Virtual Reality in Your OT Practice

I think we can safely assume that we are only beginning to see the potential that VR has for transforming occupational therapy (as well as physical therapy and speech therapy.)  

There are whole societies that OTs can join, focused on the use of virtual reality (VR) in rehabilitation (like the International Society for Virtual Rehabilitation).  New VR technologies and applications seem to be emerging almost daily.  

Whether you are interested in incorporating virtual reality into your therapy practice, are a self-proclaimed "techie" or are just interested in glimpsing the future, this article is for you.

 The post features:

• What the research says about VR and OT
• Therapy focused VR that is currently on the market
• Discussion of product development and VR research that is in the works 

Technology as Occupation: Why VR?

Technology is not only a means for occupation, including how we work and relate to each other, but is also the target of our occupation now more than ever before.  As a human race, technology consumes a great deal of our occupational behavior.  Why?  We are engaged, connected and rewarded through technology.  

A number of studies over the last decade and a half have revealed that game playing triggers dopamine release in the brain, a finding that makes sense, given the instrumental role that dopamine plays in how the brain handles both reward and exploration.  Virtual reality (VR) activities rooted in games or ADL tasks with a distinct aim, reinforce voluntary repetition, which is a key ingredient for motor recovery based on principles of neuroplasticity.  

Another benefit of virtual reality therapies is that patients can be engaged in a high dose of therapy or repetition early on in their stroke recovery, taking advantage of the window where cortical reorganization is at its peak.  For children with neuromuscular challenges like CP, since technology and gaming has become second nature for many in the youngest generation, children may not even recognize that they are participating in rehabilitation through virtual reality.  

What the Research Says About VR and Therapy

The literature shows that engagement in graded, appropriately dosed and task-oriented practice are contributors to upper limb improvement and cortical reorganization (Timmermans et al, 2010).

In traditional occupational therapy sessions focused on upper limb improvement post-stroke, research shows that only 23 to 32 repetitions are completed in a standard session (Kimberly et al, 2010).  This is far fewer than is necessary for motor improvement.  In addition, during sub-acute stroke rehab, an average of 4 minutes are spent on task-specific upper limb training in a typical session (Hayward & Brauer, 2015).  In comparison, virtual reality interventions can yield an average of 200-300 functional movements per one hour session (Adams et al, 2015).

A randomized controlled trial using the Neofect Smart Glove, compared to a control group of “standard occupational therapy” along with use of the VR tool, demonstrated improvement for both the proximal and distal upper extremity on the Fugl-Meyer.  The device is primarily focused on forearm, wrist and hand motion, yet prompted shoulder and upper arm improvement as well as hand, wrist and forearm (Shin et al, 2016).  

This speaks to the engagement in upper extremity task-oriented practice as counteracting the “learned non-use” that many stroke survivors experience.  All participants received a 4-week face to face intervention program that included use of the Smart Glove along with traditional occupational therapy (OT) interventions or traditional OT only.  The dosage of therapy or this study was daily intervention for 30 minutes, five days per week for a total of 20 sessions.  Patients using the Smart Glove also demonstrated improvement in health related quality of life utilizing the Stroke Impact Scale compared to those that did not use the VR intervention (Shin et al, 2016).

Saposnik and Levin (2011), in a review of twelve VR approaches, reported that eleven of the twelve virtual systems showed significant benefit in the selected outcome measure.  In an assessment of the use of virtual environments for stroke rehab, Holden (2005) noted that improvement in motor function appears to translate to real life tasks.  A comparative investigation of an intervention in a real-life environment versus in a virtual environment, yielded nearly equivalent improvements in motor function (Subramanian et al, 2013).

What VR is Currently Available for OTs?

