Annual Continuing Competence Review

The purpose of the Annual Continuing Competence Review (ACCR) is to support and enhance occupational therapists’ continued competence.

Highlights from COTBC’s 2021 ACCR

When completing the ACCR occupational therapists:

  • review their practice hours, roles, and reflect on current and pending personal and career transitions, and resources to support these transitions; and
  • complete a practice quiz using practice cases. This quiz helps occupational therapists to identify gaps in understanding regarding newly released standards, and recent changes in legislation (e.g. naloxone administration). In 2018 we introduced cases/questions focused on specific clinical areas where new evidence, best practices or new processses should trigger changes in practice.

After completing the required activities, occupational therapists immediately receive an individualized feedback report. It includes a record of their:

  • practice (currency hours)
  • perceived confidence in various roles;
  • identified transitions and resources impacting practice; and
  • practice quiz results with detailed College explanations including links to relevant resources on regulatory standards and practice resources to encourage further exploration and learning.

Individual results from the Annual Continuing Competence Review are not available to the College. The College will only know which occupational therapists completed it and can therefore renew their registration. The confidentiality of these results is ensured by directing OTs to a secure, password-protected website that is not accessible to the College. COTBC can request anonymized aggregate data to inform development of additional College resources and continuing professional development needs of occupational therapists but they do not have access to individual records.

2021 Annual Continuing Competence Review Results

The College moved to a new online delivery platform for this year’s ACCR, which was open for completion between May 5th and June 30th, 2021. An extraordinary 74% of registrants took the time to complete the evaluation survey, with 91% of respondents agreeing that logging in and navigating the website was easy. Respondents also had many helpful suggestions for improving the user experience (e.g., exploring accessibility options, having the option to download content), which will be considered for future platform improvements.

The 5 Most Frequently Identified Transitions Influencing Competence

Transitions are a natural part of work, experienced as a process of change that occurs when moving from usual routines to new ones. Occupational therapists are asked to recognize, prepare for, and take action to manage transitions to maintain their competence and reduce risks to their clients’ safety. Not surprisingly, the COVID-19 pandemic was cited by registrants as influencing their transitions, such as changes to workload and pivoting to deliver virtual health services. The top 5 transitions identified include:

  1. Significant change in my workload (19%)
  2. Recent change in policies and/or procedures at my workplace that impact the way I practise (17%)
  3. Adjusting to a significant change in my workplace organization (16%)
  4. Adjusting to a significant change in my family demands that impacts my practice (15%)
  5. Adjusting to a return to practice after a leave (10%)

Practice Quiz Results

As part of the ACCR, registrants were required to complete a Practice Quiz comprised of case-based scenarios and questions. Case scenarios are based on newly released standards, recent changes in legislation, or specific clinical areas where new evidence, best practises or new processes should prompt changes in practice. In 2021, 90% of survey respondents agreed that in general, the content in the Practice Quiz was appropriate to assess safe, ethical, and competent occupational therapy practice and 91% of respondents agreed that overall, the experience felt supportive and educational.

Continuing Professional Development

Added to the ACCR in 2021, registrants were required to identify a continuing professional development (CPD) goal. 92% of respondents indicated they would use their CPD goal to guide their continuing competence for the upcoming year.

The 12 Most Frequently Identified Areas of Focus for CPD

  1. Indigenous Cultural Safety and Humility (e.g., self-reflection, understanding of history, impact of intergenerational trauma, practical suggestions for real practice change, heartfelt opportunities for relationship, learning and partnership building)
  2. Cognitive Assessment and Interventions (e.g., brain injury, concussion, determining capacity for decision-making, executive function, functional vs. standardized assessment tools)
  3. Mental Health Assessment and Interventions (e.g., CBT, DBT, exposure therapy for PTSD, motivational interviewing, suicide risk, trauma informed care, anxiety, mindfulness, acceptance and commitment therapy, sensory and emotional regulation, substance use and harm reduction)
  4. Leadership (e.g., business practices, conflict resolution, change management, mentorship, coaching, providing feedback, having difficult conversations, knowledge translation strategies, evaluation and outcome measurement tools, program development, communication skills, leadership styles, advocacy, public speaking, interprofessional practice)
  5. Pediatric Assessment and Interventions (e.g., autism, dysphagia, feeding and eating skills, sensory and emotional regulation, assistive technology, handwriting development, DCD, anxiety, school-based practice, attachment theory, relationship with parents/guardians)
  6. Adult and Older Adult Assessment and Interventions (e.g., stroke, complex pain, hand therapy, aging in place, arthritis, constraint-induced movement therapy, driver rehabilitation, dysphagia, gentle persuasive approach, dementia, caregiver support, living at risk, low vision, hoarding, falls, delirium, end of life care)
  7. Seating, Positioning and Mobility Assessment and Interventions (e.g., complex wheelchair prescription, pressure and wound considerations, ADL equipment provision practices, home modifications, universal design, community accessibility, writing letters of justification, knowledge of leading edge and innovative equipment and technology)
  8. Obtaining Consent (e.g., for OT services, for disclosure of information, for facility admission, application of legislation and COTBC practice standards, determining capacity for decision-making)
  9. Quality Management of Practice (e.g., efficacy of documentation skills, education and teaching skills, personal health and wellness strategies, research skills, building professional support networks, self-reflection skills, working in interprofessional teams, applying ethical frameworks, caseload prioritization skills, supervising OT and RA students, working with support personnel, application of risk assessment and management approaches)
  10. Private Practice Assessment and Interventions (e.g., business practices, hand therapy, workplace injury prevention, developing return to work plans, ICBC Enhanced Care changes, Functional Capacity Evaluations, Cost of Future Care assessments, testifying in court, ergonomics)
  11. Justice, Equity, Diversity, and Inclusion (e.g., practical considerations for addressing and taking action regarding discrimination, racism, inequality, ableism, biases, and systemic barriers in practice)
  12. Impacts of COVID-19 on Clients and OT practice (e.g., best practice interventions for long-COVID, infection prevention and control practices for communicable diseases, balancing risk with the qualify of life in care home environments, the efficacy of virtual care)

Note: intervention means action taken to improve functioning or prevent harm.

Ongoing Evaluation

The Quality Assurance Committee encourages occupational therapists to complete the evaluation included as part of the Annual Continuing Competence Review. This feedback will inform ongoing improvements to the Quality Assurance Program that balances the needs of occupational therapists with the public’s right to safe, ethical and quality care.