OT/OTA Admission Series Part 2: Strategies for Academic Success in an OT/OTA Program

Dear (Insert your name here), Congratulations! You have been accepted into the Occupational Therapy Program. You did it! Your hard work paid off and you got into an OT/OTA Program! Now what? The nice thing about occupational therapy is that you are entering a profession. This is not just a job, this is your future, a career, and honestly, the sky is the limit as an occupational therapy practitioner. So, succeeding in an OT/OTA Program is imperative.

In the interest of full disclosure, the work is hard. But, again, I am 100% biased here, this is the best job ever! With a holistic view of a person, occupational therapy practitioners can provide services across the lifespan and in a variety of facilities: nursing homes, hospitals, mental health, community centers, and so much more.

As a person that tackles large tasks in chunks or focuses on patterns, I wanted to compartmentalize success in OT/OTA schools as I had with post that addressed getting accepted into an OT/OTA Program, found here: OT/OTA Admission Series: Part 1 Getting In The locus of control strategy does not fit well with being successful in OT/OTA school, because, well, everything is under your control. Also, all courses are completed in your new OT Program. So, there is little wiggle room for, say, taking a class in another college or modifying credits to be successful or the like. Schedules are set, time is limited, and the work is focused. But, success is as easy as 1, 2, 3…4, 5. There are 5 key areas to view all aspects of your OT academic career: (1) Professionalism (2) Communication (3) Knowledge (4) Clinical Skills and (5) Time Management.

Professionalism

At the foundation of any successful occupational therapy student is professionalism.  Professionalism helps you successfully navigate all the other components of your academic success. DeIuliis (2017) points to four key components that make up professionalism: (1) behavior (2) competency (3) responsibility and (4) ethics.

There were actions that were generally accepted in an undergraduate studies program that will be frowned upon in many, if not all occupational therapy programs. These include being late to class (even in an online format), providing assignments late, emails that are unstructured, not replying to emails, being disrespectful to instructors and classmates, to name a few. The list of what constitutes professionalism can be long. While there are student concerns that these types of expectations are extraneous or some might say unrealistic, the expectations are set to benefit the student to become a successful clinician to ensure optimal client care and to be able to work well with your rehab colleagues.

If you think about the way we deliver occupational therapy services, providing care to clients at a certain time (for example in an outpatient setting), in coordination with other services (in a rehab or hospital setting where occupational therapy, physical therapy, and speech therapy care for the same client), following a schedule is key and showing up on time is also important. If you are scheduled to work with a client for 90 minutes, if you start 15-30 minutes late, you can picture the domino effect on other clinicians.  In addition to the clinician, the client will also be anxious or upset that they are kept waiting or have their daily schedule affected.

Timely provision of work is also an important component of success. This is also essential for clinical practice. Being an occupational therapy practitioner involves documentation that must be completed in pre-determined timeframes (daily, weekly, monthly). Providing documentation for an evaluation three or four days later will not be accepted. Without the completed evaluation, there is no information on the client’s functional status or the plan for intervention. The same concept stands for assignments. Think of a due date as the date that your documentation is due in the client’s medical chart. Train yourself to meet deadlines.

In addition to punctuality, appropriate engagement with others is also a component of professionalism. When emailing others, use language that is respectful.  Using slang, emoticons, and unstructured thoughts, will show poorly on your ability to communicate with others. If you feel that within the email things are escalating or you are not getting your point across, request an appointment to speak to the instructor. Advocating for yourself is important and learning how to do it professionally is a life skill.

Call professors by their preferred titles…professor, Dr., Mr., Ms. First name. Each instructor is different. Always err on the side of caution and call professors by the title on the syllabus. Let the instructor tell you to call them by their first name. Again, in the clinical setting, respecting clients and caregivers involves calling the client by their preferred name. Get in the habit of never assuming what a person wants to be called. Start with the most respectful of the salutations (Mr. Ms.) and then let the client be the one to let you know that you can call them by their first name.

Communication

Mason et al. (2020) found that fieldwork educators rated communication as an important skill needed for Level II FW success and one that the same fieldwork educators felt was lacking in students. In today’s world of decreased attention spans, the ability to communicate is an important skill.  DeIuliis (2017) notes, “Interacting with others appropriately and respectfully, communicating clearly and directly, and having the ability to relate and feel comfortable with people at different levels are essential to being professional (p. 26).” Communication includes more than verbal exchanges. This includes body language, empathy, the ability to diffuse a situation, and maintaining your composure during conflict. These skills allow for not only success in your academic program, but the same skills also are needed for daily interactions with your clients.

