Cancer Learning - Occupational Therapy PD Pathway

Download the complete Occupational Therapy Professional Development pathway in PDF.

Occupational Therapists analyse and assess the various occupational roles and other meaningful activities that people undertake in their daily lives. They assist their clients to develop skills that minimise the limitations caused by illness and injury, enabling them to sustain active participation in their roles; enhancing productivity, quality of life and physical and mental wellbeing.

Occupational Therapists can play a role in all phases of cancer care to meet patients’ needs before, during and after treatment. There are two main areas of practice in which Occupational Therapists operate in the cancer field, acute services and palliative care services. A number of occupational therapists also practice as lymphoedoema practitioners.

In acute cancer care, the goal of the Occupational Therapist is to optimise the patients’ potential to function to the best of their ability. This is achieved via a range of activities that address physical, cognitive and psychological aspects of the illness experience. It may also require a home assessment and prescription of assistive equipment.

In palliative care occupational therapists aim to assist patients to maintain quality of life by enabling them to continue to engage as actively and as fully for as long as possible in those activities that are of primary importance. What is important will differ from person to person and includes activities that may fall in the areas of self care, domestic tasks or recreational activities.

In cancer care, Occupational Therapists aim to optimise participation in valued occupational roles where possible. They employ a number of strategies to do this, including:

Assessment and identification of physical, cognitive and psychological impairments and environmental surrounds that lead to functional and occupational difficulties
Prescription of assistive equipment to optimise and facilitate safe function
Relaxation training to alleviate anxiety, assist with management of breathlessness and pain management
Cognitive behavioural strategies to assist management of anxiety
Fatigue management training
Manual handling training to families and care givers to assist them to safely assist the patient without hurting themselves
Optimise function and involvement in activities at end-of-life

Professional development opportunities in cancer care are available to Occupational Therapists through a range of avenues, including workplace-based learning, self-directed learning, workshops, short courses, networks, conferences and postgraduate qualifications to broaden experience and develop the knowledge and skills required to progress their careers and to provide optimal services to cancer patients.

Where are you in your career?

New to cancer care

If you are new to cancer care, you will probably want to start with information that will provide you with general knowledge about cancer, its diagnosis, treatment and management. Gaining experience in a broad range of areas may help you not only in your understanding of the needs of patients with cancer but also in your decisions about future career directions.

Tips

Find a mentor

A mentor is a colleague who can provide you with individual advice, feedback and support. A mentor can be a great source of advice and support. Mentors can be occupational therapists or other health professionals working in cancer care. Mentors can help you develop your career, as well as answer clinical and service-related questions that you may have. Talk to senior colleagues and other allied health professionals in your area or contact professional organisations and networks to find out more.
Some professional mentoring programs to assist you with this are available and include:

MentorLink: http://www.otnsw.com.au/pd/mentoring.php
OT SA Mentor/Peer support program – includes downloadable guidelines and policies: http://www.otsa.org.au/content/default.asp?mainID=24

"I had a mentor, Deidre Burgess, for approximately one year in 2005 through the Mentor Link Program, during transition period from clinician to manager, which I found very beneficial. " (Julia)

"My supervisor during my time working as a Grade 1 inspired me to be the best OT I can be; she also continued to heighten my enthusiasm for working with people who are facing a terminal diagnosis and helping them to address these issues and find solutions. " (Erin)

"I kept in contact with the Occupational Therapist who had written the Post Graduate Certificate course I completed and approached her to mentor me on an informal basis, which was generally just email and phone contact. " (Deidre)

Work in different cancer environments

Spending some time in cancer care environments can help you decide whether this area of occupational therapy might be for you. Larger hospitals may offer clinical rotations that include inpatient oncology, chemotherapy day units and palliative care but this will vary from hospital to hospital. Arranging informal visits with occupational therapists already working in cancer care may also be possible.

"All career movements so far have been due to choice and following areas of interest, whilst working with the needs of my department. Chronic illness and end of life care are areas of interest and in my current role there is a good balance between these and other areas of Oncology to maintain a fulfilling role." (Amy)

"Working in the neuropalliative rehabilitation model sparked my interest for end of life care and the OT role within this." (Erin)

"I have worked as an OT for almost 10 years, and in cancer services since 2003. My various positions over this period have given me exposure/experience across all clinical areas within cancer services (acute, day oncology, PCU & Radiotherapy) which has been invaluable in developing an understanding of the systems and processes in each area, which may also have assisted my career development." (Julia)

Self-directed learning in cancer care and terminology

Driving your own learning is important. Occupational therapists working in the area need to have an understanding of cancer, including the disease processes, staging and the different types of cancer decisions. In addition to cancer expertise, it is important to have a good understanding of medical, clinical trial, and clinical research terminology. Sources of information may include cancer text books and cancer websites. Electronic data bases such as Medline, CINAHL, Web of Science and Caresearch also provide information on previous and current research.

"I completed a Graduate Certificate in Allied Health and palliative care which provided me with comprehensive overview of palliative care It covered topics such as , symptom control, mechanisms of pain, communication, psychological and spiritual issues associated with palliative care… There are also opportunities for training in related areas. Another colleague has just completed a two day course in Sydney in counselling techniques for people with a cancer diagnosis." (Deidre)

"Self directed learning is a large component of my professional development, especially when I was commencing my new role within Cancer Services. Our wider OT department has in-house PD regularly which has sessions with a Cancer focus a few times per year." (Erin)

"Self-directed learning is paramount at this time as there does not seem to be much opportunity for participation in specific Oncology training for Allied Health. " (Amy)

Workshops and seminars

Workshops, short courses and seminars may be available through a range of avenues and can help you develop networks as well as expertise. Ask colleagues about local talks being given in your hospital or local area. Events may be available through a range of avenues including professional groups and societies, local institutions and commercial groups. The Cancer Council in each state and territory often run workshop and seminars on a range of cancer topics.

