CERTIFICATION EXAMINATION

Now that you have nearly completed your degree, it's time to begin thinking about the next step...taking the national exam through NBCOT. 

Here is the link to review the NBCOT Examination Handbook:

https://www.nbcot.org/-/media/NBCOT/PDFs/Cert_Exam_Handbook.ashx?la=en

READ IT CAREFULLY! It has lots of information you will need to navigate the process of setting up an account, completing the application, and what to expect before and after the examination.

Here is a tutorial to help you with the process:

Mind Your Manners:

Remember Etiquette in Your Job Search

By: Matthew T. Patton           Advance for Occupational Practitioners    June 6, 2012|

From the initial phone call about a job opportunity all the way to the point when you accept the offer, social etiquette is essential. Missteps along the way, even seemingly benign ones, have the potential to knock you out of the running.

Use these seven tips as a "refresher course" to ensure you are on top of your game when it comes to being perceived as someone with manners and grace.

1. Find a quiet place. During phone screens, don't be afraid to ask if you can call back in a few minutes if you are in a noisy place. You want the conversation to be easy for both parties. Background noise and the hollow sounds that often are typical of speakerphone or Bluetooth calls can be annoying. If you're on a cell phone or driving, pull over to minimize the chances of the call being dropped. This also allows you to give your undivided attention to the call. You should put forth the idea that there is no one more important than that individual at this moment.
2. Be professional. Don't say things like "yeah" and "dude." You want to show potential employers how you would act in front of clients, patients or even other internal contacts.
3. Be respectful of the hiring manager or recruiter's time. Interviewers can be very busy and often calls or meetings can run long. For example, if a recruiter says she will call you at 2 p.m. and you haven't heard from her, give her a few minutes. Don't call every 2-3 minutes in a panic, thinking you've missed the call and therefore, the opportunity. One voicemail message a few minutes after your designated time will suffice. In the age of caller ID, you don't want to have your number show up every 1-2 minutes. That's a bad impression.
4. Wear proper business attire. Be conscious of your personal appearance. Take a moment to stop by a restroom to make sure you look presentable. Make sure there's no spinach in your teeth.
5. Use discretion when speaking about yourself. It is alright to speak of some of your strengths, but don't appear to be bragging or pompous.
6. Be conscious and aware of your conversations. For example, avoid name dropping unless it's appropriate to the conversation. Don't discuss your family or personal life unless the conversation is casual on the other and is related to the conversation. Be "present" and engaged with the conversation and, again, be professional.
7. Say "thank you." When an organization has spent its time and resources to speak with you, you owe them a thank you. An email will suffice, but there's still something to be said for the old-fashioned pen and paper note.

As a side note, address your letters/e-mails/phone messages to "Mr./Ms." rather than a first name. If the individual says to call them by a first name, then that becomes acceptable. These differentiations that make you stand out from other candidates could lead to a rewarding and exciting career.

Put Your Best Foot Forward: 

INTERVIEW STRATEGIES

You put together the perfect resume and someone is very interested in meeting with you to discuss the position you applied for! This can be an exciting and nerve wracking time for those with little experience with professional interviews. 

The following information will help you arrive prepared to make a confident and positive impression on a potential employer. 

BEFORE THE INTERVIEW

Research the company/organization/facility.

Become familiar with services offered, history, accreditation, awards, etc.

Many organizations have information on their websites which can be helpful in gathering this information.

Utilize any contacts to gather information about job descriptions, departmental needs, populations served, etc.

Be early. This will help you relax prior to the interview and help you make a good impression by being reliable and organized.

Get directions and take a test drive if you are unfamiliar with the area.

Allow enough time for traffic and unexpected delays. Getting stuck behind school buses will not be an excuse for being late.

Be familiar with the parking situation in the area.

It's better to be over-dressed than under-dressed. Even if the work environment is casual, your appearance still must be neat, clean and professional. A classic suit is always your best bet. Limit use of jewelry, makeup and cologne/perfume.

Be polite to everyone you encounter.

You never know who you'll meet in the parking lot, elevator or lobby. You never know who will be in the interview meeting or who may influence the hiring process.

Review your resume thoroughly.