Virtual reality technology is quickly evolving.  Here is a short list of accessible Virtual Reality devices that can be used in your practice:

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Neofect

Rapael Smart Glove and Smart Kids (Pediatric Version)

Description: Smart Glove is a lightweight, silicone exo-glove that interacts with tablet using bluetooth technology.  SG has an assessment mode to track changes in AROM and PROM as well as coordination and timing.  Employs artificial intelligence to change parameters of activities for “just right challenge”.  Even with a small amount of activation, a patient can be successful with the device.  

Tasks Involved: Challenges wrist, digit and forearm motion.  Includes activities such as, catching balls or butterflies, squeezing oranges, fishing, cooking, cleaning the floor, pouring wine, painting fences, and turning pages along with other more novel and complex games.  There are also games that target visual and cognitive processes.

Minimal Motion Required: Minimal activation of the forearm (supination/pronation) and wrist (flexion/extension) or digits is needed for best success.  The device does not provide active assistive motion.

Research Support: Randomized controlled trial demonstrates improvement of distal and proximal items on Fugl-Meyer and Jebsen-Taylor as well as quality of life on the Stroke Impact Scale.

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Flint Rehabilitation

MusicGlove

Description: Music Glove is a glove with finger sensors to work on timing of finger motion and fine motor control.

Tasks Involved: Opposition of digits to thumb coordinated to music to improve coordination and timing.  Interface looks like “guitar hero”, encourages the patient to make contact to the beat.

Minimal Motion Required: Lateral pinch is required for successful participation.

Research Support: Music Glove users demonstrated Improvement in box and blocks scores over controls.

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Flint Rehabilitation

FitMi

Description: FitMi consists of “pucks” that interact with therapeutic exercise apps on Flint Tablet, PC or Mac.  The apps are designed to target hand, arm, trunk and leg impairment.

Tasks: RehabStudio regimens can be created from a library of 40 classic exercises.  Real-time visual, auditory and repetition feedback is provided and tracked.

Minimal Motion Required: Puck can either be handheld or on a tabletop for targeted reaching to full UE ROM.  

Research Support: New product, limited published research support at this time.

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Saebo

SaeboVR

Description: SaeboVR is a virtual ADL (activities of daily living) rehabilitation system. The proprietary platform was specifically designed to engage the client in both physical and cognitive challenges involving daily functional activities.

Tasks: SaeboVR‘s ADL-focused virtual world provides clients with real-life challenges. Users will incorporate their impaired upper limb to perform simulated self-care tasks that involve picking up, transferring and manipulating virtual objects.

Minimal Motion Required: The program detects movement but does not assist with mobility.  A mobile arm support or other assistive device can be used for UE support.

Research Support: Patients engaged in the Saebo VR therapy demonstrated improvement on Fugl-Meyer measures with an average of close to 200 motions per session.

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The Future of VR and Rehab

Scott Kim, CEO of Neofect, the makers of the Rapael Smart Glove and Smart Kids, has seen patients engage with the device unlike other previous rehabilitation options. He is seeing therapists also find growing value in its use as a rehabilitation tool.  “The more efficient the therapists are, the more they can do their work to best reach the patients.  There is so much more to be learned, discovered, and taught as it relates to neuro-rehabilitation.  The more tools that we can get into the hands of therapists focusing on neurological conditions, the more opportunities for us as a company to learn from them and their experience (S. Kim, personal communication, Nov 13, 2016).”  Neofect has a couple of other developments on the horizon including a Smart Board to encourage shoulder and other upper extremity functions in a virtual reality environment as well as a Smart Pegboard with visual and cognitive components for a multi-sensory rehab experience. The Smart Board launched in June of 2017 and the Smart Pegboard is slated to be released in September of this year.   

