Occupational Therapy Month: Just-Right Challenge

Occupational Therapy Month: Just-Right Challenge

Letter “j” is for the just-right challenge!

Occupational therapists are apparently masters of just-right challenges. A just-right challenge is exactly what it sounds like. It’s something that’s not too easy, nor too hard. The purpose of the just-right challenge is to give clients something that is within their current ability level. If the activity is too easy, they’ll assume we think they are incompetent and they’ll become bored and/or offended. If the activity is too hard, they may feel degraded, losing their belief in themselves to achieve what is meaningful to them.

With that in mind, it’s important to provide a just-right challenge. Not too easy. Not too hard. Somewhere in the middle. Somewhere where we can provide just enough challenge to promote continued growth in their ability.

Occupational Therapy Month: Homonymous Hemianopsia

Occupational Therapy Month: Homonymous Hemianopsia

Today is letter “h” so I get to teach you about my favorite medical term to pronounce – homonymous hemianopsia (also known as homonymous hemianopia – without the “s”).

Homonymous hemianopsia is a condition involving loss of part of the visual field. To break it down, “homonymous” means “same side”. “Hemi-” means half. “Anopsia”means “defect in the visual field”. When you put it all together you have visual field defect on the same side of each half of the eye. The lack of peripheral sight of one side of both eyes becomes problematic in many instances.

As an example and from a clinical standpoint, an individual with homonymous hemianopsia could have have a visual defect within the right side of both eyes. The individual can’t see anything on their right side unless they move their entire head to utilize the left half of the eye. In other words, they “forget” about anything on the right. An individual with homonymous hemianopsia may be observed only eating food on the left side of their plate, completing neglecting the food on the right side of the plate. They may bump into walls that they don’t notice. Cutting vegetables with a knife in the right hand and the vegetable stabilized with the left hand becomes dangerous.

Occupational therapists can help individuals with homonymous hemianopsia by teaching them compensatory techniques. OTs can teach individuals with this visual field defect to turn their head/body to scan their entire environment.

Check out the picture below to get an understanding of homonymous hemianopsia. The picture on the left represents normal sight with no visual field deficits. The picture on the right represents an individual with right-sided homonymous hemianopsia. Do you see how this could be problematic?

homonymous

Occupational Therapy Month: Gait

Occupational Therapy Month: Gait

Letter “g” is for GAIT!

From an occupational therapy standpoint, gait promotes functional mobility. For individuals who can walk, gait provides opportunities to explore the environment and complete tasks within the environment as needed.

It important to note that occupational therapists look at gait from a functional perspective. Is the individual able to ambulate to the bathroom without falling? Can they move around the kitchen to prepare a meal? Can a child ambulate from the classroom to the bus or playground? Gait assessments and gait improvements are in the realm of physical therapy, not OT; therefore, gait issues alone should be referred to PT. From a functional standpoint, OTs investigate how one’s gait affects one’s ability to complete necessary and meaningful tasks.

I leave you today with a picture of my friends walking (proper gait and all) which from a functional standpoint allowed them to get from lunch back to class.

20190411_124731

 

Occupational Therapy Month: Fieldwork

Occupational Therapy Month: Fieldwork

Conveniently, letter “f” falls on the last day of my first Level I fieldwork placement. To celebrate, I’m posting that “f” is for fieldwork!

“Fieldwork” is the OT school term for internship, clinical, or rotation. All graduate OT programs require completion of fieldwork placements in compliance with ACOTE (Accreditation Council for Occupational Therapy Education). Fieldwork placements provide students with the opportunity to go out into the a variety of settings to work with or alongside a fieldwork educator to apply what is being taught in the classroom. Fieldwork grants students the opportunity to experience application of occupational therapy in real life settings with clients.

Over the course of my time in the Master’s program at my grad school, I must complete four Level I placements and two Level II placements. For my Level I placements, I will have the opportunity to see occupational therapy practice with pediatrics, adults, older adults, and the mental health population. Level I placements, at my grad school specifically, take place in my second, third and fourth semesters once per week for 10 weeks (disclaimer: every OT program does their scheduling differently). As a student, Level I fieldwork placements involve a lot of observation and trying to connect what was taught in the classroom with what is seen in practice. During these placements, very little, if any, hands-on practice occurs because we are still in the process of learning everything we need to know.

