Are you spoon-feeding answers or helping to build competence and confidence?

I’ve been chatting with some other senior OTs lately and we think something has changed. New grads are needing lots more support, for a lot longer than they used to. And there’s an obvious reason why – the NDIS. But, there’s also something else…

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NDIS caseloads often involve complex clients with complex needs. New grads have to learn how to work effectively with these clients while also navigating a broken system with inconsistencies and goal posts that change all the time. And let’s not forget the challenge of keeping a customer-service focus when we often don’t feel appreciated for the services we provide.

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But what’s the “something else?”

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Well, it could actually be something we’re doing, or rather not doing, as the senior OTs training them.

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Because we’re all busy ourselves, sometimes we fall into the trap of just spoon-feeding answers and over-functioning for our new grads, instead of teaching them the fundamental clinical reasoning and professional skills they need to develop to be able to survive without us.

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We may be thinking we’re doing it for their own best interests – saving them a bit of headspace or stress when they’re already feeling overwhelmed. And sometimes that’s an approach that’s needed. But sometimes we need to stop and think – are we doing it for their benefit, or our own?

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It’s definitely quicker to just tell someone the answer, rather than having to go further and help them understand the ‘why’ behind the answers. It takes even longer to try to guide them to find their own answers with the right amount of scaffolding so they believe they can do it without us.

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But we need to try.

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Rather than focusing on all the reasons why it’s too hard to do, I’d love to chat about solutions too. Here are some practical examples of how you can flip a spoon-feeding approach to an approach that will help your new grad develop foundational OT skills.

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1.?????? The “just write me a letter scenario”

Your new grad may come to you and say “My client has asked if I can write a letter for a massage chair. What should I do?” Your short answer may be “Tell them no, the NDIA won’t fund that, but we can refer them to a physio.”

The competence-building approach could involve pulling out an OT model or process framework and going back to the beginning. Prompt them to think about:

-????????? What was the functional difficulty they want the massage chair for in the first place?

-????????? Have all other treatment modalities been explored? If it’s pain related have they considered positioning, posture, daily movement patterns, medications and pain patterns to see if the pain can be avoided rather than relieved with a massage chair?

-????????? What do the NDIS guidelines tell us? Get them to reflect on each of the reasonable and necessary criteria to see if it’s likely to tick the boxes.

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2.?????? Choosing the right standardised assessments

This time your new grad is wondering what standardised assessments they should include in their FCA report. You could just tell them which ones to include, or you can get them to tell you their suggestions and talk them through it.

You might ask probing questions like:

-????????? How old is the client and what is their diagnosis? Does their assessment choice suit?

-????????? What functional difficulties does the client experience? Will their choices capture the full picture?

-????????? What support needs will you be recommending? Will the assessments provide the evidence needed to support them?

-????????? What assessments will the NDIS expect for that diagnosis? Do they know where to find this out?

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3.?????? Writing in NDIS-style

You’re reviewing your new grad’s NDIS report and your feedback is that there is too much jargon, the format is hard to follow, and there’s some inconsistency in the level of function they reported.

You could just mark it up with track changes, or you could explain what needs to be changed and why, so they can keep these things in mind when they are writing a report for a different funding body:

-????????? Who is your audience? The NDIA planner may not have health-related training, so we need to use plain language.

-????????? Will the audience be reading it word for word or skim-reading? What formatting could you use to make it easier for the reader to pick out key information quickly?

-????????? Get them to read back the part where they said the client is “independent with showering with prompting” – so are they independent, or do they need prompting (because we know which part the NDIA planner will see).

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4.?????? Working with a multidisciplinary focus

Your new grad is hoping to work on cooking skills with a client with impaired swallowing and some dietary restrictions and they ask what meal options to start with. You could tell them to check with the dietitian and speech pathologist, or you could:

-????????? Prompt them to think about what is within scope for an OT – should we decide which foods are safe for different levels of swallowing dysfunction?

-????????? Ask them to think about what other disciplines may be able to help – do they know what the role of a dietitian or speech pathologist involves?

-????????? Role play what they may say when reaching out to another clinician they don’t know.

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5.?????? Selecting the right CPD

Does your new grad come to you every month or so with a request to do a webinar or course, but then when you ask them how it went you just get “I liked it, it was good.” You could just keep approving their requests, or you could:

-????????? Make sure they have a documented CPD plan based on specific learning goals – prompt them to think about whether their request relates to a goal.

-????????? Setup a list of questions they need to answer as part of requesting approval for the course – does it relate to their caseload and how will it add value for their service provision?

-????????? Ask a few more questions if all you get afterwards is “it was good.” What other team members may benefit, can they give a recap for the team, or what else do they need to learn related to this topic?

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From those scenarios it’s probably obvious why the short, spoon-feeding answer may be our default – so much quicker and easier for us in the moment! Hopefully you can also see that asking those extra questions is essential if we want our new grads to understand the why, and be able to answer their questions for themselves next time.

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I’ve got one more tip for you – you don’t have to do all this teaching alone! My NDIS courses, resources and membership content are put together with this fundamental clinical reasoning in mind. You can outsource some of your training and know that they won’t just be spoon-fed the answer, they’ll be shown the why and how too.

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If you’d like to find out more about how Your OT Tutor can help you and your new grads, get in touch and let’s chat.

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P.S. Curious what I’ve got available to help with the scenarios above? Here’s some links to check out:

Scenario 1. Just write me a letter – Managing challenging situations in the NDIS online course

Scenario 2. Choosing the right standardised assessment – The OT guide to completing a functional capacity assessment online course

Scenario 3. Writing in NDIS-style – 10 Steps to NDIS report writing success online course

Scenario 4. Working in a MDT – YOTT Alliance membership workshop – Effective multidisciplinary teamwork

Scenario 5. Selecting the right CPD – YOTT Alliance membership workshop – CPD Magic AND free CPD reflection template

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