Have I Loved?

Have I Loved?

Tell me...

Have I loved lately?

Through the briars, pricked my heart to love

Tell pray...

Soon as the burst of light

Fills to the brim

Have I loved?

Too soon, we pull from thorns

Scathe from shadows past

Wallow in collection of self-indulgence 

Pray tell!

Have I loved?

In this cycle, we feed none

But the weeds of pride

'Til thorns grow round the heart

Letting no love in, nor love out

What then lives?

What then dies?

Take apart the heart 

To save what is left 

As each compartments grow small

In its love

Half a heart given,

Half of half shall return

Until thorns grow hard and thick

Like corundum

Yet corrodes easily in spite

Like chalk

What then is left?

What then is gone?

What then...is love?

I pray, Lord, should my heart

Give way to hardness

That you break it to pieces 

Wet the debris with Your grace 

And mould it once more in Your healing

Then I shall say to You,

Oh Merciful God!

"I am saved by Love!"

Saved from the pride

Saved from the thorns

Saved from myself

Most Gracious, Most Gracious...

Should fear take hold 

And shackles bind my mouth

Let me smell Your Mother's roses

To remind me of You

Let my heart be as fearless as Yours

To choose Love each time,

To take in the wrath and hurt of others,

Lift them up to the Father

And it shall be gone

Then, oh then, My Lord

My lips dare say,

"Ah..."

"I have loved..."

Written October 12, 2014

Finished October 23, 2014

The Joys Of Having A Public Library

"There is not such a cradle of democracy upon the Earth as the FREE PUBLIC LIBRARY...where neither rank, office, nor wealth receive the slightest consideration."

- Andrew Carnegie

Reading, as much as writing, has been a major part of my life.  I am in honesty, very much in love with reading.  I don't know when it started but for as long as I can remember, I've been hogging books at my nightstand.  Assiduously exploring the different worlds offered by each books - every new word expanding the territories of my imaginative mind.  However, in the twenty years of my life, I never knew of the bliss of visiting a public library.  A free, totally updated, no padlocked encyclopedias, public library. Well, that is, until now.

I grew up in the Philippines, a third world country where more often than not books get washed away by yearly floods.  Coming from a middle class family, I was one of those lucky kids whose books don't get washed away and even if they did, my family has the money to buy them back.  The earliest books I remembered having were those Disney colored books - the ones with the golden spines.  I had them at the age of 3 and re-read them a lot.  Who doesn't fancy those happy ending stories eh?  I'm proud to say that a decade later, they've been in good condition as both my little sisters were able to use them as well.  At the start of pre-school, my mom provided me a lot of reading comprehension books and math worksheet books.  Quite the "Kumon" training really, as my elementary days were full of those books.  I enjoyed them so much that my mom decided that I was ready to read novels.  Really mom?  Buying "Moby Dick" and "The Swiss Family Robinson" for a seven year old?  I tried reading it for a bit but I didn't last a page!  Five years after, I would find out that Moby Dick was one of the hardest read novels in history.  Fancy that!

What I was most fascinated with most though, among the ton of books mom bought for us was the Britannica Encyclopedia set.  Ah...those golden edges and the crispy smell of that special paper they printed it on. It was just amazing beyond words!  I woke up to the Nara bookshelf filled with large black books and with all three layers of the two-meter long furniture, occupied.  Mind you, they seemed endless for a kid like me!  You know how Belle reacted when Beast showed her his magnificent library?  That's how it felt.

Wow!  Much amaze!  Such Books!  Wow!

Looks very much like the City Centre Library at Surrey Central (well, to me that is ^-^)

Naturally, having grown in a house where I can open all the books I want, I was excited with our school's library.  Since I was the lucky first born, I was enrolled in private schools.  They have libraries! Public schools as I reckon, rarely have one or even if they did, the books aren't updated as much as private ones; even for some, they constantly rebuild their libraries everytime the books get soaked with mud after great floods.  So, I was really lucky.  The libraries at school not only had textbooks for gradeschool, they had encyclopedia sets as well.  Much like the ones at home.  It saddened me though, that the school keeps them out of reach.  They have the encyclopedia sets and other "expensive" prints padlocked.  The school staff have it displayed on lacquered furniture and they dust it off regularly but, they wouldn't let us touch it so freely.  The only way to have them opened is to ask permission from the principal!  In a formal letter with parent's signature. Seriously? Why would I do that?  It was a really troublesome feat for a youngster like me back then (and maybe to some of my classmates but I never really asked.) I wouldn't want my mom to constantly tell me that it was too much of a hassle to borrow the books I like.  It was already hard convincing them to buy me books that were unrelated to school. 

