OCCT 506: Clinical Reasoning about Occupation

Student: James Stewart, Josee Lundquist, Meredith Petrillo

Location & Job Duty: REM Nevada, My Life Program Director

Date: 8-15-12

Activity Analysis for Expected Performance

On-The-Job Analysis
Directions: Respond to the following in complete sentences. Be sure to provide clear explanations or descriptions for each category.
Section I

Name and Brief Description of the

Activity Observed
Sequence of Major Steps
10 steps or less
Specify time required to
complete each step

Precautions
Review Sequence of Major
Steps
Special Considerations
Age appropriateness
Educational requirements
Cultural relevance
Gender identification
Other

Observed the program director of the My Life program for REM-Nevada. She
facilitates independent living for adults with developmental disabilities.
We observed Brenda following some of the steps to create new ISP for a client.
The first step in getting a new client is receiving a referral from the state. In step
two, she evaluates if they can offer services to the new client. This can take a few
days to make a decision. The third step after accepting the client is to set up a
meeting with the client coordinator, and this can take several days. Then in the
fourth step, she meets with the client coordinator, the new client, and the clients
family. She then offers them 30 days of trial services. In step five, after those 30
days, they make an ISP and proceed with services.
The precautions to observe in this sequence involves following HIPPA rules in
that there should be no breach of confidentiality. Another precaution to observe is
making sure the client is eligible for services. Lastly, Brenda is required to
evaluate the client and the environment to ensure a good fit for interaction and
providing the most appropriate services to the client.
REMs independent living program is geared towards adults. Although there are
childrens homes, Brenda only supervises the adult independent living
environments. The educational requirements are shifting from having some
college background to having at least a bachelors degree in social work or public
health. It can be helpful to achieve a bachelors degree so that the director has a
better understanding of cultures. It is important that clients receive these services
so that they can participate in their families cultural events. It is also important to
make sure that cultural practices of each family can be taken into consideration so
that the family member can still participate in family cultural events.
The position of program director is not gender specific and anyone with the
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OCCT 506: Clinical Reasoning about Occupation

Acceptable criteria for completed

activity
Section II

Activity Demands: Objects and their

properties
Tools
Materials
Equipment
Include inherent properties of
each item listed above

proper experience or degree is able to fulfill the position. REM-Nevada does not
exclude clients based on gender.
Acceptable criteria for successful completion of the ISP is to complete all the
necessary paperwork and offer services to the client if they have met the
appropriate criteria. She must also make sure that services do not exceed the
budget.
The equipment, tools, and materials used as the program director are common
and essential things you would find in most offices.
Equipment:
A laptop computer is needed to keep documentation of clients. The
computer is 16 inches wide, with small keys. The computer is structurally
made of hard plastic and is light weight, weighing at a max of 5 pounds.
A comfortable office chair is required to attend to tasks at desk and be
comfortable for multiple hours at a time. The chair was structurally large,
and on wheels. The chair is leather, with a padded seat, back, and arm
chairs.
A desk was in the office, as a work station for completing everyday tasks.
The desk used was a large wooden desk. It is about 5 feet wide and 3 feet
wide, with drawers on both sides. It is made with dark wood, is heavy, and
would be hard to move.
She required a book shelf to hold her reference binders, books, and
program information. The book shelf was made with dark wood, heavy
and was about 6 feet tall and 3 feet wide.
Tools:
She used a wireless computer mouse to assist with navigation on the
computer. The mouse was physically small, made with hard plastic, and
black in color.
She needs a phone to communicate with clients, the government, and
program employees. The phone was black, made of hard plastic, and was
attached to phone stand by a cord. The handle of the phone had about a 2
inch diameter and was about 8 inches long. The buttons were dime-size,
and black with white numbers.
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OCCT 506: Clinical Reasoning about Occupation

A printer is needed to print information for both employees and clients.