"At the Royal Adelaide Hospital we have regular ‘Grand Round’ education sessions and I endeavor to attend those focused on Oncology….There is also a comprehensive ‘inservice’ program within the OT department across both here and our associated rehabilitation site. However there has been limited Oncology-based education provided at this time. " (Amy)

Join networks and special interest groups

Occupational therapy in cancer care is an emerging area in cancer care. Involvement in local, state-based, national or international networks or special interest groups can be a valuable source of information, ongoing learning and support that will help you keep up to date with the latest evidence, treatments and events, and introduce you to the key people in the area. Belonging to networks and groups can also help keep you informed of upcoming workshops and courses.

"Get involved in organizing or facilitating cancer specific support programs eg. Living With Cancer Education Program and Look Good, Feel Better, as the area of supportive care and wellness is becoming a huge focus in cancer care. It is also very rewarding and gives you a different perspective of the patient experience." (Julia)

"There is a special interest group in oncology and palliative care run by OT Victoria in Melbourne. We meet on a bi-monthly basis and I mentor a few people as well. It is definitely a growing area, though it is limited as well, in that it can be difficult to have a cancer specific case load, because there are only a few oncology and palliative care-loads which are usually in the tertiary teaching hospitals. Occupational Therapists tend to have a mixed case load – either mixed clinically (cancer + another area) or a management/clinical split. In my last position I was site manager and had pall as my clinical case load." (Deidre)

Multidisciplinary teams

Multidisciplinary care is becoming a fundamental part of the delivery of best practice in cancer care. Being a member of a multidisciplinary team can be a valuable source of information and can provide ongoing learning opportunities. For further information about Multidisciplinary Teams, see Cancer Learning MDC Toolkit

"Liaise with other Allied Health working in Oncology to determine their existing roles and where OT fits within… the Multidisciplinary team…, as well as OT boundaries within this." (Amy)

"Allied health workers on the whole all tend to share information and ask and answer each others questions – we act very collaboratively." (Deidre)

Taking the next step

If you are considering working in a cancer-specific role, you will benefit from building your cancer-related knowledge and practice-based experience. This may involve attending courses and conferences, undertaking self-directed learning, getting involved in professional networks and groups, and pursuing opportunities to work in physiotherapy cancer care services within or outside your workplace.

Tips

Ask questions

Asking other occupational therapists and specialists is a good way to build your knowledge. Talk to colleagues about their experiences. Seek professional development opportunities and be creative in approaches to your learning. Ask others what they have found helpful, look for opportunities outside your own organisation and learn from the people who inspire you. You may need to look for funding to undertake particular educational initiatives.

"You have to make your opportunities. If you don’t ask, it won’t be answered, you have to be proactive and approach people to get information. I have been very fortunate to work with some really fantastic clinicians who are very happy to answer my questions. Palliative clinicians on the whole do tend to be quite collaborative. " (Deidre)

"If possible, consider positions where you can complete a rotation in cancer services as a Grade 1 to gain experience across a range of clinical areas in cancer services. " (Julia)

Build your experience

Seek and take advantage of all opportunities as they arise. Make your interest known within your workplace, talk with other occupational therapists that work in the cancer area, offer to work in a support role with a more senior therapist from the area, take up a relief position, accept a position with rotations in cancer, or seek opportunities outside your current workplace.

"Work shadowing or liaison with therapists already in the area is invaluable to gain a concept of what it is like to work with a specialised group of patients." (Amy)

"There are not many opportunities to gain experience in Cancer Care, as in my experience clinical placements in an oncology setting were not regularly offered to students, and jobs in Cancer Care are rarely advertised. If you get the opportunity to complete a placement; provide leave relief or assist an OT to cover a busy workload in Cancer Care, take these opportunities as they come up, as the only way you can really prepare yourself is to get as much experience as possible." (Erin)

Professional memberships

Becoming a member of local, state-based, national or international professional bodies and organisations can provide you with access to a whole new area of information, contacts and opportunities. Membership benefits can include free or subsidised access to members only online content, newsletters, professional development opportunities, journal subscriptions, events and conferences.

"I am currently participating in research and evidence gathering for the Geriatric Oncology team. I am aware of a Palliative Care network online and have used this for information gathering." (Amy)

"OT Victoria in recent years has developed a strong interest in Oncology and Palliative Care and send out emails and alerts about upcoming conferences and visiting specialists." (Deidre)

Attend Conferences

Attendance at relevant (discipline specific or cancer specific) state-based, national or international conferences can be helpful for building knowledge, for networking and raising the profile of OT in cancer care and palliative care. Opportunities to raise the profile include both attendance and presentation at these conferences. They can also be great networking events, providing the opportunity to meet other cancer professionals.

"I have attended Palliative Care Australia and Palliative Care Victoria conferences, where the presence of allied health is growing. The role of OTs in cancer care and palliative care is also gaining voice in both state and national OT conferences. There are some palliative units that are really good at understanding what allied health do and what we can offer, but others aren’t so good. It is important for us to promote what we can offer to patient care as Occupational Therapists." (Deidre)

Diversify your skills

As you practice, you will find that your role as an Occupational Therapist requires a wide range of skills, not just the ability to assess functional ability. Many OTs find that training in counselling greatly beneficial for working with patients who are facing life threatening illnesses that are impacting their ability to carry out roles in their lives. Consider training in other areas to complement your practice.