All I wanted to do was to read the encyclopedia.  I'm tired of the kiddie books and textbooks similar to what I use in school.  My mom already bought extra ones I read after school.  All I wanted to do is to compare them - to find out if they had a picture of the Great Wall of China like the ones we have at home. If they have cool DIY experiments I could do as well.  If the Hittites really were the first ones to temper iron. Or if they have a different story about Pocahontas's life - like the Disney one. (Yeah, I was kind of disappointed when I knew of the real story of Pocahontas) My school library treated the books like they were cursed jewels - never to be touched.   If you don't read them, what use will those words be?  Treasure was to be found there but they let the years pass as the information becomes stale.

Friends, let me tell you, a book unopened is as good as a blank paper.   

Just last month, I remember my big brother posting in his Facebook status, a commentary made by Ambeth Ocampo - a historian and great writer.  It went like this:

"FILIPINOS ARE NOT A READING PEOPLE, and despite the compulsory course on the life and works of Rizal today, from the elementary to the university levels, it is accepted that the 'Noli me Tangere' and 'El Filibusterismo' are highly regarded but seldom read (if not totally ignored). Therefore one asks, how can unread novels exert any influence?”

I agree wholeheartedly with him. It's true that Filipinos are not a reading race. The source of it can be traced out to a lot of political plays and simultaneously ingrained with historical roots. Although, I never considered myself a non-reader, I have to admit that I did not constantly read books.  Partly because, I never really saw my elders do it, but mostly because I was not exposed to different types of books.  You might find it weird but I only really read our Britannica set before I was exposed to other books in my teenage years. (exempting all of the school related books) Totally weird right?  I never read Dr. Seuss's work until I got here in Canada.  I never even touched a newspaper unless I needed it for a crafts project.   I started reading mysteries and classics in highschool and Filipino literature in early college.  The compulsory reading of "Ibong Adarna", "Florante at Laura", "Noli Me Tangere" and "El Filibusterismo" during highschool were tad boring for me.  Mainly because the teachers weren't as excited in the literature as they were supposed to.  They were only excited to grade us in questions of identification of characters and their dialogues; to see if who memorized the book and characters.  But they have failed to ask relevant questions on reflection and how those masterpieces relate to our present culture.  How then can we appreciate reading them?  And what more for those who didn't even touch the books?

If you think about it, I am only a part of a small percentage of the Filipinos who do read and keeps themselves informed.  Do you know why?  It's because I'm part of the middle class who can afford books.  I had an early access to them at home that is why I have grown to be this way - grown up to be an informed reader.  The poor don't have this kind of privilege.  They must rely on public libraries, which are few and most probably are protecting the books from the people it must serve.  A paradox of the inherited title - public but not really public. 

Therefore, I am grateful of Canada's public libraries.  Thank you for existing!  I would never have known the joy of visiting the libraries if it weren't for you.  Books are free from being encased in fragile glasses and people are not kept out by iron bars.  You always display the books at the entrance to make me and the other readers feel welcomed.  Thank you for trusting me. I could never bring home the maximum of 50 books at a time but I would like to try that sometime. Hope that I won't lose one of them though, if I bring them home.   Thank you also for always keeping the bookshelves organized and up-to-date.  New books come in everytime to fill the community with new ideas.  Thank you for buying my suggested books!  I was surprised when you called me up and told me that I had a "held" book; it was the "Pathological Altruism" book that I suggested 3 months before. Wow!  I thought the suggested items were never really taken seriously.  Thank you also for encouraging me to suggest more books.  I am happy to know that my "wants" are important to the wonderful collection you keep.  I felt honored - that I actually have the power to shape the community with the books I choose to suggest.  Thank you for not banning books!  The library is a haven for our aspired ideal of faultless democracy - all ideas are welcomed.  And most importantly, all kinds of people are welcomed.  Whether you're rich, poor, newly landed, unstable part-timer or overly worked employee, you are duly welcomed.  Services are the same for everyone. They won't ask for your name or judge you for what books you decide to take. It might as well be paradise.  So, what I suggest everyone do is to go to your public libraries today and thank your librarian!