Upper extremity rehabilitation is often delayed in the acute phase of rehab due to the need for medical stabilization and other priorities.  How might VR change the timing of intensive UE rehabilitation post-stroke?  MindMaze, a company headquartered both in Silicon Valley and Lausanne, Switzerland is attempting to answer that question.  Primary clinical results suggest that their technology, which consists of a motion sensing camera and an avatar of the patient on a screen, can increase the number of repetitions of UE movement by 60% in 10 sessions, improving patient efficiency early in the rehabilitation process (Chevalley et al., 2015).  The company’s main product, currently commercially available in European markets, is the Mind Motion Pro.  Its main goal is to provide patients with an immersive experience early on in their rehabilitation to capitalize on early upper extremity training.  The device can be wheeled up to the patient’s bedside and lets the patient begin to train using mirror preparation with the unaffected limb right away post-stroke.  This helps to minimize downtime in the acute care and inpatient rehabilitation units.  Patients have been shown to be able to participate as early as 4 days post stroke for an average of 20 minute sessions to start upper limb training early on in the rehab process (Kinzner et al, 2015).  

Dr. Karen Kerman, Chief Medical Officer of MindMaze, is encouraged by the reception of virtual reality devices in the medical community.  “The goal of virtual reality and of the Mind Motion Pro, for example, is not to replace the therapist with technology but to provide motivation to the patient and free the patient up a bit as they are tasked to do more within a rehabilitation environment (K. Kerman, personal communication, Dec 17, 2016).”  MindMaze aims to create products throughout the continuum of care as well, training a patient on a device in an outpatient setting that they would have access to at home.  The Mind Motion Go, not yet commercially available in the US, is a portable tabletop unit where the patient plays a series of games to address the wrist, arm, and shoulder using a virtual environment.  While the device doesn’t eliminate compensatory movement, it gives real time feedback, an important hallmark in task-oriented practice.  

Beta testing is currently occurring in the US and Europe to get therapist feedback on the device and clinical trials.  MindMaze is seeking to receive feedback from therapists that are technologically savvy as well as those that may not be as comfortable with technology. In doing so, MindMaze hopes to close the gap that some patients experience in regards to an OT’s comfort level with technology driving whether or not they choose to engage a patient with such devices.  

“There is a great future in the area of virtual reality and neuro-rehabilitation.  There are patients that have grown up with technology, they interact socially using technology, and they use it to do their work.  We hope that MindMaze technology can allow stroke patients to have a social network to work with and engage in game play.  The technology provides a social connection during this sometimes disconnected experience.  Clinically, We want to increase the number of repetitions and compliance in an enjoyable gaming experience and we hope that this is a gateway to better functional performance for patients,” Dr. Kerman notes.  “If we can motivate and engage patients with games, we hope patients will work harder and feel less isolated overtime.  Our hope is not only to improve the number of rehab sessions, but to customize it overtime so that patients can reach their maximum potential (K. Kerman, personal communication, Dec 17, 2016).”  

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Have you utilized VR in Your OT Practice? What questions do you have about VR (that we could possibly answer in updates to this post?) Please share in the comments below! 

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About the Author

Lauren is celebrating her 10th year as an occupational therapist in 2017.  Her dream to join a technology company was realized when dreaming about the possibility of doing something “outside the box” after spending the last decade in outpatient neuro clinical practice and most recently in administration and management roles.  Lauren has served in various roles on her state occupational therapy associations and is a proponent of being an active member, particularly in advocating for occupational therapy through legislation and contact with elected officials.  She has enjoyed planning and organizing Washington state’s “Hike the Hill” event for the last three years.  She is also currently serving as the AOTA Representative Assembly Member for the state of Washington.  

Lauren has published multiple articles with OT Practice and is excited to be back to writing, starting with OT Potential, in this new intersection of neuro-rehab, OT and virtual reality.  Lauren believes that OT professionals are poised to be product designers, user experience experts and consultants as it relates to technology solutions that meet the needs of individuals with disabilities.  

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References:

Chevalley, O., Schmidlin, T., Perez-Marcos, D., Garipelli, G., Leeb. R., Duc, C., Vollen, R., Marchand, C., Vuadens, P., Tadi, T., Blanke, O., d.R. Millán, J.  Improved Upper Limb Motor Control with Intensive Virtual Reality Training in Chronic Stroke, European Congress for Neurorehabilitation, Vienna 2015.

