Canadian Association of Occupational Therapists | Association ... … · 1993 with occupational...

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Table of Contents2 In Memoriam

3 Introducing the new guidelines - Enabling Occupation II: Advancing an Occupational TherapyVision for Health,Well-being, & Justice through OccupationJanet Craik, Elizabeth Townsend and Helene Polatajko

6 The third edition of the Profile of Occupational Therapy Practice in Canada: A new tool to defineand strengthen our professional identityClaudia von Zweck

9 Joint Position Statement on Diversity

12 TELE-OCCUPATIONAL THERAPYVirtual rehabilitation with video games: A new frontier for occupational therapyJonathan Halton

15 Coming June 11, 2008 in Whitehorse, Yukon where the adventure awaits! Pre-conference workshops at the CAOT conferenceJanet Craik

17 WATCH YOUR PRACTICEEleven steps to improve data collection: Guidelines for a retrospective medical record reviewLisa Engel, Courtney Henderson and Angela Colantonio

21 OT THEN Collecting occupational therapy stories enriches retirement for Catherine BrackleyLynn Cockburn

23 PRIVATE PRACTICE INSIGHTSMeet Tricia Morrison – Occupational therapist, business owner, mentor, researcher, wife and motherErica Lyle

25 Highlights from the November 2007 CAOT Board meetingErica Lyle

26 Welcoming new staff to CAOTErica Lyle

27 Update from the Canadian Occupational Therapy Foundation

28 Canadian Association of Occupational Therapy endorsed courses

january/february 2008 • VOLUME 10 • 1

ISSN: 1481-5532 CANADA POST AGREEMENT #40034418

Occupational Therapy Now is published 6 times a year (bimonthly beginning with January) by the

Canadian Association of Occupational Therapists (CAOT).

MANAGING EDITORFern Swedlove, BScOT, Diploma in Communications

Tel./Fax. (204) 453-2835 (MB) E-mail: [email protected]

Assistant Editor: Alex Merrill

TRANSLATIONDe Shakespeare à Molière, Services de traduction

DESIGN & LAYOUTJAR Creative

ON-LINE KEY WORD EDITORKathleen Raum

CAOT EDITORIAL BOARDChair: Anita Unruh

Members: Emily Etcheverry, Mary Forham, April Furlong,Stephanie Koegler & Catherine Vallée

Ex-officio: Marcia Finlayson & Fern Swedlove

COLUMN EDITORSCritically Appraised Papers

Lori Letts, PhD

International ConnectionsSandra Bressler, MEd

In Touch with Assistive TechnologyRoselle Adler, BScOT & Josée Séguin, MSc

OT ThenSue Baptiste, MHSc

Private Practice InsightsLorian Kennedy, MScOT

Sense of DoingHelene J. Polatajko, PhD & Jane A. Davis, MSc

Tele-occupational TherapyLili Liu, PhD & Masako Miyazaki, PhD

Theory Meets PracticeHeidi Cramm, MSc

Watch Your PracticeSandra Hobson, MAEd

occupational therapy now volume 10.12

Statements made in contributions toOccupational Therapy Now (OT Now) are made solely on the responsibility ofthe author and unless so stated do notreflect the official position of CAOT, andCAOT assumes no responsibility forsuch statements. OT Now encouragesdialogue on issues affecting occupa-tional therapists and welcomes yourparticipation.

EDITORIAL RIGHTS RESERVEDAcceptance of advertisements does notimply endorsement by OT Now nor bythe CAOT.

CAOT PATRONHer Excellency the Right Honourable Michaëlle Jean C.C., C.M.M., C.O.M., C.D.Governor General of Canada

CAOT PRESIDENTSusan Forwell, PhD

CAOT EXECUTIVE DIRECTORClaudia von Zweck, PhD

RETURN UNDELIVERABLECANADIAN ADDRESSES TO:CAOT – CTTC Building3400 – 1125 Colonel By Drive Ottawa,Ontario KIS 5R1 CANE-mail: [email protected]

INDEXINGOT Now is indexed by: CINAHL, ProQuestand OTDBase.

ADVERTISINGLisa Sheehan (613) 523-2268, ext. 232E-mail: [email protected]

SUBSCRIPTIONSLinda Charney (613) 523-2268, ext. 242E-mail: [email protected]

COPYRIGHTCopyright of OT Now is held by theCAOT. Permission must be obtained inwriting from CAOT to photocopy, repro-duce or reprint any material publishedin the magazine unless otherwisenoted. There is a per page, per table orfigure charge for commercial use.Individual members of CAOT or ACOTUPhave permission to photocopy up to 100copies of an article if such copies are dis-tributed without charge for educationalor consumer information purposes.

Copyright requests may be sent to:Lisa SheehanE-mail: [email protected]

In Memoriam

Betty Baird EatonSt.John's, Newfoundland – September, 2007

Joy BassettDuncan, British Columbia – September, 2007

Jeanne FosterMississauga, Ontario – December, 2006

On the cover – The image, a creation of the authors with the assistance of a graphic artist, represents enablement of a worldof occupations. The globe is to suggest a world, the puzzle pieces on the surface of the globe are there to sug-gest that the occupational world is comprised of all manner of occupations.

The hands suggest both doing - as in the doing of occupations - and enabling - as in helping to mak-ing the doing possible. The arrows wrapping around the globe, borrowed from the Client Model of Client-Centred Enablement, suggest the interaction of therapist and client interacting in an enablement process.

Thank you to Helene Polatajko and Elizabeth Townsend for providing this description.

Occupational Therapy Thesis Database

Any occupational therapist who has completed a Master’s or PhD thesis is invited to provide us with information regarding your thesis to be entered into the OT EducationFinder. Please contact [email protected] for more information.


At the annual Canadian Association of OccupationalTherapists (CAOT) conference in St. John’s,Newfoundland and Labrador, the CanadianAssociation of Occupational Therapists (CAOT)launched Canada’s latest guidelines, EnablingOccupation II: Advancing an Occupational TherapyVision for Health, Well-being, & Justice throughOccupation. In October 2007, the Australian launch of these important new guidelines was organized byDr. Gail Whiteford of Charles Sturt University with theCanadian High Commissioner to Australia in atten-dance. Throughout this year, you will be presentedwith a series of articles in OT Now to provide you withinformation on how these guidelines can enhanceyour occupational therapy; a practice described asone “dedicated to enabling all people to be engaged inmeaningful occupation and to participate as fully aspossible in society (Townsend & Polatajko, 2007, p. 2).”

In this, the first of the series of articles onEnabling Occupation II, we will tell you about theguidelines creation and format. The subsequent arti-cles will introduce some of the specialized languageand new models and will provide highlights ofbehind the scenes stories regarding the guideline’spublication.

Canada’s latest guidelines provide are a companion document to Enabling Occupation: AnOccupational Therapy Perspective (CAOT 1997; 2002)reflecting the growth and development of the profes-sion’s knowledge in occupation-based, evidence-based and client-centred practice. In this article wewill journey back in time and present the steps andstages that produced these new guidelines, acknowl-edge some of the many people involved and summa-rize what you will find in Enabling Occupation II:Advancing an Occupational Therapy Vision for Health,Well-being, & Justice through Occupation.

Impetus for Enabling Occupation llIn 2004, the vision for Enabling Occupation IIemerged when CAOT decided to support a new gen-eration of guidelines to start off the 21st century. Forthe next 3 1/2 years CAOT actively engaged in theprocess of developing a publication to complementprevious CAOT documents and provide a vision forthe future of occupational therapy practice, educa-

tion and research inCanada. During the 1980s,CAOT’s mission was toarticulate the conceptualgrounding, processes andoutcomes of occupationaltherapy in Canada, and alsoto produce a series ofguideline documents in col-laboration with a Federalguidelines program forhealth professions(Department of NationalHealth and Welfare & CAOT1983, 1986, 1987; CAOT, 1991, 1993). The first three pub-lications were consolidated in 1991 and expanded in1993 with occupational therapy guidelines for mentalhealth practice. Enabling Occupation: An OccupationalTherapy Perspective was launched in 1997 and updat-ed in the 2002 with a new preface. As the eighthlandmark publication in Canada’s practice guidelinesseries, Enabling Occupation ll marks almost 25 yearsof advancing an occupational therapy vision, models,processes and outcome evaluation focused on occu-pation-based, client-centred practice.

As with previous guidelines, EnablingOccupation (1997; 2002) has been a core text forCanadian occupational therapy education curricula.Practitioners have reported using the publication tohelp guide the development of documentation proto-cols and practice policies. Not only has this book soldwell across Canada, it has had a considerable impactinternationally and is available in French, Danish andRussian.

Since 2002, key points of critique have beenraised and changes have occurred in the context ofoccupational therapy practice. As well, an increasedemphasis on evidence and accountability hasemerged as have new language and models of health.These and related factors were the impetus to move

Introducing the new guidelines - Enabling Occupation II:Advancing an Occupational Therapy Vision forHealth,Well-being, & Justice through Occupation

Janet Craik, Elizabeth Townsend and Helene Polatajko

“Enabling Occupation ll marks almost 25 years of advanc-ing an occupational therapy vision, models, processes andoutcome evaluation focused on occupation-based, client-centred practice.”

forward with new guidelines. Hence EnablingOccupations II was born.

Writing Enabling Occupation llA unique national consultation process was estab-lished to create Enabling Occupation II. Invited byCAOT to lead the process, two primary authors,

Elizabeth Townsend and HelenePolatajko, worked with the assis-tance of a project manager,Janet Craik. Guided by an 11member National AdvisoryPanel, the two primary authors,worked with 61 contributingauthors to create a coherent andcomprehensive document toguide the wide scope ofCanadian occupational therapypractice with clients, and in con-sulting, management, educa-tion, research and policy devel-opment in the private and pub-lic sectors. In addition, two CAOTteam members provided direc-tion and support, 12 reviewersraised critical reflections andeight publication team mem-bers helped to bring the book topress. A great accomplishmentwas achieved by all in an incredi-bly short time!

To ensure that the newpublication was in keeping withnational perspectives and stateof the art evidence in occupa-tional therapy, numerous consul-tative strategies were usedincluding the following:• National Advisory Panel

represented diverse areas ofpractice including clinical,management, education andresearch, various geographicregions of Canada, con-sumers of occupational ther-apy services, Health Canadaand CAOT staff.

