Community-based competencies for entry-level occupational therapy educational programs

The changing health care system is bringing new challenges to the occupational therapy (OT) profession to make a significant paradigm shift from a medical model to a community-based (CB) model (McColl, 1998). One of the main challenges to occupational therapists in contemplating a major shift to CB practice is that their competencies are confined to practice within the traditional medical model. From an educational perspective, OT educators need to be concerned with this phenomenon because the traditional OT curriculum and fieldwork do not prepare students for the new and often demanding roles of community services (Vanier & Hebert, 1995).

Changing our arena of practice or simply adding the community as a viable service will require alterations and changes in our entry level education. Community practice education is the core factor in preparing OT students for various community services (Fisher, 2001; Townsend, 1988).

The purpose of this dissertation was to explore and identify the competencies that entry-level OT students need to practice in CB settings. Three studies were conducted to complete this line of research. The objective of the first study was to analyze CB Competencies for OT and other allied health practitioners by way of a systematic review of literature both within and outside of the OT profession. Similarities and differences among these competencies were discussed. A comprehensive list of CB competencies that were considered important by both OT and other allied health practitioners were presented. The second study addressed the issue of what CB competencies are currently being taught in entry-level OT programs in the United States (U.S.) by way of an Internet survey. The questionnaire was guided by the CB competencies compiled from the author's literature review and sorted under three major categories: knowledge, interpersonal and clinical skills, and community specific skills. A Likert scale was used for the respondent to indicate the level of his or her agreement with a certain subcategory of competencies. Both closed-ended and open-ended questions were utilized to obtain quantitative and qualitative data. Forty-three out of one hundred and thirty-eight OT programs (a response rate of 31%) participated in the survey. The results identified essential CB competencies that are currently being taught in entry-level OT programs.

The third study compared what CB competencies are being taught or not being taught in current educational programs to what is identified and recommended by OT and other health care professionals. The results revealed a hierarchy of CB competencies that is currently being taught in entry-level OT programs. Examples of innovative strategies used by some respondents to incorporate CB competencies into traditional curricula are presented.