Narrative summary of the ACOTE Occupational Therapy Entry Level Survey

*This represents MY Summary and opinions on this report:

As part of the process of gathering data to inform decision making regarding the entry level degree required for occupational therapy practice, the Accreditation Council on Occupational Therapy Education conducted a survey.

In summarizing these statistics, categories of respondents were combined to simplify analysis.  Also, in summarizing agreement or disagreement, categories of 'strongly agree' and 'agree' were combined as were 'strongly disagree' and 'disagree.'

That survey was open between March 13, 2015 and closed May 15, 2015.  There were 2,829 respondents.  The generalized categories of respondents were OT practitioners (50%), OT students (19%), OT academicians (29%),and employers (3%).

The overwhelming majority of respondents (71%) agreed that the OT profession should embrace a single entry level.  This opinion was similar across all categories of respondents.

When asked if the body of OT evidence would benefit if the entry level degree moved to the doctorate, 61% of respondents disagreed.

When asked if if a doctoral entry level degree would allow for an increased impact on healthcare reform, 61% of respondents disagreed.  Practitioners in particular disagreed with this statement (70%).

When asked if moving to an entry level doctorate would positively impact practice on the respondent's particular region, 69% disagreed.  Practitioners in particular disagreed with this statement (78%).

When asked if such a change would positively impact students, 70% disagreed.

67% of respondents did not think that a doctoral entry level degree offered more opportunity for promotion.    Only 23% of practitioners thought it could offer such opportunity as opposed to 43% of educators who thought it could offer such opportunity.

 Securing fieldwork placements was a concern of the majority of respondents (66%).  Most respondents (57%) did not believe that academic institutions are positioned to meet the changing needs of OT programs.  70% of respondents believed that there was a lack of qualified faculty, 40% believed that there was a lack of State support, and 42% believed that there was a lack of institutional support.  72% believe that an entry level OTD will decrease the number of applicants to OT programs, and 64% believe that it will decrease the diversity of applicants.  Only 12% of respondents believed that no challenges were anticipated.

Cost was a significant concern; 74% of respondents believed that the cost of a higher entry level degree would not be worth any benefits that it might bring.

Employers responded in an overwhelming fashion (82%) that they are not more likely to hire OTs with a higher entry level degree.

Most respondents overwhelmingly felt that the current degree requirements were sufficient: 92% believed that basic tenets were sufficient,  90% believed that theoretical perspectives were sufficient, 87% believed education on evaluation was sufficient,  85% believed that education on intervention was sufficient, 89% felt that education on service delivery context was sufficient, and 94% believed that education on ethics and professional responsibilities was sufficient.   Beliefs on sufficiency of education on scholarship (79%) and management (82%) were lower, but still rather high.



The ACOTE decision to support dual entry into the profession is in opposition to the AOTA Board of Director's opinion on the doctoral degree as a single point of entry.  The recommendation is certainly not based on survey results alone.  However, the largest concern for the OT community should be the overwhelming and consistent difference of opinion between this survey and the responses and recommendations of the AOTA Ad Hoc Committee on the Future of Occupational Therapy Education and the AOTA Board of Directors.

The future of this doctoral issue remains uncertain, but the OT community should study the results of this survey and attempt to understand why the OT leadership would come to a conclusion that is so apparently out of step with its membership and other stakeholders.

Based on previous analysis, there was a concerning lack of diversity on the Ad Hoc committee.  That committee was composed almost entirely of academics.  I reported on the concern 18 months ago when the recommendation for the OTD was made:

The AOTA Board informed their decision on two workgroups: one an Ad Hoc Board Committee on the Future of OT Education chaired by Dr. Thomas Fisher and the other an internal subcommittee of the Board itself that reviewed the Ad Hoc Committee's findings.

The Ad Hoc Committee was comprised of occupational therapists who also served as Deans, Provosts, or other high ranking University officials as well as the AOTA Director of Accreditation and Academic Affairs.  Task groups were developed to address specific questions.  Specifically, one task group called the "Maturing of the Profession" task group made the specific recommendation for mandatory doctoral level education.  This group consisted of a physical therapy educator/Dean and four occupational therapy academics who all held high ranking University positions.

It is not known who comprised the sub group of the AOTA Board of Directors that looked at the Ad Hoc groups findings.  However, the AOTA Board of Directors is known to be heavily weighted with those who work in academic settings.  Among those who are not currently in academia, most either hold dual academic appointments, have held academic appointments in the past,  or are in senior administrative positions in their work settings.

The fundamental problem with the composition of these committees and task groups is that they are making recommendations that stretch outside the confines of academia.  The recommendation for mandatory doctoral level training is not an academic recommendation.  It is a practice recommendation.

The ACOTE survey provides a rich data set that reflects the position of a more diverse group of stakeholders.  Perhaps even more importantly, the survey represents an opportunity for the AOTA Board of Directors to reflect on how they constitute Ad Hoc committees and how they might promote more diverse engagement from the entire occupational therapy community in the future.


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