• Invitations were accepted by 61 Canadian contributingauthors to participate as

chapter co-authors, case writers and text boxwriters

• Topic specific focus groups were held withnational and international audiences

• CAOT website provided updates • CAOT public discussion board invited input• CAOT Conference June 2006 forum invited

input• National Diversity Review offered consciousness

raising cases and text boxes • Consumer, national and international peer

review offered insights & edits• French translation/review responded to

Canada’s francophone community particularlyin Quebec

Momentum of Enabling Occupation llEnabling II is honoured to have endorsements fromtwo long standing advocates for client-centred prac-tice in occupational therapy: Mary Law wrote theforeword and Thelma Sumsion the prologue to thenew guidelines. The introduction of the publicationprovides the background and cultural context. Theguideline’s vision is “to herald an era of occupationalenablement for occupational therapists and ourclients”, and its purpose is “to honour our past, affirmour present, and profile a future that is focused onoccupation-based enablement” (Townsend &Polatajko, 2007, p.1).

The new guidelines are organized into the following four sections:

Section I Occupation: The core domain of concern for occupational therapy

Section II Enablement: The core competency of occupational therapy

Section III Occupation-based enablementSection IV Positioning occupational therapy

for leadershipEach section is a complete unit unto itself,

containing an introduction, a vision statement, a purpose, learning objectives for the reader, practiceimplications an opening case, and additional cases toillustrate points in various chapters. The publicationconcludes with an epilogue written by the primaryauthors who invite readers to reflect upon theirlearning and practice with clients in management,


“The book’s vision is to herald an era of occupationalenablement for occupational therapists and our clients.”

About the authors –Janet Craik is an occupa-tional therapist currentlyworking for CAOT as theProfessional EducationManager. Janet was theproject manager for theEnabling Occupation proj-ect and was thrilled to workcollaboratively with somany great occupationaltherapy minds on the pro-duction of this book.

Elizabeth Townsend hasbeen an author on allCanadian guidelines sincethe series started in theearly 1980s. As the firstauthor of the latestguidelines, she combinedher clinical, consulting,management, educationand research practiceexperience. It was a huge-ly invigorating process ofprofessional collaborationfor her to write the bookwith Helene Polatajko andmany of Canada’s leadingoccupational therapists,with wonderful assis-tance from Janet Craikand the CAOT office.

Helene J. Polatajko is aninternationally respectedresearcher, educator and

clinician. She has over 150publications, and has doneover 250 presentations in 13 countries, and over$6,000,000 in researchfunds. She is a Muriel DriverLecturer, a Fellow of theCanadian Association ofOccupational Therapistsand an inductee in theAcademy of Research of theAmerican OccupationalTherapy Foundation.


consulting, education or research. Enabling Occupation llalso provides a detailed index, an extensive referencelist and a comprehensive glossary of terms.

Overall the guidelines were written for occupa-tional therapists, by occupational therapists - fromfront line practitioners to consultants, administrators,policy analysts, researchers, and academics. The con-tent spans the diverse practice mosaic of occupation-al therapy providing case examples from a variety ofclient and practice contexts.

During the first six months after publication,this 418 page text has been extremely well received.All copies on hand at the CAOT conference wereimmediately sold out and 1,100 copies have been soldacross Canada and around the world in just 4months.

Dr. Gail Whiteford organized an Australianlaunch and media event in October, concurrent withher launch of a Practice Scholarship Project onEnabling Occupation II involving both Australian andCanadian occupational therapists in discussing thebook’s application in practice.

We invite your comments and questions andhope that this and future articles will spark points ofdiscussion and celebration! Your feedback is welcomeat OT Now and on the CAOT website’s public discus-sion board. We would love to hear comments on thequestion: Does the new guidelines indeed help you to“herald an era of occupational enablement for occu-pational therapists and our clients?”

Please address any questions or feedbackregarding this publication on the EnablingOccupation ll public discussion board at:

� www.caot.ca� Periodicals and Publications� Enabling Occupation� Public discussion board

ReferencesCanadian Association of Occupational Therapists. (1991).

Occupational therapy guidelines for client-centred prac-tice. Toronto, ON: CAOT Publications ACE.

Canadian Association of Occupational Therapists. (1993).Occupational therapy guidelines for client-centred men-tal health practice. Toronto, ON: CAOT Publications ACE.

Canadian Association of Occupational Therapists. (1997).Enabling occupation: An occupational therapy perspec-tive. Ottawa, ON: CAOT Publications ACE.

Canadian Association of Occupational Therapists. (2002).Enabling occupation: An occupational therapy perspec-tive (Rev. ed.). Ottawa, ON: CAOT Publications ACE.

Department of National Health and Welfare, & CanadianAssociation of Occupational Therapists. (1983).Guidelines for the client-centred practice of occupationaltherapy. Ottawa, ON: Department of National Healthand Welfare.

Department of National Health and Welfare, & CanadianAssociation of Occupational Therapists. (1986).Intervention guidelines for the client-centred practice ofoccupational therapy (Cat. H39- 100/1986E). Ottawa, ON:Author.

Department of National Health and Welfare, & CanadianAssociation of Occupational Therapists. (1987). Towardoutcomes measures in occupational therapy (Cat. H39-114/1987E). Ottawa, ON: Author.

Townsend, E. A., & Polatajko, H. J. (2007). Enabling occupation II:Advancing an occupational therapy vision for health,well-being & justice through occupation. Ottawa, ON:CAOT Publications ACE.

“Overall the book was written for occupational therapists, by occupational therapists - from front linepractitioners to consultants, administrators, policy analysts, researchers, and academics.”

L to R: Professor Gail Whiteford of Charles Sturt University, Albury, NSW,Mr. Leir, Canadian High Commissioner to Australia,

and Carol Crocker, President OT Australia

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The Canadian Association of Occupational Therapists(CAOT) is proud to introduce the third edition of theProfile of Occupational Therapy Practice in Canada.This document articulates the skills, knowledge andabilities needed to practice occupational therapy inCanada. The Profile is used for many purposes, includ-ing by CAOT for the measurement of outcomes inoccupational therapy education during academicaccreditation and the development of the certifica-tion examination blueprint. CAOT undertakes areview of this document every five years to ensurethe Profile accurately reflects occupational therapy inthe context of current practice.

The development of the third edition of theProfile involved multiple steps. Initiated in 2005, anational advisory committee with representationfrom a wide variety of stakeholder groups includingregulators, educators and practitioners oversaw thedevelopment process. The creation of the Profilebegan with a review of best practices in competencydevelopment. As a result of this review, the CanMEDsmodel, originally developed by the Royal College ofPhysicians and Surgeons in Canada was adapted for use as the Profile framework (Frank, 2005).Competencies were identified with the assistance ofthe Content Working Groups comprised of membersfrom across Canada. Validation of the completedProfile occurred in the spring of 2007 and involved asurvey of over 2000 CAOT members. Based on thefeedback received from the successful results of thisvalidation process, the Profile was published in thefall of 2007. An in-depth mapping of the validatedcompetencies with the Essential Competencies ofPractice (Association of Canadian OccupationalTherapy Regulatory Organizations [ACOTRO], 2003)was performed to ensure congruence between thetwo sets of entry-level competencies.

The development of this third edition of theProfile was purposively undertaken in conjunctionwith other CAOT projects that guide and describeoccupational therapy practice in Canada, includingthe creation of Enabling Occupation II: A Vision forHealth, Well-being and Justice Through Occupation(Townsend & Polatajko, 2007). The Profile integrates

concepts described in these initiatives to provide aninnovative approach to define our profession.Essential features of the Profile include:

1. Reflection of a broad definition of occupational therapy The Profile depicts occupational therapy as both anart and a science that has a focus of enablingengagement in occupation to promote health andwell-being (Townsend & Polatajko, 2007).Interventions are directed at the individual, group,community and population level to effectivelyaddress barriers that interfere with occupationalengagement and/or performance.

2. Acknowledgement of the diverse rolesinvolved in occupational therapy practice The Profile recognizes the wide range of requirementsof occupational therapists for today’s practice con-text. Our work demands leaders that use evidence-based processes and our complex knowledge, skillsand abilities in relation to the seven roles for occupa-tional therapists as depicted in figure one (adaptedfrom Frank, 2005):

The third edition of the Profile of Occupational TherapyPractice in Canada: A new tool to define and strengthen our professional identity

Claudia von Zweck, CAOT Executive Director


Figure One:

Occupational therapists are described as autonomous,self-regulated professionals, who individually and collectively monitor and manage their personal andprofessional limits. Occupational therapists enableeffective dynamic interactions with clients, teammembers and others about occupations, occupationalperformance and daily life, as well as about occupa-tional therapy services as communicators. As a schol-arly practitioner, reflection and quality improvementare incorporated into everyday practice. As collabora-tors, occupational therapists work effectively in teamsto enable participation in occupations by using andpromoting shared decision-making approaches. Theuse of expertise and influence to advance occupation,occupational performance and occupational engage-ment is inherent in the role of change agent. Effectiveand efficient practice is dependent upon the role ofthe practice manager to manage time, prioritize andsupport the organization of occupational therapyservices.

3. Identification and celebration of enablingoccupation as the core competency of occu-pational therapists Consistent with the Canadian Model of Client-CentredEnablement (Townsend & Polatajko, 2007), our work inoccupational therapy as an expert in enabling occupa-tion is considered the central role, expertise and com-petence of an occupational therapist. Work in this corefunction is interconnected with all other roles anddraws upon required competencies to effectively useoccupation as both a medium for action and an out-come for occupational therapy intervention.

4. Recognition of the impact of practice contextInvolvement in the seven roles depicted in figure oneis not equal, as not all roles may be part of everydaypractice. The roles required in any situation are influ-enced by and dependent on the client (i.e. individuals,groups, communities or populations) where the workis done and the client’s needs. While compatible withthe Occupational Performance Process Model (CAOT,2002), the Profile is aligned with the more genericCanadian Practice Process Framework that is relevantin a broad range of practice contexts (Townsend &Polatajko, 2007). The Profile advances an inclusive definition of the work of occupational therapists thatinvolves clinicians as well as practitioners in less tra-ditional areas of practice such as community develop-ment, research, education, administration and policy.

5. Description of competency developmentas fluid and dynamic The Profile articulates a competency continuum thatdescribes the skills, knowledge and abilities of occu-pational therapists who are competent as well asthose considered proficient. The Profile defines thecompetent occupational therapist as an individualthat meets or exceeds the minimal and ongoing per-formance expectations and demonstrates the requi-site knowledge, skills and abilities for safe and effec-tive practice of occupational therapy at the beginningof and throughout their career. Occupational thera-pists who are proficient also have the knowledge,skills and abilities of the competent practitioner butvary in how the competency is performed (i.e. ease ofperformance, professional sophistication and artistryof practice).

In the day-to-day work situation all occupationaltherapists, whether newer graduates or seasoned vet-erans, are competent. Some occupational therapistsmay have a few roles they are performing at the pro-ficient level and in rare circumstances there may bepractitioners who demonstrate all of the roles at theproficient level.

Competency development is dependent on prac-tice context, experience and opportunity for continu-ing education. For example, a researcher may becomemore proficient in the roles of scholarly practitioner,change agent, practice manager, communicator andexpert in enabling occupation (depending on thearea of research) as depicted in figure two:


Figure Two:Profile of an Occupational Therapy Researcher

6. Development of a framework for additional purposesThe Profile provides a framework that can be expand-ed to describe other practitioners in occupationaltherapy, including occupational therapists who areexperts/advanced practitioners as well as individualsworking as occupational therapy support personnel.CAOT recently completed a project to articulate a newconceptual framework for describing support person-nel competencies in relation to the Profile. The Profilealso supports inter-professional education and serv-ice as the framework was adapted from the work ofother Canadian health practitioners and utilizes common terms.

The development of the third edition of theProfile of Occupational Therapy Practice in Canadarepresents a significant step forward in how we con-ceptualize and recognize our profession. The knowl-edge, skills and abilities described in the Profile leadto a variety of career paths for occupational thera-pists that are valued and necessary for effectivelyenabling occupational justice. The Profile can serve asan excellent tool to assist occupational therapistswith career planning and development by providingthe foundation for functions such as defining job

descriptions, completing performance appraisals anddetermining compensation structures. By recognizingthe full potential of occupational therapists, theProfile offers the opportunity to strengthen our iden-tity and enable the further growth of occupationaltherapy in Canada.

ReferencesAssociation of Canadian Occupational Therapy Regulatory

Organizations (2003). Essential Competencies of Practicefor Occupational Therapists in Canada. (2nd ed.).Toronto, ON: Association of Canadian OccupationalTherapy Regulatory Organizations.

Canadian Association of Occupational Therapists. (2002).Enabling Occupation: An occupational therapy perspec-tive (Rev.ed.). Ottawa, ON: CAOT Publications ACE.

Frank, J.R. (Ed). 2005. The CanMEDS 2005 physician competencyframework. Ottawa, ON: The Royal College of Physiciansand Surgeons of Canada. Retrieved November 10, 2007from http://meds.queensu.ca/medicine/obgyn/pdf/CanMEDS2005.booklet.pdf

Townsend, E., & Polatajko, H. (2007). Enabling occupation II:Advancing an occupational therapy vision of health,well-being and justice through occupation. Ottawa, ON:CAOT Publications ACE.

Note: Profile of Occupational Therapy (Third Edition) isavailable on the CAOT website.


Call for PapersOT Now September 2008 Theme Issue on Knowledge

Deadline: March 1, 2008

In today’s health system, we are experiencing a transformation of health care into a knowledge-based activity. This theme issue of Occupational Therapy Now will examine this transformation asit relates to our field, highlighting the far-reaching implications for occupational therapists, as wellas the far-reaching benefits for consumers.

The success of our profession depends on both the generation and the application of newknowledge. Educational initiatives, knowledge translation, evidence-based practice and new tech-nologies are all potential topics for this special issue.

Submissions should consider the issue’s audience, which includes occupational thera-pists, policy makers, payers and consumers. Language should be accessible to a wide range ofreaders.

Visit www.caot.ca for further details on the 2008 OT Now theme issue on knowledge.For further information, please contact Fern Swedlove, OT Now Editor at [email protected]


This is a joint position statement of the Association ofCanadian Occupational Therapy RegulatoryOrganizations (ACOTRO), the Association of CanadianOccupational Therapy University Programs (ACOTUP), theCanadian Association of Occupational Therapists (CAOT),the Canadian Occupational Therapy Foundation (COTF)and the Professional Alliance of Canada (PAC).

Position StatementOccupational therapy is committed to promoting anequitable Canadian society and to practicing in waysthat are accessible, welcoming, meaningful and effective for people from diverse social and culturalbackgrounds. Multiple definitions of and approachesto diversity already exist; however, there is not yetconsensus within the profession about definitions or approaches. There is discussion within the occupa-tional therapy profession to identify the definition ordefinitions of diversity that most effectively move theprofession toward greater inclusion, while exploringthe consequences of adopting particular definitionsalong with attendant frameworks for action. The fiveorganizations strongly support initiatives within theprofession to examine the impact and potentialimpact of diversity on occupations; therapist-clientinteractions; occupational therapy theoretical con-cepts and models; professional culture; recruitmentand retention of university faculty, staff and students;and on effective work with students and colleagues.

Recommendations to OccupationalTherapists

1. Occupational therapists, working through theirorganizations and local communities of prac-tice, begin the discussions necessary to identifywhich definitions of diversity move the profes-sion toward greater inclusion and what frame-works for practice those definitions support.

2. Occupational therapists engage in continuingeducation to better understand the social and cultural factors that influence occupation andparticipation for individuals, families and communities.

3. Occupational therapists support one another to engage in self-reflexive1 practice, critically

examining the ways their own social and cultural background affects practice.

4. Occupational therapists who are addressing diver-sity issues through innovations in practice and/orin educational approaches document and dissem-inate those innovations for broader learning.

5. Occupational therapists employ research evidence, as well as contribute to increasing ourknowledge base, to better understand sociocul-tural2 diversity in relation to occupation, health,therapy and professional education.

6. Those who are teachers, preceptors and mentors in occupational therapy draw uponother fields as well as occupational therapyscholarship to help make clear the impact ofsociocultural factors on occupation and occupational therapy practice in Canada.

Organizational Initiatives1. Promote further discussion and debate within

the profession to enhance awareness concern-ing the relationships among occupation, healthand sociocultural status.

2. Promote and publish research and theory con-cerning the meaning of diversity and its impli-cations for occupational therapy as a profession.

3. Promote discussion, research/scholarship and ini-tiatives concerning the experiences of clients frommarginalized and dominant sociocultural groups.

4. Promote discussion, research/scholarship and initiatives concerning the experiences of thera-pists and occupational therapy students from marginalized and dominant sociocultural groups.

5. Actively support initiatives in professional practices and structures to enhance work across and within diversity.

6. Promote occupational therapy education thatcentrally attends to the impact of socioculturalfactors on clients, families and communities, aswell as on therapists and the profession.

7. Document existing sociocultural diversity within the profession to better understandwhere recruitment and retention efforts may be needed and where they are not.

Advancing excellence inoccupational therapy

Promouvoir l’excellenceen ergothérapie

Joint Position Statement on Diversity


8. Explore avenues through which the professioncan promote and contribute to initiatives thatmove toward a more equitable society for allCanadians, particularly in terms of occupationand participation.

Background1. Occupational therapy’s commitment to issues

of diversity arises from its historical roots in19th century social activism (Townsend, 1993)and its contemporary commitment to enablingoccupational participation among those whohave been disabled by organic condition,sociopolitical circumstances, economic situationand/or physical and other environments. Theprofession’s commitment to equitable practiceis evidenced in its philosophy of client-centredpractice, acknowledging that each individualcarries a unique combination of personal histo-ry, experiences, capacities, abilities, tempera-ment and spirit. Yet being client-centred alsomeans recognizing how individuals’ member-ship in sociocultural groups systematicallyaffects access to, engagement in and meaningof occupations. Socially structured differencesleave many therapists questioning how best toimplement equitable practice in an increasinglydiverse Canadian population (Lum et al., 2004).

2. In occupational therapy, diversity and culturaldifference are often treated as if synonymouswith ethnicity. Increasingly this understandingis broadening to include differences in age, abil-ity status, gender, race, ethnicity, religion, socialclass, sexual orientation, citizenship status andso on. All of these sociocultural factors influenceexperiences, opportunities, values, attitudes andbeliefs in patterned ways. Culture can be under-stood as shared spheres of experience andmeaning as well as the processes involved increating, ascribing and maintaining meaning(Iwama, 2003).

3. A range of approaches to diversity have beenput forward. Thus far, the focus has been ondeveloping awareness, knowledge and skills towork effectively with people from minority

cultural groups – in other words, finding outmore about specific cultural groups (Dillard etal., 1992). The importance of scrutinizing one’sown thoughts and actions to avoid unintention-al imposition on others and the need to inviteclients to share themselves fully by creating asafe space and time within the therapeutic relationship to explore their backgrounds, theirbeliefs, their practices and their preferences hasalso been emphasized (Kirsh, Trentham & Cole,2006). Other approaches focus more on dispari-ties between social and cultural groups, arguingthat some social groups systematically enjoyunearned powers and privileges, while othersface unearned disadvantages: here the focus ison social patterns and individual actions (andinactions) that reproduce social inequities suchas racism, classism, ablism, heterosexism,sexism and so on (Beagan & Kumas-Tan, 2006).

4. Many core concepts, values and theoreticalmodels in occupational therapy such as occupa-tional balance, autonomy, independence andchoice may not be relevant and valid across allcultures (Iwama, 2003; Hocking & Whiteford,1995). Perceptions about what constitutes well-being, the centrality of meaningful action, theimportance of balance – these may all be funda-mentally rooted in white, western, middle-classcultural values (Humphry, 1995; Iwama, 2003).

5. Evidence is lacking concerning who comprisesthe Canadian occupational therapy populationin terms of race, ethnicity, language, social classbackground, disability status, sexual orientationand religious affiliation. Without this evidence,we cannot know where recruitment and reten-tion efforts may be needed. Nor do we have ade-quate information concerning how such factorsaffect occupational therapy students or practi-tioners. Therefore, we cannot know the extentto which therapists from diverse social and cul-tural groups experience discrimination andmarginalization. We do know, however, that inone recent British study the majority of clini-cians studied did not feel that they receivedadequate education on diversity issues during





their occupational therapy studies (Chiang &Carlson, 2003).