Perform a salary review for similar positions in the area. Although salary is an important factor in your job search, don't let it be the driving force behind your choice.

Fill out applications and forms neatly and completely. Bring information to the interview related to dates and positions held in the past.

If there are online applications, review them so you are familiar with information you may need if the application is filled out prior to/following the interview.

Have prepared questions about the employer and position you are interviewing for.

Bring a pen, small notebook and an extra copy of your resume and references with you. Keep supplies in a portfolio for a more professional and organized impression.

DURING THE INTERVIEW

When greeting the interviewer(s), make eye contact, pay attention to names of those in the room.

A firm handshake is a sign of confidence. A bone-crushing handshake is not necessary. Weak and clammy handshakes typically make a bad impression.

Appear confident! Sit up straight, maintain good eye contact, refrain from fidgeting, chewing gum or mints. Poor posture may translate to low self-esteem.

Be enthusiastic! 

Stay on topic and answer the question asked clearly.

Focus on your skills and accomplishments and how they correlate to the position you want.

Stress how your experience has prepared you for this job and what you can bring to the table.

Convey the message you are hardworking and dedicated. Stress you are results-oriented and a creative problem-solver. Use adjectives such as dependable, organized, cooperative, and a good communicator.

Be prepared to communicate your professional goals clearly

Remind yourself the objective of the interview is to get the job. Being humble or arrogant will not achieve that.

Take time to think before answering difficult or unexpected questions.

Mention any committees, associations, study groups, etc. that you are/have been involved in.

Avoid criticizing past supervisors and stress what was learned in past positions.

Display an appropriate sense of humor.

AFTER THE INTERVIEW

Always follow-up the interview with a phone call reiterating your appreciation for the opportunity and interest in the position.

Send a thank you following the interview to those who met with you. 

Ask for business cards during the interview to help recall names and positions held.

DO NOT:

• be overaggressive or arrogant  
• emphasize money as your main interest in the job
• expect too much too soon - be open to the idea of starting at the bottom and working your way up
• make excuses for unfavorable factors on your record
• display a marked dislike for schoolwork
• be indecisive
• display intolerance or prejudice
• interview unless you are interested in the job...don't just "shop around."
• state specific geographic restrictions.
• contradict yourself in responses
• assume that all employers will be thrilled about your plans to return to school or start a family in the next year or two

INTERVIEW QUESTIONS

Give some thought to the questions below and rehearse them out loud or role play with a friend so you will appear prepared, self-assured, and capable in the interview. Those are among the key qualities that make a job applicant stand out among the competition and create a dynamic impression.

Describe where you would like be professionally in five years. What will you need to do to get to that point?

Describe your skills and talents which would best serve you in this position.

Tell me about your professional accomplishments.

Describe a significant contribution you made in your current (or past) position.  

Describe a challenging situation you faced which involved meeting a tight deadline.  

Describe a stressful situation you experienced at work. How did you handle it and what was the outcome?  

Share a situation where you had to manage a difficult person. What strategies did you use to address the issue?

Talk about aspects of this position which may be challenging for you.

What is it about this organization and position that drives you to seek employment here?

Why are you leaving your current position?  

Discuss a situation where you received some “less than” feedback. What did you do with the feedback?

Describe a conflict you experienced at work? How was it resolved?

Give me an example of a professional risk you took in a position and describe how it turned out.  

Let's Get to Work: RESUME  WRITING

Many new grads are intimidated about putting a resume together. They are not certain where to begin, may not have put together a professional resume before, and don't feel they have mad OT skills to write about!

Read through the following information to get some ideas on how to approach this important step.

Length of Resume

Your resume should be no more than 1-2 pages in length. Get the most bang for your resume-buck! Each word should be focused upon giving a potential employer an impression you are the best candidate for the position.  

Organization of Content

Include your name, address and contact info (phone, e-mail) on the top of each page.

Put the most important information first. For a new grad, this might be your fieldwork experience followed by previous work experience. Be specific with information.

There are many free online templates to help you produce a professional and organized resume. Don’t get too creative! Create a professional looking resume.

Format: Professional and Easy to Read

Use bullet points whenever possible to make the process quicker for the individual reviewing your resume. Highlight critical experience with bullets and short sentences packed with information. Do not bullet your entire resume, however, as it will look like you threw it together in an unorganized manner.

