Exciting developments and a new image

There has been an increasing call for peer-reviewed journals that publish scholarly evidence to become ‘Open Access’ whereby their contents can be freely retrieved with cost incurred to individuals accessing them. Two subtypes of Open Access journals are ‘hybrid open access’ (some articles are open access and others not), and ‘delayed open access’ (some articles are open access and other articles have delayed access) (Ohno-Machado, 2011). Traditionally, journals have been published in two ways. In the first instance, professional associations, government organisations, universities or learned societies published journals that were only available to members as a benefit or subscribers to that journal. The second option included journals that were published by private companies (e.g. Sage and Wiley-Blackwell) and subscriptions were sold to those who wanted access to the journals. In both these contexts, access to journal articles was restricted to individuals who had a paid subscription or access fee. There are several reasons why journals' becoming Open Access has become a timely topic. An emphasis on evidence-based practice; knowledge translation; journal quality metrics (such as impact factor); increased international visibility; higher citation rates for authors; plus many agencies who fund research requiring grant recipients to publish their findings in journals that are classified as Open Access (Willinsky, 2006) all put pressure on journals to provide this. Journals can be ‘Open Access’ in several ways. Firstly, a journal can be completely ‘Open Access’ using a fee-based approach or a no-fee option. The costs associated with fee-based open access journals is borne either by the journal's sponsoring organisation, the journal's publisher, the authors who submit the articles to the journal, the author's employer, a research grant an author has received, or a combination thereof. The Australian Physiotherapy Association's Journal of Physiotherapy is a recent example of a journal that is now no-fee, open access. Alternatively, a journal can have specific articles that are classified as accessible even though there may be other articles that are not. Editors can decide to make an article freely available or authors pay a fee to the journal publisher to enable free access. This is the current arrangement for the Australian Occupational Therapy Journal (AOTJ) with Wiley-Blackwell. One result of passing on the cost of making an article ‘Open Access’ is the rise of ‘vanity publishers’ and ‘predatory publishers’ who produce material that is presented as ‘open access’, but then charge authors large fees to accept and publish their manuscripts as a means of generating profits. ‘Many of these publishers are corrupt and exist only to make money off the author processing charges that are billed to authors upon acceptance of their scientific manuscripts’ (Beall, 2013, n.p.). These sources of information are considered not credible and are best avoided. A list of these journals and their publishers is available from Beall's List of Predatory Publishers 2013 (http://scholarlyoa.com/2012/12/06/bealls-list-of-predatory-publishers-2013/). AOTJ currently complies with all relevant research funding requirements by offering a variety of Open Access options. The AOTJ utilises a ‘hybrid open access’ approach where an author who has an article accepted for publication is able to pay a fee directly to the publishers to make it Open Access. The first issue of the current year and special issues of the AOTJ are also freely accessible for a period of time when they are first published. If the AOTJ wanted to become completely Open Access, then the cost linked to this would need to be carried either by the individual authors publishing in the AOTJ or by Occupational Therapy Australia Limited (OT AUSTRALIA) who contracts Wiley-Blackwell to publish the AOTJ and provides AOTJ as a member benefit. Both options would have additional cost implications for the parties involved. One primary advantage of making the AOTJ Open Access would be that it would likely increase the journal's Impact Factor by making its articles easier to retrieve and cite (Björk & Solomon, 2012). The question to be considered and debated is the cost-benefit of such a move for the Australian occupational therapy community, OT AUSTRALIA as an organisation, and OT AUSTRALIA's membership, Wiley-Blackwell as the publisher of the AOTJ and the users and consumers of occupational therapy evidence.

