Student Name_________Shawnee Burnett___________________________

Date 4/1/16

OCCUPATIONAL THERAPY STUDENT PERFORMANCE ASSESSMENT

Documentation Competency Evaluation
Competency Components
SOAP NOTE (MS Word Document)
1.Types SOAP note with proper spelling and grammar
2. Organizes SOAP note so that ideas and sections flow logically
from one to another.
3. S The statement is a reflection of the clients narrative
stance and is from the clients perspective and relevant to the rest
of the note. If the statement is a direct quote it is in quotations, if
not, the client stated or something equivalent is used.
4. O Includes all outcome measure data and scores in a way
that makes sense to the reader (case info, COPM, PASS)
5. O Accurately and succinctly documents clients occupational
performance during observation including measurements (ie level
of physical assist or cueing, timing, environmental factors, etc)
6. A Clearly communicates which person, environmental, or
task factors are hindering or supporting successful occupational
performance. Comments on strengths and adaptive capability of
the client.
7. A Provides professional interpretation of objective results
and states whether client potential.
8. P States the intervention that will be implemented to
address the problems in the A, the frequency, duration, and
intensity of the treatment, and reinforces the need for SKILLED
OT services.
9. Goals Identifies two appropriate occupation-based LTGs
with each accompanied by 2 occupation-based STGs (SMART
format); skill is obvious. Goals reflect the priorities of the context.
INTERVENTION PLAN FORMS
10. Occupational Performance Problem area reflects relevant
occupational performance area; barriers are present in evaluation
and goal identified above
11. What will you do section is relevant to clients interests,
priorities, and identified goal. Will provide opportunity to make
progress on stated goal. Reflects skilled OT services. Provides
detail of how you would set up the activity and what you are doing
to address the performance problem.
12. Practice Mode/Rationale described is consistent with goal
and activity/progression described
13. Grading section is realistic and reflects students knowledge
of diagnosis and activity analysis. Reflects areas being
addressed. Grading is taking place within task or related task
demands; reasonable for 1 step up/ down and is not just
amount/type of cueing or interaction of therapist.
Overall rating of Students Documentation Competency Level
(Circle One)
Additional Comments:
Overall, well written

Absent or
Ineffectively
Written

Present

Written
Well

N/A

X
X

Documentation
skills do not meet
competency
requirements

Documentation
skills meet
competency
requirements

Documentation skills
exceed competency
Requirements

Student Name_________Shawnee Burnett___________________________

Date 4/1/16

Scoring rubric for the Adult OTSPA

To pass this examination, a score of 80% or higher must be earned on both parts of the
exam.
Documentation Portion
All students start with 69/75 points for earning adequate skill levels. (All checks down the
middle column on page).
For each item marked outstanding, 2 points are added For each item marked as not
observed/ not performed appropriately, 4 points will be deducted.
Starting points
69/75
# Outstanding skills items checked
2___x2=4
# not observed/ not performed
appropriately ____1_x4=4
Total points
69___/75
92%