The resume should be professional looking. Do not include pictures, fancy fonts, designs, etc. Avoid over using capitals and bold text. Font should be 11-12 in size. Utilize bold text for headings (ex. Work history, educational history, professional affiliations, volunteer experience, special certifications, etc.)

If printing your resume, make certain the quality of print and paper is good. Take it to a printer if your printer will not produce something of quality.

Make Resume Specific for the Position

Your resume should be tailored for the position you are applying for. This may require preparing several versions of your resume when your first begin your search (pediatrics, rehab, psych, acute care, etc.).

Your employment objective should be reflective of the position you are applying for.

Ex. Employment Objective: To obtain a professionally challenging position as an Occupational Therapy Assistant in a dynamic pediatric setting dedicated to providing quality service to the clients served.

Powerful Word Selection

Clearly communicate achievement by using verbs to describe experience. See list included in “Pages” in this blog.

Avoid  using pronouns such as “I” or “me” as they are redundant and unnecessary when every word counts.  It is assumed the resume is about you and therefore unnecessary to use such terms.

Highlight Strengths and Achievement

Support your strengths with examples from work experience. Avoid including a long list of attributes (disciplined, creative, problem solver). Include examples of how these skills were applied in fieldwork, the clinic, or in past work experience. Avoid using the term “responsibilities”. Consider using “achievement” as it has a stronger message of your ability and contributions in past positions.

Ex. Problem solving skills: Created a new tracking sheet to address weekend per diem coverage issues. Organizational skills: Responsible for organizing OT department daily schedule.

Prior Work Experience

Stress skills which carry over from past work experience to the one you are applying for. This is where your task analysis skills can help you! Even if your work history appears unrelated to the professional position you are applying for, there are skills which cross over.

Ex. A position as a waitress: Requires organizational skills, problem solving, interpersonal skills, team building skills, ability to plan ahead, ability to multi task, ability to establish rapport quickly, ability to anticipate needs, multicultural exposure.

What to Include from Fieldwork

Adaptive equipment and technology experience

Advocacy (client, caregiver, profession, departmental)

Assessments performed/observed

Competencies (modalities, specific interventions)

Disciplines and professionals you worked closely with (PT, SLP, SS, MD, teacher, administrator, parents, volunteers, psychologist, etc.)

Functions within department

Group work

Inservices provided and attended

Marketing of OT services

Meetings you actively participated in or conducted (IEP, case conferences, family meetings)

Quality assurance tasks

Reimbursement systems you were exposed to

Role in care coordination and case management

Role in transition services

Scheduling responsibilities

Scholarship and research activities

Specific populations you worked with

Supervisory experience

Treatment models used (SI, NDT, PNF, Rood), o

Types of documentation (daily, weekly, monthly, quarterly, electronic, SOAP, PAP, DAP)

How Can You Help the Employer

Clearly illustrate how you can be an asset to the organization you are applying to. Describe how the company will benefit from hiring you. This may require you do a bit of research about the organization to find out about the services they offer and who their client-base is.

Carefully read the job description. If the ad does not include many details, request a copy from their human resource department. You could also perform an online search for posted job descriptions for similar positions. This will help you embed language from the job description into your resume.

Ex. Redesigned patient education handouts to improve patient follow-up and ease of use.

Provided inservice training to CNA staff regarding strategies to encourage patient independence in ADL’s

Many resumes are now submitted online. If your resume is heavily formatted, save it as a pdf, then upload that copy of the file.

Be Selective in What You Include

Avoid including hobbies unless they directly relate to the position.

Include special skills, certifications or training (CPR, first aid training, sign language, certain drivers licenses can be useful if client transport is common, modality training, additional languages you speak, swim certifications, ethics training, etc.), committee involvement, and association involvement.

You may include volunteer information as long as it relates to your objective. Volunteering in a beer tent at the local chowder cook-off is not useful. Volunteering at Special Olympics IS useful information!

Review Your Resume!

Spelling and grammar errors on a resume shows a lack of attention to detail. Ask a friend or mentor to review your resume prior to sending or posting it.

