The Portfolio Review is on the assessment tools to determine advancement to the next professional level in the Professional Advancement and Recognition model.

The applicant’s portfolio provides comprehensive background information and provides the therapist with an opportunity to highlight how their background impacts his or her practice and meets the expectations of the Practice Model Continuum and the requirements of the position applied for.

The portfolio contains the following elements:

1. Cover Letter

2. Resume/Curriculum Vitae

• Education
• Experience
• Presentations
• Research/Publications
• Community Involvement
• Committee Participation
• Student/Resident Teaching Activities
• Mentoring Activities

3. Letters of Recommendation

An interview will be conducted for each applicant during the review process for professional advancement.

The interview process is a tool for the review board to collect objective information that demonstrates the applicant’s level of expertise.

Interview questions will be formulated based on analysis of the information the therapist provides through the application and portfolio, which also includes the clinical case presentation, the clinical narrative, and if applicable, case report (expert only).

The interview serves to help the applicant reveal aspects of level of expertise not otherwise demonstrated in the written application materials or through documentation review.

Therapists applying for Advanced Clinician or Expert Clinician will interview with a subgroup of the Review Board. The therapist and the interview team are expected to have an open, direct dialogue about issues pertinent to the therapist’s practice.

In the interview, a majority of the questions asked will be behavioral in nature. Behavioral questions are based on the premise that past behavior predicts future behavior. Rather than providing hypothetical answers, applicants are asked to provide specific examples from their actual practice. Behavioral interview questions ask about past experiences as they relate to specific and concrete situations. A sample question might be: “Tell me about a specific time when you influenced the outcome of a team project by taking a leadership role.”

The Professional Advancement and Recognition program is designed to support professional development and to recognize professional contributions by occupational therapists and physical therapists at all points in one’s career.

The program serves as the formal process for promotion and advancement to develop and recognize clinical expertise.

A chart review will occur during the review process to determine advancement to the next clinician level. The chart review assesses components of practice across application themes and sub-themes of the Practice Model Continuum (pdf). Elements of the chart review are used to assist with developing questions for the interview process.

In total, three patient’s documentation is reviewed. One of the records chosen for review is from the therapist’s Clinical Case Presentation (Advanced Clinician) or Case Report (Expert Clinician), and the other two medical records are randomly chosen from the applicants patients within the previous six months.

All therapy documentation is thoroughly reviewed by the interview team subgroup of the Review Board.

The Professional Advancement and Recognition program is designed to support professional development and to recognize professional contributions by occupational therapists and physical therapists at all points in one’s career.

The program serves as the formal process for promotion and advancement to develop and recognize clinical expertise.

For the advancement to Expert Clinician level, a Case Report is required.

• View Position Descriptions

A Case Report is a comprehensive document. The case report should be written to a sufficient level such that publication in a peer reviewed journal is possible, but publication is not required for promotion.

Case Reports involve a formal style of writing and follow a specific format. Case Reports reflect typical clinical practice in that they have only one pre-intervention measurement and one post-intervention measurement. Thus, the purpose of a Case Report is to describe practice and not to determine cause and effect relationships.

Issues highlighted in the Case Report may include:

• Patient/client management
• Ethical dilemmas
• Use of equipment or devices
• Administrative or educational concerns

A Case Report is not equivalent to a single subject design research study which uses experimental controls and repeated measures and, therefore, may be used to show cause and effect relationships among variables. Case Reports refer to descriptions of practice that do not involve “research methodology.”

Additional Resources

McEwen Irene. Writing Case Reports A How-To Manual for Clinicians, 2nd ed.

Green, B, Johnson, C. Writing Patient Case Reports for Peer-Reviewed Journals: Secrets of the Trade. Journal of Sports Chiropractic and Rehabilitation. 2000; No. 3.

Iles RL. Guidebook to Better Medical Writing: Case reports, letters to the editor, book reviews, review articles and scientific posters. Accessed May, 2007.

The Professional Advancement and Recognition program is designed to support professional development and to recognize professional contributions by occupational therapists and physical therapists at all points in one’s career.

The program serves as the formal process for promotion and advancement to develop and recognize clinical expertise.

The Clinical Narrative is a written document that serves as a tool to assist therapists with self reflection and professional growth. It is considered during the review process for advancement to the next professional level.

The Clinical Narrative is a tool that allows therapists to describe and demonstrate their practice within a specific case (over a number of days or treatment sessions) or at a specific point in time.

The Clinical Narrative is a document written in an informal manner in the first person used to facilitate reflection by the therapist regarding their practice and their thought processes. It provides an opportunity to show a therapist’s practice level across the themes and sub themes of the Practice Model Continuum (pdf). 

The Clinical Narrative provides the writer with the opportunity to address critical components of care including communication, teamwork, patient advocacy, critical thinking skills and other areas.

What is a Clinical Narrative?

• It is a story written from the therapist’s perspective describing a specific clinical case that happened within the last year
• It provides the therapist with a tool for self reflection on their current practice
• It enables the therapist to depict her/his current clinical practice
• It presents information in a way that promotes discussion with colleagues

What should the Clinical Narrative be about?

