ILDP

Post-URLEND Review

Name: Caitlin Winters

Date: April 6, 2018
Core Faculty: Danielle Friberg
Core faculty Approval date: April 12, 2018

Competency #1: Self

Increase MCH Knowledge Base
Rationale Working with vulnerable populations has always been of interest to me. In my
past work experiences involving state/federally funded health care programs, I
relied heavily on others to ensure that I met all of the expectations of the system
(ie. requirements, billing, documentation, etc.). Although I had a job working for a
state funded public health program, I was unsure of how the structure of the
system was designed and for what reasons it was designed in such a way. I feel
that if I can better understand the structure of MCH programs, and why they are
designed in specific ways, that I can be a more successful caregiver. By better
understanding the MCH system, I feel that I will be better equipped to serve
children, mothers, and families within this population.

Current skill level I feel that I currently have a very basic level of understanding of the MCH system.
Although I am constantly learning more about MCH, I still feel there is so much
more that I can better understand.
Skill Level At this time, I am able to identify some health disparities and provide ideas of how
Example(s) to address them. An example of this may be populations that are prone to
diabetes and creating programs to address better nutrition. I am also able to
examine statistics and identify issues related to health for certain MCH
populations.
Impact of further If I can build a foundational understanding of the MCH knowledge base, I feel that
development of I will better be able to provide services for my future clients and their families. By
this goal on your increasing my ability to navigate the public healthcare system, I will more
future work effectively be able to do my job. I will be able to ensure that I am following the
standards that are designed by the system in order to meet the goals of MCH,
provide a high level of care to families, and get reimbursed for my services.
Steps you will The major steps that I will take to accomplish this goal are to attend all URLEND
take (the plan) to didactic seminars, complete all of the required readings, engage in discussions
accomplish your amongst URLEND faculty and fellow trainees, and ask questions when topics are
goal unclear. Evaluating and incorporating evidence that supports OT in the MCH
system will also be helpful in expanding my knowledge base. In addition, I will
take the information that I have gained from my professional program (U of U;
MOT) that relates to federal healthcare programs, and incorporate that into my
understanding of MCH knowledge. Lastly, I think that another very important step
in developing this competency will be engaging with my mentor family in order to
understand the MCH system from the consumer’s perspective.
Final Reflection:
Increase MCH Knowledge Base
As I look back over the course of the year, I feel that my MCH knowledge base has definitely
increased, but I also feel that there is still so much to understanding. I would say that my skill level has
increased from basic to an advanced. I feel confident that I could assess existing programs for this MCH
population groups and use a systems approach to explain the interactions between individuals, groups,
organizations, and communities.
I feel that he most influential activity that has helped me to achieve this skill level in this
particular competency is through the URLEND didactic seminars. Seminars that have discussed the life-
course model, public health, and program assessments have helped me to understand this particular
population from a dynamic perspective. My interactions and discussions with fellow trainees and faculty
members have also helped to broaden my perspective and understanding of this population which has
helped to expand my knowledge base.
Additionally, my interactions with my FMP family were invaluable. They taught me so much
about their everyday lives and the “hoops” that they have to jump through just to get the services that
they need. I think that understanding the MCH system by reading and talking about it in a classroom
gives a basic understanding, but learning from a family that is actually utilizing its benefits gives a
completely different picture.
I think that this competency will help to give my future professional activities a more well-
rounded perspective of healthcare for children and families with special health care needs. The
profession of occupational therapy puts such a large emphasis on a holistic understanding of the client –
this competency has helped me to better understand the system of which many of these families are
working within. Overall I get a sense that the MCH system is a broad network of professionals,
programs, and organizations, that have the main goal of supporting families of children with special
health care needs.
 Competency 2: Others
Negotiation and Conflict Resolution
Rationale I feel that this an area of weakness for me. I tend to avoid and deflect situations in
which I may have to confront individuals (especially bosses, or those of “higher-
rank”) in order to resolve issues. My way of resolving problems tends to be to
perseverate and internally consider my options, while not actually acting on them
– if I let it go long enough, my problem will just take care of itself. This is an
extremely ineffective way to function professionally.

Current skill level My current skill level here is extremely lacking. Granted, I have confronted
coworkers and bosses in the past, I need a great deal of self-reassurance and
motivating self-talk in order to do so. According to the MCH competencies, at a
basic level I should have the ability to “apply strategies and techniques of effective
negotiation and evaluate the impact of personal communication and negotiation
style on outcome.” I am able to do this minimally, but with very little confidence.

Skill Level When negotiating, I am able to talk and actively listen to the person in which I am
Example(s) working with. This helps me to understand the perspective in which they are
coming from, but I struggle to effectively express my own needs. I think this may
be because I sometimes don’t believe that my needs are relevant or deserving.