DO NOT RELAY ON SPELL CHECK! (FYI: Spell check did not pick up on the incorrect use of “relay” in the previous sentence!)

This should give you some ideas on how to proceed. Begin by brainstorming your experiences and compile a list. From that list, you can begin to get organized. Share a draft with a classmate for feedback. 

GOOD LUCK!

HIPAA

The Health Insurance Portability and Accountability Act (1996) addresses protection of confidential patient medical information, reducing insurance fraud, and facilitating insurance portability when changing jobs.

Level I and II fieldwork sites require students to be HIPAA trained prior to entering the clinic. The CCRI Rehab Health Department requires students to complete HIPAA when entering the program and just before going out on level II fieldwork. Some sites may require students complete additional site-specific training.

Any student violating HIPAA guidelines will be subjected to a remedial plan of action typically developed in collaboration between the site and the school. The plan will identify specific areas of understanding the student is lacking, a plan of correction (i.e. additional HIPAA training, reflective writing about how HIPAA influences practice in that site, research about HIPAA standards), and possible placement termination should the infraction be viewed as severe.  

Students must be vigilant in where they store notes regarding patients. Official files must be locked when not in use. Informal notes should not include identifiable information and stored safely. They should not be left out in the open if non-staff and other patients move through the area. All non-essential notes and “working charts” should be shredded when no longer needed (i.e. patient discharge, end of student placement).

When students are completing fieldwork-related reflection or assignments they must not include the following information:

• Account numbers or any identifying number, characteristic, or code.
• Biometric identifiers (i.e. finger and voice prints)
• Certificate and/or license numbers
• Dates - all, including date of birth, admission and discharge dates
• Device identifiers and their serial numbers
• E-mail addresses
• Fax numbers
• Full face photographic images
• Health plan beneficiary numbers
• Internet Protocol (IP) address numbers
• Location - includes anything smaller than a state, such as street address
• Medical record numbers
• Name
• Social security number
• Telephone numbers
• VIN numbers and license plate numbers
• Web Universal Resource Locators (URLs)

Students can include the following information in fieldwork reflection or assignments:

• Age - “Over 90” must be used in related cases
• Race
• Ethnicity
• Marital Status

For more information about HIPAA go to:
AOTA 
US Dept of Health and Human Services

SHARE YOUR EXPERIENCE

Discuss 5 specific actions you routinely engage in to protect patient information in the clinical setting you are in.

Provide 3 other examples of how you have seen other disciplines adhere to HIPAA guidelines.

Read the article linked below and share one "take-away" related to this current application to HIPPA regulation.

Las Vegas hospitals must follow regular HIPAA privacy rule  By Rachel Z. Arndt  | October 2, 2017

CONSENSUS DOCUMENT ON COMPLIANCE REPORTING: 

FRAUD &ABUSE

OTA has collaborated with the National Association for the Support of Long Term Care (NASL), the American Speech-Language-Hearing Association (ASHA), and the American Physical Therapy Association (APTA), to create a consensus document on Medicare compliance. PDF of the document here

The information below provides a pathway for clinicians who have questions about inconsistencies between their employer’s and Medicare’s policies, including recommended steps and resources.

COMPLIANCE REPORTING

Compliance is an organization’s adherence to laws, regulations, and policies applicable to its operations. Violations may result in punitive action, including the imposition of fines and/or criminal charges. Clinicians have a responsibility to adhere not only to their profession’s clinical and ethical standards, but all applicable laws, regulations and policies.

WHAT ARE CORPORATE COMPLIANCE PROGRAMS?

A compliance program integrates health care federal and state regulations, laws and professional standards and company standards into a common framework and provides a means for confidentially reporting concerns. An effective corporate compliance program helps ensure that clinicians and managers are conducting clinical activities and business operations ethically, legally, and with a high level of integrity. A successful compliance program also helps develop a culture of accountability and shared responsibility within an organization, facility, or company. A compliance program may be developed and carried out by the internal staff of the organization or may be contracted to an external entity. In both instances, the rules governing confidentiality of reporting and protections are the same.

