I have been listening to occupational therapy practitioners and reading a lot about concerns over the ACOTE mandates to move to a single point of entry for the occupational therapist at the doctoral level and for the occupational therapy assistant at the baccalaureate level by 2027. One issue that I am gravely concerned about is one gap in thinking between some of those who support these moves and some who oppose it. This gap has to do with thinking about what these changes mean, why they are being proposed and about how we value the skills, knowledge and experience of seasoned practitioners.
Many of those who support the mandates focus on the possibilities for changing the knowledge and skills of the entry-level practitioners we graduate. The thinking is that we can reform our educational programs to prepare graduates to move into leadership roles in existing practice settings more quickly and to be better prepared for practice in evolving settings. Essential to this line of thinking is that we not just “tack on” an additional semester or two, but that we reformulate the accreditation standards to provide content that supports entry-level practitioners thriving in the practice settings and environments of 2027 and beyond.
One theme I am hearing among the concerns of some who oppose the mandates is that they are perceiving the message that the knowledge, skills and critical reasoning abilities that they have gained over years of practice is not being valued; that advanced degrees are being valued more than experience. It strikes me that regardless of how we move forward as a profession and regardless of whether you support or oppose the mandates, this is a perception gap that we must close.
My occupational therapy degree is at the baccalaureate level in 1984. I went on and obtained a Master’s degree in 1992 and a research doctorate degree in 2002. I chose to obtain advanced degrees because I perceived that they would provide me skill sets I did not obtain in my entry-level education and open doors to roles and opportunities that would not be accessible to me with my entry-level degree. I do not remember if there was expressions of concern over not valuing experience equally with a graduate degree as the profession debated the move to a post-baccalaureate level. They may have existed and I was just not tuned in to them at the time. However, I am sure that I never had concerns that my years of experience (which would have been 13 in 2007) would not be valued.
I have worked in one form of administrative role or another since 1989 and have frequently been in the position of evaluating candidates for hire or other opportunities. While I value what advanced degrees bring to a candidate, they do not replace experience. I have perceived that many entry-level candidates with an OTD (or DPT, as I am responsible for a large rehabilitation department) have skills that students prepared at the masters level do not (it depends on the programs!). Still, I have never perceived the clinical doctoral degree as any form of substitution for the skills, knowledge, critical and professional reasoning that comes with years of practice. If we are open to, or especially interested in an entry-level practitioner than the OTD may be a tipping point on the scale, but if we need experience, the clinical doctorate has never been seen as equal or a substitution.
Many times now I have read the questions, “What is wrong with our students now?” or “What is the problem with the quality of our current education?” More often I am hearing the question, “What is lacking that my years of experience won’t satisfy?” My answer has been that if we move forward with the OTD as the single point of entry for the occupational therapist, it has to be about preparing for a different future. It is NOT a reaction to a problem now or to fix any issue with quality, but about graduating a different type of entry-level practitioner for a future that will require a different set of entry-level skills.
I appreciate that many members of the profession think that the move is unnecessary or that it will not achieve the desired outcome for one reason or another. Debate on those issues as well as other pros and cons is important and should continue, and as much as possible should be driven by data, the highest quality evidence available, and sound logic. However, I think that as the debate continues it is critical that our messaging and our common understanding changes.
We need to acknowledge clearly and loudly that, experience matters. If you are a baccalaureate or masters educated practitioner with years of experience under your belt, you offer the profession something than cannot be replaced with any advanced degree. Your skills, knowledge and capacity for reasoning are golden, and you should hear loud and clear that you critical to our future, and part of the solution. You are not a problem to solve and we cannot replace you. If that message has not been clearly conveyed, as someone who has advocated for moving to the OTD as entry-level, I apologize and seek to correct the record.
I would love to hear others’ thoughts questions and concerns. Please feel free to email me at firstname.lastname@example.org, friend me on Facebook, send me a tweet at @brentbraveman or contact me through my personal website www.brentbraveman.com.
The opinions expressed in my blog are personal and neither represent the views of my employer nor any organization.