6. Perhaps, most importantly, we lack substantialevidence concerning how clients from diversegroups (including dominant groups) experienceoccupations and occupational therapy in theCanadian context. More broadly, we needresearch concerning how members of differentsociocultural communities experience andattribute meaning to particular occupations, aswell as how occupational therapy itself is or isnot experienced as discriminatory, marginaliz-ing and/or empowering.

Endnotes1 Reflective practice means being aware of our own

experiences. Self-reflexive practice goes beyondthis to examine how even our awareness andunderstandings are themselves shaped by ourexperiences. Critical self-reflexivity meansexamining how our experiences, awarenessesand understandings are shaped by, maintainand/or alter existing social structures (Kondrat,1999).

2 The term “sociocultural” is further discussed inthe background section. It refers to those socialand cultural differences that hold social andpolitical relevance due to historical and contem-porary power relationships.

ReferencesBeagan, B.L., & Kumas-Tan, Z.O. (2006). Diversity issues in

Canadian occupational therapy: A background discus-sion paper for the profession. Unpublished manuscript.

Chiang, M., & Carlson, G. (2003). Occupational therapy in multi-cultural contexts: issues and strategies. British Journalof Occupational Therapy, 66, 559-67.

Dillard, M., Andonian, L., Flores, O., Lai, L., MacRae, A., & Shakir, M.(1992). Culturally competent occupational therapy in a

diversely populated mental health setting. AmericanJournal of Occupational Therapy, 46, 721-6.

Hocking, C., & Whiteford, G.E. (1995). Viewpoint - Multi-cultural-ism in occupational therapy: A time for reflection oncore values. Australian Occupational Therapy Journal, 42,172-175.

Humphry, R. (1995). Families who live in chronic poverty:Meeting the challenge of family centered services.American Journal of Occupational Therapy, 49, 687-693.

Iwama, M. (2003). The issue is - Toward culturally relevant epis-temologies in occupational therapy. American Journal ofOccupational Therapy, 57, 582-588.

Kirsh, B., Trentham, B., Cole, S. (2006). Diversity in occupationaltherapy: Experiences of consumers who identify them-selves as minority group members. AustralianOccupational Therapy Journal, 53, 302-313.

Kondrat, M.E. (1999). Who is the self in ‘self-aware’? Professionalself-awareness from a critical theory perspective. TheSocial Services Review, 73, 451-477.

Lum, J.M., Williams, A.P., Rappolt, S., Landry, M.D., Deber, R., &Verrier, M. (2004). Meeting the challenge of diversity:Results from the 2003 survey of occupational therapistsin Ontario. Occupational Therapy Now, 6(4), RetrievedNovember 1, 2007, from http://www.caot.ca/default.asp? pageid=1162

Townsend, E. (1993). 1993 Muriel Driver Lecture: Occupationaltherapy’s social vision. Canadian Journal ofOccupational Therapy, 60, 174-184.

Note: This Joint Position Statement on Diversity hasbeen prepared with the input of ACOTRO, ACOTUP,CAOT, COTF and PAC. The first two organizations aremade up of the representatives of the provincialoccupational therapy regulatory organizations andacademic programs, respectively, and the PAC ofprovincial professional organizations. The participa-tion of these groups represents a desire to reach abroad common understanding on this topic: it doesnot imply the explicit endorsement of each con-stituent of these consortiums. The Joint PositionStatement on Diversity Working Group approved thisjoint position statement on February 15, 2007.




Position statements are on political, ethical and social issues that impact on client welfare, the profession of occupationaltherapy or CAOT. If they are to be distributed past two years of the publication date, please contact the Director ofProfessional Practice, CAOT National Office, CTTC Building, Suite 3400, 1125 Colonel By Drive, Ottawa, ON. K1S 5R1.Tel. (613) 523-2268 or E-mail: [email protected].


As science and technology change, so do our occupa-tional therapy practice methods - this is shown notonly within our field, but also within health care.Certainly, technological advancements continuallyinfluence our current practice and occasionally theycreate new tools for intervention. Virtual rehabilita-tion is one of these areas of advancements, wherechanges have driven new and unique treatmentmethods.

Virtual rehabilitation is the use of virtual reality(VR) and virtual environments (VE) within rehabilita-tion. VR and VE can be described as a simulation ofreal world environments through a computer andexperienced through a “human-machine interface”(Holden, 2005, p. 188). Virtual rehabilitation hasreceived increasing attention from researchers andclinicians who recognize potential therapeutic bene-fits due to the immersive nature of the medium.

Benefits of virtual rehabilitationVirtual rehabilitation is able to provide a natural orreal-life environment; individuals have the opportuni-ty to forget about their surroundings and situationand focus directly on a task in the simulated environ-ment (Schultheis & Rizzo, 2001). Clinical work oftentakes place outside individuals’ normal environments- in hospitals, care centers or clinics. By facilitatingtherapy in a controlled virtual environment, we areable to offer functionally relevant and ecologicallyvalid therapy and assessment (Rizzo, 2002). Ecologicalvalidity refers to how performance in an experimen-tal context (i.e. VR) relates to and is predictive ofbehavior in the real world (Cooke, McKenna, Fleming& Darnell, 2006). In addition to immersion, there hasbeen increased interest in VR due to its motivationalnature; individuals using VR tend to have fun and arethus more motivated to continue therapy (Berger-Vachon, 2006).

Providing rehabilitation services from a distancevia technology, known as telerehabilitation, hasrecently been coupled with the world of VR (Deutsch,Lewis & Burdea, 2007). Together, these two technolo-gies have the potential to provide an alternative wayto deliver therapy services to clients in rural settings

as well as therapy home programs. A particularobstacle to recovery post discharge is for clients tocontinue with home exercises and therapy programs;researchers now see the promise of using the motiva-tional nature of VR via telerehabilitation to enhancecompliance with occupational therapy interventions(Bowman & Speier, 2006).

Challenges of virtual rehabilitationThe world of virtual rehabilitation is exciting andlooks promising, but it is not without problems. Twochallenges to the use of VR is the expensive cost ofthe systems and operation usually requires technicalexpertise (Burdea, 2003). These issues have ledresearchers and clinicians to consider more accessiblecommercial technology to provide VR therapy. Thistechnology most often comes in the form of videogame consoles, such as Microsoft Xbox and SonyPlaystation 2 (Morrow, Docan, Burdea & Merians,2006; Rand, Kizony & Weiss, 2004). Researchers haveused modified versions of these consoles to create VR-like therapy systems. The goal is to get all the benefitsof virtual rehabilitation without the cost and compli-cation of true virtual reality systems.

Introduction of the Wii game consoleNintendo released the Wii game console in NorthAmerica, November 2006. Unlike previous gamingconsoles, the Wii gaming system is based primarilyaround its wireless controller, the Wii Remote. Thecontroller is a television remote sized device that usesaccelerometers in three axes as well as an infra-redsensor bar to recognize gesturesin an environment (Newbon,2006). This technology creates avideo game system that relies onthree dimensional movements tocue real-time responses withinthe software. Previously consid-ered separate to VR, the gaming industry has now mergedinto the world of VR through thedevelopment of the Wii.

Virtual rehabilitation with videogames: A new frontier for occupational therapy

Jonathan Halton

TELE-OCCUPATIONAL THERAPY

Column Editors: Lili Liu and Masako Miyazaki

About the author –Jonathan Halton, BScOT(c)is an occupational thera-pists at the GlenroseRehabilitation Hospital,10230 111 Ave., Edmonton, ABT5G 0B7.You can contactJonathan by e-mail [email protected]


With this physical based input interacting witha video game environment, suggestions have beenmade that the Wii could be used as a therapeuticdevice in the same manner as VR devices. Facilitatedby a therapist, the movements required to play thegame have the potential to work with rehabilitatingindividuals with physical and possibly cognitiveimpairments.

The Wii has several advantages. As a commercialproduct, it has graphics and interactivity driven by acompetitive gaming industry where graphics, soundand play must be cutting edge. Furthermore, thevideo games are fun to play, which facilitates motiva-tion for therapy and in turn will influence perform-ance. The unit is affordable, with the cost of the Wiiconsole currently listed at $279 Canadian. Finally, theWii has built in networking capabilities and then haspotential to be used in telerehabilitation in the samemanner as a VR system.

Application of the Wii at the GlenroseRehabilitation HospitalOccupational therapists have begun to use the Wiiwith adults as a part of their regular treatment at theGlenrose Rehabilitation Hospital, a tertiary rehabilita-tion centre in Edmonton, Alberta. Using the principlesof activity analysis, therapists use the Wii system andthe Wii Sports software as a functional therapy task.Clients are oriented to the system and closely moni-tored by the therapist throughout the session.

Wii Sports includes five different activities: ten-nis, baseball, bowling, golf and boxing. If the playerhas difficulty operating the game, it can provide con-tinuous instruction. Each sport requires the playerrespond with specific movements to play the game.For example, movements required for the tennisgame include shoulder abduction, flexion, extension,horizontal abduction and adduction as well as elbowflexion and extension. The trunk requires movement

L to R – As part of her occupational therapy program, Eileen Beryl McManus works with occupational therapist Jonathan Halton using the Wii game console.


side-to-side and front to back. The feet can be movedand body direction switched. For those with less phys-ical function, the movements for the games can begraded, as the Wii Remote can respond to smalleramplitude movements. Clients can participate whilestanding or sitting. The therapist facilitates move-ment through verbal encouragement or by providinghands on guidance and support.

Initial responses from clients and occupationaltherapists have been positive. Clients report theyenjoy playing the Wii and work longer at therapy. Anunexpected benefit is the positive group interactionbetween clients. Clients stay in therapy session longerthan usual, engaging in social interaction and mean-ingful occupation. Some clients report that as theirfocus turned to the game, there was a less negativefocus on the affected limb.

The response from occupational therapists hasalso been positive. They report that they can continueto work on identified client-centred goals while usingthe Wii; it is not entertainment alone. According totherapists at the Glenrose, clients appear to enjoy theWii and it is a welcome occupational therapy tool.

While there have been no significant problemsor disadvantages to date, it is important to acknowl-edge potential drawbacks to the Wii system. It willbe important to develop evidence supporting thetherapeutic use of the Wii so therapists can under-stand the types of clients and conditions who expe-rience benefits. Overexertion is an important aspectto be considered; with motivation observed to behigher than conventional therapies, individuals havethe risk of harming themselves from either toomuch use or exaggerated movements within a shorttime. Therapist monitoring is essential for clientsafety.