LONG LIVE LIBRARIES!!!

The Centre City Library in Surrey. Look at that!!!  I could stay in it and never go home

Introduction to the NOTCE

DISCLAIMER:  ALL IMAGES IN THIS BLOG POST ARE IN ENTIRETY OWNED BY THEIR RESPECTIVE ORGANIZATIONS. SOURCES ARE PROPERLY LISTED AT THE END OF THE POST.  NO ILLEGAL IMAGES ARE SHARED. THEY ARE CROPPED FROM DOCUMENTS FREELY SHARED BY THE ORGANIZATIONS. 

What is it?

The National Occupational Therapy Certification Exam (NOTCE), formerly known as the Canadian Association of Occupational Therapists (CAOT) Exam, is the nationwide written test of OT knowledge of theory and applications here in Canada.  Its prime purpose is to protect the public by assessing individuals who wish to practice occupational therapy (OT) all over the country.  Second, since OT is a regulated health profession, all regulatory organizations require the NOTCE for full registration.  It is held twice a year on the first Saturdays of July and November.  Exam sites are available nationwide.  You can choose which province you want to take the exam early in registration, although the specific location is not given until a few weeks before the exam date.  As you go on reading this, we will delve on the resources you need to read, question formats and scoring method of the NOTCE.  Essential web reads and stuff to browse and download are linked in the text.  

The Blueprint, Profile and Essentials

In order for you to be successful in any exam, there are many things to know aside from the content of the exam.  To be fully ready, one must know how the exam is written.  You might remember from highschool or college days how teachers and professors have different formulations of their quizzes.  Who gives out keywords?  Who doesn't?  Who likes essays and tables?  Who likes identification or multiple choice type of questions?  Some of those may seem minuscule to the content of the exam but it might surprise you to know that how you organize the content of your review to a certain design may score you more points than just merely memorizing the books from page 1 to the glossary page.

To start off knowing the NOTCE, let me tell you, there is nothing quite like the Resource Manual to let you have a peak at your Lady Victory.  It has it all!  The purpose of the exam, question formats, reference source and even sample exam questions.  It's like our lovable Spacky - everything essential condensed in one.  Now, the most important thing to take note of in this manual is the BLUEPRINT.  The blueprint is a graphic representation of the exam components and its framework.  In a simpler angle, I'd like to think of it as a flower in a plant box.

The Blueprint¹

It displays the dynamics of OT knowledge of the client, environment, occupation, practice process and the OT roles which we as therapists assume in the profession.  The big center where the seeds are located compose of the examinee's knowledge of the CEO and OT process.  This stands for sixty to seventy percent (60-70%) of the exam and can be found tabulated in more detail in figure 2.

The Matrix²

The colorful petals represent the six (6) major roles we assume in professional practice. These overlap at the center to show the dynamic unfolding of the roles centralized on the knowledge we know to enable our clients through the occupations they deem meaningful in their lives.  This comprises of the thirty to forty percent (30-40%) of the exam.  Lastly, the plant box nurtures the flower of knowledge and roles by supporting the practice with theories that we apply in clinics; vice versa, the applications evolve the theories we use through research.

Upon introduction to the blueprint, I'm sure more questions will surface in your mind - most especially, on the definition of each role in professional practice.  This is where we turn to the Profile of Occupational Therapists in Canada (a.k.a. the Profile) and the Essential Competencies of Practice for Occupational Therapists in Canada (a.k.a. the Essentials).  The PROFILE provides the big picture of Canada's vision for its occupational therapists and is updated/revised every so often by the council.

Canada's vision for every OT - from competent to proficient and eventually to advanced practice³

The Profile briefly defines the competencies that OTs need to achieve in practice.  These are the OT roles I have enlisted below: (1) expert in enabling occupation; (2) communicator; (3) collaborator; (4) practice manager; (5) change agent; (6) scholarly practitioner and (7) professional.