• A patient interaction in which your intervention made an impact on the patient’s outcome
• A situation that was challenging or particularly meaningful to you, but could also be rather ordinary in nature, as an example of your current practice
• A situation that you frequently experience that highlights your role in the patient care team that gives you new insight into your role as a therapist

What should be included in the Clinical Narrative?

• A detailed account of the case that helps the reader to visualize and understand the situation even if they are unfamiliar with your specific clinical role
• A discussion of your thoughts, feelings and actions surrounding the situation – your description should indicate the rationale for your actions
• Aspects of the situation that concerned you at the time
• Why this situation was important to you
• Conversations you had with others including, but not limited to the patient, family members and the patient care team

What are some of the tips for writing an effective Clinical Narrative?

• Present the story from your point of view, changing the patient’s name and any other identifying information
• You may find it helpful to review the story with a colleague who is familiar with the patient’s case
• Have someone who is unfamiliar with the patient read your Narrative to identify areas that lack clarity
• Include your thought and decision making process to help illustrate how and why you made your choices in this situation as it took place
• Be specific. Give the reader an accurate picture of the situation. Avoid general or summary statements

Additional Resources

Benner P. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Addison-Wesley Publishing Company. 1984; 2001.

Jensen GM, Gwyer JM, Hack LM, Shepard KF. Expertise in Physical Therapy Practice. Second Edition. St. Louis: Saunders. 2007.

Mattingly C. Healing dramas and clinical plots: The narrative structure of experience. Cambridge University Press. 1998.

The Professional Advancement and Recognition program is designed to support professional development and to recognize professional contributions by occupational therapists and physical therapists at all points in one’s career.

The program serves as the formal process for promotion and advancement to develop and recognize clinical expertise.

The Clinical Case Presentation is used as a tool to assess practice at all four practice levels and follows departmental guidelines. The Clinical Case Presentation format asks each therapist to present a specific patient case and to discuss clinical decision making surrounding the patient’s care (i.e. evaluation, intervention, progress, evidence-based treatment with literature citations, lessons learned, etc.).

Along with their application, applicants seeking advancement to Advanced Clinician must submit written materials that provide detailed information about the applicant’s most recent Clinical Case Presentation and that specifically highlight the applicant’s clinical decision making throughout the patient/client management process. This written documentation should include:

• Applicant’s presentation materials
  • Copy of initial note
  • Power point presentation handout (if used)
  • Any additional handouts provided at the time the presentation was made

Applicants should also include a reference list and paper or electronic copies of the 2-3 most important articles.

Fundamental job duties, responsibilities and essential functions for the Physical Therapist – Expert Clinician level include:

1. Clinical Decision-Making

Evaluates and re-evaluates patient/clients using high-level knowledge of the principles and methods of patient/client assessment and on-going reassessment to develop and modify effective assessments and treatment plans. Able to make a comprehensive assessment of patient needs that span across the continuum of care. Demonstrates leadership and is viewed and utilized by peers as the primary resource in area(s) of expertise in clinical decision making. Actively mentors staff throughout all components of clinical decision-making.

• Assessments and re-assessments are patient-specific and consider alternative hypotheses to specific clinical questions
• Demonstrates high-level proficiency in data gathering skills efficiently and selectively. Uses relevant sources of information with a strong emphasis on information obtained from patient/client/family.
• Exceptional critical analytical skills are applied to all aspects of clinical decision making
• Consistently incorporates relevant data in clinical decision making
• Intuitively uses available resources, including patient outcomes and past experiences, to guide patient/client assessment
• Using multiple sources, comprehensively assesses patient/client factors that impact treatment plan and outcome
• Selects appropriate assessment tests and measures to conduct patient/client assessment and re-assessment. Demonstrates a superior understanding of the relationship between functional performance on specific tests/measures and underlying impairments in body structure/function.
• Proficiently uses standardized assessment tools that address function and disablement by measuring relevant information that impacts patients/clients. Modifies tests and measures based on patient/client needs.
• Consistently recognizes signs and symptoms of medical problems that require further medical evaluation and facilitates follow-up
• Comfortably and effectively evaluates complex patients with problems in multiple body systems and develops a comprehensive, patient-centered plan for managing multiple therapy needs.
• From the start of care, anticipates and prioritizes the key underlying impairments that result in physical, behavioral, and/or cognitive dysfunction that are typical of specific patient populations. Understands the complex relationship between underlying impairments and demonstrates expert knowledge and decision making in complex situations.
• Establishes a therapy classification or therapy diagnosis that is specific to the patient/client. Intuitively and accurately classifies patients based on impaired body/structure, activity limitations, and participation restrictions, as well as therapy practice patterns.
• Makes accurate predictions about patient/client outcomes across the continuum of care. Recognizes and addresses factors that may promote further recovery or future decline in function.
• With input from the patient/client and/or the patient/client’s family, establishes patient-centered goals that reflect anticipated outcomes. Therapy goals address the complex relationships between body structure/function, activity and participation, as well as show greater emphasis on personal and environmental factors that influence long-term functional recovery.
• Based on assessment and on-going reassessment, selects and modifies appropriate interventions with an emphasis on patient/client education. Makes selective use of inter-disciplinary collegial knowledge, particularly in challenging clinical situations by incorporating highly individualized, patient centered interventions that target key concerns/goals of the patient/client. Interventions are modified continuously and effortlessly within and between patient/client visits.
• Anticipates future patient outcomes in terms of future disablement or enablement for across patient populations through high-level integration of relevant clinical data
• Demonstrates leadership and is viewed and utilized by peers as the primary resource in area(s) of expertise in clinical decision-making
• • Demonstrates understanding of the value of patient empowerment and self-efficacy and plays a primary role as a coach, guide, or facilitator. Emphasizes creative, collaborative problem solving with patients/clients to implement effective strategies for self-management.
• In adherence to the profession’s Code of Ethics, uses ethical reasoning to make decisions based on objective principles and values. Identifies and examines ethical dilemmas using clinical reasoning to guide decision and actions. Serves as a resource to others when ethical dilemmas exist.
• Takes a leadership role by taking accountability and responsibility for the care needs of all patients in their team, discipline, department and across the organization. Seeks alternate strategies and/or other resources to make sure patient/client needs are met.