In your academic program, for 2-3 years, you are part of a cohort and have pretty much the same instructors. You become a family. Gone are the days when you can expect a brand-new set of faces in your class next semester or new instructors. And as with any family, there will be differing ideas, which may lead to conflict. Maintaining open, mature, effective lines of communication is key to functioning in harmony and performing optimally within a setting that has high demands. In addition to success in the classroom, effective communication in the clinic is also a must for optimal collaboration with your interdisciplinary team members to deliver effective client care. Negative, harsh, aggressive tones in the workplace does not allow for collaboration. When looking at communication, similar to professionalism, there are general ground rules that are at the foundation of effective communication.

For optimal communication, use objective words, repeat what the speaker says and your interpretation to allow for clarification if needed, realize when the conversation is escalating and determining strategies to prevent a negative situation. These strategies include informing the individual that you need some time before returning to the conversation or requesting a change of subject.

Knowledge

Recognize that you are now in a program that will teach you a profession. The nice thing about occupational therapy is you are entering a career. This is not a job where in 3-5 years, you will need to ask yourself—where is this job going? What am I going to do next? Will I need a new degree to learn something new? This is it. In 3-5 years after you graduate, you will be an occupational therapist or occupational therapy assistant. You may ask yourself that question. However, the answer will still be that you are an OT or an OTA, maybe in a different practice setting but still an OT or OTA. You are learning everything you need to learn to be an entry level therapist. So, make certain that you focus on your studies to be a competent clinician.

When you graduate from your OT or OTA Program, your first step to being a clinician is successfully passing a comprehensive national certification exam, which will allow you to become licensed to practice in your state. So, it goes without saying, that you need to focus on the material that is taught to you in an OT or OTA Program. What is the best way to learn this material? Respect the material. It is a lot of material to cover and with strategic preparation, you can learn.

What to focus on:

Textbooks. NBCOT has a list of 10 textbooks that are referenced by NBCOT Item writers and can be found here for OT texts: 2018 OTR® Curriculum Textbook Report and here for OTA texts: 2018 COTA®Textbook Report . Keep those texts to study from in the future. Know the material in those texts because that information is the standard in the respective practice area. This is not a secret. NBCOT is literally informing you that these are the texts are referenced for the certification test exam questions. Learn the material and keep the books.

Alphabetical Listing of the Top 10 Textbook References Currently Used by NBCOT OTR Item Writers

Brown, C., & Stoffel V. C. (2011). Occupational therapy in mental health: A vision for participation. Philadelphia, PA: F.A. Davis Company.

Cara, E., & MacRae, A. (2013). Psychosocial occupational therapy: An evolving practice (3rd ed.). Clifton Park, NY: Delmar Cengage Learning.

Case-Smith, J., & O’Brien, J. C. (2015). Occupational therapy for children and adolescents (7th ed.). St. Louis, MO: Mosby Elsevier.

Cooper, C. (2014). Fundamentals of hand therapy: Clinical reasoning and treatment guidelines for common diagnoses of the upper extremity (2nd ed.). St. Louis, MO: Mosby Elsevier.

Gillen, G. (2016). Stroke rehabilitation: A function-based approach (4th ed.). St. Louis, MO: Elsevier.

Jacobs, K., & McCormack, G. L. (Eds.). (2011). The occupational therapy manager (5th ed.). Bethesda, MD: AOTA Press.

Pendleton, H. M., & Schultz-Krohn, W. (Eds.). (2018). Pedretti’s occupational therapy: Practice skills for the physical dysfunction (8th ed.). St. Louis, MO: Mosby Elsevier.

Radomski, M. V., & Trombly Latham, C. A. (Eds.). (2014). Occupational therapy for physical dysfunction (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Schell, B. A. B., Gillen, G., & Scaffa, M. E. (2014). Willard & Spackman’s occupational therapy (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Smith-Gabai, H. & Holm, S. (Eds.). (2017). Occupational therapy in acute care (2nd ed.). Bethesda, MD: AOTA Press

Alphabetical Listing of the Top 10 Textbook References Currently Used by NBCOT COTA Item Writers Textbook Title

Case-Smith, J., & O’Brien, J. C. (2015). Occupational therapy for children and adolescents (7th ed.). St. Louis, MO: Mosby Elsevier.

Early, M. B. (2013). Physical dysfunction practice skills for the occupational therapy assistant (3rd ed.). St. Louis, MO: Mosby Elsevier.