"I have completed a Graduate Certificate in Counselling separately, as this is an area that really wasn’t covered in my OT training Patients may talk to you about being scared about dying or become distressed by what is confronting them. How to respond to these concerns is something Occupational Therapists don’t usually receive significant training in. It is important to be mindful that just sitting with people and letting them talk these things through is a valid intervention… The focus isn’t just on doing ‘for’ somebody – it is meeting them where they are and hearing what is important to them. We are starting to provide palliative care lectures lectures to OT undergraduates now that address both physical and psychological aspects of care but I would really recommend doing some training in counselling and reflective clinical practice." (Deidre)

"Occupational therapists need to develop skills and knowledge around grief and loss; complex equipment prescription and complex discharge planning; supportive care e.g. fatigue management, relaxation, body image; dealing with death and dying and professional resilience to avoid burnout and manage stress." (Erin)

Gain postgraduate qualifications

Relevant postgraduate qualifications, such as a graduate certificate or diploma can be a valuable way to find out more about particular areas of care and will help you in your career progression. A Masters degree can be a valuable way to develop specialist skills in an area of interest to you.

"I stumbled across the Graduate Certificate, I think because the Occupational Therapist that had written it had published a couple of articles… After that I did a Masters in Clinical Science, which comprised course work and a minor thesis where I interviewed Occupational Therapists about their experiences during home assessments with palliative care clients… Further representation on behalf of OT Australia at a Palliative Care forum resulted in connection with one of the people who is my current PhD supervisor and has led to an expanding network of connections within Palliative Care." (Deidre)

"I completed a Masters of Occupational Therapy (Health Sciences) by coursework through The University of Sydney, graduating in 2004. One subject completed which was very relevant to my work in cancer services was 'Sociology of Death, Dying & Grief' through La Trobe University." (Julia)

Self-directed learning

Once you have a general understanding of cancer, the next step is to build detailed, specific knowledge. A range of sources of information are available including websites, journals, textbooks, and interactive CD-ROMs. Clinical practice guidelines are available for a range of cancer types.

"I started some further study soon after I started in Palliative Care because when I went through university, in the early 1980’s, we had the standard Kubler Ross ‘Death and Dying’ lecture and that was about it. Allied Health are trained to help people get better and the concept of someone not getting better isn’t really considered in great depth although this is changing. I found working in palliative care confronting but liked it so I did some of my own investigation and found an online Graduate Certificate in Allied health and Palliative care that was set up by an Occupational Therapist and a Nurse in Western Australia. I did that while I was working, and got some external supervision as well, which really helped me to manage my emotional response to the people I was looking after." (Deidre)

"Within the Cancer Services OT Stream, we have access to internal professional development opportunities including Cancer Grand Rounds, in-services, and case study discussions and conduct journal reviews once a month." (Julia)

Self care

In addition to your cancer skills and knowledge, occupational therapists require strong interpersonal skills, compassion and the ability to work as part of a team. Self-care (link) is crucial for those who work in cancer care and ongoing supervision is one way to support this.

"It’s very important to be aware of processes of grief and loss and how to access assistance in coping with this." (Amy)

"Good self care and supervision is crucial – I think you will burn out without it. You need the ability to reflect on what is happening to you, how it is affecting you, and why. It is also beneficial to have a supervisor who will support you in this." (Deidre)

"“You need to have a sensitive and compassionate approach to patients & family members, so you require sound communication skills and the ability to respond appropriately to emotional cues. You also need to be aware that it can be an emotionally difficult area to work in and it is vitally important to have adequate opportunities in supervision to de-brief and self-reflect to avoid burnout/compassion fatigue.”" (Julia)

For more information on self-care, click here for Work/life balance

General skills

Develop your general work skills by taking short courses in areas including project management, stats, IT, data management, research, communication, human resource management, finance, leadership.

For more information on general skills, click here for Non Clinical Skills

Advanced Practice

If you are working at or considering moving into an advanced role in cancer care, your professional development needs will be more specific.

Tips

Progress the Field

Occupational therapy as a core part of cancer and palliative care is quite a new and continually developing area. You can use your knowledge and experience to define the role of the occupational therapist in the management of cancer patients and pioneer new strategies for care involving occupational therapy concepts.

"I have… recently been appointed 0.5FTE in an outpatient position with the Geriatric Oncology team. This is a role with no previous OT and therefore I am just commencing specialised OT input. In this role, I review patients in our Oncology Day Centre to consider areas of their function that are limiting feelings of independence… There is a focus on research and EBP in this area. " (Amy)

"One of the challenges that has come out of my research about rehabilitation for those with a palliative cancer diagnosis is that there is a lack of shared terminology between rehabilitation and palliative care disciplines – what is supportive care? What is palliative care? What is rehabilitation? So there is a need for a more consistent terminology across health. Some of the patients also have difficulty with these concepts as well. Some think rehab is for people who will get better, and because they are not getting better it is not appropriate for them So it might be that we change the terminology – some clinicians struggle with the concept because the term ‘rehabilitation’ is so focused on getting better. And then there are the very real constraints of limited funding and available EFT – what resources you pour into someone whose outcome isn’t recovery? However, there are inequities – there is a lot of money invested into ‘search for a cure’ but much less money invested in researching programs that may maintain function or slow the rate of functional decline. These people will not be cured but there are significant benefits nonetheless for both patients and carers. " (Julia)

Research projects

Involvement in practice-based research, projects and steering committees can help build your expertise, or you may decide to undertake a research-based university qualification. As you build your skills, you may have the opportunity to take a more active role in planning research activities and applying for grants. As part of your role you may identify gaps in knowledge and be in a position to develop research projects aimed at addressing these gaps. You could lead your own project at a local, regional, state, national or international level.

"Work shadowing or liaison with therapists already in the area is invaluable to gain a concept of what it is like to work with a specialised group of patients." (Amy)

"I think it is a tremendously satisfying area to work in – it isn’t always easy…. But the amount of evidence out there about what Occupational Therapists can do to support cancer care is limited, so there is huge opportunity to go out and create the evidence." (Deidre)

"I am a co-researcher in a multi-centre research study in collaboration with Peter MacCallum Occupational Therapists exploring the use of the Quality of Life (QOL) assessment tools as an outcome measure for Occupational Therapy in palliative care. I have also co-authored a published journal article in Palliative Medicine with Elizabeth Pearson and Jennifer Futcher entitled ‘How Can Occupational Therapists Measure Outcomes in Palliative Care?’ (2007; 21: 477-485. http://pmj.sagepub.com/cgi/content/abstract/21/6/477." (Julia)

Present at conferences

Giving presentations at national and international conferences can help you learn while also sharing knowledge with others and keeping up to date with current knowledge. Being involved in the organising committees for conferences can be rewarding and can help you develop new networks.