This paper summarises results from an evaluation of the adequacy and utility of the Australian Competency Standards for Entry-Level Occupational Therapists (OT AUSTRALIA, 1994a). It comprised a two-part study, incorporating an online survey of key national stakeholders (n = 26), and 13 focus groups (n = 152) conducted throughout Australia with occupational therapy clinicians, academics, OT AUSTRALIA association and Occupational Therapy Registration Board representatives, as well as university program accreditors. The key recommendations were that: (i) urgent revision to reflect contemporary practice, paradigms, approaches and frameworks is required; (ii) the standards should exemplify basic competence at graduation (not within two years following); (iii) a revision cycle of five years is required; (iv) the Australian Qualifications Framework should be retained, preceded by an introduction describing the scope and nature of occupational therapy practice in the national context; (v) access to the standards should be free and unrestricted to occupational therapists, students and the public via the OT AUSTRALIA (national) website; (vi) the standards should incorporate a succinct executive summary and additional tools or templates formatted to enable occupational therapists to develop professional portfolios and create working documents specific to their workplace; and (vii) language must accommodate contextual variation while striking an appropriate balance between providing instruction and encouraging innovation in practice.

On my second last day as editor I received the important news that Thomson ISI had listed the Australian Occupational Therapy Journal for inclusion on their data base. This means the journal should get an Impact Factor in 2009, which will be released in mid-2010. The ISI maintains a large collection of bibliographic and indexing data for scientific literature and measures the impact and influence of published research. The AOTJ Board and Wiley–Blackwell have been working towards this listing for a number of years. This listing means that the AOTJ will become more attractive for authors whose employers require an Impact Factor for ranking their publications, this particularly relates to universities. A journal's Impact Factor is improved by increasing the number of citations; this is also affected by the visibility of the journal, we are fortunate to have online access to enhance this. We first applied for listing in 2003, but were unsuccessful, so it is a perfect way for me to hand over to Elspeth Froude, our new editor, after this second application has been successful. We were fortunate to have several applicants for this position, thus necessitating a thorough appraisal and interview process by a panel selected by OT Australia. Elspeth graduated in 1987 from Cumberland College of Health Sciences, NSW with a Bachelor of Applied Science in Occupational Therapy. She then went on to work in a number of paediatric settings in Tasmania and Victoria. Elspeth joined the School of Occupational Therapy, LaTrobe University as a lecturer in 1991. She has taught and supervised honours and postgraduate students in the field of paediatrics. Elspeth completed a Graduate Diploma in Neuroscience and then enrolled in a PhD researching in the area of children's handwriting. She has always been a keen supporter of the AOTJ through publishing and extensive reviewing. She has also been involved with OT AUSTRALIA through the paediatric special interest group and has been an Accredited OT since the program's inception. I wish Elspeth every success in her new role and take this opportunity to thank the AOTJ Editorial Board, the Editorial Advisory Board, and most importantly all at Wiley–Blackwell.

A timely evaluation of the Australian Competency Standards for Entry-Level Occupational Therapists (1994) was conducted. This thorough investigation comprised a literature review exploring the concept of competence and the applications of competency standards; systematic benchmarking of the Australian Occupational Therapy Competency Standards (OT AUSTRALIA, 1994) against other national and international competency standards and other affiliated documents, from occupational therapy and other cognate disciplines; and extensive nationwide consultation with the professional community. This paper explores and examines the similarities and disparities between occupational therapy competency standards documents available in English from Australia and other countries. An online search for national occupational therapy competency standards located 10 documents, including the Australian competencies. Four 'frameworks' were created to categorise the documents according to their conceptual underpinnings: Technical-Prescriptive, Enabling, Educational and Meta-Cognitive. Other characteristics that appeared to impact the design, content and implementation of competency standards, including definitions of key concepts, authorship, national and cultural priorities, scope of services, intended use and review mechanisms, were revealed. The proposed 'frameworks' and identification of influential characteristics provided a 'lens' through which to understand and evaluate competency standards. While consistent application of and attention to some of these characteristics appear to consolidate and affirm the authority of competency standards, it is suggested that the national context should be a critical determinant of the design and content of the final document. The Australian Occupational Therapy Competency Standards (OT AUSTRALIA, 1994) are critiqued accordingly, and preliminary recommendations for revision are proposed.

