Date of Award

2025

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Sarah Nielsen

Abstract

Introduction: Occupational therapy practitioners often work with individuals with deficits in cognition due to an acquired brain injury (ABI). Individuals who experience an ABI may have deficits in functional cognition, making it difficult to complete everyday complex tasks, resulting in decreased independence, safety, engagement, health, and wellness (Engel et al., 2019; Erez & Katz, 2018; Klepo et al., 2022; O’Donoghue et al., 2022; Scharaga & Holtzer, 2015). Implementing current evidence-based functional cognition evaluations is difficult for occupational therapy practitioners due to the 17-year lag between evidence and implementation into clinical practice; therefore, practitioners need support in these efforts (Rubin, 2023). The intended purpose was to develop a toolkit that supports occupational therapy practitioners at a major Midwestern medical center to implement evidence-based evaluation of functional cognition.

Methodology: A preliminary literature review was conducted to understand the needs of individuals with an ABI during their inpatient and outpatient occupational therapy rehabilitation. Upon arriving at the site, observations, discussions, and survey results of occupational therapy practitioners were analyzed to understand how functional cognition was addressed. Utilizing this information, a product was developed to address the gaps identified.

Results: Barriers to the implementation of functional cognition evaluations included a lack of knowledge of current evidence-based practice, access to current research, time constraints, lack of resources, and facility or individual characteristics (D’Cruz et al., 2021; de Charentenay 2024; Fischer et al., 2016; Juckett et al., 2019; Murrell et al., 2021). Effective ways to combat barriers include education and training, access to current research, facility support, opportunities for education inside the workplace, and small group interactions (de Charentenay et al., 2024; Fischer et al., 2016; Juckett et al., 2019; Waltz et al., 2019). A toolkit was created that contained functional cognition assessments, associated documents for each assessment, educational videos for administration, scoring, and interpretation, and a documentation outline that was programmed in the electronic medical record system to reduce barriers.

Conclusions and Significance: The toolkit decreases barriers and allows occupational therapy practitioners to use evidence-based evaluations when assessing functional cognition.

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