2. Performance Skills

Provides interventions across a broad range of needs with increased selectivity to patients/clients that are safe, timely, effective, efficient, patient-centered and equitable, in compliance with organizational policies and procedures. Demonstrates leadership and is viewed and utilized by peers as the primary resource in area(s) expertise in regards to performance skills. Actively mentors others in regards to selection and performance of therapeutic interventions.

• Maintains competency within area(s) of expertise. Demonstrates competency in treatment skills by completing institutional and program-specific competencies and consistently meets annual requirements. Assesses peers for basic and advanced competency skills.
• Practices competently in accordance with professional practice standards and expectations
• Employs highly refined visual, tactile and auditory skills to aid with patient/client assessment/reassessment and intervention
• Provides highly selective therapeutic interventions
• Progresses treatment interventions timely, selectively and effectively
• Interventions take into account behavioral, cognitive, and perceptual dysfunction and appropriate referrals to specialists are made, if needed
• In accordance with patient/client need, selects treatment with consideration of resource utilization, including space, time, people and equipment
• Anticipates patient/client learning needs and is prepared for session. Identifies and provides appropriate strategies to educate patients so that environmental constraints, learning barriers and cultural factors are addressed effectively. Assesses effectiveness of teaching and considers emotional impact of condition on learning.
• Actively engages the patient to take responsibility to ensure that needs are adequately addressed
• Delegates treatment to appropriate clinical staff and provides necessary supervision. Maximizes efficiency in patient outcomes by use of appropriate support personnel.
• Demonstrates leadership and is viewed and utilized by peers as the primary resource in area(s) expertise in regards to performance skills. Actively mentors others in regards to selection and performance of therapeutic interventions.

3. Interpersonal Abilities

Demonstrates respectful interactions with patients/clients, colleagues and others. Leads by example when interacting with others and mentors others on interpersonal skills.

• Actively and independently advocates on behalf of patients to appropriate individuals and is aware of common patient needs for similar patient populations
• Anticipates and understands multiple cultural values and incorporates these values in developing rapport and treatment plan to maximize patient outcomes
• Establishes and maintains rapport with patients by respecting others’ values and adapting interactions to build trust
• Works cooperatively with co-workers demonstrating respect, trust and support
• Initiates team approach to patient care as indicated and mediates patient goals among team members. Mediates conflict effectively with others.
• Actively mentors others in collaboration
• Has achieved credibility within the health care team; expertise is sought by team members in planning patient care
• Consults with or refers to other colleagues/disciplines to meet patient/client needs
• Incorporates critical feedback from supervisor and colleagues and works towards improving areas of weakness

4. Professional Behaviors

Acts professionally to all individuals. Takes an active role in organizational initiatives to improve patient care, practice and institutional performance.

• Actively identifies problems related to systems issues and works diligently to develop potential solutions to these problems as part of their professional practice. Actively provides feedback.
• Actively identifies challenges and actionable solutions that impact clinical practice
• Actively participates on committees or task forces that focus on improving patient care, practice and/or institutional performance
• Written communication is timely, succinct, clear, and meets all regulatory and hospital standards. Documentation anticipates the needs of the reader.
• Practices in ways that ensure patient care and administrative tasks are performed timely while remaining flexible with changes in schedule. Takes on other responsibilities and incorporates into day.
• Able to prioritize and triage to maximize effectiveness and efficiency. At a high level, adapts to the factors that influence time management.
• Meets and/or exceeds productivity expectations
• Advocates for the profession internally and externally to UW Health. Advances the profession through professional activities within and/or outside the institution.
• Identifies when communication is necessary and directs communication at the right time in the right place to the right person using an appropriate medium. Therapist anticipates the need to change verbal communication style depending on situational needs. Communication reflects comfort, skill and a full grasp of the content in all situations.
• Verbal and non-verbal communication is respectful, empathetic and appropriate to individuals and groups
• Is accountable and takes responsibility for identifying trends in practice gaps and actively pursues opportunities (i.e. through continuing education, mentorship, etc.) to improve practice. Independently seeks resources to improve knowledge base and skill level.
• Respects others’ values

5. Administration/Education/Outreach/Research

Actively participates in at least two activities that extend beyond patient care, including administration, education, outreach and research as defined in the Practice Model Continuum (pdf) for the Advanced Clinician across all themes and sub-themes.

