OT Analysis & Practice Management 5 — Questions and Answers
Question 1: An OT department is implementing the Kawa (River) Model for assessment. This model is MOST useful for:
- Measuring fine motor coordination deficits precisely
- Understanding occupational performance through a culturally relevant, metaphorical narrative (Correct answer)
- Quantifying functional independence for insurance billing
- Analyzing biomechanical demands of work tasks
Correct answer: Understanding occupational performance through a culturally relevant, metaphorical narrative
The Kawa Model uses a river metaphor to explore how cultural context, life circumstances, and personal assets shape occupational flow and meaning.
Question 2: A healthcare organization requires OTs to complete peer review of documentation. The PRIMARY purpose of this process is to:
- Increase productivity by identifying inefficient therapists
- Ensure documentation meets professional, legal, and payer standards through collegial accountability (Correct answer)
- Satisfy a state licensing board requirement for all disciplines
- Provide grounds for disciplinary action against underperforming staff
Correct answer: Ensure documentation meets professional, legal, and payer standards through collegial accountability
Peer review promotes quality by having qualified colleagues evaluate documentation for accuracy, completeness, and compliance with standards.
Question 3: An OT conducting a home assessment for a client post-stroke identifies that narrow doorways prevent wheelchair access to the bathroom. This barrier is classified under which OTPF context category?
- Personal context
- Cultural context
- Physical environment (Correct answer)
- Temporal context
Correct answer: Physical environment
Architectural features such as doorway width are physical environmental factors that either support or hinder occupational performance.
Question 4: Under the Americans with Disabilities Act (ADA), an employer asks an OT to determine if a job applicant with a disability can perform essential job functions. The OT should FIRST:
- Administer a comprehensive neuropsychological battery
- Conduct a functional capacity evaluation (FCE) matched to the specific essential job functions (Correct answer)
- Recommend the applicant be denied the position to avoid liability
- Prescribe adaptive equipment before evaluating the applicant's abilities
Correct answer: Conduct a functional capacity evaluation (FCE) matched to the specific essential job functions
An FCE matched to the job's essential functions determines whether the applicant can meet those requirements with or without reasonable accommodation.
Question 5: A newly hired OT discovers that a department policy conflicts with AOTA's Code of Ethics. The MOST appropriate action is to:
- Follow the department policy and ignore the ethical concern
- Immediately resign from the position
- Raise the concern with the supervisor and work through appropriate channels to resolve the conflict (Correct answer)
- Report the department to the state licensing board without first attempting internal resolution
Correct answer: Raise the concern with the supervisor and work through appropriate channels to resolve the conflict
OTs are professionally obligated to address ethical concerns through appropriate channels, starting with internal resolution before escalating externally.
Question 6: A productivity-based compensation model rewards OTs based on units billed per day. Which unintended consequence is MOST likely to occur?
- Improved patient satisfaction scores
- Pressure to overtreat or up-code to maximize billable units (Correct answer)
- Stronger interdisciplinary collaboration
- Reduced documentation burden for therapists
Correct answer: Pressure to overtreat or up-code to maximize billable units
Productivity-based pay creates financial incentives that can pressure therapists to bill more units than clinically justified, risking ethical and legal violations.
Question 7: When analyzing the occupational profile of a client with traumatic brain injury, which information is MOST essential to gather first?
- Scores on standardized cognitive assessments
- The client's prior roles, routines, and what occupations hold meaning for them (Correct answer)
- Medical records documenting the injury severity and location
- Family members' perceptions of the client's deficits
Correct answer: The client's prior roles, routines, and what occupations hold meaning for them
The occupational profile prioritizes understanding the client's history, values, and meaningful roles before identifying deficits or setting clinical goals.
OT Analysis & Practice Management 5
An OT department is implementing the Kawa (River) Model for assessment.
This model is MOST useful for: