D4B482A8044A 1/10?accountid=15115

Feb. 23 JW Guests: Susan Moir and Karen

Wheelchair Assessment and Prescriptions

Wheelchair and Seating Assessment Overview (WebCT)

Page 10 of 14 OT 9542 Evaluating Occupation in Context Trenholme (Parkwood) Feb. 28 JW Guests: Susan Moir and Karen Trenholme Mar. 1 JW Universal Design/Home Assessment Radomski and Trombly, Chap. 11, pp. 311-357, Assessing Environment: Home, Community and Workplace Access

Wheelchair Assessment and Prescriptions

See above information for Feb. 23rd, 2012

Mar. 6 JW Guests: Cheryl MacDonald and Shannon Howson (Parkwood)

Post-Stroke and Driving Assessments in the Elderly

Elekman. B.A., Stav, W., Baker, P., ODell-Rossi, P. & Mitchell, S. (2009). Community mobility. In B.R. Bonder & V. D. Bello-Haas (Eds.), Functional performance in older adults (3rd Ed.) (333-379). Philadelphia: F.A. Davis Company. (copy can be found in the filing cabinet)

Mar. 8 JW/DD Mar. 12-16 Mar. 20 JW Debbie Kemp (DMA Rehability)

Midterm Test No classes Reading Week Functional Capacity Assessments

Jacobs (2008) Chapter 2, A client-centered framework for therapists in ergonomics, pp.17-36 (copy available in the filing cabinet) Shaw, L. & Polatajko, H. (2002). An application of the Occupation Competence Model to organizing factors associated with return to work. Canadian Journal of Occupational Therapy, 69(3), 158-167. (copy available in the filing cabinet) Jacobs (2008) Chapter 11, Lifting Analysis, pp.173190. (copy available in the filing cabinet) **readings recommended by guest speakers

Page 11 of 14 OT 9542 Evaluating Occupation in Context Mar. 22 JW Physical, Cognitive and Psychosocial Job Demands Analysis Jacobs (2008) Chapter 16, Ergonomics in Disability Management, pp.277-312 (copy available in the filing cabinet) Jacobs (2008) Chapter 7, Cognitive and Behavioral Demands of Work, pp.103-122. (copy available in the filing cabinet) **readings recommended by guest speakers Mar. 27 JW Debbie Kemp and Cheryl Fountain Gore Mar. 29 JW FCA and Upper Extremity Assessment Labs/Video

Debbie Kemp

FCA and Upper Extremity Assessment Labs/Video

Debbie Kemp and Cheryl Fountain Gore Apr. 3 DD Mental Health Creek and Bullock, (2008), In Occupational Therapy and Mental Health, pp. 85-107. (copy available in the filing cabinet) Radomski and Trombly, 6th ed., Chapter 9, Assessing Abilities and Capacities: Cognition

Apr. 5 DD

Cognition/Capacity

Apr. 10 DD

Independent Living

Loukas and Dunn In Case Smith, Chap. 17Instrumental Activities of Daily Living and Community Participation Shepherd, (2012) In Lane and Bundy, Chapter 8, Self-Care: A Primary Occupation (copy available in the filing cabinet)

Apr. 12 DD

Chronic Pain

Pedrettis Occupational Therapy, Chapter 27, Evaluation and Pain Management.

Page 12 of 14 OT 9542 Evaluating Occupation in Context (copy available in the filing cabinet) Guest: Kelly Farrell (DMA Rehability) Apr. 17 DD OccupationFocussed Bonder, Haas and Wagner, 3rd ed., Chapter 12, Leisure. (copy available in the filing cabinet) Knox, In Case Smith, Chap. 18 - Play

Apr. 19 DD

Pearson Representative Guest: Michael Charron Presentations Presentations Flex Date Course Evaluation Final Test

Apr. 24 DD Apr. 26 DD May 1 May 3 DD

Course Evaluation:
1. MIDTERM TEST 25% March 8/12 A multiple choice test will be given at the beginning of class on March 8/12. Questions will be based on the classes that took place from Feb. 7 to March 6/12. The questions will cover the required readings, lectures and labs. 2. ASSESSMENT PROJECT - 50% The purpose of this assignment is to provide in-depth exposure to standardized assessments used by occupational therapists to gain familiarity with them, to explore their psychometric properties, to consider their clinical utility, to review the literature available related to the assessments, to gain experience with scoring and interpreting results, to communicate results in report fashion and to effectively communicate findings with the class.

Page 13 of 14 OT 9542 Evaluating Occupation in Context The students will divide themselves into 19 groups of 3. Each group will explore and decide which assessment they would like to focus on for this project. Each group will be asked to submit a hard copy of the first and last names of each group member as well as the full name of their first, second and third preferences of assessments for the project on Feb. 21/12 at the beginning of class to Jessie Howe. Assessments in the OT Assessment Library are available to use but the groups are not limited to using these assessments. Assessments covered in the work-focussed labs of this course should not be chosen as they will be reviewed in more depth in the labs. It is the responsibility of the group members to ensure that they have access to a complete assessment before submitting their choices. A final decision will be made by the instructors with respect to group membership and assigned assessments on Feb. 23/12. Coverage of assessments across the lifespan and in diverse clinical areas will dictate assignment of projects to groups. The level of difficulty of the assessment will be considered in the grading of this project. Step 1: 10% Mar. 29/12 Each group will find a volunteer subject, that is not a group member and is appropriate for the type of assessment, to conduct the entire assessment on, in as close to a standardized manner as possible if there are such requirements. Subject information should be provided in a manner that does not compromise confidentiality unless the subject agrees to disclosure of this information. Practise attempts can be made in advance with group members or other volunteers. The version that is handed in for grading must have only been conducted once on the subject to avoid a practise effect. The group will submit the legible and properly scored assessment on Mar. 29/12 at the beginning of class. The scored assessment will be worth 10% of the final grade and a group grade will be assigned that considers each members participation as well as the final product. If an assessment manual is not available in the assessment library, scoring and interpretation information/tables need to be provided to the instructors with the scored assessment. Any pertinent information that is necessary for scoring of the assessment but space is not provided for on any recording forms, must be attached. Step 2: 10% Mar. 29/12 Each group will interpret the results of the assessment and communicate the results in the format of a clinical assessment report. This report will also be due on Mar. 29/11 at the beginning of class. The report should be 2-3 pages in length. The report must be organized using the SOAP format. Reports should resemble an actual clinical report in their layout but a fictitious letterhead, organization and therapist name can be used in the report. Reports should be concise and clearly worded and written as being produced by a single occupational therapist in a clinical setting. The results should be consistent with the actual assessment conducted. The Plan section should be written as if OT services could be continued. The assessment report will be worth 10% of the final grade and a group grade will be assigned that considers each members participation as well as the final product. Step 3: 10% April 19/12 The group will prepare a one page, one-sided handout to summarize pertinent information about the assessment and to provide useful information for the rest of the class. A hardcopy will be handed in by all groups to Donna Dennis on April 19/12 at the beginning of class but an electronic copy should be kept by the group members. Donna Dennis will be responsible for

Page 14 of 14 OT 9542 Evaluating Occupation in Context compiling the handouts into one larger handout and making photocopies for each class member. This assignment is worth 10% of the final grade and a group grade will be assigned that considers each members participation as well as the final product.

Step 4: 10% Individual and 10% Group = Total 20% April 24 or 26/12 The classes on April 24 and 26 are reserved for presentations of the assessments. Attendance at both classes is mandatory for all students. Assignment of dates to the groups will be decided at least a week in advance of the presentations. Each group will have 15 minutes to present information to the class in whatever method they feel would be effective to provide a thorough review of the assessment but each member must present some of the information. A brief period of time will follow each presentation to allow for questions or comments from the class. A powerpoint presentation should be used as part of the presentation. All of the groups will hand in a hardcopy as well as an electronic copy to Donna Dennis on the first day of the presentations, April 24/12 regardless of which day they are presenting. An individual grade and a group grade will be given for the presentations, each of which will be worth 10% of the final grade for a total of 20% of the final grade. These grades will be based on effectiveness of presenting verbal and visual information as well as content. 3. FINAL TEST 25% May 3/12 A multiple choice test will be given on May 3/12. Test questions will cover the required readings, lecture and lab information for the classes from March 20 to April 19/12.