Compliance officers function as an independent and objective body that is responsible for developing and implementing the compliance program as well as reviewing and evaluating compliance issues/concerns within the organization. Specifically, compliance officers carry out the following responsibilities:

• Serve as the primary point of contact for all compliance concerns
• Direct compliance issues to appropriate resources for investigation and resolution
• Represent an internal resource with whom concerned parties may communicate
• Facilitate requests from external entities on behalf of the organization in the case of denials, medical review, and investigations related to fraud, waste, and abuse
• Have a duty to report violations to duly authorized enforcement agencies as appropriate and/or required by law
• Are legally bound to maintain confidentiality of those reporting violations and to ensure those who report violations not subject to retribution.
• In instances where confidentiality has been breached or a retaliatory measure has occurred as a result of information shared with the compliance officer, the situation can be reported to the Office of the Inspector General (OIG). See the contact information at the end of this document.

ETHICS IN OT PRACTICE

Every profession has ethical standards created to guide practice. AOTA has created Code of Ethics for all OT practitioners to adhere to. These standards provide structure for behavior, guidance for practitioners to resolve concerns, and communicates the commitment of the profession to providing ethical care to those we service.

ETHICS DEFINED 

The ethics of an organization or an individual is a complex system of interwoven beliefs and principles. The development of ethical beliefs is influenced by a number of factors:

• Experience
• Laws, rules and regulations of an industry or organization
• Family and friends
• Education
• Religious and spiritual belief system

Developing an ethical foundation requires the individual to reflect upon and analyze moral principles or standards of conduct, personal or professional. Ethics serve as a guide to an individual’s behavior and influences the decisions they make.

The AOTA Code of Ethics provides a code to structure the relationship between the client and the therapist. The code of ethics provides a foundation for expected behavior within the profession by providing a common set of values and principles to promote and maintain high standards within the profession.

Therapists may find themselves in challenging ethical situations which may place them in the position to make a decision to resolve the issue. It can be helpful to identify the type of situation in order to determine the best path. The therapist should examine the situation and look at which area of the AOTA Code of Ethics appears breached. It will also be necessary to identify the locus of authority, the primary decision maker in the situation.

Ethical Distress

This refers to situations which challenge how a practitioner maintains professional or personal integrity. It can be helpful to discuss the situation with a supervisor or mentor in order to clearly identify the situation and possible options for resolution.

Ethical Dilemma  

This refers to a situation where 2 or more ethical principles fail to match. This can cloud the identification of a clear path for resolutions. The best course of action may ultimately be driven by legal requirements or an organizational policy versus what the therapist may personally wish to do. The hierarchy of governing influences must be carefully examined.

http://www.authorstream.com/Presentation/benjatchison-1309505-ethics-and-values-of-occupational-therapy/

AOTA CODE of ETHICS

Principle 1: Beneficence    

This refers to the expectation therapists demonstrate a concern for the health and welfare of all clients. Each patient should be treated fairly and equitably. This principle addresses the expectation the therapist will advocate for the client’s needs. It promotes public health and safety and insures services are reasonably priced.

Principle 2: Non-maleficence    

Simply stated, therapists will not cause a client harm in any way, physically or emotionally.

Principle 3: Autonomy and Confidentiality   

This outlines the expectation the therapist will acknowledge the clients right to determine their care and has the right to refuse care. The therapist should routinely collaborate with the client and caregivers when identifying goals. The patient must be cautioned about potential risks, fees, and anticipated outcomes of service. The client can expect personal and medical information will be confidentially maintained.

Principle 4: Justice      

OTs will provide services to clients fairly and without regard to race, socioeconomic status, religion or culture. Therapist must accept the responsibility for educating the public about the value of OT services. 

Therapists are expected to comply with organizational rules, local, state, federal, and international laws. Also, therapists are expected to honor documents out out by AOTA which govern OT practice. Documentation about service provided must be accurate. Any report or evidence of professional development provided to maintain credentials or be in compliance with practice laws must be accurate.

Principle 5: Veracity    

The OT must accurately represent professional qualifications, education and training when supporting information is required. Therapists must identify is a potential conflict of interest exists. The therapist is viewed as responsible to their actions and maintaining public trust of the profession.

Principle 6: Fidelity    

Therapist must be fair, respectful and demonstrate integrity when interacting with colleagues and other professionals. The therapist must address breeches in confidentiality in matters related to staff and colleagues and report misconduct observed.