Leadership and mentoring skills

You may decide to take on an additional role, such as that of a supervisor, educator or team leader. In addition to your cancer skills and knowledge, you may also identify other general management, communication, administrative and leadership skills that will help you in your role.

"One of the people I mentor is completing a Masters in Palliative Care that was made possible with funding from Palliative Care Victoria. Other Occupational Therapists have been able to attend short clinically focused palliative care courses with funding from Palliative Care Victoria and I have played a role in assessing course work." (Deidre)

For more information on leadership skills, click here for Non Clinical Skills

Case studies

Find out what Occupational Therapists working in cancer care do, what they enjoy about their work, and how they have built their careers in cancer care:

Deidre Burgess, Occupational Therapist and PhD student

Role	Currently in third year of PhD for which she received NHMRC scholarship to research the concept of occupational therapy and rehabilitation for palliative populations. This study is focusing on what can be done to assist people with end stage cancer to make the most of the life they have left.
Areas of interest and achievements	Previously managed Occupational Therapy in a Palliative Care ward. PhD is focusing both on how the perceptions of oncology and palliative clinicians regarding Occupational Therapy and rehabilitation in palliative care; as well as the patients experience of functional decline and what is most important for them to be able to continue to do at the point in their life when they commence palliative care. Currently mentoring an Occupational Therapist who is completing a Masters in Palliative Care
Pathway	Commenced working in rehabilitation. After birth of children, began part time work in an acute hospital that had recently opened a palliative care unit. Following a chance referral to the palliative unit, was offered a part time role as the Occupational Therapist for the unit, whilst continuing to work in neurology and emergency. Progressed to a full-time load split between palliative care and oncology. Became the Department OT manager with a palliative care case load. After completing Masters, commenced PhD research.
Training and courses	Undergraduate degree in Occupational Therapy Graduate Diploma - Allied Health & Palliative Care Masters in Clinical Science (OT) with minor thesis Currently undertaking PhD Graduate Certificate in Counselling
Groups and networks	Member of: OT Victoria Oncology and Palliative Care Special Interest Group Palliative Care Victoria and Australia South Melbourne Integrated Cancer Service(SMICS)
What would you recommend?	Having a theoretical background and basic clinical knowledge really supplements Occupational Therapy skills when working with patients to understand treatments and side effects. Education is required regarding the beneficial role of OT in palliative care, even though patients are not expected to make a full recovery. Seek funding for training and conferences through cancer services and other sponsoring organisations. OT needs to become recognised as an integral part of any MDC team. Networking with other clinicians who work in cancer and palliative care. Connections with other disciplines as well as OT is incredibly beneficial.

Julia Todd, Continuing Care Stream Leader/Occupational Therapy Quality Coordinator, VIC

Role	Grade 4 Cancer Services Stream Leader/Occupational Therapist, managing a team of 4.
Areas of interest and achievements	Convenor of OT AUSTRALIA Victoria Oncology/Palliative Care SIG from 2004-2006. Co-researcher in multi-centre research study in collaboration with Peter MacCallum Occupational Therapists exploring the use of Quality of Life (QOL) assessment tools as an outcome measure for Occupational Therapy in palliative care (2007 – current). Co-author of journal article titled ‘How Can Occupational Therapists Measure Outcomes in Palliative Care?’ Palliative Medicine, 2007; 21: 477-485.
Pathway	Commenced in 2000 as a new graduate in a locum position in the general medical ward. After 6 months, successfully applied for a permanent Grade 1 Rotation position, involving 6-monthly rotations across all three campuses of the organisation. I completed rotations in the areas of: amputees/musculoskeletal rehab, spinal rehab, neuro rehab, aged care rehab and acute cancer services/surgical. In March 2003, appointed permanent Grade 2 position in Cancer Services, later reclassified as Grade 3 due to the senior requirements of this role. Became the “Look Good, Feel Better” Hospital Coordinator Acted up as OT Student Coordinator for 12 months from April 2004 and during this period changed caseloads to cover the Palliative Care Unit & Radiotherapy. Appointed to higher duties in a maternity leave position as Stream Leader in Cancer Services for 12 months from August 2007 and I then successfully applied for the permanent position as Stream Leader in 2008, my current position. Acted co-OT Manager during May 2010 to cover Manager's leave. Due to commence maternity leave in mid June 2010.
Training and courses	Masters of Occupational Therapy (Health Sciences), The University of Sydney in 2004 Eliciting and Responding to Emotional Cues communication skills workshop run by TCCV at Mercy Hospital for Women, 2008 Program of Experience in the Palliative Approach (PEPA) Workshop, 2005 Living with Cancer Education Program Facilitator Training, The Cancer Council of Victoria in 2004 Providing Effective Grief and Bereavement Support Workshop, Centre for Grief Education, Monash Medical Centre in 2002 Internal workplace training eg. Cancer Grand Rounds, monthly in-service program as part of Cancer Services Allied Health group, internal stream in-services, case-study discussions NEMICS The Quality Coordinator/Projects officer in Cancer Services regularly forwards professional development/grant opportunities to cancer services staff Journal reviews within Cancer Services OT Stream (once a month) Living with Cancer Education Program facilitator update sessions 1-2 per year
Groups and networks	Member of: OT AUSTRALIA Victoria Oncology/Palliative Care SIG and Convenor from 2004-2006 The Cancer Council Victoria (including LWCEP) Cancer Services Allied Health group, NEMICS
What would you recommend?	Gain experience across a range of clinical areas in cancer services to develop your knowledge of common conditions in oncology & haematology, the potential impact of disease and/or side effects of treatments including chemo, radiotherapy and surgery on a patients level of occupational performance and an understanding of the palliative care approach. Complete post graduate study with cancer and palliative care related subjects. Get involved in cancer specific support programs e.g. Living with Cancer Education Program, "Look Good, Feel Better". Have a sensitive and compassionate approach to patients & family members so you require sound communication skills and the ability to respond to emotional cues. Build your skills in relaxation training & stress management, fatigue management education, carer training, short term equipment prescription and minor home modifications, home assessment and grief & loss issues.

