Introduction to the NOTCE

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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

Silver Thaw

By Akemi

In the waking midst of winter,

Little Jack Frost invited a game of tag,

As I bound for home,

He gleefully skips along the pavement-

Leaving a glistening carpet of the night sky.

He left a mark on the path yonder,

As each puddle was playfully stomped on-

Aha! A silver thaw on every block.

As I am sure to lose this game 'til deep winter comes,

To when the barren Earth is blessed

By tiny nymphs of Father Christmas

Neatly laying an endless carpet

Of virgin snow at our humble abode-

Like confection over cake.

A sweet promise of something wonderful this season.

(December 9, 2013)

Typhoon Haiyan: Rising From The Rubbles

"Through people I see, Your will in me - 
A kindness seeps through the soul,
By and by"

I am awe-inspired by the people mobilizing to extend their help in different ways to the Philippines after Typhoon Yolanda has struck Visayas. More than five thousand people were killed and tens and thousands of people were rendered homeless by this disaster. Friends back home, volunteer with the Department of Social Welfare and Development (DSWD) to sort out clothes and pack relief goods to be distributed in Visayas.

Levi Azarcon, Yang Bautista and  Erika Pabon after packing relief goods at DSWD NROC Pasay
Photo Credited to Levi Azarcon

Lanekar Uriarte sorting clothes( ^ - ^ )
Photo Credited to Lanekar Uriarte

Here in the first world, we are doing our best as well.  People, regardless of race, are extending help in their own ways.  Many donate material needs such as clothes and canned goods but even those who already donated these donate money as well.  The government announced that monetary donations to registered charities will be matched up.  Which means that, a dollar donated by Canadians to charity will be another dollar donated by the federal government to the Philippines.  Among the charities that are widely endorsed by establishments such as cafes and restaurants are the Canadian Red Cross and World Vision Canada.  Other registered charities can be found in the Department of Foreign Affairs website.  Last November 15, I had a chance to fundraise for the Typhoon Haiyan Relief Program with three (3) magnificent volunteers.

From Left to Right: Muhammed, me and Carlo!  Jodie hasn't come yet

"The funds will not only help my own people in short term but with the long term as well, as they start building their lives from the ruins."

We managed to fundraise three thousand CDN ($3,000.00) just from that day alone!  Starbucks, as I know, have donated three hundred fifty thousand CDN ($350,000.00) already.  I also see some fundraising events on the local community board scheduled even after the match up date is done.  In Youtube, you can see people from different places with their own fundraisers as well. Help is pouring from every corner of the world. I am grateful beyond words because I know how much a dollar can help them, sardonically, more so than the local government usually provides.  And yes, in the midst of the oligarchs' continuous farce, it's great to see that people still have the will to help.  I'm sure that a lot of North Americans were rather turned off when Anderson Cooper started pointing out the faulty ways of the government.  What he said was the naked truth!  It reflects how disorganized our leaders are in their priorities. It reflects how easily the supposed leaders put blame on their own people and not in their own incompetency to conduce swift and rhythmic organization amongst the people.  And most importantly, it reflects exactly what the government has been doing with the public's money the past couple of decades. With the super large budget cuts from different departments - including health and education -  in the past five years, public hospitals are so poorly funded to even function at these times. One can't also expect programs for training individuals in times of disaster.  How ironic, really, since storms happen almost every month.  The only thing people know how to prepare for these calamities is to "go to evacuation centers" - which by the way, are old school buildings and open gyms.  When can the higher ups learn to stop playing the blame game like kids?  When can the public get the help they deserve from their own government?  When is the time that a disaster this big happens that we won't need other nation's help?  That we can stand up, and organize ourselves for once.  Tell me, when?

The world weeps with the Filipinos in this unwanted tragedy. Although storms are never new to the Philippines, the trauma from the mishap always is.  For now, as we wait for the time when corruption finally meets its end, our fellow kin faces this nightmare with their bright smiles and resilient hearts. Stay strong, Philippines!