Figure in the Profile similar to the exam blueprint ⁴

There is a table after the image that delineates each component.  Though this is just a very general description of each role.  To further explain these competencies, we will need to turn to the ESSENTIALS.  You'll be able to understand more about the profile more and what are the criteria that deem all practitioners "competent".  To put it simply, the essentials is the detailed qualities that make a "competent" OT.



Resources and Reads

So now that you are familiar with the manual, profile and essentials, we will be discovering important resources for your review.  Although you might be with lots of OT resources, there are other references you might not be aware of just like the Profile and Essentials.  The first place you look into for identifying potential review materials would be the Resource Manual.  They are magnificently chronicled at the back of the manual.

The start of the reference list, perfectly written in APA format⁵

I marked all of the books I have then I browsed on the web to have information on the others.   I checked the local library if they had any occupational therapy books.  Sadly, they don't have much OT books there.  I heard from a friend thought that I can access the University of British Columbia Library where they have a large collection of allied health professional books.  If you can, borrow books to save money.

Here I list the resources that I have referenced from in my review:

1. Enabling Occupation I and II - both books are definitely a necessity to read.  You can buy it in the CAOT store or borrow it from a library that has it.  Important to note the CPPF and the OPPM.
2. Trial Occupational Therapy Exam Manual (TOTEM) and the Trial Occupational Therapy Exam (TOTE) - contains exam questions you can practice on.  Check out CAOT website for more details.
3. Occupational Therapy for Physical Dysfunction (Pedretti or Trombly) - covering for the physical dysfunction knowledge.
4. Willard and Spackman's Occupational Therapy - need I say more?  It's your Yorozuya and it has it all.
5. Quick References to Occupational Therapy - good for when you need to quickly refer to conditions
6. Conditions in Occupational Therapy - much like the "Quick References" book, this is also a nice book in which they condensed all of the conditions.
7. Group Dynamics in Occupational Therapy - best resource for knowledge on groups, from theory to application.
8. Psychosocial Occupational Therapy: Frames of Reference for Intervention - greatest reference on theory in psychosocial practice.
9. Kaplan and Sadock's Symptoms of Psychiatry - where all the psychological conditions can be found.  The resource manual has listed the DSM-IV-TR but I find this easier to remember.
10. Occupational Therapy for Children - the pediatrics Bible.
11. Ethical and Legal Dilemmas in Occupational Therapy - this book is magnificent for knowing ethical practice with case scenarios.
12.  Introduction to Splinting - the foundation for splinting.   The review questions every chapter is great for igniting your clinical reasoning skills concerning with this OT task.  Case studies available as well.
13. Cook and Hussey's Assistive Technologies - essentials on the types of assistive devices, assessment procedures. Another thing that is wonderful about this book is that it has a list of organizations in which these devices are available. I'm pretty sure that there was another book on assistive devices but I wasn't able to borrow it from the library.  Everytime I went there, it's always borrowed.
14. Measuring Occupational Performance - worried about your knowledge on assessments and performance measures?  This is the ultimate book!  It classifies them into categories and tabulates its information.  This is a definite must-read for review.
15.  Guidelines on Controlled Acts and Delegation - list of controlled acts in the profession.
16.  Regulated Health Professions Act - it is most important to know certain legislation that concerns the practice.
17.  Canadian Health Act - yet another legislation we must be aware of.
18.  Health Professions Act - another legislation on the health care world.  Pretty long but knowing it early on will help you in practice in the future.  Especially when it comes to claiming your rights as a professional and to have an idea on how the regulatory body works.
19.  Accessible Housing by Design (ramps) - a question on accessibility might come out and knowing about the design acceptable is sufficient.
20. Occupational Therapy Assessment Tools:An Annotated Index - again, another magnificent book on instruments used in practice.
21. Functional Performance in Older Adults - knowledge on geriatrics practice.
22. Conceptual Foundations of Occupational Therapy Practice - a great book that summates the most widely used body of theories in practice.
23. Research in Occupational Therapy - best book to read about research in our field.  In fact, it is very easily understood that you needn't look elsewhere.  I'm pretty sure I browsed another book about research but I totally forgot that other one.