Impact of further This skill will greatly impact my satisfaction and ability to carry out my job in an
development of effective manner. There will continue to be conflicts that arise amongst my co-
this goal on your workers and myself. In order to continue to function successfully as a team,
future work problems will need to be resolved in a way that satisfies all parties involved. I
think that by learning to appropriately negotiate my needs and what is best for
my future workplace, my ability to appropriately handle these situations will be
extremely beneficial.
Steps you will The primary step that I have taken to address this goal, is volunteering to be the
take (the plan) to interpersonal liaison for my leadership group. I will be contacting individuals if
accomplish your they are missing meetings, not completing their portions of the projects, or if
goal others are having problems with them. When faced with a problem that I am
unsure of how to professionally address, I will utilize readings from The Intentional
Relationship, by Renee Taylor, to help guide my interactions. Specifically, I will
reference the chapters that refer to “Professional Communication,” and
“Understanding and Managing Difficult Behaviors.” I put myself in this position,
specifically, in order to give myself opportunities to involve myself in conflict
resolution. I am hoping that by doing so I will develop the skills necessary to
address similar conflicts in the future.

Final reflection:
Negotiation and Conflict Resolution
As I stated in my mid-year review, I have been lucky enough in my leadership team to work with
a group of individuals that get along really well. We have had very few disagreements and have
managed to make great progress with our leadership project. I think that the leadership group has
helped me to see that conflicts can occasionally arise simply by the way a concern is presented by an
individual. For example, if a group member presents a concern in a way that is blunt or with a certain
tone of voice, other members may perceive this person as being aggressive and/or anti productive.
Realizing this, I have helped to diffuse a couple of potential situations by asking questions to the group
member for clarification, listening to the person’s concerns, and asking for group feedback instead of
just making a decision based on one person. This helped to resolve the issues in a way that provided the Commented [DF1]: Great!
individual with a voice and also work as a group to come up with a solution that everyone could agree
upon.
I think that my group interactions have supported my skill advancement from basic to
moderately advanced. Although I do feel that I have gained some ability to manage conflicts in a
constructive manner, I also feel that I may not be able to do so in all situations and in different groups. I Commented [DF2]: Interesting insight
also think that it depends on conflict itself and how serious the situation is.
I will say that my clinical experiences also gave me an interesting perspective on conflict
resolution. When I visited a few different interdisciplinary clinics, they repeated told me that OT services
were not relevant for the populations that they work with. As I sat through exams in the CF, RF1, and
South Davis clinics, I couldn’t help but think to myself, “how could OT NOT be relevant for these
kiddos?” It made me really frustrated, and it also felt like my profession wasn’t truly understood, or was
being swept to the side. I think in future practice, not expressing these feelings, or speaking up about my Commented [DF3]: Yes you will definitely run into this a
profession, when the opportunity arises could potentially lead to major conflicts. I think that from a lot. I agree it can be challenging to speak up in these
conflict management perspective, it is important to recognize and understand the importance of each situations some times, but you can totally help other
disciplines understand the broad role of OT!
healthcare professional so that no one feels that their role is discredited. It also helps to provide a more
cohesive team that can provide an exceptional level of care for CSHCN.

Competency # 3: Others
Interdisciplinary Team Building
Rationale Individuals with disabilities have many different strengths, barriers, and needs. In
order to provide the best care possible an interdisciplinary team needs to be
established in order to attend to whatever deficits need to be addressed. The
ability to form and work within an interdisciplinary team is extremely beneficial in
providing a high level of care for patients and their families. Along with an
interdisciplinary environment comes a lot of pride within each individual area of
expertise – the ability to trust and work with (instead of against) one another is
crucial.
Current skill level I believe that at this point in time I am at a basic level of interdisciplinary team
building. I am able to collaborate on projects and respect the ideas of individuals
from other disciplines, but it is still slightly unclear what many of the other
disciplines are responsible for doing and the extent to which they fulfill their
responsibilities. Honestly, I am still in the process of fully understanding my own
roles and responsibilities as an OT, let alone how I will function within an
interdisciplinary team.
Skill Level I am currently working within an interdisciplinary team for the leadership project
Example(s) with two audiologists, a social worker, a clinical psychologist, and a
neuroscientist. I was speaking to one of the audiologists concerning BPPV testing,
which lead to discussion of therapy treatments. I had no idea that audiologists
performed therapy interventions, and he didn’t realize that OTs conducted BPPV
testing.

Impact of further As an occupational therapist, I will not be able to address hearing deficits, or gait,
development of or speech patterns. In order to address the individual holistically, a team of
 this goal on your professionals will need to work together to help the person live the most
future work meaningful life possible. By understanding how each professional contributes to
the care of the individual, a more effective level of care can be established. In
addition, I can provide the professional perspective on the important role that
Occupational Therapy plays with in the team environment.

Steps you will I will continue to function as a representative of the OT profession within my
take (the plan) to leadership team. I will further my conversations with my colleagues and continue
accomplish your to ask questions in order to better understand other professionals’ roles within the
goal team. I will also provide the OT perspective, and work with individuals from other
disciplines, to come up with therapy/treatment options during at least one PDC
meeting. I will try to address issues that arise with non-bias for my own
profession, and consider all different contributors to the issue and what they can
bring to the resolution of the issue. Lastly, I will utilize the hours that I am required
to be in clinic for URLEND, to ask questions regarding ways interdisciplinary teams
are beneficial for their clients, and how the teams are utilized in their specific
clinical practice.