Future directions for the WiiThe above observations support the utilization of theWii as a therapeutic occupational therapy tool. Withbenefits paralleling those of virtual rehabilitationtechnology, the low cost and intuitive nature of the

Wii make it an exciting new therapy device. However,the therapeutic effects of the Wii must be empiricallyinvestigated for an evidence-based practice. In addi-tion, the potential application of the Wii as a telere-habilitation device and for service delivery in clienthomes and in rural settings is an area worthy ofinvestigation.

Partnership between rehabilitation, engineer-ing, computing science and industry would be astrategy that brings together the necessary expertiseto examine the therapeutic benefits of and furtherdevelop VR and related technologies.

ReferencesBerger-Vachon, C. (2006). Virtual reality and disability.

Technology and Disability, 18, 163-165.Bowman, T., & Speier, J. (2006). Videoconferencing, virtual reali-

ty and home-based CIMT - Opportunities to improveaccess and compliance through telerehabilitation. 2006International Workshop on Virtual Rehabilitation, NewYork, 121-125.

Burdea, G. C. (2003). Virtual rehabilitation - Benefits and chal-lenges. Methods of Information in Medicine, 42, 519-523.

Cooke, D. M., McKenna, K., Fleming, J., & Darnell, R. (2006).Construct and ecological validity of the occupationaltherapy adult perceptual screening test (OT-APST).Scandinavian Journal of Occupational Therapy, 13, 49-61.

Deutsch, J. E., Lewis, J. A., & Burdea, G. (2007). Technical andpatient performance using a virtual reality-integratedtelerehabilitation system: Preliminary finding. IEEETransactions on Neural Systems and RehabilitationEngineering, 15, 30-35.

Holden, M. K. (2005). Virtual environments for motor rehabilita-tion: Review. Cyberpsychology and Behavior, 8, 187-211.

Newbon, B. (2006). Virtual reality: Immersion through input.6th Annual Multimedia Systems, Electronics andComputer Science, University of Southampton, UK.

Morrow, K., Docan, C., Burdea, G., & Merians, A. (2006). Low-costvirtual rehabilitation of the hand for patients post-stroke. 2006 International Workshop on VirtualRehabilitation, New York, 6-10.

Rand, D., Kizony, R., & Weiss, P. L. (2004). Virtual reality rehabilita-tion for all: Vivid GX versus Sony PlayStation II EyeToy.Proceedings of the 5th International Conference onDisability, Virtual Reality and Associated Technologies,Oxford, UK, 87-94.

Rizzo, A. (2002). Virtual reality and disability: Emergence andchallenge. Disability and Rehabilitation, 24, 567-569.

Schultheis, M. T., & Rizzo, A. A. (2001). The application of virtualreality technology in rehabilitation. RehabilitationPsychology, 46, 296-311.

“With benefits paralleling those of virtual rehabilitationtechnology, the low cost and intuitive nature of the Wiimake it an exciting new therapy device.”


The CAOT pre-conference planning committee hasbeen busy coordinating four full day pre-conferenceworkshops to be held Wednesday, June 11, 2008 inWhitehorse, Yukon. The committee used the follow-ing criteria to select the workshops:

- Relates to the conference theme: Exploring thefrontiers of occupation.

- Evidence-based, current and relevant for thediverse occupational therapy practices inCanada.

- Relates to northern health initiatives.- Appeals to an interdisciplinary audience.

While the committee received many interestingworkshop proposals, we had to carefully review eachproposal and use the selection criteria to choose fourworkshops. The 2008 pre-conference planning com-mittee is pleased to announce that the followingworkshops will be hosted this year:

1. Primary health care: A new frontier Presenter: Mary Ann McColl Mary Ann McColl is the acting director at the Centrefor Health Services and Policy Research and a professorin the Department of Community Health andEpidemiology and in the School of RehabilitationTherapy at Queen’s University. Her primary researchinterests are health services and policy, communityintegration and social support for people with disabili-ties and measurement issues in disability and rehabili-tation.

Primary health care providers, health adminis-trators, occupational therapists and other interdisci-plinary team members will explore the unique issuesof people with disabilities in primary health care andinnovative models to improve access to primaryhealth care for people with disabilities. Participantswill work collaboratively with the presenter to identi-fy models for providing service to people with disabil-ities within a primary health care model; explore thepolicy framework around primary health care inCanada; and to offer guidelines for proposing a newprogram of disability-related services to primaryhealth care providers and settings.

2. Fetal Alcohol Spectrum Disorder (FASD) –Making sense of their worldPresenters: Dorothy Schwab & Brenda FjeldstedDorothy Schwab is an occupational therapist currentlyworking at a clinic for alcohol and drug exposed chil-dren in Winnipeg as a community liaison/follow-upworker. She also works with children diagnosed withFetal Alcohol Spectrum Disorder (FASD) in a classroomsetting. Her work has been published in the book enti-tled "Living and Working with FASD".

Brenda Fjeldsted is an occupational therapistcurrently working as a member of the multidiscipli-nary team with the clinic for alcohol and drug exposedchildren in Winnipeg. Her role in the clinic is primarilyassessment of the children as part of the diagnosticprocess, as well as provision of some follow-up services.She presented at the International FASD conference inMarch, 2007.

Occupational therapists in addition to fami-lies/caregivers, teachers, educational support workers,allied health professionals, child and family workersare invited to participate in this workshop. The pres-entation will be a combination of lecture format,interactive component and sensory simulation of

Coming June 11, 2008 in Whitehorse,Yukon where the adventure awaits! Pre-conference workshops at the CAOT conference

Janet Craik, CAOT Professional Education Manager

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what an individual with FASD may experience in anoverwhelming and over stimulating environment.Participants will also learn about the new Canadiandiagnostic guidelines for FASD, the impact of this dis-ability on daily functioning and best practices for themanagement of FASD in children and adolescents.

3. Cultural safety and its impact on healthcare servicePresenter: Alison Gerlach Alison Gerlach is an occupational therapist involved ina research project to explore how traditional Lil'watvalues and beliefs influence raising a child with specialdevelopmental needs. Alison is the author of Steps inthe Right Direction: Connecting & Collaborating inEarly Intervention with Aboriginal Families andCommunities in B.C. She is currently involved in projects promoting cultural safety in Aboriginal early childhood development programs in B.C.

Aboriginal and non-Aboriginal health adminis-trators, occupational therapists and other interdisci-plinary team members as well as physicians willexplore how cultural safety impacts health profes-sionals’ clinical reasoning. This interactive workshopwill explore the nature of cultural safety in providinghealth care services in collaboration with Aboriginalpartners. A community development approach willalso be presented where trust, strengths, communityintegration and sustainability are key components.The workshop will conclude with a panel discussion

by representatives from the Yukon Council of FirstNations.

4. Recovery in mental health and addictionsfor an interdisciplinary electronic era Presenter: Carrie ClarkCarrie Clark is an advanced practice clinician and anassistant professor in the Departments of OccupationalScience and Occupational Therapy and Psychiatry atthe University of Toronto. She is the project lead for theimplementation of an electronic center-wide recoveryoriented care plan at the Centre for Addiction andMental Health in Toronto.

Health administrators, occupational therapists,interdisciplinary team members, physicians and educators will learn how to implement a recovery-oriented, interdisciplinary electronic documentationmethod in addictions and mental health. An interactive approach will be used including, smallgroup activities and demonstrations of the electronicrecord and unique electronic education tools.

If you have any questions regarding the 2008 pre-conference workshops please contact JanetCraik, Professional Education Manager [email protected].

The conference supplement that describes all conferencepapers and activities will be available February 1, 2008 onthe CAOT website.

Are you interested in becoming involved in the PrivatePractice Insights column published in OT now?

Recruitment is now taking place for a co-editor for the column. Working withLorian Kennedy, this would provide an opportunity to develop articles for thecolumn as well as review submitted articles. You can contact Lorian Kennedy [email protected] or Fern Swedlove, OT Now editor at [email protected] forfurther information.


A medical chart or medical record review (MRR) is adata collection method used in occupational therapyclinical and research practice. Clinically, a MRR is oftenutilized for quality assessment and performanceanalysis, and in research it may be employed to col-lect retrospective data. However, issues have beenraised concerning the feasibility, validity and reliabili-ty of a MRR (Luck, Peabody, Dresselhaus, Lee, &Glassman, 2000; Peabody, Luck, Glassman,Dresselhaus, & Lee, 2000; Wu & Ashton, 1997) andthere is a lack of literature summarizing best practicefor the development, planning and methodology of aMMR (Allison et al., 2000; Eder, Fullerton, Benroth, &Lindsay, 2005). While creating a MRR for a researchproject concerning work-related traumatic braininjury, the intricacies and complexities of this methodof data collection became apparent. Developingguidelines helped to improve the reliability and utili-ty of this project. The purpose of this article is to out-line 11 current guidelines for utilizing a MRR as a datacollection method.

Guidelines for completing a MRR

1. Define the research questionAll research projects should start with a question tohelp clarify and focus what information one wants toaccrue (Panacek, 1997; Portney & Watkins, 2000;Schwartz & Panacek, 1996). Knowing one’s questionhelps inform the other components of the MRR.Further in this article the components of the MMRwill be explained.

2. Understand the data source Not all data sources are optimal for a MRR (Allison etal., 2000; Eder et al., 2005; Schwartz & Panacek, 1996).One needs to know if the information required toanswer the research question is (a) available in therecord, (b) consistently available in all of the charts, (c)recorded legibly in order to facilitate abstraction, and(d) not contradictory within each chart. Thus it ishelpful to know where the information comes from,

the methods of gathering the information, as well asthe who, when and how this information is docu-mented in the chart.

3. Choose sections or areas of record/datasource to review Utilized charts may have different sections thatdescribe similar information. However, as literaturehas identified, contradictory recordings of similarinformation within each chart may emerge (Banks,1998; Eder et al., 2005; Krinsley, Gallagher, Weathers,Kutter & Kaloupek, 2003). Thus, to increase the relia-bility of the MRR it is beneficial to understand wherethese contradictions can or tend to occur (Schwartz &Panacek, 1996). Furthermore, an educated choiceabout where each variable is to be abstracted shouldbe made based on knowledge of which section tendsto report the information consistently within thedata source. All data abstractors should be expectedto collect each variable from the same designatedsection.

