Importance: Student teaching clinics (STCs) are an increasingly popular means of providing clinical learning opportunities to health profession students. Although research exists on the learning outcomes of students participating in STCs, little research exists on the outcomes of clients participating in STCs. Objective: To examine client-perceived outcomes at a university-based occupational therapy STC in the Pacific Northwest. Design: Retrospective chart review. Participants: Participants included all clients (pediatric and adult) attending the STC during spring 2016. Seventy client charts were reviewed, and 56 charts (80%) met the study inclusion criteria. Intervention: Intervention included 12 wk of student-led occupational therapy that was client centered and occupation based. Outcomes and Measures: Client perceptions of performance and satisfaction in self-identified valued occupations were measured using the Canadian Occupational Performance Measure (COPM) before and after intervention. Results: Clients demonstrated statistically significant increases in both COPM Performance and Satisfaction scores as well as clinically significant improvement in Satisfaction scores. Conclusions and Relevance: Clients reported improvements in performance and satisfaction in valued occupations after attending an STC. The COPM has potential to be used as a client-reported outcome measure for occupational therapy services in STCs, across diagnoses and ages. Areas for future research and clinical implications are discussed. What This Article Adds: This study demonstrates that STCs have the potential to provide positive outcomes for clients as well as student therapists. It provides preliminary support for using the COPM to assess client outcomes in STCs.

OBJECTIVE. We evaluated the feasibility of an intervention combining metacognitive strategy instruction (MSI) with training in implementation intentions for adults with mild traumatic brain injury (mTBI). Implementation intentions are written premade decision statements specifying when, where, and how goal behaviors are to be enacted. METHOD. Two participants with mTBI received a six-session intervention that included setting a daily implementation intention for an occupational therapy goal. A scoring rubric was used to evaluate the quality of implementation intentions; goal achievement was measured using the Canadian Occupational Performance Measure (COPM) and goal attainment scaling. RESULTS. All implementation intentions received perfect quality scores, suggesting participants learned to correctly craft implementation intentions. Improvements in COPM self-ratings exceeded minimal detectable change values; goal attainment levels indicated better-than-expected goal achievement. CONCLUSION. An intervention combining MSI and implementation intention training appears to be feasible. As an adjunct to MSI, implementation intentions may contribute to clients’ ability to achieve their own occupational performance goals. Further study is needed.

As the health care system continues to evolve toward one based on quality not quantity, demonstrating the value of occupational therapy has never been more important. Providing high-quality services, achieving optimal outcomes, and identifying and promoting occupational therapy’s distinct value are the responsibilities of all practitioners. In relation to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 , the Centers for Medicare and Medicaid Services (CMS) is implementing new functional items and related outcome performance measures across postacute care (PAC) settings. Practitioners can demonstrate the role and value of occupational therapy services through their participation in data collection and the interpretation of the resulting performance measures. In this column, we review the objectives of the IMPACT Act, introduce the new self-care and mobility items and outcome performance measures being implemented in PAC settings, and describe ways to use these new data to advocate for occupational therapy. We also discuss American Occupational Therapy Association initiatives to provide materials and guidance for occupational therapy practitioners to contribute to PAC data collection.

OBJECTIVE. This study aimed to understand how the Canadian Occupational Performance Measure (COPM) can be used as an outcome measure in primary care and to identify the occupational performance profiles in this setting. METHOD. First, the COPM was administered to all eligible clients at two sites. Second, a focus group with participating occupational therapists explored the feasibility of using the COPM in primary care. RESULTS. A total of 161 COPMs were initially administered. Self-care goals were identified most frequently (n = 248), followed by productivity (n = 229) and leisure (n = 179) goals (total goals = 656). Mean initial performance and satisfactions scores were 3.2 and 2.8, respectively. The average change (n = 22) scores were 2.1 and 2.6, respectively. CONCLUSION. The COPM is an invaluable tool to guide initial assessments and offer an occupation-focused lens. Given the lifespan approach and an emphasis on screening and assessment, the challenge was finding the opportunity for readministration.