After my academic classes are done (spring 2020), I will begin my Level II fieldwork placements. Level II placements take place five days per week for 12 weeks. For my graduate program, my first Level II placement will occur in the summer (of 2020), followed by my second Level II placement in the fall (of 2020). Level II placements can occur with any population within any setting. At this time, students are expected to competent in completing evaluations, creating interventions, and implementing clinical reasoning skills; therefore, hands-on practice occurs throughout the entire placement. Additionally, we are technically working under our fieldwork educator’s license.

In some instances, emerging fieldwork placements can occur. Just as the term depicts, “emerging” means that these placements are at locations that don’t yet have an OT but would benefit from having an OT hopefully in the future. With emerging placements, fieldwork educators could be facility directors, teachers, or other health professionals. Emerging placements help to advocate for our role in non-traditional OT settings.

I have just completed my first Level I fieldwork placement in a pediatric setting. I feel like the past 10 weeks have flown by and I have most definitely learned a lot from my experiences and opportunities. I am excited to learn where my next placement will be as I am most interested in working with adults or older adults in the future.

OT Chronicles Chapter 3: Observation Hours

OT Chronicles Chapter 3: Observation Hours

Observation hours are a typical requirement for applying to OT grad school.  Observations are beneficial for several reasons!  This is a great time to explore the field of occupational therapy.  It is a great time to learn if the career is a right fit for you.  Lastly, it is a wonderful time to start making connections with occupational therapists in your area.  You might find it overwhelming at first to lock down observation sites, but, with persistence, you can succeed!  I’ve organized this post into before, during, and after segments.. enjoy!

Preparing for Observations

I Googled occupational therapy services in a variety of settings and populations.  I Googled nearby schools, rehab centers, hospitals, assisted living communities, and nursing facilities.  I made an organized list of locations and contact information to start reaching out to occupational therapists.

My list was quite long; however, some sites didn’t have availability for observations and some sites required you to become a volunteer before attending observations (which included orientations, medical protocol, and the occasional fees).

It is probably in your best interest, especially if you are working part-time or are a current student, to avoid locations that require you to become a volunteer first.  This can be time-consuming and unnecessarily stressful.  I am not discouraging sites that require this particular protocol; however, personally, knowing that I would only be logging a few hours at such sites wasn’t worth the reward.  Instead, I found sites that welcomed me as I was – someone simply interested in becoming an occupational therapy student!

Plan to do more observation hours than what is required by the school you are applying to.  I personally logged over 60 hours at 7 different sites.  This provided me with so much time to learn and experience what each setting/population had to offer in the field of OT.  Added bonus: schools love seeing that you put in more time than you were required to complete!

When in contact with the OT you will be shadowing, there are several things you should verify prior to the observation date(s):

  • Observation Hour Totals:  Make sure to tell the OT you contacted how many hours you are interested in logging with them so they can provide appropriate dates/times for you to observe.
  • Dates/time: Some places offered full-day observations, some offered half-day observations.  Write down which day(s) you’re observing, when to arrive, and when you’ll be leaving so you know if you need to bring lunch/snacks.
  • Contact Person upon Arrival:  Some OTs you contact will be the OT you observe.  Some OTs you contact will send you off with a fellow colleague to observe them.  Make sure you know who to ask for when you get to your observation site.
  • Dress code: Most of the places I observed at wanted me to dress in business casual attire.  Make sure you ask what the dress code is because every site is different!

Always plan to arrive early to the observation site.  This gives you time to find parking, locate the entrance, and relax before heading inside.

During Observations

You’ve walked into the observation site.  Now what?!

Remember this: You are there to observe.  You are there to learn.  You are there to experience what OTs do everyday.

Allow the OT to do their job while they are with a patient.  Some OTs will walk you through each step of what they are doing and why they are doing it.  Other OTs will let you observe and then debrief you later.  Save your inquiries until treatment is over, unless the OT is providing an environment of open-communication.