4. Create a standardized abstraction form/tool A standardized abstraction tool should be developedto help abstractors collect the data from the records(Schwartz & Panacek, 1996). The variables included inthe tool should relate to the research questions andobjectives. Furthermore, the format of the tool and

Eleven steps to improve data collection: Guidelines for a retrospective medical record review

Lisa Engel, Courtney Henderson and Angela Colantonio

WATCH YOUR PRACTICE

Column Editor: Sandra Hobson


wording of questions should also be considered.Questions within the standardized abstraction toolshould be synonymous with the language and timeframe used within the data source. Also the order ofthe questions within the tool should correspond to

the order of information in the chart to facilitate efficient abstraction and decrease abstractor fatigue(Allison et al., 2000; Banks, 1998).

Each chart should be assigned a project identifi-cation (ID) number in order to ensure confidentialityand the ID number, not chart or person identifyinginformation, should be indicated on each page of the

tool. Also, the ID number shouldbe indicated on the top, right-hand corner for ease of retrievalonce the tools are filed. Formsshould have an easy to read layout that uses number basedvariable choices (e.g. 0 = negative; 1 = positive), and theamount of text should be minimized. Circling or checkingoptions aids in ease of abstrac-tion versus having to fill in infor-mation. Date and time formatshould be predetermined (i.e.use of leading zeros, 24 hour versus 12 hour time, number of digits for dates), and when numbers need to be indicatedbroken lines should indicate thenumber of digits to be collectedincluding spaces for leadingzeros. Options to variablesshould be inclusive of all possi-ble options, and the investigatorshould consider whether a“missing/not noted” option isappropriate. As well, simplybecause a variable is notmentioned in a chart may not

necessarily indicate that the variable is missing. Forexample, a health professional may not report that apatient is not experiencing headaches. However, thismay not necessarily indicate that this data is missing,but rather that it was simply not recorded. In thesecases, the investigator may need to use the options of

“stated negative” and “inferred negative” to be inclu-sive of all possible responses. Please refer to the arti-cle by Nagurney et al. (2005) for further explanation.

5. Develop an abstraction manual and protocolThe investigator also needs to create an abstractionmanual to complement the abstraction tool (Allisonet al., 2000; Banks, 1998; Schwartz & Panacek, 1996).The manual should outline rules or considerations forabstraction, where to find the information, synonymsthat may impact collection, inclusion or exclusionaryvariable information, guidelines for recording thedata, as well as information regarding time frame,dependent questions and negative information.

6. Develop and provide data abstractor trainingData abstractors should have the implicit or specialized knowledge needed for a particular MRR;nonetheless, multiple abstractors will not have exact-ly the same knowledge base leading to increasedinter-abstractor variability (Schwartz & Panacek, 1996;Wu & Ashton, 1997). Also, inter-rater reliability is further decreased if data abstraction and coding isdependent on abstractors making choices or infer-ences (Wu & Ashton, 1997). If specific implicit know-ledge is required of abstractors, abstractors should bechosen based on their education and occupationalbackground. As well, abstractors should be trained in the explicit rules and standards for reviewing themedical charts (Allison et al., 2000; Wu & Ashton,1997). The content and length of training is dependenton the length and complexity of the MRR.

7. Pilot study the tool One needs to know if the tool and manual createdwill work for the data source. The best way to accomplish this is to pilot test the tool and manualbefore delving into the bigger project (Allison et al.,2000). This will clarify areas for tool and manualimprovement.

8. Listen to the opinion of the abstractorsOften the person creating the project is not the onewho is collecting the data. In such instances it is theabstractor who becomes the most familiar with theabstraction process. Therefore, it is beneficial to listento the abstractors’ opinions in order to improve theMRR (Allison et al., 2000). Abstractors can offer valuable information regarding the consistency andlegibility of the data source, the compliance of the

“The MRR is often regarded as an easy, inexpensive andquick research method.”

About the authors –Lisa Engel is currently completing her MSc inOccupational Science andOccupational Therapy atUniversity of Toronto (2007).She completed her Bachelorof Kinesiology and HealthStudies at the University of Regina (2005). Questionsregarding this article can be forwarded [email protected] Henderson is working towards completing her MSc inOccupational Science andOccupational Therapy atthe University of Toronto(2007). She completed herdegree in Human Kineticsat the University of Ottawa(2005).Angela Colantonio is aSenior Research Scientistat Toronto Rehab, where she holds the SaundersonFamily Chair in AcquiredBrain Injury Research.Dr. Colantonio is also anAssociate Professor at theUniversity of Toronto.


tool with the data source, as well as the usability andfeasibility of the created tool and manual.

9. Utilize the advice of othersIn order to create the most reliable and useful MRR,one must acknowledge that he or she can not be anexpert in all areas and should be willing to accept theadvise and guidance of other professionals, cliniciansand experts. Projects may need to rely on the knowl-edge of other professionals such as medical experts,data analysis personnel, software engineers or infor-mation technology experts (Allison et al., 2000).These people should be consulted before andthroughout a MRR project.

10. Create guidelines for abstraction processOther guidelines suggested to ensure continued reli-ability include keeping accurate records; arrangingregular research team meetings and engaging in con-tinual abstractor/abstraction monitoring, especially if

using multiple abstractors (Allison et al., 2000;Gilbert et al., 1996; Schwartz & Panacek, 1996).Abstraction can be a tedious and tiring process espe-cially if the tool is long or complex. Providing breaksin between consecutive charts can aid in limitingabstraction bias due to fatigue.

11. Perform statistical analysisLastly, it is recommended that when using multipledata abstractors inter-rater reliability should bemeasured either within a pilot study before formal

data abstraction or throughout the entire study -preferably both (Allison et al., 2000; Luck et al., 2000;Schwartz & Panacek, 1996; Yawn & Wollen, 2005).This should include qualitative observations of dis-crepancies and statistical analysis. Common statis-tics used are percent agreement, Kappa statistics andinter-class correlations (ICC) (Hunt, 1986). For furtherinformation on inter-rater reliability statistical analy-sis please refer to Hunt (1986) or Portney and Watkins(2000, chapter 26).

The key to a high-quality MRR is planning(Panacek, 1997; Wu & Ashton, 1997). However, MRR isvery project specific making a “cookbook approach” toindividual projects difficult (Allison et al., 2000, p.116).All details should be well planned before data collec-tion begins because any significant changes requirethat abstraction begin anew (Schwartz & Panacek,1996).

As a note, this review of guidelines is notexhaustive and readers are encouraged to reviewresearch methods textbooks and other readingsbefore commencing a MRR. Readings the authorsfound helpful were Allison et al.(2000), Banks (1998),Eder et al. (2005), Gilbert et al., (1996), Hess (2004),Schwartz and Panacek (1996), Worster and Haines(2004) and Wu and Ashton (1997).

The MRR is often regarded as an easy, inexpen-sive and quick research method (Allison et al., 2000;Schwartz & Panacek, 1996). However, while medicalrecords can represent a convenient and accessiblesource of data that is not available through otherresearch methods (Allison et al., 2000; Horan &Mallonee, 2003; Worster & Haines, 2004), a MRR canbe a complex and difficult process (Gilbert et al., 1996;Wu & Ashton, 1997). Researchers and cliniciansinvolved in a MRR need to appreciate the potentiallimitations and difficulties in order to address themin the design and preparation. Time and effort needto be invested to create a MRR with high quality valid-ity, reliability, and utility, and the aforementionedguidelines can be used to aid the planning of a MRR.This process, however, can also influence how medicalrecords and forms are designed in order to increasethe usability of medical records for prospective andretrospective research purposes.

Acknowledgements:The authors of this article would like to acknowledgethe research support and funding of the TorontoRehab Institute and the Ontario NeurotraumaFoundation.

Guidelines for completing a MRR

1. Define the research question2. Understand the data source3. Choose sections of data to review4. Create an abstraction tool5. Develop a manual and protocol6. Develop abstractor training7. Pilot the tool8. Listen to abstractor’s feedback9. Utilize advice

10. Create guidelines for abstraction11. Perform Statistical Analysis


ReferencesAllison, J., Wall, T., Spettell, C., Calhoun, J., Fargason, C., Kobylinski,

R. et al. (2000). The art and science of chart review. JointCommission Journal on Quality Improvement, 26(3), 115-136.

Banks, N. (1998). Designing medical record abstraction forms.International Journal of Quality in Health Care, 10(2),163-167.

Eder, C., Fullerton, J., Benroth, R., & Lindsay, S. (2005). Pragmaticstrategies that enhance the reliability of data abstract-ed from medical records. Applied Nursing Research, 18,50-54.

Gilbert, E., Lowenstein, S., Koziol-McLain, J., Barta, D., & Steiner, J.(1996). Chart reviews in emergency medicine research:Where are the methods? Annals of Emergency Medicine,27, 305-308.

Hess, D. (2004). Retrospective studies and chart reviews.Respiratory Care, 49, 1171-1174.

Horan, J., & Mallonee, S. (2003). Injury Surveillance.Epidemiologic Reviews, 25, 24-42.

Hunt, R. (1986. Percent agreement, Pearson’s correlation, andKappa as measures of inter-examiner reliability. Journalof Dental Research, 65(2), 128-130.

Krinsley, K., Gallagher, J., Weathers, F., Kutter, C., & Kaloupek, D.(2003). Consistency of retrospective reporting aboutexposure to traumatic events. Journal of TraumaticStress, 16, 399-409.

Luck, J., Peabody, J., Dresselhaus, T., Lee, M., & Glassman, P.(2000). How well does chart abstraction measure quali-ty? A prospective comparison of standardized patientswith the medical record. The American Journal ofMedicine, 108, 642-649.

Nagurney, J., Brown, D., Sane, S., Weiner, J., Wang, A., & Chang, Y.(2005). The accuracy and completeness of data collectedby prospective and retrospective methods. AcademicEmergency Medicine, 12, 884-895.

Panacek, E. (1997). Basics of research (Part 9): Practical aspects ofperforming clinical research. Air Medical Journal, 16, 19-23.

Peabody, J., Luck, J., Glassman, P., Dresselhaus, T., & Lee, M.(2000). Comparison of vignettes, standardized patients,and chart abstraction. The Journal of American MedicalAssociation, 283, 1715-1722.

