Professional Development: Resources

OT REgulatory Entities

NBCOT

Initial vs. Continuing Competency
- The AOTA's Standards for Continuing Competence define initial competency as "An individual’s demonstration of having the requisite qualifications of knowledge, skill, and ability to enter into the occupational therapy profession" (2021). While they define continuing competence as "An individual’s ongoing process of building their capacity to perform a task, function, or role" (2021).
- In other words, initial competence are the demonstration of qualifications that we receive through our graduate program, fieldwork, and other experiences, which have prepared us to become entry-level OT practitioners. Continuing competence is the continued learning and building of knowledge after becoming professionals, in order to further demonstrate our ability as skilled practitioners.
Credentialing Process
- Be accepted to and then graduate from an accredited (by ACOTE) occupational therapy program.
  - Earn a doctoral or master's degree for OT
  - Earn an associates or bachelor's degree for OTA
- Complete the NBCOT character review
- Take and pass the NBCOT exam.
  - Registration exam for OTR
  - Certification exam for COTA
- Apply for licensure within the state you want to practice in. The agency which governs this varies by state.
  - In Virginia this agency is the Virginia Board of Medicine
  - This grants you the /L at the end of OTR/L & COTA/L
- Congratulations you can now practice occupational therapy!
NBCOT Certification Renewal Activities Chart
- The NBCOT requires 36 Professional Development Units (PDUs) every 3 years in order to renew certification

OT Licensure

In Virginia, OT licensing is run by the Virginia Board of Medicine
The Virginia Board of Medicine requires 20 units every 2 years in order to renew license

OT Professional Member Organizations

World Federation of Occupational Therapy (WFOT)

The global voice for occupational therapy and sets the standard for its practice.

American Occupational Therapy Association (AOTA)

AOTA represents occupational therapists, occupational therapy assistants, and occupational therapy students in the United States and beyond, to advance occupational therapy practice, education, and research.

AOTA Continuing Education & Professional Development

Online Continuing Education Courses
Micro Credentials & Professional Certificates
Approved Providers for outside CE

AOTA Ethics

Parts of AOTA:

American Occupational Therapy Foundation (AOTF)

The AOTF is a charitable, scientific, and educational organization with the task of supporting occupational therapy research and increasing public knowledge of the importance of occupations.

Society for the Study of Occupation (SSO)

The SSO:USA is a research society that strives to build the body of knowledge in occupational science to benefit humanity.

Virginia Occupational Therapy Association (VOTA)

The Virginia Occupational Therapy Association or VOTA is the state association that represents Occupational Therapists and Occupational Therapy Assistants who live and work in the Commonwealth of Virginia. VOTA seeks to increase public awareness about occupational therapy and its value in meeting diverse health and participation needs.

OT Supervision

Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy ServicesAbstract. This document is a set of guidelines describing the supervision, roles, and responsibilities of occupational therapy practitioners. Intended for both internal and external audiences, it also provides an outline of the roles and responsibilities of occupational therapists, occupational therapy assistants, and occupational therapy aides during the delivery of occupational therapy services.

General Principles

1. Occupational therapists and occupational therapy assistants are equally responsible for developing a collaborative plan for supervision. The occupational therapist is ultimately responsible for the implementation of appropriate supervision, but the occupational therapy assistant also has a responsibility to seek and obtain appropriate supervision.
2. To ensure safe and effective occupational therapy services, it is the responsibility of occupational therapy practitioners to recognize when they require peer supervision or mentoring that supports current and advancing levels of competence and professional development.
3. The specific frequency, methods, and content of supervision may vary depending on the client (person, group, or population) and on the
  1. Complexity of client needs,
  2. Number and diverse needs of the client,
  3. Knowledge and skill levels of the occupational therapist and the occupational therapy assistant,
  4. Type of practice setting,
  5. Service delivery approach,
  6. Requirements of the practice setting,
  7. Payer requirements, and
  8. Other regulatory requirements.
4. More frequent supervision of the occupational therapy assistant may be necessary when
  1. The needs of the client and the occupational therapy process are complex, diverse, and changing or
  2. The occupational therapist and occupational therapy assistant collaborate and determine that additional supervision is necessary to ensure safe and effective delivery of occupational therapy services.
5. A variety of types and methods of supervision apply to occupational therapy practice settings. Methods can include, but are not limited to, direct face-to-face contact and indirect contact. Examples of methods or types of supervision that involve direct face-to-face contact include observation, modeling, demonstration with a client, discussion, teaching, and instruction. Examples of methods or types of supervision that involve indirect contact include phone and virtual interactions, telehealth, written correspondence, and other forms of secure electronic exchanges.
6. Occupational therapists and occupational therapy assistants must abide by facility, state or jurisdictional, and payer requirements regarding the documentation of a supervision plan and supervision contacts. Documentation may include the following information:
  1. Frequency of supervisory contact
  2. Methods or types of supervision
  3. Content areas addressed
  4. Evidence to support areas of practice and levels of competence applicable to the setting
7. Names and credentials of the persons participating in the supervisory process.