As this will be my last editorial for the Australian Occupational Therapy Journal (AOTJ), I decided to review the aims and objectives of the journal. It is pleasing to note that they are being fulfilled. We do produce a high-quality peer-reviewed journal, which promotes research and communication and provides a forum for discussion and debate. The manuscripts published are relevant to occupational therapy theory, practice and education, and we are able to provide analysis and commentary of other research articles in the form of Critically Appraised Papers. We have a large number of voluntary reviewers who donate their time to review submitted manuscripts – in fact we had 140 individual reviewers over the last 18 months, some providing reviews for four different manuscripts. It is also encouraging to note that online downloads have increased from 2005 by 49%, to 135 939 in 2006! This demonstrates the increasing use and significance of the journal as a professional, clinical, educational and research resource. Over the 2-year period 2004–2006, the submission rate of all manuscripts increased by more than 100% including an increase of 30% in international manuscripts over the period 2005–2006. It is also interesting to note that the cost per member for the AOTJ has reduced from $A20.00 in 2005, to $A16.00 per annum in 2006. The members of the AOTJ Editorial Board feel this is a small percentage of the National Levy to be paying for such a quality publication. The AOTJ is the public face of occupational therapy and OT AUSTRALIA nationally and internationally. The increased submission rate is related to a number of factors. There are more occupational therapy courses with more postgraduate and honours students who are undertaking research; there is a demand from the universities that staff publish; senior clinicians are required to undertake research and publish, and there is demand for evidence-based practice. In summary occupational therapists are becoming more research active, and our journal is highly regarded by profession. However, it is not all good news. The page allocation during this time has fluctuated, from 380 pages in 2005, 352 pages in 2006, to 304 pages in 2007. This of course results in a backlog of manuscripts waiting to be published, notwithstanding the rejection of manuscripts which do not reach the required standard. The Editorial Board of the AOTJ recently made some very hard decisions to develop strategies to overcome the backlog of manuscripts. The Board decided to discontinue the ‘In Practice’ section of the journal—any new manuscripts for this section will be returned to the authors, suggesting that they consider submitting to OT Connections, or to another journal. Thesis Abstracts will no longer be published, Book Reviews and Critically Appraised Papers will be reduced to two per issue. In addition, the Board decided to reduce the word limit for all research and feature manuscripts to 4000 (from 5000), reduce the number of figures and tables to four per manuscript and reduce the number of references to 25 (from 60) per manuscript. These strategies should result in the equivalent of an extra 100+ pages of available space per volume, which will enable more manuscripts to be published. At the current submission rate, it is proposed that from 2009 AOTJ be published as six 80-page issues per year. Online Early is to be retained, which offers the opportunity for authors to cite their publications prior to their publication in the hard copy of the journal. In addition to these strategies the Council of OT AUSTRALIA has been asked to consider the importance of the AOTJ to the profession and allocate more funding to publish a special supplement in 2007 and six large issues in 2008 to overcome the balance of the backlog of manuscripts. Good times should lie ahead for our Journal, we have an innovative Editorial Board; the journal has been a leader internationally with Critically Appraised Papers and Online Early and was in fact the first occupational therapy journal to be published online. It is important that this fine reputation is maintained and that the journal is respected and supported by the professional body under whose banner it exists.

