Being an ot in europe

Being an OT in Europe!

Maria Skouroliakos
President of COTEC

Maria Skouroliakos, President of COTEC
88th Annual AOTA Conference, Long Beach, 11 April 2008

The European Council in Brussels agreed in 1983
that “mutual recognition for diplomas was an
important step in creating satisfactory
conditions for the exercise of a number of
professions” including Occupational Therapists.


COTEC was established in 1986 to co-ordinate
the views of the National Associations of
Occupational Therapy of the ten Members
States of the European Communities.


Strasbourg 04. 25. 1986
The words Occupational Therapy and
Ergotherapy would from now on described the
name and title of the profession


The terms
Ergotherapy and Occupational Therapy
were the most frequently used terms.

Each delegate reported on potential confusion
with other workers.


Italy
Terapista della Reabilitazione “O.T. means an
industrial worker in the psychiatric field. In
people‟s minds “ Rehabilitation Therapist is, at
the moment (1986), the qualification for:
Occupational Therapist, Physiotherapist, Speech
Therapist.

Netherlands
“Ergotherapeuten”.
Translation of the words O.T. means someone working
in an industrial workshop with a one year training.
Germany
“Beschaffigungs/ Arbeits – therapeut”
But were trying to change to Ergotherapeut


U.K.
“Occupational Therapist”
In English Ergotherapist is not understood, so it
seems impossible to change OT into
Ergotherapist.


Spain
“Terapeuta Ocupacional”
Belgium
Officially Ergotherapeute
“Ergotherapeute” for the French speaking
“Arbeitstherapeut” for the Dutch speaking


France
“Ergotherapeute” and “Ergotherapeute in
Psychiatry”
This title has been given by equivalence to
about 300 psychiatric nurses.


The words Ergo and Occupation have similar
definitions but they are not direct
translations of each other.
The term Ergo is used as the term most closely
related to the concept of Occupation.


Εργο [ancient εργον] –
1. the TOTAL of actions and efforts to
accomplish something, to succeed, to get
there
2. work, job, creation, lifelong work, labour,
play, film, handiwork.
3. duty, obligation, mission.
(Greek Dictionary, 1993)

Occupation
1. holding, possession
2. profession, job

(Oxford English-Greek Learner‟s Dictionary,
1997)


The fact that the two words are not
interchangeable has added another challenge
for the European Occupational Therapists who
for 20 years now try to organize the official
terminology of our profession.


Terms like occupational performance,
occupational performance component,
occupational performance areas, occupational
health are hard or impossible to be translated.
Their actual translation has not the same
meaning or has no meaning.
Many of those terms must be paraphrased to
be used.

The difficulty of this situation was highlighted
during the Tuning process when the
competencies had to be translated in 20
languages.
Many of them when being translated, they
were hard to comprehend or explain to other
people.


The Hellenic Association of Ergotherapists
published a monolingual dictionary of the most
used terms.
In the introduction of this booklet it is described
the methodology and it is also acknowledged
the fact that many of the terms are rather
inapt terms in Greek.


The terminology group of the European
Network of Occupational Therapists in Higher
Education (ENOTHE) has produced consensus
definitions of 11 terms.
These definitions were translated into 6
languages giving meaning to inapt terms.


In 24 countries the Occupational Therapy
profession has a legal standing
In 20 countries there is an official job description
In 15 countries Occupational Therapists have a
recognized pay scale


In 7 European Countries their association has a
trade union status
13 European Countries use Ergotherapy as the
recognised job title.


The Tuning OT Project Group
Represents:
• The Council of Occupational Therapists for
the European Countries (COTEC)
and
• The European Network of Occupational
Therapy in Higher Education (ENOTHE)
The Tuning Project. Developing Competences for Occupational Therapy in Europe

The Bologna Process 1999 – 2010
• Degree System – 3 cycles of education
• Quality Assurance
• Recognition of Degrees and Study Periods (e.g. ECTS
and Diploma Supplement)
• Life Long Learning
• Joint Degrees

It is a process regarding the educational systems of the
member countries

The Tuning Project was introduced by the
The European University Association (EUA) in
response to the Bologna process, with the
support of the European Commission

Tuning = „tuned - in‟, but not the same


The Tuning Project aims to describe the structure and
content of educational programmes in line with the
Bologna process
Tuning originally included all European countries and
is now extended to Latin America
Considering: Russia, China, India and Japan

The Tuning Project has developed a common
methodology for all disciplines/ professions
Cooperation is required between academics and
professionals in the development of a description of
contemporary practice and education


Five lines:
1. Generic competences
2. Subject-specific competences
3. ECTS as an accumulation system
4. Approaches to learning, teaching, and assessment
5. Quality enhancement

Two main documents:
• Generic and subject specific competences
• Professional profile (including discussion on all
five lines)


