Innovative Knowledge Translation Strategies Used to Promote the Use of the COPM in Inpatient Stroke Rehabilitation

PURPOSE: The purpose of this research is to increase the knowledge and self-efficacy of occupational therapists (OTs) on the consumer and practice benefits of the Canadian Occupational Performance Measure (COPM) in inpatient stroke rehabilitation (ISR).

RATIONALE: OTs can utilize knowledge translation (KT) strategies to integrate the COPM into ISR. KT is important for OTs because inconsistent assessment continues despite a consensus on its need in occupational therapy. OTs can demonstrate its critical value in rehabilitation through use of standardized assessment such as the COPM. Using the COPM, consumers direct occupational therapy goals and perceive that their goals are addressed. OTs need education on COPM strategies to increase administration comfort and confidence and decrease time to administer.

This project combines KT and transformative curriculum research. This interplay of KT and curriculum design models provides insight into how research from KT science can impact curriculum. As the health care environment evolves, OTs must continue to advocate for the profession and consumers, standardize evidence-based practice, and consistently integrate assessment.

DESIGN: The design of this study was pretest and posttest of OTs to determine the effect of a developed curriculum on the COPM in a pilot application.

PARTICIPANTS: Seven OTs completed the informed consent process to participate. OTs who primarily worked in ISR were recruited.

METHOD: A pre and post survey was administered to determine the effect of a developed curriculum and impact of a COPM pilot and to explore knowledge and self-efficacy using the COPM.

ANALYSIS: The mean change scores were used to determine the impact of the research. The effect size of each survey question was also analyzed, with all but two questions indicating a moderate to large effect size. These questions were also the pretest questions that were scored high initially, and change may have been limited by ceiling effect. These questions reviewed confidence and knowledge of the International Classification of Functioning, Disability, and Health model and participation as part of the treatment plan. The questions with the greatest pre to post change score were the most clinically relevant. This included impact of COPM training and interpretation of the COPM for goal setting and statistical information for goal setting. The overage change score from the pre- to the postsurvey for all questions combined was a total score of 22.71 to 27.98 or an average score of 2.84 presurvey to 3.45 postsurvey.

DISCUSSION: Despite previous traditional education on the COPM, none of the OTs had previously used the COPM with the stroke population. This research used KT strategies to address the significant disconnect between clinical guidelines for assessment and actual integration of the COPM during inpatient stroke rehabilitation. With only 2 hr of additional education, in addition to resources to address OT-reported barriers during pilot testing, the study was able to demonstrate a moderate to large effect on self-reported knowledge of the COPM and self-efficacy using the COPM in this population.

IMPACT STATEMENT: This research is a step in exploring the impact of KT in OT. Focused, multimodal education can be successfully implemented to increase OT self-efficacy and implementation of the COPM during stroke rehabilitation as well as applied to translate other assessments critical to support OT. Replication of this research can have an impact on the successful standardization of assessment in occupational therapy regardless of measure or setting to make occupational therapy a more powerful influence in rehabilitation.