Essential Supports for Early Career OTs

Essential Supports for Early Career OTs (Essential Support Guide) outlines the minimum recommended supports that Occupational Therapy Australia (OTA) advises for early career occupational therapists. The Essential Support Guide also identifies enabling factors that enhance the effectiveness of these minimum recommended supports and contribute to the success, job satisfaction, and retention of early career therapists in their roles.

Who is an early career therapist

Occupational Therapy Australia defines an early career therapist as an occupational therapist who is within the first 0-5 years following graduation from their occupational therapy degree.

Who can use this guide

The Essential Supports Guide is intended to be used by early career occupational therapists, employers of early career occupational therapists, supervisors and managers of early career occupational therapists, and any persons responsible for the planning and/or implementation of occupational therapy graduate programs or early career supports.

What is the guide used for

The Essential Supports Guide is designed to address the individual support needs of early career occupational therapists and guide the planning of graduate/early career programs. The Essential Supports Guide can be used to facilitate discussions between early career therapists and their workplaces, helping to establish and regularly review their professional support requirements.

Early career scope of practice

Occupational therapy (OT) is a holistic, client-centered profession focused on enabling people to participate in meaningful activities (occupations) that impact their health and well-being.

The OT scope of practice is broad, encompassing areas such as physical rehabilitation, mental health, paediatrics, aging, and disability. The OT scope of practice is defined in the Occupational Therapy Australia Scope of Practice Framework (2017). Early career occupational therapists are not expected to address the full breadth of OT practice and should focus on working within a clearly defined personal scope in a chosen area of practice.

Registration and standards of practice

All occupational therapists must be registered with the Australian Health Practitioner Regulation Agency (Ahpra). Professional registration requires adherence to strict standards of practice, including recognising and working within one’s own knowledge and abilities, as outlined in the Ahpra Shared Code of Conduct and Australian Occupational Therapy Competency Standards (2019).

Employers share responsibility in ensuring early career therapists meet these standards. It is important that early career occupational therapists work within their own skill level to maintain their professional registration, ensure client safety, and deliver high-quality care. By staying within these boundaries and seeking professional support and further training when needed, early career occupational therapists can prevent potential harm to clients, avoid errors, and provide effective, evidence-based interventions.

Practical experience, learning and development

Employers can expect early career occupational therapists to bring foundational level knowledge to their roles. In their first years of practice, occupational therapists are expected to refine and expand these foundational skills through supported practical experience and learning and development opportunities. This critical period is often focused on refining clinical reasoning, enhancing technical skills, building understanding of healthcare services and systems, gaining confidence, and developing professional identity. It is expected that therapists will continuously build their skills in their chosen area of practice throughout their careers, including staying up to date with current best practices and research evidence.

OTA has a series of Capability Frameworks that can help to understand the expectations of foundational level practitioners in different areas of practice.

Early career essential supports

OTA recommends that early career occupational therapists have access to a minimum or baseline level of key supports, supplemented by a series of enabling factors to foster good practice and career longevity.

The minimum recommended supports can be provided internally by the employer, externally by a third party, or a combination of the two. External supports should be carefully evaluated to ensure they come from a reputable source, are high-quality, and address the specific needs of the early career occupational therapist.

Funding for supports can be negotiated between the early career therapist and their employer. Workplaces can enhance recruitment and retention by providing access to supports as an employment benefit.

Minimum recommended supports

OTA considers the following supports essential for all early career occupational therapists 0-5 years post-graduation to ensure client safety, provision of highquality care, and success in their roles.

Note: Final document to include diagram that illustrates these minimum recommended supports in the first concentric circle around the clinician

Supervision: Professional supervision is a supportive process where an experienced occupational therapist helps guide another therapist to improve their skills, ensure high quality care, and promote professional growth and wellbeing. Supervision is considered essential for all occupational therapists.

Supervisors should be well trained and have sufficient time to effectively support the early career therapist. Supervision for early career therapists should be conducted by a senior occupational therapist with experience in the relevant area of practice.

It is recommended that supervision be provided in line with Occupational Therapy Australia’s Supervision Framework (2019), which outlines the necessary intensity, structure, and documentation of supervision.

Regular evaluation of the supervision process is essential to ensure it meets the needs of the early career therapist. The early career therapist should be encouraged to provide feedback or express any concerns about the supervisory relationship.

Structured skill development: Early career occupational therapists need to develop expertise in their chosen area of practice through supported practical experience and targeted learning opportunities. Early career therapists should work with their supervisor to develop a structured, intentional plan for building their technical skills, utilising capability frameworks and other clinical guidelines where they are available. In situations where the therapist is working within a formalised graduate/early career program, their individual learning needs should still be considered and addressed. When applying new knowledge and developing new skills, it is important for early career therapists to do so under the supervision or direct guidance of a more experienced clinician.