REGULATION for ETHICAL OT PRACTICE

There are a number of agencies which govern OT practice and all do so in different ways. Accurately identifying the ethical issue will help the therapist identify the best agency to contact when needing information. Agencies or statutes can be federal, state or professional regulating laws or bodies responsible for different aspects of OT service provision.

Federal Statutes

These statutes passed by Congress can be enforced in the federal court system and violation may result in fines, injunctions, or prison time. Some statutes affecting OT include:

HIPAA

IDEA

ADA

Social Security Amendments

State Statutes

These have been passed by individual state legislatures and will vary from state to state. The state’s OT practice act is the most significant statute affecting OT practice within a particular state. Therapist moving or practicing in multiple states must be familiar with the scope of practice guidelines and licensure requirements in each state. The state’s licensure board carries out the task of implementing the licensure laws and regulation and they possess the authority to discipline members if the public is determined to be at risk.

Professional Regulatory Bodies

AOTA

Possess jurisdiction over members only. Disciplinary actions are reported to NBCOT and state agencies. The Standards of Ethics Commission (SEC) is responsible for informing and educating members about current ethical issues, upholding practice and education standards, monitoring member behavior and reviewing allegations of unethical conduct.

When a complaint is filed, the SEC initiates an investigation. If found guilty, sanctions will be imposed:

Reprimand: Formal expression of disapproval communicated privately in a letter from the Chairperson of the SEC. It is not disclosed to other regulatory agencies. 

Censure: Formal expression of disapproval which is public

Membership probation: Could be the need of the practitioner to meet stated terms, suspension for a specified period of time, or revocation of membership permanently.

ACOTE

State licensure requires practitioners to complete the academic and fieldwork requirements of an ACOTE accredited program. ACOTE sets the standards in which all OT programs must comply.

NBCOT

This organization has jurisdiction over all certified and eligible-for-certification practitioners. Continuing education is required in order to maintain certification (COTA) or registration (OTR).

State Licensure Board

The board has an established disciplinary process designed to protect the public from harm. Possible sanctions include:

• Fines                        
• Order of abatement or correction within a designated time frame
• Public censure            
• Temporary suspension of practice privileges
• Permanent prohibition from practice in the state

SOLVING ETHICAL PROBLEMS

Now that you have become well acquainted with the ethical principles of OT, let’s look at a simple way to solve potentially complex ethical situations. It is always a good idea to discuss the situation with someone informed and trustworthy prior to taking action.

Organizations often have policies and an identified chain of command for addressing Ethical concerns. Examining these policies may help guide you. Some organizations have anonymous tip-lines or hot lines to report suspected abuse. Gather your facts first. If you still have doubt about whether to report a situation, it typically means you need more information. BE careful your motivation is not personal and the interest of the client remain at the core of any action you may pursue.

1. Gather relevant facts about the situation
2. Describe the clinical, contextual, individual preferences influencing the situation
3. Identify the type of ethical situation – distress, dilemma, locus of authority
4. Identify the AOTA ethical principle involved (beneficence, non-maleficence, etc.)
5. Identify professional duties outlined in the Code of Ethics and required conduct of all involved
6. Explore parties involved, alternatives, desired outcomes and consequences
7. Identify facts, laws, resources and wishes of those involved
8. Complete the action based on identified policy outlining steps required
9. Evaluate the process and outcomes

      FAQs About Ethics 

SHARE YOUR EXPERIENCE

Provide specific examples of how you are seeing the AOTA Code of Ethics and Standards of Practice upheld in the clinical setting you are currently in. 

• Speak to your supervisor and ask them to describe an ethical situation they experienced and how it was ultimately resolved. Share the story here. These stories can later help you identify alternative options in situations you may encounter later in your career.

• Discuss the systems, informal and formal, in place for resolving conflict affecting ethical OT practice in the clinical site you are in.

• Discuss a situation where you needed to utilize concepts included in the AOTA Code of Ethics and/or Standards of Practice or some organizational ethical policy to make a difficult choice or decision related to patient care or a challenging situation with another professional or caregiver. It may have been a situation where there was "no good answer" but a decision had to be made.