It is now over 12 months since I took over as Editor-in-Chief of the Australian Occupational Therapy Journal. I consider it a great privilege to be involved in such an important aspect of our profession and to work with such dedicated colleagues. It has been an exciting time for the journal with ISI listing, Medline indexing, and the move to six issues of the journal per year in 2009. We have also started a new review category to encourage submissions of narrative, systematic and meta-analytic reviews. The role of the Editor-in-Chief is varied and challenging, ranging from allocating reviewers (which involves reading through every submission to ensure the guidelines are met regarding format, relevance to the journal and, most importantly, ethics) to making final decisions on reviewed manuscripts and allocating manuscripts for each issue. Continued development of the journal is also part of the role, which includes marketing, and the reviewing of procedures and processes. Through Wiley-Blackwell the AOTJ is a member of COPE — the Committee on Publication Ethics, which describes its role as ‘a forum for publishers and editors of peer-reviewed journals to discuss issues related to the integrity of work submitted to or published in their journals. It supports and encourages editors to report, catalogue and instigate investigations into ethical problems in the publication process’. The COPE website (http://publicationethics.org/) also provides valuable information relating to common issues that arise in journal publication such as authorship, including an article on ‘How to handle authorship disputes: a guide for new researchers’ (Albert & Wager, 2003), which is helpful for researchers negotiating authorship dilemmas. The integrity of our journal is paramount, and through membership of this group and following recommended procedures a high standard is ensured. We are fortunate in occupational therapy to have high ethical standards, with infrequent breaches. The journal continues to receive constant support from OT Australia and the publishers Wiley-Blackwell, which, when combined with the dedicated editorial board, makes for a smooth-running high-quality journal. The quality of submissions continues to rise, and we are also seeing a heightened interest from international occupational therapists. The members of the Advisory Board provide a valuable contribution to the journal and provide an important international connection and representation. The letter to colleagues by Lannin et al. (2009) published in the April issue, entitled ‘Scholarly communication and concerns for our conferences’ has stimulated considerable discussion and debate. The letter was also published in the British Journal of Occupational Therapy, Dutch Journal of Occupational Therapy and Norwegian Occupational Therapy Journal, stimulating far-reaching discussion. To date, AOTJ has received two letters in response, which were both published in the June issue. This type of discussion is an important means for advancement of the profession. Not challenging the status quo for fear of offending someone or rocking the boat only serves to stifle a profession. It would be encouraging to see even more discussion on topics that might be considered controversial, either through viewpoints, letters or commentaries. We as board members are constantly considering how well we are meeting the aims of the journal and your feedback as authors, reviewers and readers would be most welcome. I hope you enjoy this issue, which covers a broad range of practice areas to resource and support your evidence-based practice. Elspeth FroudeEditor-in-Chief

This editorial introduces a new era in the life of the Australian Occupational Therapy Journal (AOTJ): the publication of the first Online Only issue. While this is a new venture for AOTJ, it is important to note that a journal issue which is available online exclusively is as legitimate and citable as a paper issue and, in fact, many journals are now only available online. The need for this development has come about because of the significant increase in submissions to the AOTJ over the last few years and the necessity to overcome the resultant backlog of manuscripts. OT AUSTRALIA has supported the journal to manage the problem by the provision of extra funding for this special supplement on occupational therapy education. It is most valuable to the profession and academic institutions to have these education manuscripts together in one issue. The Australian and New Zealand Council of Occupational Therapy Education supports the role that occupational therapy journals play in the promotion of evidence-based practice, the publication of research and provision of a forum for professional debate. It is of note that articles selected for this issue cover a large range of educational concerns, with many addressing the theme of fieldwork education. There are several innovative models for fieldwork including a collaborative fieldwork model, intercultural fieldwork and the value of fieldwork for supervisors. In the current climate where there are well-documented difficulties in finding sufficient fieldwork placements, it is important to publish articles that address and provide some solutions to these pressing problems (Adamson, 2005). The publication of an Online Only issue is supported by statistics included in AOTJ annual reports which show that online readership increased by 49% between 2005 and 2006. This indicates a substantial trend towards and interest in the expediency and advantages of online access for Australian readers. In addition, the added opportunity for more national and international colleagues to have access to the journal via university library online subscriptions is a welcome development, and contributors to the journal will also benefit from this wider readership. With the increase in the number of occupational therapy university courses and graduates, and the subsequent increase in the research profile of occupational therapists, this initiative is a significant indicator of the profession's expansion and progress. I support the AOTJ Board in its endeavours to overcome the manuscript backlog with the provision of Online Early, and now the introduction of this special Education Supplement, and commend OT AUSTRALIA for supporting our journal in this manner.

