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The term "advanced practice" is used increasingly by occupational therapists, employers, educators and regulators across Canada. Variability, however, exists in the meaning and use of the term. In an effort to draw greater consensus regarding advanced practice for occupational therapy in Canada, professional issue forums on the topic were hosted by the Canadian Association of Occupational Therapists (CAOT) in 2009 and 2010. Surveys of the CAOT membership were also undertaken to inform the development of these forums
Findings of CAOT consultations regarding advanced practice
During the CAOT consultations, strong support was received for addressing this issue (Finlayson, 2010). Advantages from the perspectives of many stakeholders were identified. Top benefits for occupational therapists include recognition and acknowledgement of advanced practice, as well as specialization and careerladdering opportunities within the profession. Employers were considered to benefit from a more autonomous and highly trained occupational therapy workforce that can fulfill a broader range of responsibilities. The public benefits from greater access to highly trained occupational therapists for provision of evidence-based occupational therapy services.
Occupational therapists that self-identified in a CAOT survey as an advanced practice practitioner most frequently differed from other members in terms of their primary job responsibility rather than in their overall range of duties (CAOT, 2009a). They were less likely to report a primary job responsibility as direct service provision and more likely to act as a professional leader/ coordinator. While it was clearly evident that interpretation of the term "advanced practice" varied greatly, it was possible to identify several core characteristics of advanced practice practitioners (Finlayson, 2010), including:
* Using theory and evidence deliberately to improve the quality of care provided to clients;
* Engaging actively in knowledge translation to change and improve how practice is carried out;
* Contributing to / being involved in research activities;
* Being a leader;
* Having breadth of knowledge (for example, health care environment, policy); and
* Collaborating, communicating, partnering across sectors.
Several profiles were identified from the range of positions described as advanced practice by survey respondents. Specialists focus their work in particular practice areas where they have gained additional credentials or expertise. Global leaders are innovative occupational therapists that contribute to the development of emerging roles. Beyond scope practitioners assume responsibility for authorized acts...