Additional resources:
1. Occupational Therapy examination and practice preparation project for IEOTS (aka OTepp project)

A wonderful organization which helps you understand the health care system here in Canada.  It is also, as I have described in my previous post, a virtual agora in which occupational therapists worldwide gathers and shares their knowledge.  I learned a lot from the OTepp program and I have to say, I never would have imagined starting from elsewhere.  Check out their website and see for yourself how magnificent the program is.

2. CAOT's Occupational Therapy Exam Module (aka OTEM) 

This used to be offered by OTepp but it was carried over to CAOT.  It is an online discussion group which assists examinees in preparing for the exam.  It has over 100+ questions in reserve to discuss with in order to mold the quick rationalizing during the actual exam.  

3. Orientation to the Canadian Health Care System, Culture and Context 

They offer online courses for internationally educated health professionals (IEHPs) on the Canadian Health Care system.  

For your basic sciences and medical-surgical review, I suggest that you stick to resources you feel comfortable with.  After all, there can be lots I can suggest but it will be up to you and on how your reinforcement system works.  I decided to stick wiht my old books Seeley, Snell, Guyton and Gilroy for I've used them quite a lot since college; thus, retrieval of information may be easier due to the repetitive factor.

Questions and Format

The way the examiner formulate the questions are quite unique.  They present a case to you in such a way that you might be in front of the actual client.  From there, they derive 2 to 5 questions.  I suggest from here, you must have at least read the resource manual.  If not, please do.  It will be less confusing.

Now, here is the number 1 case and question example on the resource manual⁶:

Client: Mrs. C is a 66 year old woman. 

Situation: 

• She is recently divorced. 

• She lives alone in a seniors’ apartment 

• She has decreased functioning as a result of a degenerative neurological disorder 

• She was getting home-making services in her apartment 

• She was going to a geriatric day hospital to receive treatment related to physical problems 

• Her physical problems include unstable gait, decreased balance, potential risks for falls, 

decreased vision and general safety 

• She has been admitted to an in-patient geriatric unit due to increasing depression 

• On admission to the in-patient geriatric unit, she is withdrawn, irritable, expressed vague 

suicidal ideation, and has stopped doing previous leisure activities 

• Her previous leisure activities included music and sewing 

• She has few close friends who are of the same age nearby 

• She has one daughter who lives several hundred kilometers away 

ITEM 1 

What should the occupational therapist do FIRST to address Mrs. C’s depression? 

1. Arrange a visit from her friends. 

2. Challenge her with new activities. 

3. Engage her in short term, familiar activities. 

4. Suggest she attend the unit’s Friday evening social event. 

ITEM 2 

Mrs. C. tells the occupational therapist that she is upset that her decreased vision means that she is no 

longer able to sew. Using a client-centred perspective, what should the therapist do FIRST? 

1. Suggest other leisure activities using the Interest Check List 

2. Explore low vision aids and techniques that could allow Mrs. C. to sew 

3. Encourage Mrs. C. to join activities at her local Senior’s Center 

4. Assist Mrs. C. to find a volunteer to help her do her leisure activities 

ITEM 3 

At discharge, the occupational therapist will recommend that Mrs. C. attend an activity at her local 

Seniors’ Centre. Which activity would be MOST appropriate for the therapist to suggest? 

1. Music enjoyment group. 

2. Recreational dancing. 

3. Playing cards. 

4. Recreational swimming. 

ITEM 4 

Mrs. C. is often impulsive and is not following safety guidelines when walking with her walker. What 

should the occupational therapist do? 

1. Set up a behaviour modification program for Mrs. C. 

2. Continue teaching walker use, providing only 1 to 2 step instructions. 

3. Further assess Mrs. C’s comprehension and ability to remember information. 

4. Encourage Mrs. C. to regain internal locus of control and take responsibility for her safety. 

ITEM 5 

The multidisciplinary term is not confident that Mrs. C. has the functional ability needed to return to 

her apartment. Mrs. C. strongly states that she wishes to return to her apartment. What should the  occupational therapist do? 