Hayward, K. S., & Brauer, S. G. (2015). Dose of arm activity training during acute and subacute rehabilitation post stroke: A systematic review of the literature. Clinical Rehabilitation, 29(12), 1234-1243. doi: http://dx.doi.org/10.1177/0269215514565395

Holden, M. K. (2005). Virtual environments for motor rehabilitation: Review. Cyberpsychology & Behavior : The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society, 8(3), 187-211; discussion 212-9. Retrieved from https://search.proquest.com/docview/67962132?accountid=143111

Kimberley TJ, Samargia S, Moore LG, Shakya JF, Lang CE. Comparison of amounts and types of practice during rehabilitation for traumatic brain injury and stroke. J Rehabil Res Dev. 2010;47(9):851-62. DOI:10.1682/JRRD.2010.02.0019

Kinzner, H., Garipelli, G., Perez-Marcos, D., Tadi, T., Diserens, K. Virtual Reality Based Upper Limb Neurorehabilitation in Acute Stroke: A Single-Case Study, 45th annual meeting of the Society for Neuroscience, Chicago, IL, USA, 17-21, October, 2015.

Mindmaze SA. Study evaluating the MindMotionPRO for early post-stroke upper-limb rehabilitation (MOVE-Rehab).  In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [citied 2017 Jan 14]. Available from: https://clinicaltrials.gov/ct2/show/NCT02688413. NLM Identifier: NCT02688413

Saposnik, G., Levin, M., & Outcome Research Canada (SORCan),Working Group. (2011). Virtual reality in stroke rehabilitation: A meta-analysis and implications for clinicians. Stroke, 42(5), 1380-1386. doi:http://dx.doi.org/10.1161/STROKEAHA.110.605451

Shin, J., Kim, M., Lee, J., Jeon, Y., Kim, S., Lee, S., Seo, B., Choi, Y. (2016). Effects of virtual reality based rehabilitation on distal upper extremity function and health-related quality of life: a single, blinded, randomized controlled trial. Journal of NeuroEngineering and Rehabilitation, 13, 1-17.

Subramanian, S. K., Lourenço, C.,B., Chilingaryan, G., Sveistrup, H., & Levin, M. F. (2013). Arm motor recovery using a virtual reality intervention in chronic stroke: Randomized control trial. Neurorehabilitation and Neural Repair, 27(1), 13-23. doi:http://dx.doi.org/10.1177/1545968312449695

Timmermans, A., Spooren, A., Kingma, H., Seelen, H. (2010). Influence of task-oriented training content on skilled arm–hand performance in stroke: A systematic review. Neurorehabilitation and Neural Repair, 24(9) 858–870.   

Negotiating Your Occupational Therapy Job Offer

Congratulations on your occupational therapy job offer! 

Now it’s time to negotiate. Always negotiate. Whether you have the upper-hand in negotiations or you desperately want the job, you will set the tone as a therapist who thoughtfully advocates for what is mutually beneficial for the company, yourself, and ultimately your patients. 

Don’t ask; don’t get--that is what my traveling therapist friends says. I can also add that my own job satisfaction has been higher in therapy jobs where I negotiated. 

So, take an inventory of what is important to you and chose at least one thing to negotiate.  Below are 6 options to put on the table, each with varying stakes.

Side note: Occupational therapy is predominately a field of women, and women tend to negotiate less than men. Don’t be hard on yourself. This may be because there is a higher social cost for us. Luckily, there are strategies to overcome the gender divide. I recommend reading Sheryl Sandburg’s advice for negotiating.  