I really enjoyed asking OTs about their educational background, their experiences in various OT settings, their experiences in the OT setting they are currently working in, and why they chose OT as their life-long profession.  Doing so created a relationship for broader learning.

In some settings, you will also get to interact with patients.  Some patients will tell you their stories openly.  If the OT opens this gate of communication for you, dive in!  Ask them what they’ve experienced so far through their OT treatment.  Observations are a great opportunity to experience therapy with both the OT and the patient.

If the opportunity arises, observe other colleagues who are therapists too.  I learned a lot about speech therapists and PTs while I was with OTs.  It was really eye-opening to see how all the therapists worked together.  Feel free to ask them therapy-related questions too!  Remember, you’re there to learn – soak it all in!

Before departing from the observation site, make sure to thank the OT or verify future dates/times you will be observing them.  This affirms the relationship you built with them and establishes gratitude in allowing you to be their shadow all day long.

After Observations

When your time at each observation site is complete, I found it very useful to take notes on my experiences.  I wrote down the name(s) of the OT(s) that I observed.  I wrote down what I observed in great detail.  I explained some of the challenges patients were facing and how the OT was striving to improve their success.

I also wrote down what I enjoyed about the setting and what I was unsure about.  Some settings I enjoyed way more than others!  Some settings were so educational that I can still remember what I learned from each OT.  Some settings I felt were limited by the OT’s enthusiasm to provide me with a strong educational experience.  However, some OTs made a lasting impact on my personal professional goals.

Below, I’ve created a list of the types of settings I observed at, the population I observed, how many hours I observed there, and a brief summary of what I experienced.  My observation journal is very detailed so I will do my best to provide a brief synopsis.

  • developmental center for children with developmental disorders:
    • Population: children with autism, Down Syndrome, and other learning disabilities
    • OT’s role in treatment: improvements on fine motor skills (i.e writing, use of scissors, learning shapes, working zippers) and gross motor skills (i.e coordination)
    • Priorities in this setting: classroom function, improving social skills, improving communication, improvements on age-appropriate independent activities
    • Total Observation Hours: 6.5 hours (one day)
  • hand therapy in out-patient rehab & adult day care:
    • Population: adults, geriatrics
    • OT’s role in treatment: fine motor skills via hand therapy, care for chronic pain, coordination
    • Priorities in this setting: ease symptoms of chronic pain via stretching & massage, improve ability to complete tasks independently
    • Total Observation Hours: 8.5 hours (2 days)
  • adult day care:
    • Population: geriatrics
    • OT’s role in treatment: pain management, memory testing/function
    • Priorities in this setting: ease symptoms of chronic pain via heat, massage, and stretching; evaluate memory function for potential return-to-home patients
    • Total Observation Hours: 9 hours (3 days)
  • skilled nursing facility (SNF):
    • Population: geriatrics, adults with psychological disorders
    • OT’s role in treatment: teaching ADL safety, memory/cognition treatments, fine & gross motor skills
    • Priorities in this setting: promote independence, maintain current memory/cognition functions, develop social skills
    • Total Observation Hours: 7.25 hours (1 day)
    • Special note: I observed a traveling therapist at this location who had ample experience in a variety of settings/populations.  Traveling therapy was intriguing to me and her past OT experiences were very informative.  I also observed a COTA who taught me that “everything is OT”.  I couldn’t agree more with her!
  • hand therapy in out-patient rehab:
    • Population: adults of various ages
    • OT’s role in treatment: fine motor skills, return-to-work skills, pain management
    • Priorities in this setting: strengthen fingers, wrist, and lower arm post-surgery/injury so that patients can return to work or their day-to-day activities
    • Total Observation Hours: 10 hours (2 days)
  • acute rehab
    • Population: adults of various ages
    • OT’s role in treatment: ADLs, use of adaptive equipment
    • Priorities in this setting: promote independence, transition from hospital to rehab to home
    • Total Observation Hours: 12 hours (2 days)
    • Special note:  This was actually my favorite setting because each patient was different; the OTs used different treatment plans for every patient because every patient needed something different before (hopefully) going home!
  • school/developmental center:
    • Population: children & young adults (with cerebral palsy and and other physical or developmental disorders)
    • OT’s role in treatment: adaptive classroom learning, promote communication with or without adaptive equipment, fine motor skills, gross motor skills, enhance appropriate social skills
    • Priorities in this setting: promote communication, teach play, teach classroom skills, teach behavioral skills
    • Total Observation Hours: 9 hours (2 days)