The printer was white and gray and was made with hard plastic. The
buttons were white and made with rubber. The dimensions of the printer
were about 2 feet by 1 foot.
She had a clock in her office to help her keep track of time for important
meetings and appointments. The clock was analogue, and was about 6
inches in diameter. It was silver in color with a white face. It was made of
hard plastic, and was light weight.
Materials:
She had multiple notebooks on her bookshelf that are required to be
available by the state. The notebooks were 3 inches wide and standard
hard cover notebooks. The covers were white, and had 3 hard metal rings
to hold the pages in. They were full of printer paper, and fairly
lightweight.
She had a calendar posted on her wall, with important meetings and
program activities. The calendar was about 26 inches by 12 inches and
white in color. The calendar had a cardboard back, and was lightweight.
She needs printer paper to be able to functionally use printer. The paper is
8 inches wide by 12 inches long and is white in color. The paper is very
lightweight separated out, and about 5 pounds when bundled into
packages.
Sequencing & Timing

Required Body Functions

Sequencing and timing is very important to perform the job as a program director
efficiently.
Common sequencing and timing tasks within the office include:
Picking up the phone before dialing a number, or saying hello when
answering the phone.
Load the printer with paper before printing any documents.
Turn the computer on before attempting to work on computer documents.
To work in an office as a program director, she needs to have vision to be able to
see the computer screen and complete required paperwork. She also needs to
have a voice to efficiently communicate with employees and clients in the
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OCCT 506: Clinical Reasoning about Occupation

Required Body Structures

Section III

Motor Related Performance Skills

Sensory Perceptual Performance

Skills

program over the phone and in meetings.

To perform tasks within the office she needs to have hands to work on the
computer, answer the phone, and complete paper work. Arms would be required
to reach up on the shelf case to get binders, and functionally use hands. She
would also need to have her eyes to have functional vision to complete required
paperwork on the computer and by hand.
In order for Brenda to use the phone, she needs the ability to reach for the
phone with either left or right hand, grasp phone in a gross motor cylindrical grip,
flex her elbow to bring phone next to her ear, maintain the phone next to her ear
for the length of the telephone conversation, and the ability to hold phone with
one hand and press speaker phone button with the other if she needs to talk and
write at the same time.
In order for Brenda to type on her computer she needs the ability to partially
extend her elbow to position her hands on the keyboard; flex, extend, abduct,
adduct her fingers to press the desired letter on keyboard; and stabilize her arms
while her fingers are moving.
In order for Brenda to write she needs the ability to holding a pen/pencil in the
three finger pincher grasp; flex, extend, abduct, adduct her wrist to form the
desired letters and words; maintain the grip on the pen/pencil while writing
words; and hold the paper in place with the thumb extended while writing.
In order for Brenda to work at her desk she needs the ability to rotate her head
to look at paperwork, computer screen, or notes placed at different locations on
the desk; and rotation her body in order to place her arms and hands in a position
to write, type, or look at paperwork.
Visually, Brenda needs the ability to discriminate between different colorcoded notes and files as well as between different words while she is reading
paperwork.
Through her auditory sense, Brenda needs the ability to hear her phone when it
rings and locate the phone in her office. After picking up the phone, she then
needs the ability to discriminate whether the voice on the phone is male or female
and whether the voice is familiar.
Through her proprioceptive sense, Brenda needs the ability to move and
position her body while not looking at the body part she is moving. This is
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OCCT 506: Clinical Reasoning about Occupation

Emotional Regulation Performance

Skills

Cognitive Performance Skills

Communication & Social

Performance Skills

Sequencing & Timing

Synopsis

Describe in detail each members

specific responsibility during the
observation and an individual selfreflection of the entire process
including the observation and
analysis portion.

