It first starts with a commitment to move towards Equity and Justice.

• You can foster an environment where clients and colleagues feel valued, safe and heard.
• You can demonstrate to clients and colleagues that you are seeking to understand and be approachable to conversations about this topic.
• Engage leadership in your workplaces to support inclusiveness at all levels in the organization.
• Educate others if you can and consider forming committees and working groups to discuss and develop objectives. Set small measures of success and go from there.

The 2022 PREP module will include Culture, Equity and Justice.

This process of supporting registrants will be ongoing as we learn more and look at the feedback we receive.

We plan to develop accompanying resources, using a lens of different practice areas, settings, clinical and non-clinical experiences. We will engage other partners in the discussion and enlist some of our existing resources such as the Equity and Indigenous panels for input.

The College will lead by example and be honest & transparent about the position of privilege that it is in.

As a regulatory body, we will need to be open and even vulnerable when receiving constructive feedback and accept that we do not know it all or have all the answers. We are committed to listening and acting expeditiously to serve the public interest, while keeping our positionality top of mind.

We hope that this will help model what occupational therapists can start doing in their practice. As already mentioned, the PREP module and updated Standards for Practice are just some of the resources rolling out soon to support you.

As the regulator, we hope occupational therapists will look to partner with their associations to explore literature, best practice documents and other resources available to support practice.

For example, both CAOT and OSOT have a number of resources on their websites, including some research on the standardized assessments you might be using.

Many organizations have started to think about culture, equity and justice, and the goal is to reflect on your current practices to see what changes can be implemented in the short-term.

For example, you may not be able to change the standardized assessments, but you may be able to start by changing how you write your documentation or adjust your verbal communication when asking your client questions. You can think about your consent process and take steps to ensure clients have information they can understand, engaging them through co-creation and collaboration in decision making.

WFOT has resources such as an advocacy toolkit and an interactive forum to help you build on your learning.

It starts with returning to that core fundamental right of people to access equitable healthcare, understanding that just because a service or resource is available does not mean it is accessible to a client.

Having an impact comes through knowing your client, understanding their experiences, being non-judgemental, advocating on their behalf, and to look at ways to break down systemic barriers.

Occupational therapists in Ontario work with a diverse and varied group of clients, so it will be up to each occupational therapist’s clinical judgement to determine what appropriate resources are available to provide to their clients.

When critically appraising resources, consider the language used and whether it contains offensive or biased wording, ableist language or assumptions.

Are there pictures or logos that are offensive? Consider the use of alternate communication methods if needed.

Occupational therapists are encouraged to reach out to their community partners. They may have materials that may benefit your diverse population and networking may foster the sharing of resources.

The College expects all occupational therapists to follow the Code of Ethics and the new Competencies and to take reasonable steps to incorporate these principles into practice.

Occupational therapists are expected to listen to their clients, take their concerns seriously, and start by affecting change at the micro level, within your practice setting and sphere of control. These are the minimal expectations and a starting point. Large system level changes will take more time, so start small.

Occupational therapists must be aware that socio-cultural factors such as race, ethnicity, customs, age, disability, gender, sexuality, and religion may affect screening, assessment, intervention, communication, and therapeutic relationships.

Occupational therapists should reflect on their practice and see what changes they can make in their occupational therapy interactions with clients, and avoid making assumptions about clients based on their socio-cultural background.

Each client is unique and may have specific circumstances that need to be addressed and accommodated. Service provision and collaboration must allow the client/substitute decision-maker to make informed choices based on unbiased and relevant information.

Some strategies are already inherent in occupational therapy practises whether virtual or in-person, such as looking at language and communication accommodations or the use of informal supports to facilitate access to service.

For virtual care, it may require looking at options to accommodate clients who do not have access to electronic devices or even the internet. In order to promote equity, it may require the identifying of these access issues to individuals/leaders who make decisions in order to advocate for solutions and changes.

We hope that occupational therapy programs and educators will promote reflection with students. Student should be equipped with the understanding that they come with a position of privilege as they learn to work with clients of all abilities and diverse backgrounds.

Our understanding is that curriculum updates will link to the new national competencies and other resource materials may be coming forth in 2022 to help students prepare as they come out into the work environment.

We first need to understand positionality and recognize that occupational therapists hold a position of privilege with students, just as they do with clients. The College has Standards for Practice that speak to this power imbalance.

Occupational therapists need to be mindful that students come with their own experiences and biases, and since we are in a position of power, it is imperative to co-create a safe environment and model appropriate behavior for students. You want to help students to feel safe and be able to address concerns with you.

We will be reviewing the feedback received from the feedback survey.

After the PREP module comes out, we will also look at that feedback.

The Practice team is also tracking any questions we receive related to culture, equity and justice, and monitoring complaints to see whether this is an area where registrants may be struggling.

As this domain is now part of the national competencies, it will get incorporated into the self assessment plan and competency assessment in the QA program.