Erin Webb, Occupational Therapist in Cancer Services, VIC

Role	Grade 2 Occupational Therapist in Cancer Services.
Areas of interest and achievements	Manages OT services on the Acute Surgical Ward – predominantly post-cancer removal surgery. Provides supportive care OT services (fatigue management, body image, relaxation etc) to patients undergoing cancer treatment on the acute inpatient Oncology wards and Day Oncology. Provides Occupational Therapy and supportive care to patients attending the outpatient Radiotherapy service. Coordinates the Women’s "Look good, feel better" program: http://www.lgfb.org.au/. Facilitator of Living with Cancer Education Program. Provides annual leave cover for OT’s working in the cancer services stream. Supervisor of Grade 1 rotation staff member, and undergraduate student placements.
Pathway	In 2006 commenced a new graduate rotational program in Newcastle – working 6 months in inpatient geriatric/neuro/amputee rehab and 6 months inpatient geriatric ortho rehab. From November 2006, moved to Vic and commenced working in progressive neurology (MND, Huntington’s Disease, MS, Progressive Supranuclear Palsey, Multiple Systems Atrophy etc) managing the inpatient ward, while also seeing clinic outpatients, performing community therapist duties and acting as a support and consult for community Occupational Therapists following up patients in the community (often in regional Victoria). To progress to Grade 2, in 2009 returned to rehabilitation in inpatient neuro/ortho rehab, while also covering the 0.3EFT palliative care caseload. Determined that cancer services/palliative care field was the area of greatest interest, commenced Grade 2 OT working in Cancer Services in 2010.
Training and courses	Hunter New England Health - Grief and Loss Workshop PEPA Allied Health Workshop Cancer Council Victoria – Living with Cancer Education Program - Facilitators training OT Australia Oncology/Palliative Care SIG Ongoing self directed learning, journal review, EBP Plans to complete post-graduate studies in the future
Groups and networks	Member of: OT Australia Oncology/Palliative Care SIG OT Australia Pressure Care SIG
What would you recommend?	Take opportunities to work in cancer care as they come up - complete a placement; provide leave relief or assist an OT to cover a busy workload. Be responsive and flexible to enable best care of the patient and best practice within the team. Don't forget about the family/carers of the patient – they often need just as much (or more) support, education, tips on what to do/expect and counselling. Get training in how to deal with death and dying – both how approach this topic in conversation with the patient and family and how to manage it to look after yourself. Use local supports/services as a resource and support e.g. Cancer Council, community palliative care services etc.

Amy Wigmore, Senior Occupational Therapist, Cancer Services, VIC

Role	Senior Occupational Therapist at The Royal Adelaide Hospital working half time on the inpatient cancer wards (Medical Oncology, Haematology, Radiation Oncology & Palliative Care); recently appointed to the Geriatric Oncology outpatient team for the remainder of workload.
Areas of interest and achievements	First OT member of the Geriatric Oncology staff at Royal Adelaide Hospital. Conducting research into the efficacy of OT intervention in Geriatric Oncology. Focused on evidence-based practice for OTs in cancer care. Particular interest in Occupational Therapy interventions for chronic illnesses and end of life care.
Pathway	In 2005 commenced in Vocational Rehabilitation following completion of Graduate Entry Masters OT program. This first role was focusing on rehabilitation and return to work, and later on training and development programs for injury prevention and evidence-based practice. Developed Job Dictionaries for large corporations and completed worker fatigue studies and management programs for the same. In 2007 commenced in general inpatient rehabilitation at a large rehabilitation hospital in Adelaide. Encouraged to apply for the OT position in Geriatric Oncology at Royal Adelaide in early 2010 and was recently appointed to the team with a focus on research and evidence gathering into the efficacy of OT intervention in Geriatric Oncology and reviewing patients in the Oncology Day Centre to identify areas of function that are limiting feelings of independence.
Training and courses	Bachelor of Applied Science (Human Movement) 2002 Master Of Occupational Therapy (Graduate Entry) course at The University Of South Australia in 2005 Regular Grand Rounds - Royal Adelaide Hospital Regular OT inservice program at Royal Adelaide Hospital
Groups and networks	Member of: Royal Adelaide Multidisciplinary team Geriatric Oncology team Palliative Care network online
What would you recommend?	More available information on the effects of cancer treatments on patients and the available interventions offered by OT. Training for OT and palliative care staff in grief and loss. Development of networks and professional relationships. Review literature regarding the OT role within Oncology. Consulting other Allied Health members of the MD team regarding their role and where OTs can offer assistance.