Early, M. B. (2017). Mental health concepts & techniques for the occupational therapy assistant (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Jacobs, K., & MacRae, N. (Eds.). (2017). Occupational therapy essentials for clinical competence (3rd ed.). Thorofare, NJ: SLACK, Inc.

Lohman, H., Byers-Connon, S., & Padilla, R. L. (2018). Occupational therapy with elders: Strategies for the COTA (4th ed.). Maryland Heights, MO: Mosby Elsevier.

Radomski, M. V., & Trombly Latham, C. A. (Eds.). (2014). Occupational therapy for physical dysfunction (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Schell, B. A. B., Gillen, G., & Scaffa, M. E. (2014). Willard & Spackman’s occupational therapy (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Solomon, J. W., & O’Brien, J. C. (2016). Pediatric skills for occupational therapy assistants (4th ed.). St. Louis, MO: Mosby Elsevier.

Wagenfeld, A. (2016). Foundations of theory and practice for the occupational therapy assistant. Baltimore, MD: Wolters Kluwer –Lippincott, Williams & Wilkins.

Wagenfeld, A., & Kaldenberg, J. (Eds.). (2016). Foundations of pediatric practice for the occupational therapy assistant (2nd ed.). Thorofare, NJ: SLACK, Inc.

OTPF-4. The Occupational Therapy Practice Framework, 4^th edition that came out in September is your friend. We look at the Domains to focus on areas of concern of the client and the Process to determine how we will assess these areas.  Over the two years in a program, this document will be referenced quite a bit. Take a semester to review terms and definition and review throughout the year.

Binders—I have seen many students make binders and honestly, this is a tried and true method of keeping your items organized. As a student, I kept binders of my work and it came in handy after I graduated. I think a large component of having those binders is the peace of mind that you have the information readily available for referencing during Fieldwork or when you start your first job. When I graduated, all my notes and paperwork were organized in my binders and it made studying for the NBCOT exam easy.

                 Binder headings suggestions:

Neuro

Pediatrics

Adult Conditions

Mental Health Conditions

Frames of Reference

OTPF-4

Effective studying. An important component of studying is determining what works for you and sticking with that routine. It is really that simple. I have seen the index card method, the quizlet: https://quizlet.com/ method, the highlighting method. In the end, once you figure out what works for you, then stick with it throughout the program. Research has looked at what method works the best and the research shows that writing increases retention: For More Effective Studying, Take Notes With Pen and Paper. But, if you are in the category that does best with technological methods such as quizlet, then use this method consistently. I am sure many students are familiar of the positives of quizlet. It is also important to keep in mind that though you can use the quizlet of others, you want to ensure that the information is correct! So, make your own quizlet from which to study.

Recognize the importance of the two important steps prior to reaching your goal of being an occupational therapist or occupational therapy assistant:

1. Passing all your courses to get your degree. This involves knowing the curriculum, the sequence of courses, and the progression of what you need to know and how you need to know it. Generally, the sequence is from didactic (knowledge) to clinical (application of the knowledge with client evaluation and intervention). If you think about that progression, it makes sense to focus and perform well each semester to have a great foundation in the beginning and proficient skills for application later on.
2. Passing the NBCOT Exam. The breakdown of the NBCOT exam is here: NBCOT Exam Handbook . When you approach your work, think about this exam and the questions that focus using the breakdown provided. Try to organize your work in this manner and your exam preparation material in the same manner.

Clinical Skills

Along the same lines of knowledge, there are hands-on skills where proficiency is needed. Do not wait until you have a practical or lab to test your skills. Practice, practice, practice. Practicing the skill on your own will not help you in a situation where you have to apply the skills on a person. What are you going to say? How are you going to say it? What is your strategy when you feel overwhelmed? The hands-on skills such goniometry, handling, ADLs, and transfers, are assessed with practicals. You will need to practice with a person.

In this time of COVID, it is important to determine safe ways to interact with others to practice your skills. Some options are to use your semester lab partner or a willing family member that lives with you. In most of these cases, a skill is drawn out of a receptacle (such as a hat or bag) and you must show proficiency with this skill. Rather than learn the skill in a vacuum, practice the test conditions. Draw the skill and complete all testing components to put your mind at ease that you have the skills needed to do well on your assessment. Do this for all skills that are being assessed. This takes time. But, putting in time at the front end, gives you the confidence to do well during the actual testing time.