Portney, L., & Watkins, M. (2000). Foundations of clinicalresearch: Applications to practice (2nd ed.). Upper SaddleRiver, NJ: Prentice Hall Health.

Schwartz, R., & Panacek, E. (1996). Basics of research (Part 7):Archival data research. Air Medical Journal, 15, 119-124.

Worster, A., & Haines, T. (2004). Advanced statistics:Understanding medical record review (MRR) studies.Academic Emergency Medicine, 11(2), 187-192.

Wu, L., & Ashton, C. (1997). Chart review: A need for reappraisal.Evaluation and Health Professions, 20(2), 146-163.

Yawn, B., & Wollan, P. (2005). Interrater reliability: Completingthe methods description in medical record reviewstudies. American Journal of Epidemiology, 16, 974-977.


During her career as an occu-pational therapist working in health promotion and com-munity settings, CatherineBrackley championed olderadults’ participation in valued,daily activities. Now in herretirement years, she hasapplied these principles toher new work writing aboutthe history of the occupationaltherapy profession in Canada.

Catherine has found thisexperience a privilege, as well as a rewarding andexciting learning opportunity.

Catherine’s own story writing about occupa-tional therapy history reflects some of her many passions. Early in her life, interest in the occupationaltherapy profession was piqued; Catherine still hasplacemats woven by her aunt at Toronto RehabCentre from when she was a client there over 50years ago. As an occupational therapist, Catherine’sprofessional work with older adults led to an interestin life stories and history. Often she found that shewas the one who encouraged other team members totake the time to understand the importance of anindividual’s life story.

While working with Canadian Association ofOccupational Therapists (CAOT) on a health promo-tion project, Catherine reviewed the roots of the association and became more committed to learningabout occupational therapy history. Around thistime, she had an older client who was an occupationaltherapist and learned about this woman’s personaland professional history. As a long-standing memberof the Toronto Guild of Spinners and Weavers,Catherine also had an interest in the correlation ofMary Black’s career as an occupational therapist toher work as a weaver. Mary Black wrote the book TheKey to Weaving: A Textbook of Hand Weaving for theBeginning Weaver, which can still be found in mostweavers’ libraries. Originally published in 1945, thisbook has been reprinted and the second edition waspublished in 1980. After she retired (for the secondtime!), Catherine had the opportunity to learn more

about Mary Black, a pioneer occupational therapistwell known in Nova Scotia. She enjoyed pouringthrough archival material, talking with others andreading Mary’s writing. Following her research, shewrote a history of Mary’s life available on the CAOTwebsite at http://www.caot.ca/default.asp?pageid=1463

Gradually, Catherine became more interested inrecording the stories of other occupational therapists.As she says: “Older people have great stories to telland why should we not get the stories of our ownprofession? My interest is that so often we are look-ing at others’ stories, and they are important … butwhy don’t we give occupational therapy some of thecredibility and recognition that it deserves? The sto-ries of the work that occupational therapists did areabsolutely fascinating!”

Catherine promotes doing historical work toother occupational therapists as a way of gettinginvolved in examining and record-ing occupational therapy historyand encourages occupationaltherapists to bring their own perspectives to collecting stories.Catherine’s involvement with history and the CAOT archivescommittee is a way for her to stayconnected with the profession.Although she did not originallyset out to collect history or writeabout it, she has found after manyyears of not enjoying writing,that the whole process is actuallyvery pleasurable. Catherine’sencouragement to others is “If I can do it, anyone can!”

These are Catherine’s tips about gettinginvolved in collecting stories and being a part of occupational therapy history making:

• Choose the occupational therapist or story that you would like to learn about, someone or something that fascinates you. Think aboutsomeone whose work you have admired orlearned from, an aspect of occupational therapythat you are passionate about or a story that

Collecting occupational therapy stories enriches retirement forCatherine Brackley

Lynn Cockburn

OT THEN

Column Editor: Sue Baptiste

About the author –Lynn Cockburn is an assis-tant professor at theDepartment ofOccupational Science andOccupational Therapy,University of Toronto. Lynnhas a keen interest in occu-pational therapy historyand has been involved inthe CAOT ArchivesCommittee and theUniversity of TorontoHistory Group.You can con-tact Lynn [email protected]

Catherine Brackley


• Pay attention to the questions that come up asyou hear the stories and keep digging deeper tolook for answers.

• If you don’t find the writing easy, don’t worryabout it. Just get it down. Accept the help of agood editor! Catherine has found through her own experi-

ence that the occupation of writing occupationaltherapy history is a very exciting process and she canhardly wait to hear the stories that will be collectedin the next few years. As an occupational therapycommunity, let us join in her enthusiasm!

needs to be told. If the individual is still alive,speak with them about your interest.

• Network! Friends and family may assist youwith your project. Don’t be shy to contact peo-ple. Most will be very helpful.

• Keep good records about what you find. Date,file and keep your information (even if it is notwell organized). Computers can be helpful, buthandwritten notes are fine.

• Look for tools that will help you. For example,the occupational therapy history group atUniversity of Toronto designed a template for aprofile which Catherine used to organize theMary Black story.

• Talk to people about how to get information –learn about sources and archives.

• Consider doing this with a friend who sharesyour interest.

Interested in writing about our occupational therapyhistory? You can write to Sue Baptiste, the columneditor for the OT Then column with your story ideasor questions. Sue’s e-mail address [email protected]


These are just a few of the words that describe one ofthe 2007 Ottawa Business Journal’s Forty Under 40Award recipients. Tricia Morrison, owner of TriciaMorrison Occupational Therapy ProfessionalCorporation, is in good company. Among the winnersof this year’s award recognizing Ottawa’s profession-als and entrepreneurs are CEOs, lawyers, accountants,media directors, fitness gurus, a martial arts profes-sional and a restaurant owner. Award recipients, whomust be under the age of 40, are honoured for theircareer accomplishments, professional expertise andcommunity involvement.

Inspired by her mother, who worked with dis-abled children, Tricia Morrison knew she wanted to bea self-employed therapist. “Helping people to get backto what is meaningful to them is what motivates me,and I much prefer working in the community,” shesaid. “Meeting clients in their own environment helpsme to better assess their needs, rather than in a clinicwhere there are restrictions.”

Tricia hung up her shingle and opened her pri-vate practice in 1997, four years after earning herBachelor of Science in occupational therapy fromMcGill University. For three years she worked longdays and spent many hours on the road. “I really hadno intention of hiring anyone, but an occupationaltherapist approached me about joining my practice,”she said. “After repeatedly rejecting the notion ofbringing someone else into my business, the birth ofmy daughter in 2001 finally made me realize that Icouldn’t continue working such long hours.” It wasthen that she hired her first occupational therapist.

Fast forward to 2007 and Tricia now employsnine occupational therapists who offer community-based services throughout eastern Ontario and west-ern Québec including Ottawa, Kingston, Brockville,Cornwall, Pembroke and Gatineau. She provides serv-ices in both official languages and her business cov-ers the regulatory fee required for the therapist work-ing in Québec. The team approach works well forstaff. “Being part of a team allows us the flexibility inour workload,” Tricia noted. “We’re able to choose thenumber of hours we want to work and schedule ourclients’ appointments around family responsibilities.”

Working apart does have its challenges, such ashow to stay in touch with each other. The group oftherapists meets formally once a month to shareinformation, and Tricia connects with each memberof her team on a daily basis and meets with themweekly. She attributes her success to the wealth oftheir combined experience and the knowledge theygain from each other. “The strength of the team is myproudest professional accomplishment. I am privi-leged to work with such a dedicated group of thera-pists,” she said.

Of particular interest is the collaborative part-nership that Tricia’s company has within the OntarioOT Alliance – a group of five independently-ownedoccupational therapy companies that represent over35 therapists in distinct geographic regions ofOntario. The Alliance services the insurance industryand allows occupational therapists who work at a dis-tance from one another to share ideas, informationand resources.

Meet Tricia Morrison – Occupationaltherapist, business owner, mentor,researcher, wife and mother

Erica Lyle, CAOT Communications Coordinator

Tricia Morrison accepting her Forty Under 40 Award from theOttawa Business Journal.

PRIVATE PRACTICE INSIGHTS

Column Editor: Lorian Kennedy

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Approximately 60% of Tricia’s business is con-ducting examinations for insurers as per theStatutory Accident Benefits Schedule governingmotor vehicle accidents in Ontario. A benefit of beinga member of the Ontario OT Alliance is that the

Alliance is on several insurers’lists due to the size, coverageand expertise offered by thelarge group of therapists. Othercompanies also have TriciaMorrison Occupational TherapyProfessional Corporation ontheir list for assessments ineastern Ontario. Conducting

these independent assessments has not only allowedher business to sustain itself, but has caused it tocontinually expand. The remainder of Tricia’s compa-ny’s business comes from specific client requests fortreatment, referrals from other healthcare profession-als, as well as lawyers.

Since completing her Master’s degree in educa-tion from University of Ottawa in 2003, Tricia hasbeen working on her PhD, conducting a researchstudy to “investigate the correlation between effec-tive therapeutic relationship and improved functionaloutcomes.”

Tricia lives in a serene country setting with herfamily in a sprawling bungalow built by her husband,

approximately 30 minutes southeast of downtownOttawa, near Metcalfe Ontario. The travel associatedwith providing community-based services gives Tricia“thinking time.” “To be the most productive and effi-cient I organize my time into travel days and officedays,” she explained. “I don’t really mind the travel. Itgives me time for problem solving.”

The OBJ’s Forty Under 40 Award recipients werehonoured at a gala on June 21st celebrating theaccomplishments of the young business leaders. YetTricia remains humble. “The benefit of this award isthe recognition that it gives to occupational therapy,”she said. “It brings occupational therapy into themainstream and holds up the values and benefits ofour profession.”

For more information about Tricia MorrisonOccupational Therapy Professional Corporation, visitwww.tmotpc.com or to learn about the Ontario OTAlliance go to www.otalliance.ca. A complete profileof the OBJ’s Forty Under 40 Award recipients can befound at: www.fortyunder40.com

About the author –Erica Lyle is the CAOTCommunicationsCoordinator.You may reachErica at 613-523-2268 ext.225 Toll Free: 1 (800) 434-2268 orat her e-mail address:[email protected] .