• Evidence drawn from the literature is actively pursued to support clinical practice. Incorporates research findings into clinical practice.
• Demonstrates a commitment to continued learning by attending continuing education, reviewing the literature and independently seeking other resources
• In addition to annual requirements, makes presentations and/or educates groups outside of direct patient care responsibilities
• As opportunities exist, actively participates in student clinical education often times as a clinical instructor or as an educator in clinical residencies
• Critically appraises journal articles or other sources of evidence
• Mentors others, especially in area(s) of expertise
• Leads and actively participates in at least two activities that extend beyond patient care, including administration, education, outreach and research as defined in the Practice Model Continuum (pdf) for the Expert Clinician across all themes and sub-themes.

Fundamental job duties, responsibilities and essential functions for the Occupational Therapist – Expert Clinician level include:

1. Clinical Decision Making

Evaluates and re-evaluates patient/clients using high-level knowledge of the principles and methods of patient/client assessment and on-going reassessment to develop and modify effective assessments and treatment plans. Able to make a comprehensive assessment of patient needs that span across the continuum of care. Demonstrates leadership and is viewed and utilized by peers as the primary resource in area(s) of expertise in clinical decision making. Actively mentors staff throughout all components of clinical decision making.

• Assessments and re-assessments are patient-specific and consider alternative hypotheses to specific clinical questions
• Demonstrates high-level proficiency in data gathering skills efficiently and selectively. Uses relevant sources of information with a strong emphasis on information obtained from patient/client/family.
• Exceptional critical analytical skills are applied to all aspects of clinical decision making
• Consistently incorporates relevant data in clinical decision making
• Intuitively uses available resources, including patient outcomes and past experiences, to guide patient/client assessment
• Using multiple sources, comprehensively assesses patient/client factors that impact treatment plan and outcome
• Selects appropriate assessment tests and measures to conduct patient/client assessment and re-assessment. Demonstrates a superior understanding of the relationship between functional performance on specific tests/measures and underlying impairments in body structure/function.
• Proficiently uses standardized assessment tools that address function and disablement by measuring relevant information that impacts patients/clients. Modifies tests and measures based on patient/client needs.
• Consistently recognizes signs and symptoms of medical problems that require further medical evaluation and facilitates follow-up
• Comfortably and effectively evaluates complex patients with problems in multiple body systems and develops a comprehensive, patient-centered plan for managing multiple therapy needs.
• From the start of care, anticipates and prioritizes the key underlying impairments that result in physical, behavioral and/or cognitive dysfunction that are typical of specific patient populations. Understands the complex relationship between underlying impairments and demonstrates expert knowledge and decision making in complex situations.
• Establishes a therapy classification or therapy diagnosis that is specific to the patient/client. Intuitively and accurately classifies patients based on impaired body/structure, activity limitations and participation restrictions, as well as therapy practice patterns.
• Makes accurate predictions about patient/client outcomes across the continuum of care. Recognizes and addresses factors that may promote further recovery or future decline in function.
• With input from the patient/client and/or the patient/client’s family, establishes patient-centered goals that reflect anticipated outcomes. Therapy goals address the complex relationships between body structure/function, activity and participation, as well as show greater emphasis on personal and environmental factors that influence long-term functional recovery.
• Based on assessment and on-going reassessment, selects and modifies appropriate interventions with an emphasis on patient/client education. Makes selective use of inter-disciplinary collegial knowledge, particularly in challenging clinical situations by incorporating highly individualized, patient centered interventions that target key concerns/goals of the patient/client. Interventions are modified continuously and effortlessly within and between patient/client visits.
• Anticipates future patient outcomes in terms of future disablement or enablement for across patient populations through high-level integration of relevant clinical data
• Demonstrates leadership and is viewed and utilized by peers as the primary resource in area(s) of expertise in clinical decision making
• Demonstrates understanding of the value of patient empowerment and self-efficacy and plays a primary role as a coach, guide or facilitator. Emphasizes creative, collaborative problem solving with patients/clients to implement effective strategies for self-management.
• In adherence to the profession’s Code of Ethics, uses ethical reasoning to make decisions based on objective principles and values. Identifies and examines ethical dilemmas using clinical reasoning to guide decision and actions. Serves as a resource to others when ethical dilemmas exist.
• Takes a leadership role by taking accountability and responsibility for the care needs of all patients in their team, discipline, department and across the organization. Seeks alternate strategies and/or other resources to make sure patient/client needs are met.

2. Performance Skills

Provides interventions across a broad range of needs with increased selectivity to patients/clients that are safe, timely, effective, efficient, patient-centered and equitable, in compliance with organizational policies and procedures. Demonstrates leadership and is viewed and utilized by peers as the primary resource in area(s) expertise in regards to performance skills. Actively mentors others in regards to selection and performance of therapeutic interventions.