Overall Roles of OTs & OTAs

The occupational therapist must be directly involved in the delivery of services during the initial evaluation and regularly throughout the course of intervention planning, implementation, and review and outcome evaluation.

The occupational therapy assistant delivers safe and effective occupational therapy services under the supervision of and in partnership with the occupational therapist.
It is the responsibility of the occupational therapist to determine when to delegate responsibilities to an occupational therapy assistant. It is the responsibility of the occupational therapy assistant who performs the delegated responsibilities to demonstrate service competence and to not accept delegated responsibilities that go beyond the legal and professional scope or beyond the demonstrated skill and competence of the occupational therapy assistant.
The occupational therapist and the occupational therapy assistant demonstrate and document service competence for clinical and professional reasoning and judgment during the service delivery process and for the performance of specific assessments, techniques, and interventions used.
When delegating aspects of occupational therapy services, the occupational therapist considers the following factors:
1. Complexity of the client’s condition and needs
2. Knowledge, skill, and competence of the occupational therapy assistant
3. Nature and complexity of the intervention
4. Needs and requirements of the practice setting
5. Appropriate scope of practice of the occupational therapy assistant within the boundaries of jurisdictional regulations, payment source requirements, and other requirements.

Supervision of Occupational Therapy Aides

An aide, as the term is used in occupational therapy practice, is an individual who provides supportive services to the occupational therapist and the occupational therapy assistant. Aides do not provide skilled occupational therapy services. An aide is trained by an occupational therapist or an occupational therapy assistant to perform specifically delegated tasks. The occupational therapist is responsible for the overall use and actions of the aide. An aide first must demonstrate competence before performing assigned, delegated client-related and non–client-related tasks.

The occupational therapist oversees the development, documentation, and implementation of a plan to supervise and routinely assess the ability of the occupational therapy aide to carry out client-related and non–client-related tasks. The occupational therapy assistant may contribute to the development, documentation, and implementation of this plan.
The occupational therapy assistant can serve as the direct supervisor of the aide.
Non–client-related tasks include clerical activities and preparation of the work area or equipment.
Client-related tasks are routine tasks during which the aide may interact with the client. The following factors must be present when an occupational therapist or occupational therapy assistant delegates a selected client-related task to the aide:
1. The outcome anticipated for the delegated task is predictable.
2. The client’s condition and the environment are stable and will not require that judgment, interpretations, or adaptations be made by the aide.
3. The client has demonstrated previous performance ability in executing the task.
4. The task routine and process have been clearly established.
When delegating client-related tasks, the supervisor must ensure that the aide
1. Is trained and able to demonstrate competence in carrying out the selected task and using related equipment, if appropriate;
2. Has been instructed on how specifically to carry out the delegated task with the specific client;
3. Knows the precautions, signs, and symptoms for the particular client that would indicate the need to seek assistance from the occupational therapist or occupational therapy assistant; and
4. Is not used to perform billable functions that are prohibited by the payment source of the client being served.
The supervision of the aide needs to be documented (e.g., orientation checklist, performance review, skills checklist, in-service participation). Documentation includes information about the frequency and methods of supervision used, the content of supervision, and the names and credentials of all persons participating in the supervisory process.

Virginia Supervision Requirements

18VAC85-80-110. Supervisory responsibilities of an occupational therapist.

A. Delegation to an occupational therapy assistant.

1. An occupational therapist shall be ultimately responsible and accountable for patient care and occupational therapy outcomes under his clinical supervision.

2. An occupational therapist shall not delegate the discretionary aspects of the initial assessment, evaluation or development of a treatment plan for a patient nor shall he delegate any task requiring a clinical decision or the knowledge, skills, and judgment of a licensed occupational therapist.

3. Delegation shall only be made if, in the judgment of the occupational therapist, the task or procedures do not require the exercise of professional judgment, can be properly and safely performed by an appropriately trained occupational therapy assistant, and the delegation does not jeopardize the health or safety of the patient.

4. Delegated tasks or procedures shall be communicated to an occupational therapy assistant on a patient-specific basis with clear, specific instructions for performance of activities, potential complications, and expected results.

B. The frequency, methods, and content of supervision are dependent on the complexity of patient needs, number and diversity of patients, demonstrated competency and experience of the assistant, and the type and requirements of the practice setting. The occupational therapist providing clinical supervision shall meet with the occupational therapy assistant to review and evaluate treatment and progress of the individual patients at least once every tenth treatment session or 30 calendar days, whichever occurs first. For the purposes of this subsection, group treatment sessions shall be counted the same as individual treatment sessions.

C. An occupational therapist may provide clinical supervision for up to six occupational therapy personnel, to include no more than three occupational therapy assistants at any one time.

D. The occupational therapy assistant shall document in the patient record any aspects of the initial evaluation, treatment plan, discharge summary, or other notes on patient care performed by the assistant. The supervising occupational therapist shall countersign such documentation in the patient record at the time of the review and evaluation required in subsection B of this section.