There you go!  Observation sites 101!  I hope that wherever you go or wherever you’ve been to observe has been a positive experience for you.  I am grateful for the locations I observed at and the OTs that took the time out of their hectic schedules to teach me what OT is all about!  Observing them just affirmed that this is indeed the right profession for me!

OT Chronicles Chapter 2: Applying to OT grad school(s)

OT Chronicles Chapter 2: Applying to OT grad school(s)

To begin, I will be 100% honest about applying to grad school – it’s stressful.  It will test your ability to make decisions.  It will test your creativity and determination.  It will test your patience.  But, it’s all minute stress compared to the imminent stress that grad school itself will bring.

Below are some tips, tricks, and insights to applying to grad school for a MSOT program.

Step 1:  Do your research.

When you start looking for grad schools offering MSOT programs there’s a lot to take into consideration.  Where do you want to go to school?  Will you commute or live on/near campus?  What kind of program does each school offer?  Is it a full-time, standard program?  Is it a weekend-hybrid program?  Does the school require you to take the GRE?  What are the pre-requisites required to apply to the program?  Do they have a supplemental application in addition to the OTCAS application?  Attend graduate open houses or program information sessions for the schools you are interested in applying to.  Do your research, take notes, and write down any important dates and deadlines.

Step 2:  Get ahead on application pre-requisites and other requirements

Make sure you have fulfilled all of the course pre-requisites to apply to the MSOT you are interested in.  Most pre-requisite requirements include some form of anatomy & physiology, psychology, sociology, lifespan development, and statistics.  Check the website for the program you are interested in so that you know exactly what courses you need to be considered for the program.

Also, begin researching potential locations for observation hours in the OT setting.  It would be in your best interest to chose a variety of settings and populations.  This will strengthen your application and give you irreplaceable observation experiences in the field of OT.  Contact the OT departments of each location you are interested in, explain your process of applying to grad schools, and tell them what days/times you are available to observe.  Ask about dress code expectations, where to park and enter the building, and who you will be shadowing.  (I will create a separate blog post in the future with my personal observation experiences)

Step 3:  Understanding OTCAS

OTCAS is the common app specifically for OT schools.  Make sure you check application release dates as you won’t be able to start this application until OTCAS opens their applications.  Once the application opens, start working on it.  There are multiple sections to fill out with educational & work history and other personal experiences.  You will need to have all of your undergraduate transcripts sent to OTCAS.  You will need letters of recommendation from multiple professionals involved in your educational, athletic, or professional background.

The OTCAS process is lengthy and can be very time-consuming.  It’s best to start the OTCAS process early so that you don’t feel panicked about deadlines.  You will discover that some parts of the OTCAS application are completely out of your control.  Be patient, remain persistent and attentive, and stay alert to things that are time-sensitive.  Before submitting your OTCAS application, make sure to review all of the information you’ve provided to make sure you aren’t missing any information that could strengthen your application.

Step 4:  Check for supplemental applications

Some MSOT programs have their own supplemental application.  Be diligent when researching schools so that you know which schools have a supplemental application and which ones do not.  Programs typically don’t release their individualized application until many weeks/months after the OTCAS application has been released so, once again, be attentive to when applications become available.

Make sure you follow all instructions and requirements needed in the supplemental application.  As always, proofread EVERYTHING before you submit your application.

Step 5:  Organize follow-up dates

Most schools provide the estimated time of application response on their websites and/or applications.  Some schools admit students on a rolling basis (first come, first served so get those applications submitted ASAP!) while other schools do not start considering applications until after the posted deadline.  To minimize admittance/declination anxiety, write down expected response dates.  This will help maintain relative sanity while you wait.  During this time, the applications are completely out of your control.  Have faith in the applications you have submitted.  After all, all you can truly do is wait.