• Maintains competency within area(s) of expertise. Demonstrates competency in treatment skills by completing institutional and program-specific competencies and consistently meets annual requirements. Assesses peers for basic and advanced competency skills.
• Practices competently in accordance with professional practice standards and expectations
• Employs highly refined visual, tactile and auditory skills to aid with patient/client assessment/reassessment and intervention
• Provides highly selective therapeutic interventions
• Progresses treatment interventions timely, selectively and effectively
• Interventions take into account behavioral, cognitive and perceptual dysfunction and appropriate referrals to specialists are made, if needed
• In accordance with patient/client need, selects treatment with consideration of resource utilization, including space, time, people and equipment
• Anticipates patient/client learning needs and is prepared for session. Identifies and provides appropriate strategies to educate patients so that environmental constraints, learning barriers, and cultural factors are addressed effectively. Assesses effectiveness of teaching and considers emotional impact of condition on learning.
• Actively engages the patient to take responsibility to ensure that needs are adequately addressed
• Delegates treatment to appropriate clinical staff and provides necessary supervision. Maximizes efficiency in patient outcomes by use of appropriate support personnel.
• Demonstrates leadership and is viewed and utilized by peers as the primary resource in area(s) expertise in regards to performance skills. Actively mentors others in regards to selection and performance of therapeutic interventions.

3. Interpersonal Abilities

Demonstrates respectful interactions with patients/clients, colleagues and others. Leads by example when interacting with others and mentors others on interpersonal skills.

• Actively and independently advocates on behalf of patients to appropriate individuals and is aware of common patient needs for similar patient populations
• Anticipates and understands multiple cultural values and incorporates these values in developing rapport and treatment plan to maximize patient outcomes
• Establishes and maintains rapport with patients by respecting others’ values and adapting interactions to build trust
• Works cooperatively with co-workers demonstrating respect, trust and support
• Initiates team approach to patient care as indicated and mediates patient goals among team members. Mediates conflict effectively with others.
• Actively mentors others in collaboration
• Has achieved credibility within the health care team; expertise is sought by team members in planning patient care
• Consults with or refers to other colleagues/disciplines to meet patient/client needs.
• Incorporates critical feedback from supervisor and colleagues and works towards improving areas of weakness.

4. Professional Behaviors

Acts professionally to all individuals. Takes an active role in organizational initiatives to improve patient care, practice and institutional performance.

• Actively identifies problems related to systems issues and works diligently to develop potential solutions to these problems as part of their professional practice. Actively provides feedback.
• Actively identifies challenges and actionable solutions that impact clinical practice
• Actively participates on committees or task forces that focus on improving patient care, practice, and/or institutional performance
• Written communication is timely, succinct, clear and meets all regulatory and hospital standards. Documentation anticipates the needs of the reader.
• Practices in ways that ensure patient care and administrative tasks are performed timely while remaining flexible with changes in schedule. Takes on other responsibilities and incorporates into day
• Able to prioritize and triage to maximize effectiveness and efficiency. At a high level, adapts to the factors that influence time management.
• Meets and/or exceeds productivity expectations
• Advocates for the profession internally and externally to UW Health. Advances the profession through professional activities within and/or outside the institution.
• Identifies when communication is necessary and directs communication at the right time in the right place to the right person using an appropriate medium. Therapist anticipates the need to change verbal communication style depending on situational needs. Communication reflects comfort, skill and a full grasp of the content in all situations.
• Verbal and non-verbal communication is respectful, empathetic and appropriate to individuals and groups
• Is accountable and takes responsibility for identifying trends in practice gaps and actively pursues opportunities (i.e. through continuing education, mentorship, etc.) to improve practice. Independently seeks resources to improve knowledge base and skill level.
• Respects others’ values

5. Administration/Education/Outreach/Research

Actively participates in at least two activities that extend beyond patient care, including administration, education, outreach, and research as defined in the Practice Model Continuum (pdf) for the Advanced Clinician across all themes and sub-themes.

• Evidence drawn from the literature is actively pursued to support clinical practice. Incorporates research findings into clinical practice.
• Demonstrates a commitment to continued learning by attending continuing education, reviewing the literature, and independently seeking other resources
• In addition to annual requirements, makes presentations and/or educates groups outside of direct patient care responsibilities
• As opportunities exist, actively participates in student clinical education often times as a clinical instructor or as an educator in clinical residencies
• Critically appraises journal articles or other sources of evidence
• Mentors others, especially in area(s) of expertise
• Leads and actively participates in at least two activities that extend beyond patient care, including administration, education, outreach and research as defined in the Practice Model Continuum (pdf) for the Expert Clinician across all themes and sub-themes.

Fundamental job duties, responsibilities and essential functions for the Physical Therapist – Advanced Clinician level include:

1. Clinical Decision Making

Evaluates and re-evaluates patient/clients using high-level knowledge of the principles and methods of patient/client assessment and on-going reassessment to develop and modify effective assessments and treatment plans. Able to make a comprehensive assessment of patient needs that span across the continuum of care. Actively mentors staff throughout all components of clinical decision making.