helpful with moving the mouse while looking at the computer screen and typing
while looking at the computer screen.
Through her vestibular sense, Brenda needs the ability to balance her body
while sitting in her chair so that she is not slouched or in a position that could
harm her back. She also needs balance when holding her pen/pencil or phone so
that they do not fall to the side while she is writing or holding the phone.
Brenda needs to have persistent effort in order to complete the ISP process
because at times it may seem like tedious work or become redundant after
performing the same tasks time after time. She needs the ability to manage stress
levels in order to complete needed paperwork before deadlines. She needs to
control her anger and frustration toward laws and regulations that are in place or
that she feels should be in place.
Brenda needs the ability to know and understand the federal, state, and program
laws and regulations guide the work that she performs. She needs the ability to
multitask, including: talking on the phone and writing notes or processing more
than one ISP at a time. She needs the ability to prioritize her time by completing
those items that have sooner deadlines first.
Brenda needs the ability to both initiate and continue conversations with others
over the phone and through e-mail. She needs the ability to acknowledge others
perspectives and desires in order to incorporate them into the ISP. She needs the
ability to answer others e-mails in a manner that the other person can understand
what she is trying to say without hearing her say it.
In order to write the ISP, Brenda needs the ability to use all of the skills used in
this section. She needs the ability to know how laws apply to ISP, initiate
conversations with clients in order to learn their interests and desires, use her
auditory sense to hear what others say to her, use the specific motor skills to write
the ISP, and persist through writing the ISP until it is complete.
James:
During the observation, I set up field trip and asked questions for and took
notes for section III of the document.
I feel that this was a good experience in that I was able to incorporate many of
the concepts and knowledge that I have come to understand during this semester.
For instance, I gained a new way of thinking from learning more about the OTPF,
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OCCT 506: Clinical Reasoning about Occupation

which shaped the way that I approached the observation. I saw Brenda as an
occupational being that needs and uses a wide array of skills to accomplish her
tasks that used to seem so simple to me. Now, during the analysis portion, I can
use my knowledge of kinesiology and anatomy to understand how and why the
body moves in certain ways and what muscles and nerves accomplish those
movements. I feel that am I piecing together many things that I have learned into
one way of thinking.
Josee:
During the observation I took pictures for the presentation and asked questions
for and took notes for section II of the document.
This was a great experience to not only make a community contact, but get
educated about opportunities that are available in the community for future
clients. I was able to use the base of knowledge I did have about the OTPF to
develop questions that pertained as we went through the observation. I noticed
that I had a completely different frame of mind going into it that I believe I would
have a few weeks ago. Having the opportunity to apply my knowledge to the real
world gave me a chance to see where I had improved and where I still have room
for growth. Everywhere!
Meredith:
During the observation, I drove to and from the field trip site and asked
questions and took notes for section I of the document.
I thought it was helpful to frame my questions around what steps she needed
to go through. Many of us just go through our daily routines without breaking
down the individual steps or thinking about how much time each one takes.
Breaking down a task can sometimes help eliminate unnecessary steps. It was
helpful to have knowledge of the OTPF that I could apply to her job and the skills
it required. I also had not taken into consideration some of the cultural challenges
that may face a program like this one, since there is so much diversity in the area.

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OCCT 506: Clinical Reasoning about Occupation

Professional Dress
Communication

Presentation Materials
Discussion Topics

Section I

Section II

Section III

Professional

Presentation
(1 participation point)
.25
Dress (head to toe) appropriate
for in-class presentations.
All members contribute to
speaking portion with ease,
inflection, confidence, and
pace throughout.
PowerPoint presentation free
of typos and organized.
Addressed Sections I-III of
form with good clinical
reasoning evident

0
Dress is not appropriate for inclass presentation.
Difficulty hearing/
understanding speaker due to
limited volume or unclear
speech; not everyone presented
Typos present throughout
presentation; difficulty to
follow
Missed one (or more) sections
of form; vague discussion
points

Assignment Submission
(30 points)
6
4
2
Free of errors;
1 area of
2-3 areas of
Written in
clarification
clarification
complete
required
required
sentences
Free of errors;
1-3 areas of
4-5 areas of
Written in
clarification
clarification
complete
required
required
sentences
Free of errors;
1-3 areas of
4-6 areas of
Written in
clarification
clarification
complete
required
required
sentences
Free of errors;
2-4 errors for
N/A

0
>4 areas of
clarification
required
>6 areas of
clarification
required
>7 areas of
clarification
required
>5 errors for
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OCCT 506: Clinical Reasoning about Occupation

Presentation

Synopsis

Professionally
presented;
Proper format
and intact
spelling/gramm
ar
Listed each
persons
responsibility;
individual
reflections with
good thought

grammar,
spelling,
formatting

N/A

grammar,
spelling,
formatting

N/A

Incomplete.

Total points earned: 22/30 + 1 bonus = 23/30 = 77%

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