Do you know of an occupational therapist who hasrecently been “in the news?” If so, we would love tohear from you! Please send your ideas for people tofeature in OT Now to: Erica Lyle, CAOT CommunicationsCoordinator at [email protected]


Members of the Canadian Association ofOccupational Therapists (CAOT) Board gathered inToronto for a two-day meeting on November 23 and24. Prior to the meeting, the Board met with theCanadian Occupational Therapy Foundation (COTF)Board for a collaborative session on fundraising. ACanadian Institute for Health Information (CIHI)presentation on Workforce Trends of OccupationalTherapists was provided at a CAOT wine and cheesemember reception on the same day. Highlights of theboard discussions included the following:

Finances and budget• The Secretary/Treasurer provided a positive

financial report. Year-end financial results indicated higher than anticipated revenues,primarily as a result of increased membership,the success of Conference 2007 and one-timeexternally funded projects. Audited financialstatements for the 2006-2007 fiscal year will be available to members in 2008.

• The Board will propose that CAOT membershipfees remain unchanged for the next member-ship year at the 2008 Annual General Meeting.

• The proposed budget for the operating year2008-2009 was received by the Board.

• Several strategic and operating budget propos-als were approved that will provide funding fora number of special initiatives (see below).

Special initiativesAs a result of the positive year end results and surplusfunds, the Board approved the following special initiatives:

• One-time donation to the World Federation ofOccupational Therapists.

• Access to the Cochrane Library as a member service.• Face-to-face meeting of the Academic

Credentialing Council Indicator Working Group.• Development of a Practice Profile for Support

Personnel.• Retaining a government relations consultant for

increased advocacy.• Revision of the national certification examina-

tion blueprint.

Reports• Canadian Policy Research Network, a non-profit

“think tank”, presented the CAOTcommissioned environmental scan on healthpolicy in areas relevant to occupational therapy.A copy of this report is available on the CAOTwebsite. Areas identified for advocacy will beaddressed by the newly appointed governmentrelations consultant.

• The report developed from the ProfessionalIssue Forum in St. John’s on Access toOccupational Therapy Services was approvedand is posted on the CAOT website athttp://www.caot.ca/default.asp?pageid=2159.

• The report on the internationally educated occupational therapists Access and RegistrationFramework Project was received by the Board andhas been posted to the CAOT website.This report isan outcome of a project funded by theGovernment of Canada’s Foreign CredentialRecognition Program and was completed in partnership with the Association of OccupationalTherapy University Programs and the Associationof Occupational Therapy Regulatory Organizations.

• The Board approved the revised position statement on support personnel and this willbe posted to the CAOT website.

Policy• The Board approved the following revised or

proposed policies:* Ends policies* Cost recovery products and services * Column editors* Recruitment and selection of chair* Examination bank

• The Board approved the Revised Terms of Referencefor the Academic Credentialing Council and theCertification Examination Committee.

Appointments• Isabelle Matte was appointed as Chair-Elect of

the Certification Exam Committee.• Shaniff Esmail was appointed as Chair-Elect of

the Academic Credentialing Council.

Highlights from the November 2007 CAOT Board meeting

Erica Lyle, CAOT Communications Coordinator


Janet Craik joined CAOT inJanuary 2007. Janet graduat-ed from Queen’s Universitywith a BSc (OT) and a Mastersin Rehabilitation Sciencefrom the University ofToronto. She is registeredwith the New BrunswickAssociation of Occupational

Therapists. Janet is very excited to be part of the CAOTteam as the Professional Education Manager.

Cheri Fraser joined CAOT inMarch 2007 as MembershipServices Manager. She hasprevious association experi-ence as Membership andCommunications Coordinatorfor the Canadian Aeronauticsand Space Institute. Prior tothat, she worked in property

management for the Ontario government and docu-ment co-ordination for T-Base Communications. Cherigraduated from the Public Relations program atAlgonquin College in 2003 and the BroadcastJournalism program at Loyalist College in Belleville in1998.

Christina Hatchard joinedCAOT as Finance Manager inJune 2007. She previouslyworked in both the insur-ance and non-profit sectors.She earned a Bachelor ofCommerce, SpecializationAccounting from theUniversity of Ottawa and

attained her Certified Managerial Accounting desig-nation in 2005.

Suzanne Kay joined CAOT asa permanent staff member inAugust 2007 as theEducation Administrator. Shehas over 25 years of experi-ence in office administration,client relations and webmanagement. Educated in

Québec, Suzanne is fully bilingual.

Erica Lyle joined CAOT as apermanent staff member inMarch 2007. She brings manyyears of communicationsexperience to her position asCommunications Coordinator.Erica has worked in communi-cations for a variety of indus-tries including high tech,

power generation and police services. Erica earnedher Bachelor of Arts in English from CarletonUniversity.

Photo credit:Thank you to A. Neil Craik and Anick Flynn for providing these photographs.

CAOT would like to introduce several new staff members who joined us over the past year. Each of these peopleenriches our organization with a wealth of experience and enthusiasm. A warm welcome to all!

Welcoming new staff to CAOT Erica Lyle, CAOT Communications Coordinator


Update from the COTF

Upcoming CompetitionsFebruary 15• COTF / CIHR Institute of Aging Studentship

(1 x $4,950) (applicants must apply through CIHR IA)

February 28• COTF Research Grant• COTF Critical Literature Review Grant• Isobel Robinson Historical Research Grant

(1 x $2,000)• J.V. Cook and Associates Qualitative Research Grant

(1 x $1,500)• Roulston / COTF Innovation Award• SickKids Master’s Scholarship - $5,000 (COTF is

partnering with SickKids whereby each organiza-tion is offering $2,500 towards this scholarship – last time being offered! Applicants must apply through SickKids.)

March 1• COTF / CIHR Institute of Aging Travel Award

(1 x $1,000) (applicants must apply through CIHR IA)

For details and application forms, see the awardssection at www.cotfcanada.org.

COTF’s 25th anniversary!Stay tuned! COTF will be undertaking a fundraisingevent in the New Year to mark its 25th anniversary,May 17, 1983! Everyone is encouraged to participate inorder to support research and scholarship funding foroccupational therapy in Canada.

Remember to update your COTF contactinformationCOTF would greatly appreciate it if you would informSandra Wittenberg of any changes to your COTF contact information. Sandra can be reached [email protected] or 1-800-434-2268 x226.

Your support counts!COTF sincerely thanks the following individuals, com-panies and organizations for their generous supportduring the period of August 1 to September 30, 2007.For those whose names do not appear in this listing,please see the next issue of OT Now.

Sue BaptisteLisa BartheletteJeff BonifaceJane Bowman�

Deb CameronDonna CampbellAnne CarswellChristina Ching Yee FungMary Clark �

Sandy DaughenJohanne Desrosiers�

Patricia Erlendson�

Margaret Friesen�

Karen Goldenberg�

Susan Harvey�

Paramjit Kalkat�

Lori Letts�

Mary ManojlovichKatherine McKayDiane MéthotWilliam MillerJan Miller Polgar�

Elizabeth ReidGayle RestallJacquie RipatAnnette Rivard�

Debra StewartThelma Sumsion�

Barry Trentham�

Irvine WeekesMuriel WestmorlandSeanne Wilkins�

1 anonymous donor


CO-HOSTED WITH CAOTJune 12-14CAOT 2008 Conference:Exploring the frontiers of occupationWhitehorse, YukonTel: (800) 434-2268 ext.236E-mail: [email protected]

ENDORSED BY CAOT24th International SeatingSymposiumVancouver, BCMarch 5 - 8, 2008For information: http://www.interpro-fessional.ubc.ca/24th_Seating.htm Contact: Elaine Liau at [email protected]

Choose to LearnPicky Eaters vs. ProblemFeeders: The SOS Approach toFeedingApril 23 to 25, 2008 Nouvel Hotel, Montreal, QCContact: Caroline HuiTel: (450) 242-2816 Fax: (450) 242-2331E-mail: [email protected]

Myofascial Release SeminarsCervical-Thoracic MyofascialReleaseMyofascial MobilizationMyofascial Release IMyofascial Release IIFascial-Pelvis Myofascial ReleaseMyofascial UnwindingPediatric Myofascial Release2 or 3 day seminars in various loca-tions. Offered between January andJuly 2008

Instructor: John F. Barnes, PTContact: Sandra C. Levengood222 West Lancaster Avenue,Paoli, PA 19301E-mail:[email protected]:www.myofascialrelease.com

CANADIAN HEALTHCARE ASSOCIATIONRisk Management and Safety inHealth ServicesCourse starts every September.Modern ManagementCorrespondence courseContact: Cheryl Teeter, DirectorCHA Learning, 17 York Street,Ottawa, ON, K1N 9J6Tel: (613) 241-8005, ext. 228Fax: (613) 241-5055E-mail: [email protected]

WEB-BASED DISTANCE EDUCATIONUniversity of British Columbiaand McMaster University PostProfessional Graduate Programsin Rehabilitation SciencesCourses offered twice a year:September to December & Januaryto AprilCourses: Evaluating Sources ofEvidence Reasoning, Measurement Developing Effective Programs Facilitating Learning in RehabContexts.Graduate certificate is grantedafter completion of 5 courses. Thesecourses can be applied to Master'sprograms at each university, if thecandidate is eligible.

Contact: [email protected] [email protected]: (604) 822-7050Websites: http://www.mrsc.ubc.caor www.fhs.mcmaster.ca/rehab/

Dalhousie University Series:Advanced Research Theory andMethods for Occupational TherapistsOCCU 5030January - April 2008 Instructor: Dr. Grace Warner

Program Evaluation for OccupationalTherapistsOCCU 5043January - April 2008 Instructor: Jocelyn Brown

Identity and TransitionsOCCU 5040Spring/Summer 2008 Instructor: Jocelyn BrownContact: Pauline FitzgeraldTel: (902) 494-6351E-mail: [email protected]

McGill University School of Physical andOccupational Therapy Graduate Certificate in AssessingDriving Capabilities* POTH-673 Screening for at Risk

Drivers (winter);* POTH-674 Assessing Driving

Ability (summer);* POTH-675 Driving Assessment

Practicum (fall) * POTH-676 Adaptive Equipment

and Driving (winter/spring);* POTH-677 Retraining Driver Skills

(summer/fall).Tel: (514) 398-3910 E-mail: admissionsmcgill.caWebsite: http://www.mcgill.ca

CAOT endorsed courses

For more information about CAOT endorsement, e-mail [email protected] or Tel. (800) 434-2268, ext. 231

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