Preface This manual is intended as an interactive manual for use by future occupational therapy (OT) practitioners. It is appropriate for use within an instructional setting, either as an alternative to lecturing or in a lab-type class, within an educational program that is accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association. Each student in a class should have a manual for his or her own use. Fieldwork educators might also use this manual as they supervise students in a practice setting. Specific sections may be selected to supplement and augment the students' experiences. Additionally, this manual may serve as a learning tool for the OT practitioner who is returning to practice as well as the practitioner who is changing practice settings, as it reflects current content of the OT profession. In such a case it would be appropriate to use it as an independent study tool or in conjunction with the assistance of a mentor. As OT practitioners we are charged with obtaining and maintaining competency. "Ensuring competency is key to both individual success and the continued success of the occupational therapy profession as a whole" (AOTA, 1998, p. 693). Currently there is no one suggested measure of competence but rather, as suggested by Salvatori (1996), a variety of methods are needed to do so. This manual presents such a variety of methods and represents the "can" level of Salvatori's (1996) "know-can-do" model. It teaches the basic knowledge, skills, and attributes that practitioners need to deliver effective services to clients. The professional behavior and judgments that an occupational therapy practitioner needs are many and varied. Herein is provided a solid foundation of the necessary beginning competencies needed by an OT practitioner. Clinical reasoning and consideration of the context of practice are essential for occupational therapy, as you will see throughout this manual. You will be introduced to clinical reasoning attributes, especially the tacit knowledge to which Mattingly and Fleming (1994) refer. The information that is often taken for granted in the field of occupational therapy is enunciated clearly with the necessary components presented. However, advanced clinical reasoning is beyond the teaching scope of this book. Advanced clinical reasoning will become part of a practitioner's expertise with advanced practice and education. A thorough review of the issues related to competency can be found inDeveloping, Maintaining, and Updating Competency in Occupational Therapy: A Guide to Self-Appraisalwritten by the Competency Task Force of the AOTA (1995). Additionally, the reader is directed to theAmerican Journal of Occupational Therapy'sspecial issue on professional competency (October 1998), in which experts from across the field detail the critical importance of competency as it relates to the viability of the individual practitioner and the profession. The emphasis on achieving, maintaining, and updating competency is evident throughout this significant journal issue. Content Development The content of this manual was developed by the first author's experience as an educator. Course content from many years of experience teaching occupational therapy assistant classes in an ACOTE-accredited program has been included. Visiting local facilities during a recent teaching sabbatical to include current ideas, theories and techniques used, solidified the content. It was then modified accordingly and aligned with the "Standard for an Accredited Education Program for the Occupational Therapy Assistant" (ACOTE of AOTA, 1998a) and the "Standards for an Accredited Education Program for the Occupational Therapist" (ACOTE of AOTA, 1998b). As such, this manual represents current clinical practice in the field. Throughout this manual the wordsoccupationKief, Cindy A. is the author of 'Clinical Competencies in Occupational Therapy', published 2000 under ISBN 9780838512487 and ISBN 0838512488.