1. Unpaid leave for already scheduled trips 

This is a no-brainer. If you already have a wedding, family vacation, or conference that you are planning on attending, ask for it off. Unpaid is fine. This is especially important since vacation time can accumulate slowly in the first months of employment. Also, the first months of a new job are often the most stressful, so a little break can be quite nice. 

2. Mutually beneficial continuing education

You can bet that as you start working, you will want to hone your skills in a certain area. If you already have an inkling of what you would like to specialize in, make it known upfront and suggest particular courses to your employer. Every therapy department I’ve worked for has been looking to expand their offerings and during negotiations you can position yourself to help the company expand and hopefully get some of your education paid for. 

3. The ideal schedule

Both when I was a part-time therapist and when I was a full-time 4-ten-hour-shifts employee, I always started with putting my ideal schedule on the table and ended up with something close.

There are of course typical patient hours that you have to work around, but whether you get in early, stay late, or take a certain amount of time for lunch are often negotiable. If you are not locked into M-F, let me strongly recommend not working Mondays-- these tend to be busy days, whereas Fridays tend to have a more laid-back feel.

4. AOTA and NBCOT membership 

I have a hunch that cost is the primary reason that people do not keep up with these memberships, so talk to your employer. Engagement in professional organizations will give you access to more information to serve your clients. You could even offer to host a monthly article discussion for you team in exchange for the membership. 

5. Loan repayment options

At my first job, they offer to set aside $2000/year before taxes for loan repayment. I was able to negotiate to have the maximum amount allowed by the program which was 6,000/year. When it comes to debt reduction every little bit helps. 

6. Salary

In Women Don’t Ask the authors note that by not negotiating a starting salary at their first position, an individual stands to lose more than $500,000 by age 60. Know what you are worth and don’t be afraid to ask for it. There are tools out there to help calculate the value of your work according to your field within OT, years of experience, and geography.

(If you check out my new page 6 Steps to the Right OT Job, you will find an overview of salary information resources.)

In my own experience of successful salary negotiation, I told them what I had been making before; what the national average was for mental health; and framed it that increasing the salary could make them a more competitive employer, as they had had troubles attracting OTs for the position. 

Do you have any occupational therapy negotiation stories or questions to share? Post them in the comments below! 

MedBridge Promo Code (Save $225!) & Tips for Using the Service

Need a Promo Code for MedBridge? You can use my promo code OTPotential for  $225 off the list price (you pay $200.) You can also sign up via my affiliate link. 

BEFORE you head back to the MedBridge site to plug-in the promo code, I want to give you two more things.

1. 3 Essential Tips to Maximize Your MedBridge Subscription 
2. Guidance If You Are Still on the Fence

3 Essential Tips for Maximizing Your Use of MedBridge

First a note.

These CEU tracking tips are mostly for new grads or people who are new to online subscriptions. 

If you are a practice owner or large business, there is a lot your company could do with a MedBridge subscription. But this is not the place to learn about it.

1.) Look-up Your Continuing Education Requirements for Licensing

Every state has different CEU requirements for occupational therapy practitioners. It is important that you understand the requirements for renewal in your state.

Action Steps:

 a.    Go to your state's department of health and human services website and look for the following information:

• How many CEU hours will you need to renew your license?
• When do you need to meet all of the requirements for renewal?
• Can the hours all be online?
• What do you need as evidence of completing your course?

b.   Mark license renewal dates on your personal calendar.

c.    Print off the requirements and store in a safe place for easy access.

2.) Add Your License Information to MedBridge

Now that you have your renewal date, you can add your license information to MedBridge. Doing so ensures that your license information and the course approval language (if required and applicable) will be printed directly onto your certificate. Having your license number on your certificate is required by some states, but not all. 

Better safe than sorry. 

Action Step: 

a. Add license information as pictured in the image below. 

2.)  Make a Plan for Your CEU Intake

I’ve been able to LOLz with several OT colleagues about the last minute scramble many of us have gone through to complete CEU requirements. 

But, it doesn’t have to be this way.