Final Review:
Interdisciplinary team building
Looking at the MCH skills for this competency, I feel that I have made some improvements on my
skill level, but I have not yet reached a true “advanced” level. I feel confident that I am proficient in most
of the advanced skills, but I am still unsure of the skill that states: use knowledge of discipline
competencies and roles to improve teaching, research, advocacy, and systems of care. I feel that I gained
a great deal of knowledge about the professions of the team members that I worked with throughout the
course of the program (audiology, psychology, research, social work), but I feel that there are many other
professions that I will be working with more often, from which I will need to understand their scope of
practice to build a strong team. For example, I will most likely be working on teams with speech-language
pathologists. Speech and OT services can often times overlap, and this may make for challenging team
dynamics. I definitely appreciated and learned a lot about the professions of the individuals that I worked
with, but I feel like I still have a lot to learn about other healthcare professions that I will be working with
in the future.
Going back to my previous story about being in the clinics and the professionals stating that OT
was not a necessary service for their populations brings up another important part of team building:
respecting every person’s contributions and thinking beyond my own profession to build the strongest
team. I feel that this is such an important component of team building and needs to be considered at all Commented [DF4]: Yes!
times throughout the process. I’m not sure about other professions, but I feel like I need to be a constant
advocate for OT and constantly explain what it is that we actually do. It can be frustrating and exhausting,
but I need to also think about how other professions may have to do this for themselves as well. What
I’ve gained from the program and my experiences about team building is the importance of listening to
one another and not being overly egocentric when it comes to delineating responsibilities in a team
setting. This will most definitely be something that I carry with me into my future practice. I truly hope
that I can continue to work in interdisciplinary teams because I feel that they are ultimately the best way
to provide the highest level of care.
 Competency # 4 Community
Policy and Advocacy
Rationale I feel that in the current state of our economic and political environment in the
United States, policy and advocacy will be paramount in ensuring that we can
continue to provide services to MCH populations. Without individuals who
understand the system and what needs to happen in order for voices to be heard,
we could very easily lose many public programs and the ability to get reimbursed
for the services that we provide. This is why I feel that it is so important to have
the skills necessary to effectively advocate for my clients and my profession, and
to positively affect policy decisions.

Current skill level Honestly, my current skill level in regards to policy and advocacy is below the
basic level as identified by the MCH competencies. I am able to seek out and
interpret data that relates to MCH populations, but I am unsure of how to use
that information to effect change. Also, I am fairly new to the state of Utah and
don’t know who I would contact that would be influential in making policy
decisions.

Skill Level As I stated above, I am able to research and interpret data in order to assess the
Example(s) healthcare needs of MCH populations. In regards to knowing what to do with that
information is where my skill set is lacking.

Impact of further Having the ability to influence policy and advocate for my clients will not only
development of ensure that my clients are able to receive the services that they deserve, it will
this goal on your also ensure that I have a job and that I am able to get reimbursed for my services.
future work
Steps you will My family mentor has experience with advocating and influencing policy making
take (the plan) to at a legislative level, so I am hoping that I can ask questions of her as to what that
accomplish your process looked like. I will also attend any didactic seminars that address policy
goal and advocacy skills. Another important step in gaining more knowledge in this
area is my involvement as the U of U’s student representative for the Utah
Occupational Therapy Association (UOTA). I am hoping that by involving myself in
UOTA, I will have the opportunity to gain first-hand knowledge of and
involvement in legislative sessions. This year, I plan to attend the UOTA, AOTA,
and AUDC annual conferences where I am hoping to gain more insight on the
legislative process.

Final Review:
Policy and Advocacy
I feel that this competency is one that will require continued development. I feel that I am still at
a basic skill level, and I am unsure of how I really could have done more to develop this area. One of the Commented [DF5]: This is a tough one but you identified
main activities that I used to try to work on my skills was participating in the Utah Occupational Therapy opportunities and participated where you could. That’s a
Association (UOTA) and Hill Day at the Utah state capitol. Unfortunately, Hill Day was a bit unorganized great starting point.
and I did not get to hear how the information was presented to the legislators. Regardless, I met our
governor, my representatives, and many other healthcare professionals. What I gleaned from this event
is the importance of networking and meeting others who may be able to help me, or point me in the Commented [DF6]: Agreed
right direction when I am eventually working on policy changes. I was also able to write notes in regards
to the therapy cap, which were given directly to my legislators while they were in their sessions. They
ended up overturning the therapy cap, which made me feel like I may have made a small difference in
their decision!
My experiences with the UOTA also helped me to better understand the importance of being
involved with a professional organization in order to effect policy change and continue to develop
networks of individuals who may be able guide me in future policy efforts. Although I didn’t directly
affect any legislation, by supporting the UOTA they are able to employ a lobbyist to track policy changes
that effect my profession and the populations that I serve. I think that my involvement with this Commented [DF7]: Yes!
organization has shown me how important and influential professional organizations are in matters that
will directly affect my job in the future. Policy and advocacy is something that I remain extremely
interested in; I feel like I have just skimmed the surface on how to affect change, and I plan on
continuing to involve myself in whatever ways I possibly can to learn more about how to affect
occupational therapy and the individuals that we work with.