Conferences and Events

Australian

COSA (Clinical Oncology Society of Australia) Annual Scientific Meeting
http://www.cosa.org.au/asm.html

Occupational Therapy Australia events
http://www.otaus.com.au/news-events

Occupational Therapy NSW Professional Development activities
http://www.otnsw.com.au/pd/cpd.php
http://www.otnsw.com.au/pd/events.php

Occupational Therapy QLD CPD Workshops
http://www.otqld.org.au/ot_cpd/Calendar.aspx

Occupational Therapy SA Conferences and Events
http://www.otsa.org.au/content/default.asp?mainID=12

Occupational Therapy Victoria Professional Development
http://www.otausvic.com.au/professionaldevelopment

Occupational Therapy WA Professional Development
http://www.otauswa.com.au/cpd-activity

Cancer Council WA Professional Development seminars
http://www.cancerwa.asn.au/professionals/palliative-care-profs/professionaldevelopment/

Australian & New Zealand Society of Palliative Medicine conference
http://www.willorganise.com.au/anzspm2010

International

World Federation of Occupational Therapists Congress
http://www.wfot.org/wfot2010/

New Zealand Association of Occupational Therapists Conference
http://www.nzaotevents.com/

British Association of Occupational Therapists Annual Conference
http://cotannualconference.org.uk/

Includes specialist oncology and palliative care streams

American Occupational Therapy Association (AOTA) Conferences and Events
http://www.aota.org/ConfandEvents.aspx

Canadian Association of Occupational Therapists Professional Development
http://www.caot.ca/CAOT_career_listings.asp?pageid=14

Skills Workshops

Australian

Assessment of Motor and Process Skills training
http://www.ampsintl.com/AMPS/

Independent Living Centre NSW Training Courses
http://www.ilcnsw.asn.au/home/training/training

Program of Experience in the Palliative Approach (PEPA)
http://www.pepaeducation.com/

Living with Cancer Education Program (LWCEP)
http://www.cancervic.org.au/about-cancer/for-health-professionals/training_courses_and_education/cancer_education_program_facilitators

Look Good, Feel Better Workshops
http://lgfb.org.au/lgfb_wp/workshop/
http://www.caot.ca/default.asp?pageid=14

Organsiations and Networks

Australian

Occupational Therapy Australia
http://www.otaus.com.au/

Occupational Therapy New South Wales
http://www.otaus.com.au/divisions/nsw

Occupational Therapy Australian Capital Territory
http://www.otaus.com.au/divisions/act

Occupational Therapy Queensland
http://www.otqld.org.au/

Occupational Therapy Northern Territory
http://www.otaus.com.au/divisions/nt

Occupational Therapy South Australia
http://www.otsa.org.au/

Occupational Therapy Tasmania
http://www.otaus.com.au/divisions/tas

Occupational Therapy Victoria
http://www.otausvic.com.au

Occupational Therapy Western Australia
http://www.otauswa.com.au/

Occupational Therapy Board of South Australia
http://www.otbsa.com.au/

OT NSW Oncology and Palliative Care focus group
http://www.otnsw.com.au/pd/fg_general.php

OT VIC Oncology and Palliative Care Interest Group
http://www.otausvic.com.au/contactus

OT WA Special Interest Groups
http://www.otauswa.com.au/interest-groups

Independent Living Centre Australia and Affiliates
http://www.ilcaustralia.org/home/default.asp

Palliative Care NSW Occupational Therapy Oncology/Palliative Care Focus Group
http://www.palliativecarensw.org.au/info_pro.php#_focus_group

Australian & New Zealand Society of Palliative Medicine
http://www.anzspm.org.au/

COSA Palliative Care group
http://www.cosa.org.au/groups/palliative-care.html

Queensland Occupational Therapy Fieldwork Collaborative (QOTFC)
http://www.qotfc.edu.au/

International

World Federation of Occupational Therapists
http://www.wfot.org/

British Association of Occupational Therapists/College of Occupational Therapists
http://www.cot.co.uk/

British Association of Occupational Therapists Specialist Section - HIV/AIDS, Oncology, and Palliative Care
http://www.cot.co.uk/cotss-hiv-aids-oncology-palliative-care/cot-ss-hivaids-oncology-and-palliative-care

New Zealand Association of Occupational Therapists
http://www.nzaot.com/

New Zealand Association of Occupational Therapists Oncology and Palliative Care Special Interest Group
http://www.nzaot.com/resources/sigs/oncology-and-palliative-care.php

American Occupational Therapy Association
http://www.aota.org/About.aspx

Canadian Association of Occupational Therapists
http://www.caot.ca/

Postgraduate Qualifications

Australian

Graduate Certificate

Charles Sturt University Graduate Certificate in Occupational Therapy
http://www.csu.edu.au/courses/postgraduate/applied_science/index.html

Curtin University Graduate Certificate in Occupational Therapy
http://courses.curtin.edu.au/course_overview/postgraduate/GCert-OT

James Cook University Graduate Certificate in Allied Health Sciences
http://cms.jcu.edu.au/courses/health/health-sciences/JCUPRD_039927

La Trobe University Graduate Certificate in Occupational Therapy
http://www.latrobe.edu.au/handbook/2012/postgraduate/health-sciences/coursework/hcot.htm

La Trobe University Graduate Certificate in Paediatric Occupational Therapy
http://www.latrobe.edu.au/handbook/2012/postgraduate/health-sciences/coursework/paediatrics.htm

University of South Australia Graduate Certificate in Health Science (Occupational Therapy)
http://www.unisa.edu.au/hls/What_we_do/Programs_and_Courses/Studymasters/default.asp

University of Sydney Graduate Certificate in Health Sciences (Specialist Certificate in Occupational Therapy)
http://sydney.edu.au/health_sciences/occupational_therapy/future_students/index.shtml

Graduate Diploma

Charles Sturt University Graduate Diploma in Occupational Therapy
http://www.csu.edu.au/courses/postgraduate/applied_science/index.html

University of South Australia Graduate Diploma in Health Science (Occupational Therapy)
http://www.unisa.edu.au/hls/What_we_do/Programs_and_Courses/Studymasters/default.asp

Masters

Curtin University Master of Occupational Therapy
http://courses.curtin.edu.au/course_overview/postgraduate/Master-OT

Charles Sturt University Master of Occupational Therapy
http://www.csu.edu.au/courses/postgraduate/applied_science/index.html

Deakin University Master of Applied Science
http://www.deakin.edu.au/future-students/courses/course.php?course=H831&stutype=local&keywords=occupational%20therapy