You will get more out of your CEUs if you have a plan. 

Spacing out your CEUS allows you to take time to implement what you learn into your practice. It also allows you to delve into different quandaries as they are coming up in your practice. 

Action Steps to Take:

a.     Bookmark the classes you want to take.

MedBridge has an option to bookmark courses you are interested in. So, take a few minutes right when you get the subscription to explore the catalogue and find the course that will be most beneficial to your practice. (See image below for how this will appear in your account.)

b.    Put a due date on your calendar for their completion.

Now give yourself several due dates throughout the year for getting these done. (Do this on your personal calendar, MedBridge does not yet have a system for doing this on the site.)

Maybe once a quarter, mark a morning you want to dedicate to improving your practice? 

The more specific the better. (For example: July 8th, 2017, Complete Fundamentals of TE 1&2). 

3.)  Decide How You Will Track Your CEUs

If all of your CEUs will completed in MedBridge, this step is easy. They will be automatically added to your tracker and, in the case of an audit, you will simply get the information from there. 

If you are planning on attending a conference or getting additional CEUs through another service, you will need to do a little more work....but not much. 

You can add the details of the CEU to the tracker, but you will still need a physical location to store your certificate in. This could be as simple as a folder. Designate this folder as you are making your CEU Plan so you aren't frantically going through every OT paper you've ever accumulated in the boxes in the back the back of your closet. Not that has ever happened to me :-) 

Action Steps to Take:

a. Sit back and have MedBridge do most of the work for you. 

b. Designate a folder to store certificates from other CEU endeavors. 

Still on the Fence?

If you are still on the fence about whether this is the right CEU service for you, you can see my post Is MedBridge Right for You?

I believe that this is a great option or many OTs, PTs and SLPs, but like every service it is not right for everyone. 

As you can see, I am a MedBridge affiliate. But, this post was fully initiated by myself and opinions about how to best use the service are my own. 

My Experience with OT and Outcome Measures

If you are struggling with being consistent with using objective measures in your OT practice, I feel your pain. Let’s rally together and get our sweet buns back on the road to being evidence-based and highly justified (a.k.a. critically using objective measures).

5 Steps to How I Improved Use of Objective Measures

Convicted. That’s how I felt after doing three things.

First, Mandy Chamberlain and I had a conversation. In this conversation (via a podcast on home health) I admitted (it’s about integrity) that I have begun using more observation rather than objective and validated measures during OT assessments (except when it comes to cognition in which I am currently and actively pursuing evidence on best practice including plans to meet with Mary Platt in person the first week of June to discuss more about the use of the ACL in home health and have reviewed research from the American Alzheimer’s Association).

Take home message: I felt convicted that I needed to change my approach to using objective assessments.

Secondly, I had begun using a Find Your Flow form to address key stressful areas in my days as a home health OT. While doing this, I became more aware of how I perceived myself as having a mis-fit between a challenge and my skill level while with a patient. The scenario was that I making a strong safety recommendation and felt super stressed at how resistant the patient was to making the change.

Use of the “Find Your Flow” form helped me realize I could find a way to increase my skill in communication and documentation of the conversation in order to manage the challenge (i.e.stress) in future scenarios. According to research on flow, a low skill level (compared to the challenge at hand) can cause anxiety. I realized my skills around the area of being clear, objective and feeling confident that I was handling (and therefore documenting) it correctly were, well, in need of strengthening in order to provide me a bit more flow and less stress in my HH OT practice.

Sooooo (thirdly)...I enrolled myself in a bada** online CEU course for home health OTs. After finally finishing the full 6 hr CEU on defensible documentation by Diana Kornetti and Cindy Kraftt (who regularly consult with home health companies and therapists) I was left feeling humbled and inspired to share these experience and a few quick, do-it-today goals for others in a similar spot who were looking for practical steps to take.