Tuning web presents Tuning documents on:
Business, Chemistry, Earth Science, Education, European Studies,
History, Mathematics, Nursing, Occupational Therapy, Physics
The following are being prepared:
Agriculture, Architecture, Arts, Biotechnology, Computing science,
Engineering, Food studies, Geography, Languages, Law, Medicine,
Radiography, Social Work and more


‘Competences represent a dynamic
combination of cognitive and metacognitive
skills, knowledge and
understanding, interpersonal, intellectual and
practical skills, and ethical values‟

Competences do NOT describe a specific level
Competences are on a continuum and can be
developed throughout a persons professional life
Cycle Level Descriptors describe the expected learning
outcomes for 1st, 2nd and 3rd cycle education, and are
developed from the competences

„Level descriptor is a statement (learning outcome)
that provides an indication of the depth and extent of
learning expected at a specific stage in a programme/
professional study‟


Generic Competences
• Are transferable skills common to all university
programmes
• Are particularly important for future
employability and citizenship
• Defined for Europe by central Tuning Group

OT Subject specific competences
• refer to the performance of the occupational
therapy practitioner and are the competences that
guide the whole educational programme in
occupational therapy.

• For this reason the competences were developed
through a close collaboration between educators
(ENOTHE) and professionals (COTEC).


The development of the Subject Specific competences was
based on the critical study of earlier work completed by:

– WFOT (Hocking & Ness, 2002),
– College of OT‟s in the UK (Turner, 2004),
– Australian Association of OT‟s (Ford & Tonkin, 1994),
– Canadian Association for OT‟s (CAOT, 1998)
– European Curriculum Guidelines (Howard & Lancee,
2000)
– Standards of Practice (COTEC, 1996)


…and:
• Existing curricula of Masters in OT (second cycle)
• Existing doctoral programmes in OT (third cycle)

…but especially:
• Dublin Descriptors (Joint Quality Initiative Group,
2004), which indicate outcome levels for the three
cycles

OT competences are described in 6 categories:
• Knowledge of occupational therapy (5)
• OT process and professional reasoning (9)
• Professional relationships and partnerships (5)
• Professional autonomy and accountability (5)
• Research and development in OT/science (6)
• Management and promotion of OT (5)


Competences within „Knowledge of Occupational Therapy‟
• Explain the theoretical concepts underpinning occupational therapy,
specifically the occupational nature of human beings and their
performance of occupations
• Explain the relationship between occupational performance, health and
well-being
• Synthesise and apply relevant knowledge from biological, medical,
human, psychological, social, technological and occupational sciences,
together with theories of occupation and participation
• Analyse the complexities of applying theories and research evidence
related to occupation in the context of a changing society


Professional Relationships and Partnerships
• Work according to the principles of client centred practice.
• Build a therapeutic relationship/partnership as the foundation of the
occupational therapy process
• Establish and maintain collaborative partnerships, consult and advise
with clients, carers, team members and other stakeholders on enabling
occupation and participation in a wide range of contexts
• Collaborate with clients to advocate for the right to have their
occupational needs met
• Appreciate and respect diversity, individual differences, cultural beliefs,
customs and their influence on occupation and participation


Occupational Therapy Process and Professional Reasoning
• Work in partnership with individuals and groups, using occupation in
prevention, rehabilitation, and treatment in order to promote
participation, health and well-being
• Select, modify and apply appropriate theories, models of practice and
methods to meet the occupational and health needs of
individuals/populations
• Use professional and ethical reasoning effectively throughout the
occupational therapy process.
• Utilise the therapeutic potential of occupation through the use of activity
and occupational analysis and synthesis
• Adapt and apply the occupational therapy process in close collaboration
with individuals/ populations
• Work to facilitate accessible and adaptable environments and to
promote occupational justice


Professional Autonomy and Accountability
• Prepare, maintain and review documentation of the occupational
therapy process
• Comply with local/regional/national/European policies and procedures,
professional standards and employers‟ regulations
• Demonstrate continuing lifelong learning to enhance occupational
therapy
• Practice in an ethical manner, respecting clients and taking account of
professional codes of conduct for occupational therapists
• Demonstrate confidence in self-management, self-awareness and
knowledge of own limitations as an occupational therapist


Research and Development in Occupational
Therapy/Science
• Identify the need for research on issues related to occupation,
occupational therapy and/or occupational science and formulate
relevant research questions.
• Search independently, critically examine and synthesise scientific
literature and other information relevant to occupational therapy
• Understand, select and defend designs and methods appropriate to
research in occupation and occupational therapy, considering ethical
aspects


Management and Promotion of Occupational Therapy
• Determine and prioritise occupational therapy services
• Understand and apply principles of management to occupational
therapy services, including cost-effectiveness, administration of resources
and equipment, and establishing occupational therapy protocols
• Engage in a continuous process of evaluation and improvement of the
quality of occupational therapy services, involve clients where
appropriate and communicate the results to relevant stakeholders