• Assessments and re-assessments are patient-specific and consider alternative hypotheses to specific clinical questions
• Demonstrates proficiency in data gathering skills by efficiently and selectively using relevant sources of information with a strong emphasis on information obtained from patient/client/family
• Intuitively and effectively adapts and prioritizes decision making
• Able to incorporate relevant data in clinical decision making
• Uses available resources, including patient outcomes and past experiences, to guide patient/client assessment
• Using multiple sources, comprehensively assesses patient/client factors that impact treatment plan and outcome
• Selects appropriate assessment tests and measures to conduct patient/client assessment and re-assessment
• Uses standardized assessment tools that address function and disablement. Proficient with the administration of a wide variety of tests and measures, and modifies tests and measures based on patient/client needs.
• Consistently recognizes signs and symptoms of medical problems that require further medical evaluation and facilitates follow-up
• Comfortably and effectively evaluates complex patients with problems in multiple body systems and develops an appropriate plan for managing multiple therapy needs
• Recognizes and prioritizes impairments and their influence on patient/client performance. Anticipates the key underlying impairments that result in physical, behavioral, and/or cognitive dysfunction that are typical of specific patient populations. Demonstrates refined analysis during functional tasks, play, athletic and/or work performance.
• Establishes a therapy classification or therapy diagnosis that is specific to the patient/client. Intuitively and accurately classifies patients based on impaired body/structure, activity limitations and participation restrictions, as well as therapy practice patterns.
• Makes accurate predictions about patient/client outcomes across the continuum of care. Recognizes and addresses factors that may promote further recovery or future decline in function.
• With input from the patient/client and/or the patient/client’s family, establishes goals that reflect anticipated outcomes. Therapy goals address the complex relationships between body structure/function, activity and participation, as well as show greater emphasis on personal and environmental factors that influence functional recovery.
• Based on assessment and on-going reassessment, selects and modifies appropriate interventions. Choice of interventions demonstrates greater selectivity.
• Understands the complex relationships between levels of function and disablement and is able to apply specific interventions across a wide variety of patient populations with appropriate expectations.
• Is sought out by colleagues regarding specific clinical situations. Actively mentors fellow staff in clinical decision making.
• Demonstrates understanding of the value of patient empowerment and self-efficacy and plays a primary role as a coach, guide or facilitator.
• In adherence to the profession’s Code of Ethics, uses ethical reasoning to make decisions based on objective principles and values. Identifies and examines ethical dilemmas using clinical reasoning to guide decision and actions. Serves as a resource to others when ethical dilemmas exist.
• Is accountable and takes responsibility to identify and meet the needs of the patient/client as well as actively identifying patient needs that extend beyond their discipline. Seeks alternate strategies and/or other resources to make sure patient/client needs are met.

2. Performance Skills

Provides interventions across a broad range of needs with increased selectivity to patients/clients that are safe, timely, effective, efficient, patient-centered and equitable, in compliance with organizational policies and procedures. Actively mentors others in regards to selection and performance of therapeutic interventions.

• Maintains competency within area(s) of expertise. Demonstrates competency in treatment skills by completing institutional and program-specific competencies and consistently meets annual requirements.
• Practices competently in accordance with professional practice standards and expectations
• Demonstrates effective visual, tactile and auditory skills to aid with patient/client assessment/reassessment and intervention
• Provides effective and efficient therapeutic interventions
• Progresses treatment interventions timely, selectively and effectively
• Interventions take into account behavioral, cognitive and perceptual dysfunction and appropriate referrals to specialists are made, if needed
• In accordance with patient/client need, selects treatment with consideration of resource utilization, including space, time, people and equipment
• Anticipates patient/client learning needs and is prepared for session. Identifies and provides appropriate strategies to educate patients so that environmental constraints, learning barriers, and cultural factors are addressed effectively. Assesses effectiveness of teaching and considers emotional impact of condition on learning.
• Actively engages the patient to take responsibility to ensure that needs are adequately addressed
• Delegates treatment to appropriate clinical staff and provides necessary supervision. Maximizes efficiency in patient outcomes by use of appropriate support personnel.
• Is sought out by colleagues and actively mentors staff regarding performance skills

3. Interpersonal Abilities

Demonstrates respectful interactions with patients/clients, colleagues and others. Leads by example when interacting with others and mentors others on interpersonal skills.

• Actively and independently advocates on behalf of patients to appropriate individuals and is aware of common patient needs for similar patient populations
• Anticipates and understands multiple cultural values and incorporates these values in developing rapport and treatment plan to maximize patient outcomes
• Establishes and maintains rapport with patients by respecting others’ values and adapting interactions to build trust
• Works cooperatively with co-workers demonstrating respect, trust, and support
• Initiates team approach to patient care as indicated and mediates patient goals among team members. Mediates conflict effectively with others.
• Actively mentors others in collaboration
• Has achieved credibility within the health care team; expertise is sought by team members in planning patient care.
• Consults with or refers to other colleagues/disciplines to meet patient/client needs
• Incorporates critical feedback from supervisor and colleagues and works towards improving areas of weakness

4. Professional Behaviors

Acts professionally to all individuals. Takes an active role in organizational initiatives to improve patient care, practice and institutional performance.