Client caseload should be assigned based on the therapist’s current skill level and capability.

Access to ad-hoc support: In-between supervision sessions early career therapists require access to ad-hoc support to help address unexpected challenges, respond to any risks identified, enhance learning, and support their well-being. This support could be provided by their professional supervisor, manager, other members of the team, and broader network. Early career therapists should know who they are able to contact and about what types of concerns. Where possible, workplace environments that foster informal connections are beneficial in building opportunity for ad-hoc support.

Clinical Governance: Effective leadership, risk management, and continuous improvement help early-career therapists uphold professional standards, handle challenging situations, and ensure 6 Essential Support Guide for Early Career OTs V1.1 September 2024 workplace safety. Early career therapists should have access to clear policies and procedures, receive thorough orientation to workplace processes, and be aware of reporting pathways for identified risks or near-miss incidents. Policies and procedures should align with relevant national and state based standards, examples may include but are not limited to, any relevant Australian Commission on Safety and Quality in Health Care Standards and workplace health and safety laws. Early career therapists should be provided access to any mandatory training required to complete their job safely.

Continuing Professional Development (CPD): All occupational therapists are required to complete 20 hours of CPD each registration year to maintain their professional registration with Ahpra. All CPD opportunities should be evaluated to ensure they are provided by a reputable source, are evidence based, and relevant to the therapist’s practice. Workplaces should support early career therapists to meet their CPD obligations and assist them in applying new knowledge into practice.

Networking opportunities: Networking is the exchange of information and ideas among people with a common profession or special interest in both formal and informal settings. Networking opportunities are essential to build confidence, belonging, and professional identity in early career therapists. It is beneficial for therapists to connect with their early career peers, experienced occupational therapists, and healthcare professionals from other disciplines. These interactions can take place online, in person, or through a blend of both. Workplaces are encouraged to offer and/or allocate time for networking opportunities, both within the organisation and externally.

Time for reflection and planning: During the early career period, therapists are refining their clinical reasoning, developing technical skills, building understanding of healthcare services and systems. They require extra time for reflection, research, and session planning to develop these skills effectively. This dedicated time is crucial for deep thinking and enhances their confidence and effectiveness in client care, ensuring thoughtful and well-prepared practice.

Wellbeing support: Early career occupational therapists often encounter significant stressors and challenges as they transition into professional roles and navigate a steep learning curve. Prioritising wellbeing is a key factor influencing their success in a role, job satisfaction, and long-term retention. Effective wellbeing support might include flexible expectations, access to Employee Assistance Programs (EAP), peer support, and regular debriefing opportunities. Supervisors and managers play a role in supporting this by helping therapists recognise and manage early signs of stress and burnout.

Intensity of support

Support needs will fluctuate – the intensity of support required for each individual should be negotiated between the early career therapist and their employer or manager, utilising relevant guidelines and frameworks where available. Where the therapist is working within a structured graduate/early career program, their individual needs should be considered.

Intensive support is required during the initial transition to practice or when starting a new role, however these needs generally decrease over time. Regular review of support requirements is crucial, with adjustments made as needed. An increase in responsibilities, caseload complexity, or new skill development may require a reassessment and potentially a period of more intensive support. Additionally, any signs of stress or burnout should trigger a review of support to ensure the therapist's well-being and effectiveness.

Ongoing support throughout the entire early career period (0-5 years post-graduation) is essential for managing responsibilities and maintaining overall well-being.

Evaluation of supports

Regular evaluation of the effectiveness of the supports provided should be conducted, with involvement of the early career therapist, to ensure the supports are appropriate and effective. The therapist should have pathways to provide any feedback or raise concerns regarding the supports that they are being offered/utilised.

Enabling factors

Enabling factors are the workplace and personal factors that are essential for maximising the effectiveness of the minimum recommended supports identified for early career OTs.

Note: Final document to include diagram that illustrates these personal and workplace enabling factors in the second concentric circle around the clinician.

Workplace factors

A supportive workplace culture and environment is critical to ensuring OTA’s minimum recommended supports contribute effectively to the success, job satisfaction, and retention of early career therapists.

Fostering a positive culture and strong leadership is essential. Workplaces should be aware of occupational therapy professional standards and legal requirements and create an environment that facilitates compliance with these requirements.

Understanding the occupational therapy role, scope of practice, and each therapist's competency and capability is also vital for providing appropriate support and ensuring safe practice. Early career therapists are most likely to thrive in workplaces that prioritise client outcomes and staff wellbeing, allowing therapists to work in alignment with their professional values. By aligning workplace practices with these factors, organisations can create an environment where early-career therapists receive the guidance and support necessary for provision of safe and effective practice and to maintain their wellbeing.