Reflections On Red Cross's SmartStart Program

" True connection with people transcends the vast network of vocabulary you have. It forms amorphously between beings yet, when it is born, it has the most well-defined shape you'll ever see."

At the start of the cold winter season, Red Cross has been busy warming up vulnerable communities with information on basic first aid skills and disaster preparedness with the SmartStart Program.  A diverse team of multilingual volunteers have been empowering immigrants for more than a decade now, by equipping them with skills that will prepare them for emergencies and undaunted disasters as they live out their lives here in Canada.


The first class that I taught to was in my native language - Filipino.  It was for the Multicultural Helping Housing Society (MHHS), a non-profit organization devoted to help newcomers in Canada.  The class consisted of quite a large number of  people - around 20 individuals or so.  Thankfully, the room was really large! Large enough to even accommodate a crowd twice the size. It was held in one of the much isolated tri-cities, Port Coquitlam.  Maria Luisa, a long time Red Cross volunteer, has helped me pull through the whole session.

From left to right:  Roy Recarse and Gigi Recarse from MHHS; Maria Luisa and Me

First SmartStart Multilingual Injury Prevention Class

In all honesty, I was relieved that my first class was in my own language.  It's like a preparatory class for my ESL classes.  The first class allowed me to reflect on my knowledge and skills.  To temper the dynamics of teaching and gauge my ability to make connections with my students and make connections between themselves as well.  I tried to make it as engaging as possible to make them feel that in that class, I share my knowledge but they are free to share their ideas as well.  Overall, I didn't have much problems with explaining complicated things with my them.  Whenever there is something they cannot understand, I find Filipino words that can fill in the definition. That is one of the perks of speaking with people with your own mother tongue.

The next class that I taught was in ESL.  It was held in the Burnaby English Language Centre at Sussex Avenue.  Kenny - our coordinator for the SmartStart Program - and Kevin, an ESL teacher at the centre, were there to support me in teaching.  I was really nervous as it was my first ESL class.  The people in the class were at level 3; though I did read up some stuff on how a student learns at that level, I found it really hard when I was already on the floor.  Looking back to it, I think I wasn't my best at that time.  It was hard for me to make a genuine rapport and connection.  I felt like I was sharing and yet the connection was amiss at times.  Watching Kevin do comprehensive questions as the class was ongoing made me admire ESL teachers a lot.  I felt that they were really "in sync" with each other. I want to feel that "real" connection Kevin has shown, where you feel that you and your students are on the same ground.

Honestly, after this first ESL class I felt crappy as a person.  Lonely even.  I pondered on people and making connections.  I remember people telling me that my English is great and that I was rather smart but when it comes down to truly making a bond (well, new bonds at the most), I felt that those really aren't what I need.  I remember reading off a blog about Fitzgerald on smart people and it went like this:

"Being an intellectual is a curse and a blessing at the same time. I’m not like most people and as such I have little in common with “normal” people who are able to more successfully navigate the world we all inhabit. I often ponder what it would be like to be of a more average intellect, mind you I wouldn’t classify myself as super-smart but I’m quite above the average. But I’m not really willing to give it up either. So I soldier on and work at being more normal and less of a savant. It’s a struggle and it requires lots of mental and psychological gymnastics to meet people were they are and on their terms, something that’s not required of more normal people for the most part."

I kind of understood what he said regarding his struggles on connection. I use so many flowery words (that yes, poets might appreciate) but I can't seem to cater the right words for them to understand.  I don't even know how I should level most of the phrases and words I use, to my dismay.  Words like minor or integrate. - they are the average for me.  Then, as I try to pull out a word from memory to define the complicated words, I find that I just told them yet another complicated word.  My mind was clouded with word retrieval that day as I struggled to chop my words down more.  I realized how disorganized my word bank was!  (Hahaha)

It's good to know though that after much reflection, I have come up with good conclusions of my own.  First, that is in teaching, your connection with your students will help not only you in sharing your knowledge but it will also help them to remember your words as well.  Second, that one needs not form a "superficial" connection but rather strive for a "true" connection. True connection with people transcends the vast network of vocabulary you have. It forms amorphously between beings yet, when it is born, it has the most well-defined shape you'll ever see. Lastly, that no matter what kind of person you are, if you strive to make a connection then surely, you'll be answered back.  You will have a hard time understanding them sometimes due to language barrier but so will they. So, don't worry much on awkwardness. (Just try not to look awkward, I guess)  As long as both parties wish to understand and be understood, no large lexicon is needed.  