Time Management

The advice that is most often provided to students is time management. You ask, how can I handle all of this? The response is time management. Honestly, the last component of your success is time management because if you think about it, you need to know what you are dealing with, then you organize that time based on the layers in your OT/OTA Program. In today’s fast paced world, there are many tools that guarantee to help with time management. There are apps, planners, books, that all promise to help with time management, but those are tools to help. Time management begins with the person making work the priority and using the tools to stay focused.

The roadmap to successful time management involves many components:

Look at the work that needs to be done. Take all your syllabi and plot out the semester to get a concrete idea of what is due when and what times of the semester these readings and assignments are due.

Plotting your readings and assignments can occur with a variety of resources. Are you Team Paper or Team Electronic when it comes to filling out your calendar of tasks? Whatever team you are on, make sure it works! Sometimes if you are Team Electronics, you may run into issues with maintaining focus with having your computer or phone by you all the time to track your tasks. Invariably, you will check emails, texts, and social media while your main goal is to study. I always recommend to be honest with yourself when it comes to choosing a method that works for you to stay organized and stick with what works.

After you have determined what is due, break down a study schedule based on the amount that is due. At the beginning of the semester plot your study/reading schedule.

Method for determining a reading/study schedule for optimal exam performance:

First, look at the exam date of a class. Determine the amount of days from the first day of that class to the exam date.

Second, look at the readings that need to be done for that exam. Break down each chapter for reading into either halves or thirds depending on the length of the chapter, days you have to study, and the date of the exam (farther away I break it into thirds, closer, I break it into halves).

Third, make a list of the reading schedule on your calendar for that class. During the week when going to class, review the chapters following the schedule, paying attention to what you do not know to ask the instructor in class. On the weekend when you have more time, study the material with more focus and memorize important points (definitions, lists, and tables always have information that will creep up on an exam).

Finally, the weekend before the exam, study all the chapters and work with quiz questions or questions you make based on your experience from exam questions from the instructor. If it is the first time taking an exam with the professor, always make time to ask how the questions are formulated (knowledge based, clinical, multiple choice, short answer, essay, etc.). Another tip is to look at key definitions, chapter objectives, and questions throughout the text. How thoroughly can you define terms or answer questions in a chapter gives you a good understanding of your level of understanding.

It seems like a lot of work, but you always know where you are with your readings, what you know, what you don’t know and most importantly, there is no cramming with this method. Reviewing half a chapter takes about 1 hour. This allows for reviewing all textbooks during the week. Also, if life happens, you always know where you are with what needs to be done to allow you to make shifts to your schedule and still be able to keep up with the material. You continue in this manner for all your classes, paying particular attention to the difficult classes. Do not fall behind in a difficult class. Respect the material and begin early with the work.

Working and school. Working is required for many students because of financial responsibilities. I provided some possible jobs for when you are applying to the OT Program: OT/OTA Admission Series: Part 1 Getting In. Other jobs to consider rehab tech, working with kids, grocery stores, and school libraries. I would not say do not work, but definitely keep the hours manageable. There are students that can work many hours and make it through. But, if your grades are slipping, something needs to change—either change the job or speak to your advisor to learn of options to assist you with balancing work and school.

Occupational Balance. Whatever fills your cup to allow you to keep up with the schoolwork, carve out time to make it happen. You will not be successful if your only focus is work. Burnout will occur relatively quickly or worse at the wrong time (like just before a test). Also, alienating your family and friends will lead to a loss of your support unit. Think about it. There are 24 hours in a day. Will a 30-minute walk with a friend or family make you fail out of OT school? Nope. Will 1 hour spent having dinner with a friend make you fail out of OT school? Highly unlikely. Setting up a well-organized schedule also helps you see where you have chunks of time available to go to yoga, read, go out with a friend, spend time with family or watch a few shows of Netflix. For those with kids, you will need an extra layer of organization where you map out your child’s schedule to ensure that you have enough time for your child’s activities with your school schedule.

Success in OT or OTA School is as easy at 1, 2, 3…4, 5. Make certain that when you start out, map out your plan and stick with the plan! In addition to focusing on your plan, ensure that you allow yourself some time for rejuvenation to bring your best self to your courses, instructors, and classmates.

If you have tips or tricks that helped your academics in your OT or OTA school, please feel free to share in the comments below.

References

DeIuliis, E. D. (2017). Professionalism across occupational therapy practice. Slack Incorporated.

Mason, J., Hayden, C. L., & Causey-Upton, R. (2020). Fieldwork Educators’ Expectations of Level II Occupational Therapy Students’ Professional and Technical Skills. The Open Journal of Occupational Therapy, 8(3), 1-16. https://doi.org/10.15453/2168-6408.1649