Examples of workplace factors that enhance the success, job satisfaction, and retention of early career therapists may include:

• Positive workplace culture where the therapist’s well-being and client outcomes are prioritised.
• Setting realistic expectations and demonstrating flexibility in workplace demands in response to the therapists’ needs.
• Reduced caseload expectations on entry into a new role. Graded transition to full caseload expectations with consideration of experience and learning needs.
• Role clarity and documented individual scope of practice agreed in collaboration with the early career therapist, considering their competence and capabilities. Ensuring caseload allocation aligns with the agreed scope of practice and the therapist’s competency.
• Building the workplace understanding of the occupational therapy role.
• Building understanding of the expected knowledge and competency of early career occupational therapists.
• Encouraging engagement with the broader occupational therapy profession through participation in communities of practice, consultation opportunities, working groups,
• interest groups, contributions to research, etc.
• Facilitating understanding of workplace rights and entitlements, including leave entitlements.
• Strong management and leadership who have appropriate experience and training.
• Clear channels for open communication between the early career therapist and the workplace.
• Providing opportunities for supported professional growth and career progression, aligned to the therapist’s professional goals.
• Facilitated access to resources and resource sharing platforms, such as academic journals, tip sheets, practice guidelines, client handouts etc.
• Encouraging work-life balance.
• Provision of financial support to access CPD.

Personal factors

Early career occupational therapists should be empowered to take ownership of their learning and development and self-care. They must take responsibility for adhering to relevant professional standards and legislation, including identifying their competency levels and learning needs.

Early career therapists should be prepared to engage in open communication with their employer around their support needs and any concerns that may impact their practice. They should be proactive in identifying and engaging in learning opportunities and seek out opportunities for networking and broader involvement in the profession.

In addition to developing clinical skills, early career therapists should seek opportunities to build their soft skills and self-management. Engaging in regular reflection helps early career therapists continually assess their performance and areas for further development as well as identify any early signs of stress and burnout.

Early career therapists who are proactive in their own development and self-management are more likely to succeed in their roles and are better positioned to collaborate with their workplace around their support needs.

Examples of personal factors that contribute to career satisfaction and longevity include:

• Engaging in regular reflection on practice.
• Being proactive in building professional networks internal and external to the organisation.
• Engaging in supervisee training.
• Being prepared and actively participating in supervision sessions.
• Proactively engage in the occupational therapy profession through participation in communities of practice, interest groups, working groups, consultation opportunities, contributions to research etc.
• Continuing to build knowledge and understanding of evidence based practice.
• Focusing on development of soft skills in addition to clinical skills, such as self-management,
• time-management, communication, and self-advocacy.
• Communicating clearly with supervisors and managers about goals, learning needs, risks, and challenges.
• Seek mentoring to support career planning.

Case Studies

Note: Final document to include case studies, illustrating how essential supports can be provided in different settings improve the career satisfaction and longevity of early career OTs/ improve staff recruitment and retention.

This document was informed by

Development of the Essential Supports for Early Career OTs (Essential Support Guide) was informed by findings from the Occupational Therapy Australia Workforce Development Project involving a literature review, data analysis, and consultation with the occupational therapy profession, identifying occupational therapy workforce needs and priorities.

Further consultation with the occupational therapy profession and a scan of relevant literature targeted to the support needs of early career occupational therapists was also completed. The literature scan uncovered the below references.

Aloisio, L. D., Gifford, W. A., McGilton, K. S., Lalonde, M., Estabrooks, C. A., & Squires, J. E. (2018). Individual and organizational predictors of allied healthcare providers' job satisfaction in residential long-term care. BMC Health Services Research, 18, 491. https://doi.org/10.1186/s12913-018-3307-3

Cosgrave, C., Maple, M., & Hussain, R. (2018). An explanation of turnover intention among early-career nursing and allied health professionals working in rural and remote Australia - findings from a grounded theory study. Rural and Remote Health, 18(3), 1-17. https://doi.org/10.22605/RRH4511

DeIuliis, E. D., & Saylor, E. (2021). Bridging the gap: Three strategies to optimize professional relationships with Generation Y and Z. The Open Journal of Occupational Therapy, 9(1), 1-13. https://doi.org/10.15453/2168-6408.1748

Devery, H., Scanlan, J. N., & Ross, J. (2018). Factors associated with professional identity, job satisfaction and burnout for occupational therapists working in eating disorders: A mixed methods study. Australian Occupational Therapy Journal, 65(6), 523-532. https://doi.org/10.1111/1440-1630.12503

Dymmott, A., George, S., Campbell, N., Brebner, C., (2022). Experiences of working as early career allied health professionals and doctors in rural and remote environments: a qualitative systematic review. BMC Health Services Research, 22, 951. https://doi.org/10.1186/s12913-022-08261-2