1. Have a discussion with Mrs. C. about safety and her ability to manage at home. 

2. Arrange for increased home care services. 

3. Investigate the potential for repeated hospitalizations. 

4. Provide legal documentation of Mrs. C.’s incompetence. 

For rationale, you can refer to the resource manual.  If you change information on the following case such as this:

-Mrs. C's leisure activities include watching television and walking.

-Mrs. C has macular degeneration.

NOTE:  This change in the sample number 1 of the resource manual is by NO MEANS AN OFFICIAL ONE.  It is just formulated by me in a mere example of knowing the client and their occupation. Also, the answer and rationale I have provided is again not in the official document.

If a question surfaces on which activity would be MOST difficult for her? Which would you choose? Think first before you read ahead.

1.watching television 

2. walking outside around their house

3. dogsitting 

4. playing UNO

It might surprise you that it would be number 1 because in this activity central vision is vital.  Since Mrs. C has macular degeneration thus we know that central vision is compromised.  The other activities can be done with intact peripheral vision.  See how each case can vary differently with just those alterations? It test how well you know the client in their environment and how it affects the occupations they deem meaningful in their lives. My best advice is to see it upon yourself that you view each case as if you are facing a client.  When you move on to the next question, it means that you get to meet another client who may have similarities but they are most definitely not one in the same. 

Items and Scoring

The exam for my batch was composed of two hundred (200) questions.  I assume that it was two points if you get the answer correct and zero if you pick the wrong choice.  That means overall, the exam would be a total of four hundred and in order to pass you need 70% - that is 290.  Funny though, if you calculate the 70% from the 400 it would be 280.  They added 2.5% to make it 72.5% so yeah, it's 290 points according to the PROCEDURES MANUAL.   Also some exceptions are made for certain questions.  You see, every batch of exams, a different set of questions are pulled from a "bank" and some are "experimental".  If the experimental questions are drawn from the bank, and a lot of the examinees have varied answers rather than the expected one, the question gets reviewed and possibly thrown out of the count.   That is probably why the waiting time for your exam results is a span of 6 to 8 weeks.  A council still reviews it.  

Although in the procedures manual, they indicate that they just put on the range of 290 - 450  (I'm not sure either why it's up until 450 instead of 400) if you passed, my results came in a very detailed breakdown of the components patterned to the blueprint.  I noted that they have revised it in 2010 as indicated in the copyright page.  Maybe they have yet to change it in the manual.

Of course this amateur collation of information is useful for those who are already registered to take the examination.  Please do refer to my previous post - The Unofficial Guide to CAOT Application for IEOTs for the procedures on applying for the NOTCE.  And do check the CAOT website for updates of the resource manual and other official documents.

Footnotes:

¹Canadian Association of Occupational Therapists. (2006). National Occupational Therapy Certification Exam (NOTCE)        Resource Manual. Ottawa, ON: CAOT Publication ACE. Retrieved from the website on January 11, 2014:  http://www.caot.ca/pdfs/Exam/ExamResMan10.pdf
²Canadian Association of Occupational Therapists. (2006). National Occupational Therapy Certification Exam (NOTCE)        Resource Manual. Ottawa, ON: CAOT Publication ACE. Retrieved from the website on January 11, 2014:  http://www.caot.ca/pdfs/Exam/ExamResMan10.pdf
³Canadian Association of Occupational Therapists. (2012). Profile of Occupational Therapy Practice in Canada. Retrieved from the website on January 11, 2014: http://www.caot.ca/pdfs/2012otprofile.pdf
⁴Canadian Association of Occupational Therapists. (2012). Profile of Occupational Therapy Practice in Canada. Retrieved from the website on January 11, 2014: http://www.caot.ca/pdfs/2012otprofile.pdf
⁵Canadian Association of Occupational Therapists. (2006). National Occupational Therapy Certification Exam (NOTCE)        Resource Manual. Ottawa, ON: CAOT Publication ACE. Retrieved from the website on January 11, 2014:  http://www.caot.ca/pdfs/Exam/ExamResMan10.pdf
⁶Canadian Association of Occupational Therapists. (2006). National Occupational Therapy Certification Exam (NOTCE)        Resource Manual. Ottawa, ON: CAOT Publication ACE. Retrieved from the website on January 11, 2014:  http://www.caot.ca/pdfs/Exam/ExamResMan10.pdf