Methodology
A process of consultation and validation was undertaken
with OT‟s and stakeholders throughout Europe
• Focus groups with members of ENOTHE and COTEC
• Online Questionnaire for occupational therapy
practitioners, academics and students (Tuning methodology)
• Open feedback process from COTEC and ENOTHE
including ECOTROS
• Questionnaire to employers and client groups
• Validation meeting with stakeholders


Focus groups:
• At COTEC meetings (2004 and 2005) and at annual
meetings of ENOTHE, representing 26 COTEC members
and about 190 higher educational institutions
• Questions for the groups were prepared before meetings
• All participants were divided into smaller groups
• Tuning group members chaired and minuted the group
meetings.


Online Questionnaire (2005)
Respondents were asked to:
• Rate the importance of each of the
• 30 generic competences
• 54 subject specific competences for first cycle education
• 54 subject specific competences for second cycle education
Rating scale: from 1- 4
(1 = no importance, 2 = weak, 3 = considerable, 4 = strong importance)
• To rank the 5 most important general and specific
competences


Consultation following the questionnaire
• Focus groups (COTEC and ENOTHE),
• Critical discussions in the Tuning OT Project Group
• Competences refined and reduced in number from 54 to
35


Questionnaire to employers and client groups
(2006) from 28 European countries
•Asking if the 35 competences reflect the expectations
they have of an occupational therapist.
•Responses were received from 18 countries and
demonstrated a clear recommendation supporting the
competences.


The Profile of Occupational Therapy
• Description of the subject area
• The Tuning process in OT, development of subject specific
competences
• Cycle Level Descriptors
• Typical degrees and employment
• Workload (ECTS)
• Learning, teaching and assessment
• Quality Enhancement
• 2nd and 3rd cycle education
• The implementation of competences in professional practice
• Challenges and trends for the future

Validation meeting in Brussels (June 2007)
• EU Commission invited experts to give feedback on
The Profile of Occupational Therapy
• Meeting together with medical, nursing and
physiotherapy professions
• Result: Strong support for the competences and
professional profile with recommendations for
improvements
OT Tuning publication planned for spring 2008 with
the validation of the group of experts

Validation Group
• Diederik Aarendonk Forum Coordinator, European Forum for Primary Care (EFPC)
• Dr. Jean-Marc Braichet Human Resource Officer, World Health Organisation (WHO)
• Anne Lawson-Porter Head of Education and Learning, College of Occupational
Therapists, UK
• Karin M. Liabø Head of Department National Center for Assistive Technology and
National Center for Assistive Information Technology in the Norwegian Labour and Welfare
Organisation (NAV)
• Kapka Panayotova Center for Independent Living, Sofia, Bulgaria
• Eugénia Pereira Student of the European Master of Science in Occupational Therapy
(EMScOT)
• Kathrin Reichel Coordinator of the Bachelor Programme in Physical and Occupational
Therapy, Alice-Salomon-Hochschule, Berlin
• Dr. Gaynor Sadlo Head of the OT-programme, University of Brighton, UK
• Marc Seale Chief Executive and Registrar, Health Professions Council (HPC), UK
• Anu Söderström Council of Occupational Therapists for the European Countries
(COTEC), delegate of the Finnish Association of Occupational Therapy
• Drs. Ruth Zinkstok Manager Bachelor Programme Occupational Therapy, Hogeschool van
Amsterdam, Chair of the Validation Panel

Discussions during the process
Proactive
• Should reflect current practice but also provide a
future direction for the profession.
Current practice trends
• Move away from traditional models of medical
services to include community based and socially
orientated practice.
Competences should provide a general, overall
direction or framework, enabling incorporation of
future changes and developments

Wide range of practice
• Although the underlying philosophy and theories of
the profession are common, practice itself varies
between countries.
Relevant for all countries
• with established OT-education (some near 70 years)
and for countries with newly emerging OT.

It was necessary to negotiate a middle way

Terminology
• Underlying theoretical concepts were discussed and
analysed. Inevitable that specific terminology used
and underlying theoretical foundations evident.
• At all times attempts to use as wide a theoretical
base as possible without reference to, or reliance on
one specific school of thought.


Implementation of competences
In education:
• A move from teacher-centered and subject-centered
education towards competence and student-centered
• Level descriptors for OT (Competences + Dublin Descriptors)
ensure the programme fulfills European expectations of the
cycle level, facilitating recognition of awards (degrees) and
entry to the next level.


In practice:
• Facilitate regulators in the evaluation of OT‟s
seeking employment
• Base for the new guidelines for the Code of
Ethics and Standards of Practice of COTEC


http://tuning.unideusto.org

http://www.enothe.hva.nl


COTEC website : www.cotec-europe.org


Thank You!


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