• Actively identifies problems related to systems issues and works diligently to develop potential solutions to these problems as part of their professional practice. Actively provides feedback.
• Actively identifies challenges and actionable solutions that impact clinical practice
• Actively participates on committees or task forces that focus on improving patient care, practice, and/or institutional performance
• Written communication is timely, succinct, clear, and meets all regulatory and hospital standards. Documentation anticipates the needs of the reader.
• Practices in ways that ensure patient care and administrative tasks are performed timely while remaining flexible with changes in schedule. Takes on other responsibilities and incorporates into day.
• Able to prioritize and triage to maximize effectiveness and efficiency. At a high level, adapts to the factors that influence time management.
• Meets and/or exceeds productivity expectations
• Advocates for the profession internally and externally to UW Health. Advances the profession through professional activities within and/or outside the institution.
• Identifies when communication is necessary and directs communication at the right time in the right place to the right person using an appropriate medium. Therapist anticipates the need to change verbal communication style depending on situational needs. Communication reflects comfort, skill and a full grasp of the content in all situations.
• Verbal and non-verbal communication is respectful, empathetic and appropriate to individuals and groups
• Is accountable and takes responsibility for identifying trends in practice gaps and actively pursues opportunities (i.e. through continuing education, mentorship, etc.) to improve practice. Independently seeks resources to improve knowledge base and skill level.
• Respects others’ values

5. Administration/Education/Outreach/Research

Actively participates in at least two activities that extend beyond patient care, including administration, education, outreach and research as defined in the Practice Model Continuum for the Advanced Clinician across all themes and sub-themes.

• Evidence drawn from the literature is actively pursued to support clinical practice. Incorporates research findings into clinical practice.
• Demonstrates a commitment to continued learning by attending continuing education, reviewing the literature, and independently seeking other resources. In addition to annual requirements, makes presentations and/or educates groups outside of direct patient care responsibilities.
• As opportunities exist, actively participates in student clinical education often times as a clinical instructor or as an educator in clinical residencies.
• Critically appraises journal articles or other sources of evidence
• Mentors others, especially in area(s) of expertise
• Actively participates in at least two activities that extend beyond patient care, including administration, education, outreach, and research as defined in the Practice Model Continuum for the Advanced Clinician across all themes and sub-themes.

Fundamental job duties, responsibilities and essential functions for the Occupational Therapist – Advanced Clinician level include:

1. Clinical Decision Making

Evaluates and re-evaluates patient/clients using high-level knowledge of the principles and methods of patient/client assessment and on-going reassessment to develop and modify effective assessments and treatment plans. Able to make a comprehensive assessment of patient needs that span across the continuum of care. Actively mentors staff throughout all components of clinical decision making.

• Assessments and re-assessments are patient-specific and consider alternative hypotheses to specific clinical questions
• Demonstrates proficiency in data gathering skills by efficiently and selectively using relevant sources of information with a strong emphasis on information obtained from patient/client/family
• Intuitively and effectively adapts and prioritizes decision making
• Able to incorporate relevant data in clinical decision making
• Uses available resources, including patient outcomes and past experiences, to guide patient/client assessment
• Using multiple sources, comprehensively assesses patient/client factors that impact treatment plan and outcome
• Selects appropriate assessment tests and measures to conduct patient/client assessment and re-assessment
• Uses standardized assessment tools that address function and disablement. Proficient with the administration of a wide variety of tests and measures, and modifies tests and measures based on patient/client needs.
• Consistently recognizes signs and symptoms of medical problems that require further medical evaluation and facilitates follow-up
• Comfortably and effectively evaluates complex patients with problems in multiple body systems and develops an appropriate plan for managing multiple therapy needs
• Recognizes and prioritizes impairments and their influence on patient/client performance. Anticipates the key underlying impairments that result in physical, behavioral, and/or cognitive dysfunction that are typical of specific patient populations. Demonstrates refined analysis during functional tasks, play, athletic, and/or work performance.
• Establishes a therapy classification or therapy diagnosis that is specific to the patient/client. Intuitively and accurately classifies patients based on impaired body/structure, activity limitations, and participation restrictions, as well as therapy practice patterns.
• Makes accurate predictions about patient/client outcomes across the continuum of care. Recognizes and addresses factors that may promote further recovery or future decline in function
• With input from the patient/client and/or the patient/client’s family, establishes goals that reflect anticipated outcomes. Therapy goals address the complex relationships between body structure/function, activity, and participation, as well as show greater emphasis on personal and environmental factors that influence functional recovery.
• Based on assessment and on-going reassessment, selects and modifies appropriate interventions. Choice of interventions demonstrates greater selectivity
• Understands the complex relationships between levels of function and disablement and is able to apply specific interventions across a wide variety of patient populations with appropriate expectations.
• Is sought out by colleagues regarding specific clinical situations. Actively mentors fellow staff in clinical decision making.
• Demonstrates understanding of the value of patient empowerment and self-efficacy and plays a primary role as a coach, guide, or facilitator
• In adherence to the profession’s Code of Ethics, uses ethical reasoning to make decisions based on objective principles and values. Identifies and examines ethical dilemmas using clinical reasoning to guide decision and actions. Serves as a resource to others when ethical dilemmas exist.
• Is accountable and takes responsibility to identify and meet the needs of the patient/client as well as actively identifying patient needs that extend beyond their discipline. Seeks alternate strategies and/or other resources to make sure patient/client needs are met.