James Cook University Master of Occupational Therapy Coursework
http://cms.jcu.edu.au/courses/health/health-sciences/JCUPRD_047862

La Trobe University Master of Occupational Therapy
http://www.latrobe.edu.au/courses/occupational-therapy/postgraduate

La Trobe University Master of Occupational Therapy Practice
http://www.latrobe.edu.au/courses/occupational-therapy/postgraduate

La Trobe University Master of Applied Science (Research)
http://www.latrobe.edu.au/handbook/2012/postgraduate/health-sciences/research/albury-wodonga.htm

University of Queensland Master of Occupational Therapy Studies
http://www.uq.edu.au/study/program.html?acad_prog=5147

University of South Australia Master of Health Science (Occupational Therapy)
http://www.unisa.edu.au/hls/What_we_do/Programs_and_Courses/Studymasters/default.asp

University of Sydney Master of Occupational Therapy
http://sydney.edu.au/courses/Master-of-Occupational-Therapy

Certificates

Certificate IV in Allied Health Assistance (Occupational Therapy)
http://www.opencolleges.edu.au/health-fitness-courses/certificate-iv-in-allied-health-assistance-(occupational-therapy).aspx

International

World Federation of Occupational Therapists International Educational Opportunities
http://www.wfot.org/Education/EntrylevelEducationalProgrammesWFOTApproved.aspx

International Occupational Therapy Graduate Programs
http://www.gradschools.com/listingfunctions/searchresults.aspx?SubjectId=293&Country=&State=&ProgramType=1

Postgraduate Occupational Therapy opportunities in New Zealand
http://www.nzaot.com/career.development/postgraduate.education.php

Research at the United Kingdom Occupational Therapy Research Foundation (UKOTRF)
http://www.cot.co.uk/research-ukotrf

General Skills

Australian

Occupational Therapy Leadership focus group
http://www.otnsw.com.au/otansw/leadership.php

Cognitive Institute: Communicating with Patients workshop
http://www.cognitiveinstitute.com.au/index.cfm?itemid=109

Pam McLean Communications Centre
http://www.pammcleancentre.org/main.html

Computer skills short courses
http://www.seeklearning.com.au/short-course/computer-short-courses.asp

Australian Community Colleges
http://www.art-search.com.au/information_education/community_colleges/

Vocational Education Australia
http://www.australian-education.com.au/vocational-education-australia.html

Australian short courses
http://www.courses.com.au/

Australian University short courses
http://www.australia-university.com.au/short-course-australia/

TAFE
http://www.tafensw.edu.au/

Cancer-specific courses

Australian

Cancer Learning
An online professional development website designed specifically for medical and allied health care practitioners working in cancer care to enhance their skills to ensure optimal patient care.
http://www.cancerlearning.gov.au/

EdCaN learning resources
The EdCaN resources provide highly flexible and accessible education designed to support the professional development of all nurses and allied health professionals working in cancer care regardless of experience or setting.
http://www.cancerlearning.gov.au/build/edcan_learning_resources.php

eviQ Cancer Treatments Online
Accurate, current, relevant, and evidence based protocols and information about clinical cancer treatments.
http://www.eviq.org.au/

Education Program in Cancer Care (EPICC) an initiative of Cancer Australia
An online cancer education and resource program, designed for non-cancer specialist medical practitioners. Eligible users may earn CPD points.
http://www.canceraustralia.gov.au/health-professionals/general-practice-and-cancer-care/education-program-cancer-care

Basic Sciences in Oncology
The Basic Sciences in Oncology Course supports current best practice and identifies core skills and competencies in oncology. Basic sciences of oncology and associated disciplines are linked to clinical practice.
http://www.ceti.nsw.gov.au/oncology-training/w1/i1003574/

International Atomic Energy Agency Applied Sciences of Oncology Course Version 3
Developed by the CCORE (Collaboration for Cancer Outcomes Research & Evaluation) of the South Western Sydney Area Health Service, this distance learning material contains 8 topics and 80 modules covering radiobiology, physics, oncology anatomy, palliation, chemotherapy, communication skills and molecular bioogy. The full course can be downloaded for free from IAEA website and burned to 2 CDs.
http://www.iaea.org/Publications/Training/Aso/register.html

International

Foundations of Oncology for Physical Therapists online course
A course in the fundamentals of oncology specifically for physcial therapists. Fees apply.
http://www.educata.com/courseprofile.aspx?g=16

National Cancer Institute 'Understanding Cancer Series'
Graphic-rich tutorials regarding various cancer issues for educational use. Each tutorial is available in PDF and PowerPoint formats.
http://www.cancer.gov/cancertopics

MacMillan Cancer Support
UK website providing general cancer information, including causes and screening.
http://www.macmillan.org.uk/Cancerinformation/Aboutcancer/Whatiscancer.aspx

Self-directed learning resources

OTseeker
Database of systematic reviews and randomised controlled trials relevant to occupational therapy that have been critically appraised and rated on quality, usefulness, validity and interpretability.
http://www.otseeker.com/resources/default.asp

OT Evidence
A portal of resources to aid occupational therapists to find and use information about evidence-based practice.
http://www.otevidence.info/

Online Continuing Education Courses
A range of online occupational therapy education courses. Fees may apply.
http://www.onlinece.com/pages/occupational-therapy.php

Enabling Occupation II: Advancing an Occupational Therapy Vision for Health, Well-being and Justice through Occupation.
Canadian Association of Occupational Therapists Webinar.
http://www.caot.ca//default.asp?pageid=2175

CPD for Allied Health program
Available in some Australian states only, see website for details.
http://vic.cpdforalliedhealth.org/

Grants and Scholarships

GrantsLINK
http://www.grantslink.gov.au/About.aspx

Postgraduate Scholarship Database for Australia
http://www.jason.edu.au/

Queensland Occupational Therapy Fieldwork Collaborative (QOTFC) Placement Grants Scheme
http://www.qotfc.edu.au/funding/index.html