Step 6:  Admittance/Waitlisted/Declination

Depending on the response from each school, you may or may not have follow-up steps to complete.  If you are declined from a school (and I assure you that it will happen), try not to panic.  MSOT programs are extremely competitive.  Accept that you tried your best and evaluate what may have been any weaknesses in your application (for me, it was my GRE scores).  If at first you don’t succeed, try, try, again.  Don’t give up on a goal; just work harder to achieve it – even if that means completing the application process again.

If you are waitlisted, all you can do is wait to hear back from them.  They should explain in the waitlist letter/email when to expect further communication; however, each school has a slightly different process.  Make sure to read all correspondence thoroughly!

If you are accepted to a school, they will provide follow-up steps moving forward.  This most likely includes either A) sending a deposit to guarantee your spot in the program or B) scheduling an interview for the continuation of the application process.

Step 7 (varies by school/individual):  Deposit and/or taking the next step

Personally, I was declined by the first school I heard from.  I panicked.  I doubted my worth.  I was fearful.  All I could do was wait to hear from the other two schools.  I was also waitlisted by the fourth school I heard from.  All I can say is trust that God has a plan for you.

I was accepted by the second school I heard from; however, it was my last choice on my list of school preferences.  This particular school needed a deposit within a month’s time of acceptance (basically by mid-January).  Unfortunately, I would not hear from the other two schools until AT LEAST early/mid February.  I weighed my options, wasn’t willing to take a risk, and decided to pay the deposit even before hearing from the final two schools.  So, I bit the bullet and sent in a very pricey deposit.

Deposits might be one of many challenges you’ll face during the application process.  All schools have different timelines.  Make sure you have money saved away to pay these deposits.  I erred on the side of caution by putting a deposit down on a school I wasn’t fully interested in attending.  I wanted a Plan B in place in case Plan A didn’t work.

Step 8 (varies by school/individual):  Interview

A few weeks after sending in a deposit, I heard from my top choice school who offered an interview – the final step in their application process.  My interview was scheduled for mid/late February.  They sent a webinar we were required to watch leading up to the interview day.  This explained everything we needed to know for the interview itself.

I spent the week leading up to the interview preparing.  This entailed reviewing notes on the observation hours I had completed and being mindful of my decision to apply to grad school in the first place.

Leading up to my interview I spent a lot of time writing.  I wrote about why I wanted to become an OT, what I learned about the OT profession through research and observation, what I admired about the OTs I observed, what I learned from the OTs I observed, and what drove me to seek this particular profession.  It was a mental refresher for me to visualize myself learning more and more about this career path.

Pick out a professional outfit, know where to meet for the interview process, what time to arrive, and what to expect during the final stage of the application process.  Take notes, plan ahead, arrive early, and remember to breathe.

For my personal interview experience, we had a group meeting with faculty who presented an overview of the program, completed a timed essay section that tested our ability to think on the spot, and had an individual interview with two faculty members.

Be human during the interview.  Talk with understanding, speak with confidence, listen attentively, and answer every question with your heart.  Don’t go into the interview with memorized answers that make you sound like a robot.  The interviewers are humans that want to speak with a human.  Always arrive to the interview with questions for the faculty and before departing thank them for their time.  Remember….be human.

Step 8: the end of the application process

There isn’t usually anything to do after the interview.  The interview is the pinnacle.  Waiting to hear back from schools can be painstakingly slow.  I assure you that they will contact you when everything has been reviewed.  When you hear back from a school after an interview, follow step 6 or 7.

Be excited for the schools that have offered you a spot in their competitive program.  Don’t be afraid to brag about it and be excited about it!  Call friends and family about it!  Celebrate it.

The application process is just the beginning.  It is lengthy.  It will test your patience and determination.  It will force you to face your weakness.  However, it will also force you to display your strengths.