2. Performance Skills

Provides interventions across a broad range of needs with increased selectivity to patients/clients that are safe, timely, effective, efficient, patient-centered and equitable, in compliance with organizational policies and procedures. Actively mentors others in regards to selection and performance of therapeutic interventions.

• Maintains competency within area(s) of expertise. Demonstrates competency in treatment skills by completing institutional and program-specific competencies and consistently meets annual requirements.
• Practices competently in accordance with professional practice standards and expectations
• Demonstrates effective visual, tactile, and auditory skills to aid with patient/client assessment/reassessment and intervention
• Provides effective and efficient therapeutic interventions
• Progresses treatment interventions timely, selectively and effectively
• Interventions take into account behavioral, cognitive and perceptual dysfunction and appropriate referrals to specialists are made, if needed
• In accordance with patient/client need, selects treatment with consideration of resource utilization, including space, time, people and equipment
• Anticipates patient/client learning needs and is prepared for session. Identifies and provides appropriate strategies to educate patients so that environmental constraints, learning barriers and cultural factors are addressed effectively. Assesses effectiveness of teaching and considers emotional impact of condition on learning.
• Actively engages the patient to take responsibility to ensure that needs are adequately addressed
• Delegates treatment to appropriate clinical staff and provides necessary supervision. Maximizes efficiency in patient outcomes by use of appropriate support personnel.
• Is sought out by colleagues and actively mentors staff regarding performance skills

3. Interpersonal Abilities

Demonstrates respectful interactions with patients, clients, colleagues and others. Leads by example when interacting with others and mentors others on interpersonal skills.

• Actively and independently advocates on behalf of patients to appropriate individuals and is aware of common patient needs for similar patient populations
• Anticipates and understands multiple cultural values and incorporates these values in developing rapport and treatment plan to maximize patient outcomes
• Establishes and maintains rapport with patients by respecting others’ values and adapting interactions to build trust
• Works cooperatively with co-workers demonstrating respect, trust, and support
• Initiates team approach to patient care as indicated and mediates patient goals among team members. Mediates conflict effectively with others.
• Actively mentors others in collaboration
• Has achieved credibility within the health care team; expertise is sought by team members in planning patient care
• Consults with or refers to other colleagues/disciplines to meet patient/client needs
• Incorporates critical feedback from supervisor and colleagues and works towards improving areas of weakness

4. Professional Behaviors

Acts professionally to all individuals. Takes an active role in organizational initiatives to improve patient care, practice and institutional performance.

• Actively identifies problems related to systems issues and works diligently to develop potential solutions to these problems as part of their professional practice. Actively provides feedback.
• Actively identifies challenges and actionable solutions that impact clinical practice
• Actively participates on committees or task forces that focus on improving patient care, practice and/or institutional performance
• Written communication is timely, succinct, clear and meets all regulatory and hospital standards. Documentation anticipates the needs of the reader.
• Practices in ways that ensure patient care and administrative tasks are performed timely while remaining flexible with changes in schedule. Takes on other responsibilities and incorporates into day.
• Able to prioritize and triage to maximize effectiveness and efficiency. At a high level, adapts to the factors that influence time management.
• Meets and/or exceeds productivity expectations
• Advocates for the profession internally and externally to UW Health. Advances the profession through professional activities within and/or outside the institution.
• Identifies when communication is necessary and directs communication at the right time in the right place to the right person using an appropriate medium. Therapist anticipates the need to change verbal communication style depending on situational needs. Communication reflects comfort, skill and a full grasp of the content in all situations.
• Verbal and non-verbal communication is respectful, empathetic, and appropriate to individuals and groups
• Is accountable and takes responsibility for identifying trends in practice gaps and actively pursues opportunities (i.e. through continuing education, mentorship, etc.) to improve practice. Independently seeks resources to improve knowledge base and skill level.
• Respects others’ values

5. Administration/Education/Outreach/Research

Actively participates in at least two activities that extend beyond patient care, including administration, education, outreach, and research as defined in the Practice Model Continuum (pdf) for the Advanced Clinician across all themes and sub-themes.

• Evidence drawn from the literature is actively pursued to support clinical practice. Incorporates research findings into clinical practice.
• Demonstrates a commitment to continued learning by attending continuing education, reviewing the literature, and independently seeking other resources. In addition to annual requirements, makes presentations and/or educates groups outside of direct patient care responsibilities.
• As opportunities exist, actively participates in student clinical education often times as a clinical instructor or as an educator in clinical residencies
• Critically appraises journal articles or other sources of evidence
• Mentors others, especially in area(s) of expertise
• Actively participates in at least two activities that extend beyond patient care, including administration, education, outreach and research as defined in the Practice Model Continuum (pdf) for the Advanced Clinician across all themes and sub themes.