According to this CEU training, Kornetti and Krafft, state the level of assist (min, mod, max) is not enough. WHY are these things happening? THAT’s the question that will lead to picking a solid objective measure. Then decide, which objective measure could help capture this? Even using at least a functional measure like the Modified Barthel Index would be a more standardized way of documenting the patient’s functional status. Doing this would help capture and emphasize the expertise of OT vs one person’s opinion, and therefore also better support future validity of our profession as a whole.

Based on even more conviction that objective measures are not only important, but are also very do-able, I’m sharing 5 short term goals that helped me make progress towards more flow in my OT evals and documentation (not to mention more evidence-based practice).

Here’s what I am committing to… and yes, they are specific and do-able short-term goals. (Your welcome. And yes, I’ll be fully honest with you in this commitment and even show you my real responses.)

1.) Therapist will (non-judgmentally) identify the top 3 reasons s/he does not currently use an objective measure in every assessment and re-assessment (within 2 weeks).

• Too stressed.
• Waiting to get it perfect before I start. (Yep, real thought.)
• Seems like it’s too overwhelming and not knowing where to start (aka room for skill development to match the challenge).

2.) Therapist will (non-judgmentally) identify the top 3 reasons why s/he is interested in using more objective assessments (within 2 weeks).

Finally ready to commit to being more evidence/best-practice based because I know that’s really what’s best also for my clients and this profession as a whole. It’s not about me. It’s about what works.

• Finally feeling more skilled and confident that I CAN do it realistically and sustainably.
• Not as stressed anymore so I have the energy to take it on.

3.) Therapist will complete at least one CEU/training on defensible documentation in his/her related practice area in order to improve documentation skills (within 2 months).

• Defensible Documentation for the Home Health Therapist

4.) Therapist will identify at least 5 objective measures which relate to key areas limiting goal achievement among caseload in order to more easily utilize objective measures on a daily basis (within 2 months).

• Modified Falls Efficacy Scale
• Modified Barthel Index
• DASH
• MoCA
• BORG Exertion Scale
• BONUS (Recommended by Mary Platt): LOTCA-G

5.) Therapist will implement at least one form of objective measure pertaining directly to patient’s TOP goal area during 3 assessments per week for 4 weeks. (Would I like to set this for 100%? Of course. Have I learned to set the first goal to be at least inspiringly do-able? Ab-suh-friggin-lutely.)

• Done: Modified Falls Efficacy Scale (MFES)
• Done: General Practitioner Cognitive Screen (GPCOG)
• Done: Modified Falls Efficacy Scale (MFES)

The Take Home message?

I recognized an area of weakness and am doing something specific to address it. I pursued a course and built my skills (to help increase my chances of having more flow). I recognize I’m not perfect and this will take time to become more proficient...and that’s OK and worth it. 

Will you join me in taking full ownership of using objective measures consistently during at LEAST evals in your practice?

“We are not advocating writing more, we are advocating writing (and evaluating) better.” -Kornetti & Kraftt (emphasis and agreement added by me)

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About the Author

Monika started writing for OT Potential after working as an OT for nearly 6 years. After spending time in outpatient, acute, inpatient rehab and SNFs as a local contract OT in Nebraska, she found her niche in home health. She started writing more when she realized there was a lack of resources that emphasized effective do-it-today strategies for the home health OT. She takes what helps in her own occupational therapy practice, and creates simple, potent content to help you, her fellow OT.

She believes that as you develop unique strategies to ground and care for yourself while practicing as an OT, that your clients and practice (not to mention life) naturally become more potent and meaningful. So she writes to help support that as a vision for the world.

Her projects have ranged from a Home Health OT E-book to a newly updated Find Your Flow form for daily transformation of stressful scenarios using flow-based evidence. She is also a regular guest blogger writing about topics of flow and OT burnout home health OT and motivational interviewing. She's also served as an author at OT Practice addressing team collaboration and home health tips, and as a life coach via Polish Your Light.