What advice would you give to an early career OT? In a recent webinar for my YOTT Connector membership of OT students and new grads, I shared my top 15 tips. In this article, I’ll give you the in-a-nutshell version of 10 of these tips. These aren’t quick hacks and short-cuts; they’re about going to back to solid OT processes and clinical reasoning to prioritise providing quality services that will also help you become a better OT.

1. Choose your first role carefully

Your first role doesn’t need to be perfect, and it won’t define your career pathway, but it does need to support your growth. Take the time to reflect on what type of workplace will work best for you, rather than feeling you have to accept the first offer you get. Look for workplaces where questions are welcomed, supervision is protected, and quality services are valued. There’s no specific workplace that is ‘best’ for new grads (no matter what you’ve heard), it’s more about what workplace is best for YOU.

2. Keep on top of your caseload

Caseload management is a skill that takes time to develop, but it’s critical for sustainability. Keeping on top of your caseload means knowing what’s coming up, what’s overdue, and what needs follow-up, not constantly feeling like everything is urgent. When caseloads aren’t managed well, clinicians stay late, important tasks are missed, and stress builds quickly. Developing simple systems early can improve the quality of your services, produce mechanisms for efficient clinical handover, provide clarity for supervision sessions and avoid the overwhelm of managing a large, busy caseload.

3. Come prepared for supervision sessions

You need to be the driver of your supervision sessions, and you need to come prepared to get the most out of them. If you struggle with knowing what to talk about, find a reflection model or template that works for you. If you waffle on when trying to explain your client’s situation, use a framework like ISBAR to explain the important information clearly. And if you’re worried that you’ll be bothering your supervisor if you ask for a weekly sit-down supervision session as a new grad, this is why choosing a workplace that values supervision is part of tip number 1!

4. Find the balance between saying yes and saying no to difficult referrals

There are some referrals that just shouldn’t be left for a new grad to take on without very close support (sometimes it shouldn’t be on their list at all). Things like complex seating and wheelchair prescriptions, complex home modifications, or SDA reports are just a few things that come to mind. But at the same time, don’t say no to everything that seems challenging, especially if you have the right support around you to help you work through it. Learning comes with the right level of challenge and the right support.

5. Go back to the OT process or an OT model

You learn about OT models and frameworks at university – a lot – because they are important. They teach you to think like an OT. When you’re feeling lost and not able to clarify your reasoning or come up with new solutions, it’s often because you’ve skipped some steps of the OT process. You’re not sure what the functional issue was in the first place. Or you haven’t done enough assessment to understand why the person finds the task difficult in the first place. Until thinking like an OT becomes ingrained in your brain, don’t be scared to pull out the PEO or the Canadian Practice Process Framework to analyse a tricky situation.

6. Think outside of your silo

Just because you’re working in an OT-only team, doesn’t mean that’s the way you have to deliver your OT services. Consider other multidisciplinary team members and when and why you should be speaking to them, and ensure your client knows what value these conversations can have. Also remember that clients, their families and their support workers need to be included in therapy planning and implementation too, to optimise our client's ability to reach their goals.

7. A good report isn’t dependent on your writing skills alone; it also depends on your ability to gather the right information.

You need to have a clear purpose, clear reasoning and provide clear details in your reports, but you can’t do this unless you ask the right questions and observe the right activities first. Replace generic terms like ‘short distance’ with actual measurements (e.g. 10m). Describe the type of assistance provided, not just that help was required (e.g. ‘setup assistance and verbal prompting throughout’ instead of ‘needs help with showering’). But first be a good OT detective who looks for these details before it comes time to write the report.

8. Don’t forget to follow-up and evaluate your work

It can be easy to forget when life is busy and systems don’t prioritise follow-up with adequate time or funding, but that doesn’t mean you shouldn’t try to complete this step of the OT process. If you’re not following up your reports, how will you know if what you have recommended has been approved? If you’re not evaluating the outcomes you’ve achieved, how do you know whether your therapy has been worth it? And if you’re not doing either of these things, how do you know if you’re doing a good job, and where your skill gaps might be? It’s important for our clients and our own development.

9. Client centred practice doesn’t mean signing off a client wish list

Yes, in the private sector customer satisfaction is important, but it shouldn’t come at the expense of providing ethical, clinically reasoned recommendations and services. So don’t write a support letter for something a client wants unless you agree it is clinically necessary. But also, don’t decline the referral just because the client has an expectation about what specific outcome they want from your involvement. Instead, invite them to go back to the start of the OT process to explore the functional issue first, and manage expectations that the outcome may look different to what they initially planned.

10. Challenge the status quo

If someone in your workplace says, “We’re doing it this way because this is the way we’ve always done this,” it’s OK to question why. Is it really ‘just because they’ve always done it that way’ or is it because that way of doing things still aligns with evidence-based practice? If it doesn’t, be tactful, respectful and have your own evidence-based alternatives to suggest. If you choose the right workplace, questions and innovation like this will be welcomed.

These are only 10 quick tips to get you started. To hear the other 5 tips I covered in my webinar and for more detail and practical examples related to these 10, join the YOTT Connector membership. For only $25 per month it’s the cost-effective way to go back to the core principles of what occupational therapy is all about, so you can become a better OT who loves what they do.

See you there: https://yott.au/yottconnector

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