The purpose of this study was to determine whether 155 ethnically diverse clients with traumatic brain injury (TBI) and stroke (cerebrovascular accident; CVA) who received occupational therapy services perceived that they reached self-identified goals related to tasks of daily life as measured by the Canadian Occupational Performance Measure (COPM). This study found that a statistically and clinically significant change in self-perceived performance and satisfaction with tasks of daily life occurred at the end of a client-centered occupational therapy program (p < .001). There were no significant differences in performance and satisfaction between the TBI and CVA groups. However, the group with right CVA reported a higher level of satisfaction with performance in daily activities than the group with left CVA (p = .03). The COPM process can effectively assist clients with neurological impairments in identifying meaningful occupational performance goals. The occupational therapist also can use the COPM to design occupation-based and client-centered intervention programs and measure occupational therapy outcomes.

This study sought to determine the extent to which the Canadian Occupational Performance Measure (COPM) assessed performance in elderly people after hip fracture. Correlations were found between the COPM and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Although functional improvement was noted, participants did not attain the functional status they had before hip fracture. The greatest recovery occurred within the first 130 days after surgery. These findings suggest some central implications for occupational therapy practice, although further research is required to determine the optimal time for intervention to begin. Because the COPM is sensitive to change in function in patients recovering from hip fracture, COPM use with this population is desirable and advisable.

OBJECTIVE. This quasi-experimental study sought to determine whether children with possible sensory processing deficits, as measured by the Sensory Profile, performed less well on an occupational performance measure compared to children with typical Sensory Profile scores. METHOD. Sixty-eight children were administered both the Assessment of Motor Process Skills (AMPS) and the Sensory Profile. After the assessments were completed, children were divided into two groups based on their Sensory Profile scores. RESULTS. Independent t tests indicated statistically significant differences between groups on the AMPS ADL [Activities of Daily Living] Motor and ADL Process measures (p < .05), with the children with atypical Sensory Profile scores showing more functional difficulties. Correlations revealed significant relationships among the measures. CONCLUSION. The results suggest that children identified with sensory processing deficits on the Sensory Profile are likely to experience some challenges in performing everyday occupations.

OBJECTIVE. The purpose of this study was to investigate the association between participation in goal-specific outpatient occupational therapy and improvement in self-identified goals in adults with acquired brain injury. METHOD. Thirty-one persons with traumatic brain injury of mixed chronicity participated at three sites located in different regions of the United States. Using a repeated-measures design, therapy that usually was offered at each site to achieve specific goals was followed by a no-treatment period. Participants completed the Canadian Occupational Performance Measure Performance subscale (COPM-P) and Satisfaction subscale (COPM-S), and the Community Integration Questionnaire (CIQ) at admission, discharge, and 1 to 18 weeks after discharge. Goal attainment scales were developed at admission and scored at discharge; the differences for each site were tested, using dependent t tests. Gains for the treatment period (admission to discharge) in COPM subscales and the CIQ were compared with gains during the no-treatment period (discharge to followup) for each site, using dependent t tests. The results were synthesized meta-analytically across the sites. RESULTS. The participants identified a total of 149 goals, 81% of which were achieved. Goal attainment T scores improved significantly (Z = 7.52, p < .001), and the combined effect size was large (r = .94). The COPM-P (Z = 4.13, p < .001) and COPM-S (Z = 4.25, p < .001) showed significantly greater gains during the treatment (average 15.3 weeks) versus the no-treatment (average 9.9 weeks) period. Effect size estimates were large: .71 and .76, respectively. Gain scores of the CIQ did not differ significantly (Z = .75, p = .22, r = .29) between periods. CONCLUSION. Participation in goal-specific outpatient occupational therapy that focused on teaching compensatory strategies was strongly associated with achievement of self-identified goals and reduction of disability in adults with mild to moderate brain injury.

Objective. This article describes how authenticity and directness, desired characteristics of performance measures, were applied to the development of a context-based Test of Grocery Shopping Skills (TOGSS) for persons with schizophrenia. Method. The steps used in developing the measure included interviewing consumers with schizophrenia to identify issues in grocery shopping, conceptualizing how authenticity and directness could be applied to shopping performance, and selecting grocery items to be used in the test. The two forms of the TOGSS were administered to 26 persons with schizophrenia or schizoaffective disorders to evaluate reliability (stability, equivalence, interrater) and validity (convergent, generalizability) of the TOGSS. Results. The correlations between the two forms of the TOGSS over two different testing periods were significant, ranging from .64 to .83. Subscale scores were moderately correlated (R = .52. to .94) with a similarly constructed test of drugstore shopping. Conclusion. A systematic method can be used to develop a context measure of performance. The TOGSS has beginning evidence of reliability and validity. With further study, the test will be useful in assessing the independent living skill of grocery shopping in persons with psychiatric disorders.