Evidence‐based practice (EBP) requires clinicians to access, appraise and integrate research literature with clinical experience and clients’ perspectives. Currently, little is known about occupational therapists’ attitudes to EBP, their perception of implementation barriers or their educational needs. A questionnaire reflecting these issues was sent to a proportionate random sample of 1491 members of the national professional occupational therapy association, OT AUSTRALIA. The questionnaire was completed by 649 (44%) participants. Occupational therapists were positive about EBP with most (96%) agreeing that EBP is important to occupational therapy. Although 56% used research to make clinical decisions, more relied on clinical experience (96%), information from continuing education (82%) and colleagues (80%). Lack of time, evidence and skills were identified as the main barriers to the implementation of EBP. Over half (52%) expressed strong interest in EBP skills training, and most (80%) indicated an interest in the availability of brief summaries of evidence. Targeted educational initiatives, resources and systems are needed to support EBP in occupational therapy.

Dementia significantly impacts on the individual's and caregiver's quality of life. The aim of this study was to describe Australian occupational therapy practice with people with dementia. A questionnaire was piloted and sent to occupational therapists in Australia working with people with dementia. Participants were recruited in one of three ways: (i) identified by OT AUSTRALIA as working in aged care; (ii) through dementia-specific facilities in Australia; or (iii) through occupational therapy aged care list serves. The questionnaire asked occupational therapists about referrals received, assessments and interventions used, perceived barriers to the delivery of interventions and perceived educational needs. Data were analysed descriptively and presented as frequencies and percentages. One hundred and thirty-four occupational therapists responded to this survey. Referrals were predominantly for environmental modification, home assessment or falls prevention and for assessment of activities of daily living. Therapists spent most of their time on assessment, with brief cognitive and functional assessments used most frequently. The most common interventions were environmental modification advice and prescription of assistive equipment. Lack of time was the most commonly reported barrier to the delivery of interventions with therapists also identifying concerns about staffing and role restrictions imposed by organisations. Therapists also identified that further training in this area would be useful. Therapists working in dementia care indicated that they are constrained in terms of time, staffing and organisational restrictions. Recommendations include enhanced training, further research into the most viable occupational therapy interventions, and advocating for improved funding, staffing and resources.

Competency standards outline the knowledge, skills, and attributes that are required for competent practice. This study describes the process followed to revise and validate the competency standards for occupational therapy driver assessors in order to guide clinical practice in this area of advanced occupational therapy practice. A mixed methods research approach was used in this study. In phase 1, three focus groups with driver assessors reviewed and suggested revisions to the competency standards for occupational therapy driver assessors. Phase 2 involved content validation with key stakeholders through a focus group with consumers, written feedback from Australian state, and territory driver licensing authorities, and a two-round Delphi process with Australian occupational therapy driver assessors. Forty-nine occupational therapy driver assessors participated in the phase 1 focus groups. Deductive content analysis of the transcripts provided data to revise the competency standards. Inductive analysis provided an in-depth understanding of the participants' views and was interpreted through six categories and their underlying subcategories: purposes and benefits; jurisdictional variations and practice diversity; language use; defining competent practice; challenging systems and processes; and competency standards content. Forty-eight occupational therapy driver assessors participated in the Delphi process. In Round 1, only 1 of the 164 competency standards and practice behaviours rated did not achieve the pre-determined 70% consensus rate. In Round 2, all statements achieved consensus, with the overall average consensus level obtained across the Round 2 statements at 96.8%. The revised Australian Competency Standards for Occupational Therapy Driver Assessors have been endorsed by Occupational Therapy Australia and released for clinical use. The methods described in this research provide a framework suitable for revision or development of competency standards in both other areas of occupational therapy practice and other health-care professions.

Guidelines for Contributors to AJOT.

OT AUSTRALIA's Accredited Occupational Therapist Program is promoted using the message ‘Assuring professional excellence’. It is widely assumed that professional excellence is understood. Yet, this concept encompasses complex themes, including competence and clinical reasoning. In this paper, the meaning of professional excellence is examined by investigating the perspectives of private practitioners. Private practitioners were chosen as they represent the diversity of the occupational therapy field, and may pre-empt trends within broader practice. Sixteen key informants were interviewed to obtain their perspectives on professional excellence. Common themes that arose from the findings include the significance of experience in practice, and the importance of understanding one's limitations in knowledge and expertise. Findings are discussed in relation to OT AUSTRALIA's aim to assure standards of practice.

