Title

Poster Session - Survey of assessment tool selection and use by occupational therapists in Maryland

Location

Himmarshee Room & 8th Floor Balcony

Start Time

3-10-2015 11:45 AM

End Time

3-10-2015 1:00 PM

Abstract

The American Occupational Therapy Association’s Centennial Vision establishes evidence-based practice as a profession-wide priority (AOTA, 2006). Citing recent funding caps and healthcare reforms, Doucet & Gutman (2013) caution against reliance on site-specific instruments and tools from other disciplines, in favor of psychometrically sound function-based assessments that confirm to insurers occupational therapy’s effectiveness and distinct contributions. Occupational therapy (OT) practitioners vary in their consideration of the following assessment principles in practice: (a) using standardized, evidence-based assessments; (b) using appropriate tools for diverse occupational needs; and (c) accurately administering and interpreting assessments (Coster, 2008; Piernik-Yoder & Beck, 2012).

Limitations to OTs’ best use of assessment tools may include institutional barriers, lack of educational preparation, or other factors. The aim of this study was to explore current trends and therapist perceptions regarding their tool use in practice, by investigating three main questions based on the assessment principles above:

  • Are OTs using standardized assessments?
  • What factors influence OTs’ assessment tool choices?
  • How confident are OTs in assessment administration and interpretation?

The study was conducted using an online survey. Participants (projected to be >50 licensed OTs working primarily with adult clients) completed a 55-item-maximum online survey with an adaptive format: the number of items presented was contingent upon participants’ responses. Sample characteristics are presented with descriptive statistics, and inferential statistics were used to analyze data related to participants’ assessment tool selection and use.

Preliminary results (n=34) indicate that only about one quarter of non-pediatric OTs in Maryland frequently consider the psychometric properties of a tool, and nearly 80% modify or adapt the tool from its standardized form for use in practice. Although access to a range of assessment tools varies widely by clinical site, and many therapists rated tool cost as a major factor in determining tool selection, 65% of respondents reported that the tools they do use provide “a comprehensive understanding of [their] client's holistic occupational needs.”

In her 2008 Eleanor Clarke Slagle Lecture, Coster attested to the complexity of measurement in OT, as practitioners are measuring real people in their real lives. Therefore, practitioners must assume the responsibility to choose assessments that address clients’ diverse and most pertinent occupational needs (Coster, 2008). Skillful assessment depends upon the evaluator’s procedural adherence, awareness of psychometric properties, and understanding of their implications (Sok Mui, Palethorpe, & Rodger, 2012). This survey highlights the need for more consistent assessment guidelines in adult rehabilitation, which can only serve to enhance the rigor and trustworthiness of our interpretations and professional opinion with clients, funders, and colleagues in healthcare.

Objectives for discussion

  1. Describe the benefits and barriers of adaptive survey design.
  2. Discuss the evidence to support the use of standardized versus individualized assessment in occupational therapy across various settings.
  3. Discuss the role of assessment for use and compliance with the Affordable Care Act and AOTA ethical principles.

Keywords: Adaptive survey, Assessment, Professional issues

References

American Occupational Therapy Association. (2006). The road to the centennial vision. Retrieved from http://www.aota.org/AboutAOTA/Centennial-Vision.aspx

Coster, W. (2008). Embracing ambiguity: facing the challenge of measurement. American Journal of Occupational Therapy, 62(6), 743-752.

Doucet, B. M., & Gutman, S. A. (2013). Quantifying function: The rest of the measurement story. American Journal of Occupational Therapy, 67(1), 7-9. doi:10.5014/ajot.2013.007096

Piernik-Yoder, B., & Beck, A. (2012). The use of standardized assessments in occupational therapy in the United States. Occupational Therapy in Health Care, 26(2/3), 97-108. doi:10.3109/07380577.2012.695103

Sok Mui, L., Palethorpe, N., & Rodger, S. (2012). Understanding the common inter-rater reliability measures. International Journal of Therapy & Rehabilitation, 19(9), 488-496.

This document is currently not available here.

Share

COinS
 
Oct 3rd, 11:45 AM Oct 3rd, 1:00 PM

Poster Session - Survey of assessment tool selection and use by occupational therapists in Maryland

Himmarshee Room & 8th Floor Balcony

The American Occupational Therapy Association’s Centennial Vision establishes evidence-based practice as a profession-wide priority (AOTA, 2006). Citing recent funding caps and healthcare reforms, Doucet & Gutman (2013) caution against reliance on site-specific instruments and tools from other disciplines, in favor of psychometrically sound function-based assessments that confirm to insurers occupational therapy’s effectiveness and distinct contributions. Occupational therapy (OT) practitioners vary in their consideration of the following assessment principles in practice: (a) using standardized, evidence-based assessments; (b) using appropriate tools for diverse occupational needs; and (c) accurately administering and interpreting assessments (Coster, 2008; Piernik-Yoder & Beck, 2012).

Limitations to OTs’ best use of assessment tools may include institutional barriers, lack of educational preparation, or other factors. The aim of this study was to explore current trends and therapist perceptions regarding their tool use in practice, by investigating three main questions based on the assessment principles above:

  • Are OTs using standardized assessments?
  • What factors influence OTs’ assessment tool choices?
  • How confident are OTs in assessment administration and interpretation?

The study was conducted using an online survey. Participants (projected to be >50 licensed OTs working primarily with adult clients) completed a 55-item-maximum online survey with an adaptive format: the number of items presented was contingent upon participants’ responses. Sample characteristics are presented with descriptive statistics, and inferential statistics were used to analyze data related to participants’ assessment tool selection and use.

Preliminary results (n=34) indicate that only about one quarter of non-pediatric OTs in Maryland frequently consider the psychometric properties of a tool, and nearly 80% modify or adapt the tool from its standardized form for use in practice. Although access to a range of assessment tools varies widely by clinical site, and many therapists rated tool cost as a major factor in determining tool selection, 65% of respondents reported that the tools they do use provide “a comprehensive understanding of [their] client's holistic occupational needs.”

In her 2008 Eleanor Clarke Slagle Lecture, Coster attested to the complexity of measurement in OT, as practitioners are measuring real people in their real lives. Therefore, practitioners must assume the responsibility to choose assessments that address clients’ diverse and most pertinent occupational needs (Coster, 2008). Skillful assessment depends upon the evaluator’s procedural adherence, awareness of psychometric properties, and understanding of their implications (Sok Mui, Palethorpe, & Rodger, 2012). This survey highlights the need for more consistent assessment guidelines in adult rehabilitation, which can only serve to enhance the rigor and trustworthiness of our interpretations and professional opinion with clients, funders, and colleagues in healthcare.

Objectives for discussion

  1. Describe the benefits and barriers of adaptive survey design.
  2. Discuss the evidence to support the use of standardized versus individualized assessment in occupational therapy across various settings.
  3. Discuss the role of assessment for use and compliance with the Affordable Care Act and AOTA ethical principles.

Keywords: Adaptive survey, Assessment, Professional issues