Work hard for what you want in life.  Be passionate about things that give you hope for your future.  Work persistently and with determination towards the things that give you purpose.  Be mindful and grateful always for the opportunity for learning.

If you can get through the application process, you’re on a path to better things.

OT Chronicles Chapter 1: What is OT?

OT Chronicles Chapter 1: What is OT?

As I am patiently waiting for grad school to start in September, I have decided to document my occupational therapy (OT) journey.  By doing so, I hope to help anyone looking into OT as a career.  I am starting “OT Chronicles” in the midst of Occupational Therapy Month (April) to advocate for the field of OT and to share my experiences with potential future OT professionals.

Disclaimer:  Let it be known that “OT Chronicles” is meant to enlighten and share my current knowledge of the OT profession.  Not every question regarding OT will be answered within these posts; however, I hope to enlighten whomever reads them to advocate for and teach others about this wonderful profession!  Let’s begin with the basics!

What is Occupational Therapy?

Without quoting any direct sources, occupational therapy is branch of therapy that aims to assist individuals of all ages engage in activities (occupations) that they both want and need to engage in.  Such occupations can be functional-based for successful living (i.e. showering, cooking, working, cleaning, caring for others, medication management, etc) or recreational (engaging in games/sports, age-based socialization skills, gardening, etc).  Occupational therapy is a goal-oriented career field that helps individuals adapt to their environments so that they can accomplish what they need to do and what they want to do.

Who do OTs provide therapy to?

OTs work with populations throughout the entire lifespan.  Children, adults, and the geriatric population can all benefit from OT when a therapy need arises.

Where do OTs work?

You can find OTs working in early intervention programs (children birth to 3 years old), schools, in-patient and out-patient rehabilitation centers, senior living communities, skilled nursing facilities, or hospitals.  OTs can also provide home health services.  OTs can also have a career as a traveling therapist which provides an opportunity to continuously work in a variety of environments.  The occupational therapy field provides a broad array of settings allowing for a variety of skill sets, environment preferences, and population preferences.

OT through the Lifespan:

Children with developmental disorders, behavioral issues, or cognitives or physical delays oftentimes work with occupational therapists through early intervention or in a school environment.  OTs working with children typically focus on fine and gross motor skills, communication skills, self-care, and learning how to play/interact with others.

OTs work with adults who have experienced severe injuries, who are recovering from surgery, and who have chronic diseases, mental or physical disabilities, eating disorders, the list is lengthy.  OTs working with adults typically focus on activities of daily living (ADLs) skills, return-to-work skills (when applicable), social skills, engaging in individualized meaningful activities, and the use of adaptive skills for safe and effective occupations.

OTs who work with the geriatric population typically work with individuals who have experienced severe injuries, who are recovering from surgery, who have chronic diseases or physical disabilities, or who are experiencing cognitive/memory loss.  OTs working with geriatrics focus on accomplishing ADLS, maintaining or improving levels of independence, engaging in self-care, maintaining cognitive abilities and memory, and engaging in meaningful activities important to the individual.

Why choose OT as a career?

Everyone has a different reason they decided to become an occupational therapist.  I’m not going to share all of those different reasons with you today; however, I will share with you my reason for pursuing OT.  I hosted a balance workshop during my short stint at a fitness center.  I began researching creative exercises for improving balance and I came across several videos involving OTs. BAM!  The field of occupational therapy was nearly jumping out of the computer screen at me!

At the time of this balance workshop, I was feeling shorted for a dead-end career path.  I knew I needed something more.  After researching the field of OT, I discovered how much OT matched with my functional approach to exercises, my desire for a career with endless opportunities for compassion, and my personal ambition to make a difference in the lives of individuals I interact with.  Occupational therapy seemed like a perfect match for me.

So, with that being said, I resigned from my job at the fitness center and put all of my energy towards learning more about OT, applying to grad school, and pursuing the field of occupational therapy.

Here I am now, 5 months away from starting grad school.  I’ve written my 1st ever blog post for “OT Chronicles” & hopefully I’ve enlightened the people who thought that occupational therapists just help people find jobs.  Wrong, very wrong….. stay tuned for more chapters of “OT Chronicles”!