Foster, F., Palexas, S., & Hitch, D. (2022). Early career programs for mental health occupational therapists: A survey of current practice. Australian Occupational Therapy Journal, 69(3), 255–264. https://doi.org/10.1111/1440-1630.12787

Guy, L., Cranwell, K., Hitch, D., & McKinstry, C. (2020). Reflective practice facilitation within occupational therapy supervision processes: A mixed method study. Australian Occupational Therapy Journal, 67(4), 320-329. https://doi.org/10.1111/1440-1630.12660

Harrison, H., Palermo, C., Devine, S. G., Chamberlain-Salaun, J., Nash, R., & Barker, R. N. (2023). Building the capacity of rural allied health generalists through online postgraduate education: A qualitative evaluation. Rural and Remote Health, 23(3), 1-9. https://search.informit.org/doi/10.3316/informit.434136876562243

Hitch, D., Lhuede, K., Giles, S., Low, R., Cranwell, K., & Stefaniak, R. (2020). Perceptions of leadership styles in occupational therapy practice. Leadership in Health Services, 33(3), 295- 306. https://doi.org/10.1108/LHS-11-2019-0074

Klaic, M., McDermott, F., & Haines, T. (2019). How soon do allied health professionals lose confidence to perform EBP activities? A cross-sectional study. Journal of Evaluation in Clinical Practice, 25(4), 603-612. https://doi.org/10.1111/jep.13001

Knightbridge, L. (2019). Reflection-in-practice: A survey of Australian occupational therapists. Australian Occupational Therapy Journal, 66(3), 337-346. https://doi.org/10.1111/1440-1630.12559

Matus, J., Mickan, S., & Noble, C. (2020). Developing occupational therapists' capabilities for decision-making capacity assessments: How does a support role facilitate workplace learning? Perspectives on Medical Education, 9(2), 74-82. https://doi.org/10.1007/s40037-020-00569-1

Matus, J., Walker, A., & Mickan, S. (2018). Research capacity building frameworks for allied health professionals – a systematic review. BMC Health Services Research, 18(1), 716. https://doi.org/10.1186/s12913-018-3518-7

McCluskey, A. (2003). Occupational therapists report a low level of knowledge, skill and involvement in evidence-based practice. Australian Occupational Therapy Journal, 50(1), 3-12. https://doi.org/10.1046/j.1440-1630.2003.00303.x

Moir, E. M. A., Turpin, M. J., & Copley, J. A. (2021). The clinical challenges experienced by new graduate occupational therapists: A matrix review. Canadian Journal of Occupational Therapy, 88(3), 200-213. doi:10.1177/00084174211022880

Murray, C. M., Edwards, I., Jones, M., & Turpin, M. (2020). Learning thresholds for early career occupational therapists: A grounded theory of learning-to-practise. British Journal of Occupational Therapy, 83(7), 469-482. https://doi.org/10.1177/0308022619876842

Park, E. Y. (2021). Meta-analysis of factors associated with occupational therapist burnout. Occupational Therapy International, 2021, Article 1226841. https://doi.org/10.1155/2021/1226841

Popova, E. S., Hahn, B. J., Morris, H., Loomis, K., Shy, E., Andrews, J., Iacullo, M., & Peters, A. (2022). Exploring well-being: Resilience, stress, and self-care in occupational therapy practitioners and students. Occupational Therapy Journal of Research, 43(2), 159-169. https://doi.org/10.1177/15394492221091271

Scanlan, J. N., & Hazelton, T. (2019). Relationships between job satisfaction, burnout, professional identity and meaningfulness of work activities for occupational therapists working in mental health. Australian Occupational Therapy Journal, 66(5), 581-590. https://doi.org/10.1111/1440-1630.12596

Snowdon, D. A., Sargent, M., Williams, C. M., Maloney, S., Caspers, K., & Taylor, N. F. (2020). Effective clinical supervision of allied health professionals: A mixed methods study. BMC Health Services Research, 20, 2. https://doi.org/10.1186/s12913-019-4873-8

Turpin, M., Fitzgerald, C., Copley, J., Laracy, S., Lewis, B. (2021) Experiences of and support for the transition to practice of newly graduated occupational therapists undertaking a hospital graduate Program. Australian Occupational Therapy Journal, 68(1), 12–20. https://doi.org/10.1111/1440-1630.12693

Turner, I., McMullen-Roach, S., Baker, A., & Murray, C. M. (2024). "Why is it not bringing me meaning and purpose?" Former occupational therapists' narratives of leaving the profession. Australian Occupational Therapy Journal, https://doi.org/10.1111/1440-1630.12964

Wenke, R., O'Shea, K., Hilder, J., Thomas, R., & Mickan, S. (2019). Factors that influence the sustainability of structured allied health journal clubs: a qualitative study. BMC Medical Education, 19, article 6. https://doi.org/10.1186/s12909-018-1436-3