Useful links

Council of Occupational Therapists Registration Boards (Australia & New Zealand)
http://www.cotrb.com.au/

Council of Occupational Therapists Ongoing Competency Model
For Occupational Therapists practicing in Queensland, Western Australia, South Australia and the Northern Territory. http://www.cotrb.com.au/occ.htm

Occupational Therapy Australia Code of Ethics
http://www.otnsw.com.au/download/NationalCodeEthics090801.pdf

JBI COnNECT
Joanna Briggs Institute Clinical Online Network of Evidence for Care and Therapeutics.
http://www.jbiconnect.org/

Occupational Therapy Intervention in Cancer: Guidelines for professionals, managers and decision-makers
Developed by the College of Occupational Therapists, United Kingdom.
http://www.wales.nhs.uk/sites3/Documents/362/Appendix%20VI%20-%20Role%20of%20Occupational%20Therapy%20in%20Cancer%20Care%20-%20Specialist%20Group%20Information.pdf

World Federation of Occupational Therapists Code of Ethics
http://www.wfot.org/AboutUs/FundamentalBeliefs.aspx

Canadian Association of Occupational Therapists (CAOT) Position Statement: Occupational Therapy and End-of-Life Care (2008)
http://www.caot.ca/default.asp?pageid=1284

The Role of Occupational Therapy in Chronic Disease Management
http://www.aota.org/Practitioners/PracticeAreas/Wellness/Tools/Chronic-Disease-Management.aspx

AOTA Occupational Therapy Model Curriculum Guide
http://www.aota.org/Educate/EdRes/COE/Other-Education-Documents/OT-Model-Curriculum.aspx

Occupational Therapy Critically Appraised Topics
http://www.otcats.com/

Occupational Therapy Home assessment
http://www.health.vic.gov.au/hacc/assessment.htm

Queensland Occupational Therapy Fieldwork Collaborative (QOTFC) Clinical Educator's Resource Kit
http://www.qotfc.edu.au/resource/index.html

Cancer-related fatigue assessment and management
Presentation by Sally Souraya.
http://www.palliativecare.org.au/Portals/46/Together%20conference/A11%20Sally%20Souraya.pdf

Oncology Rehabilitation: A new model of outpatient care in Australia
Presentation by Suzie Hooper, Group Manager Clinical Projects, St John of God Health Care
http://www.changechampions.com.au/resource/Suzie_Hooper.pdf

World Federation of Occupational Therapists Employment/Career Opportunities
http://www.wfot.org/Classified/JobOpportunities.aspx

Textbooks, journals and referred articles

Cooper, Jill (2006) Occupational Therapy in Oncology and Palliative Care: second edition, John Wiley & Sons.
http://www.nursingknowledge.org/portal/main.aspx?pageid=36&sku=65489&ProductPrice=55.0000

Creek, J. and Lougher. L (eds) (2008) Occupational Therapy and Mental Health, 4th Edition, Elsevier, Australia.
http://www.elsevierhealth.com.au/Health-Professions/specialty/book/9780443100277/Occupational-Therapy-and-Mental-Health/

Stevens, E and Milligan, S. (eds) (2009) Palliative Nursing: Across the Spectrum of Care, Wiley-Blackwell, Oxford, UK.
http://au.wiley.com/WileyCDA/WileyTitle/productCd-1405169974.html

Australian Occupational Therapy Journal http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1440-1630

American Journal of Occupational Therapy http://www.ovid.com/site/catalog/Journal/1740.jsp

Rehabilitation Oncology journal http://www.oncologypt.org/pubs/index.cfm#journal

International Journal of Palliative Nursing http://www.ijpn.co.uk/

Romsaas, E.P & Rosa, S.A (1985), "Occupational therapy intervention for cancer patients with metastatic disease", American Journal of Occupational Therapy, Feb;39(2):79-83. http://www.ncbi.nlm.nih.gov/pubmed/3976827

Penfold, S.L (1996), , "The role of the occupational therapist in oncology", Cancer Treatment Review, Jan;22(1):75-81. http://www.ncbi.nlm.nih.gov/pubmed/8625332

Urlic, Karen and Bennett, Sally (2010), "Some limited evidence exists for the benefits of psychosocial interventions in the management of cancer-related fatigue", Australian Occupational Therapy Journal, 57(2):148-149. http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1630.2010.00864.x/full

McCluskey, Annie and Bennett, Sally (2005), "An energy conservation program for people with cancer produced small changes in fatigue", Australian Occupational Therapy Journal, Feb;39(2):79-83. http://www.ncbi.nlm.nih.gov/pubmed/3976827

Taylor, Karen and Currow, David (2003), "A prospective study of patient identified unmet activity of daily living needs among cancer patients at a comprehensive cancer care centre." Australian Occupational Therapy Journal, 50(2):79-85. http://onlinelibrary.wiley.com/doi/10.1046/j.1440-1630.2003.00327.x/abstract

Vockins, H. (2004), "Occupational therapy intervention with patients with breast cancer: a survey." European Journal of Cancer Care, 13, 45-52. http://www.ingentaconnect.com/content/bsc/ejcc/2004/00000013/00000001/art00009

Pearson, Elizabeth; Todd, Julia and Futcher, Jennifer (2007), "How Can Occupational Therapists Measure Outcomes in Palliative Care." Palliative Medicine, 21:477-485. http://pmj.sagepub.com/content/21/6/477.abstract

Söderback, Ingrid and Paulsson, Elizabeth Hammersley (1997), "A needs assessment for referral to occupational therapy: Nurses' judgment in acute cancer care". Cancer Nursing, 20(4):267-273. http://journals.lww.com/cancernursingonline/pages/articleviewer.aspx?year=1997&issue=08000&article=00006&type=abstract

Acknowledgements

Many thanks to the individuals and organisations who contributed to the development of this pathway, particularly the Occupational Therapists who participated in case study interviews