The aim of the present study was to investigate the meaning of professional competence for occupational therapy private practitioners and their experience of the barriers to professional competence. Semi‐structured interviews with 16 key informants from private practice in Victoria elicited diverse opinions and experiences. However, the difficulty of assessing competence, and the lack of standards that identify competent practice for occupational therapy were major themes in the findings. The role of theory in competent practice was evident in discussion but it was not clearly articulated by many participants. Experiences of professional socialisation varied yet participants perceived input from peers as contributing to assuring competence. Major barriers to professional competence were identified as professional isolation, time and finances. The present study highlights the complexity of current attempts to assess professional competence for practising occupational therapists including the implementation of an accreditation program by The Australian Association of Occupational Therapists Inc. (OT AUSTRALIA), the peak body representing occupational therapists.

Bibliometrics refers to the collection and measurement of publishing and citation data configurations with the goal of quantifying the influence of scholarly activities. Advantages of bibliometrics include the generation of quantitative indicators of impact, productivity, quality and collaboration. Those parties who benefit from the results of bibliometric analysis include researchers, educators, journal publishers, employers and research funding bodies. A bibliometric analysis was completed of peer-reviewed literature from 1991 to 2015, written by Australian occupational therapists (who were able to be identified as such), and indexed in the Science Citation Index-Expanded (SCI-Expanded) or the Social Sciences Citation Index (SSCI) databases. "Occupational therapy" and "occupational therapist(s)" were used as keywords to search journal articles' publication title, abstract, author details, keywords and KeyWord Plus. Between 1991 and 2015, 752 peer-reviewed journal articles were published by Australian occupational therapy authors. On average, those articles had 3.7 authors, 35 references, and were nine pages in length. The top four journals in which Australian occupational therapists published were Australian Occupational Therapy Journal, British Journal of Occupational Therapy, American Journal of Occupational Therapy, and Physical and Occupational Therapy in Paediatrics. The four Australian institutions that generated the largest number of occupational therapy articles were the University of Queensland, University of Sydney, La Trobe University, and Monash University. The top four countries with whom Australian authors collaborated in manuscript writing were the United Kingdom, United States, Canada and Sweden. The volume of occupational therapy peer-reviewed literature has grown over the last two decades. Australian authors have and continue to make significant contributions to the occupational therapy body of knowledge nationally and internationally.

Driving is an important occupation, which enables other recovery goals for adult mental health consumers. Multidisciplinary clinicians can support consumers to engage in safe driving practices, which may include referral to a specialist occupational therapy driver assessor. There is presently limited evidence to inform us about the role of occupational therapy driver assessors in mental health and the impact of such services for consumers. Therefore, this study aimed to describe the reasons for referral and the recommendations resulting from driver assessments with adult consumers in a mental health setting and understand the experiences of driver assessors providing these services. A mixed-methods sequential design was employed in this study. Thirty driver assessments (n=27 consumers) were analysed to identify consumer demographics, assessment recommendations, impact on licence status and rehabilitation outcomes. Focus groups were then conducted with five occupational therapy driver assessors. Quantitative data were analysed descriptively using frequencies and means, while qualitative data were subjected to content analysis. The majority of consumers were diagnosed with psychotic disorders and presented with complex needs. The three primary reasons for referral were (a) cognitive or mental health concerns, (b) consumers directed by licencing authority to undertake driver assessment and (c) consumers wanting to resume driving after not driving for a significant time. Overall, 21 consumers (70%) were recommended to hold a driver licence after completion of an occupational therapy driver assessment. Qualitative themes about the experience of occupational therapy driver assessors included the reality of driver assessments; that outcomes are usually positive, and further support is needed for driver assessments. Driver assessments enable most consumers to return to driving. Occupational therapy driver assessors require greater support to perform this role, including dedicated time and peer support, to facilitate multidisciplinary clinicians and consumers to collaboratively achieve driving outcomes.