Overall, it was a magnificent experience and I think I'll grow more from the following ones.  I look forward to my future students!  Let us learn together.

Seven Ways To Motivate Yourself

As part of the rehabilitation team, we occupational therapists use our disposition to be therapeutic.  In the purest sense, we must be motivated to move others.  For how can a full-fledged bonfire start without the tiny sparks?  But, of course... we are human as well; and oftentimes in our adult lives, we face daunting situations that leave us feeling dejected.  Even for some, the everyday "normal" lives make us feel dull and jaded - that we are stagnant of some sort.  This slump can go on for as long as you allow it to.  And yes, when you're in that pit of boredom and frustration, you might start to think that that is where you ought to be - decrepit and useless.  As Dr. Seuss said, "Un-slumping yourself is not easily done."

Here I share with you the things I usually do when I'm in a slump.

1. Take a walk 

I've found that when you wake up in the morning and you feel that certain uncomfortable nudge of the slump, it will set out to keep you at home.  If it starts to whisper, then the best thing to do is to GO OUT. Take a walk!  By taking a slow walk outside, you'll be able to give yourself time to reflect. You'll notice small things that you've never concerned yourself with before.  Minuscule circumstances like a child walking with their parents, an old lady waiting for the bus, teenagers walking with their friends on the pavement and cars bustling by as you take your walk.  Random acts of kindness like a man opening a door for the next person or walking by the dangerous side of the pavement to shield a stranger.  And in that simple walk you took, you'll be filled with obscurity of wonders - how people in your small community live their best in small ways.  That your existence may be small but significant and surely, as you traveled from your house to whichever direction you went, you're unmotivated self too shall pass.  

2. Read something inspirational 

I always believe that words have spirit. That whatever kind of words you speak can hold a person captive or unbind them if you will.  It goes the same for whatever you feed your mind.  Words that you read can inspire you into motion or keep you prisoner in your current mindset.  True to my belief, I have survived the adjustment phase in Canada by living on my everyday "inspirational something".  Be it a quote from a scientist of the past century, a contemporary poem or a Dr. Seuss book, I read them and let them linger in my mind.  It's even funny to admit that I look forward to reading Vancouver 24 Hours's horoscope because I find them inspiring.  The way in which they construct their sentences are always so positive and encouraging. I also have this application with lots of motivational quotes that randomizes quotes everyday. I start my day empowered by such words and still do.

Here is a list of quick motivational reads and links to quote sites I frequent:

1. Don't Quit Poem - a very famous poem since I was a child.  Whoever wrote it, kudos to you.

2. If - by Rudyard Kipling - this is a great poem to make you start reflecting on yourself.

3. Mutability by Percy Bysshe Shelley  - a poem that will make you realize the world is never stagnant.

4. On Quitting by Edgar Guest - a poem telling on how hard it is to let go of something you truly love.

5. Brainy Quotes - frequent site I visit for quotes.  They have an archive of quotes in landscape backgrounds.

6.  Think Exist - frequent site I visit again for quotes.  No pictures however.

7. I Like To Quote - an imageboard for quotes that is easy to share with social media.
8. Incidental Comics - I recently discovered the genius of Grant Snider.  He has some really great stuff in his site about a variety of topics.  Well, mostly art but still his works are quite inspiring.

3. Listen to music

Much like how words move you, add melody to that and you have magic.  I grew up in a house filled with song and I've realized how music can generally empathize with you to heal your soul.  To me, listening to music is like breathing, like going back to the basics of life.  There's nothing like a song that can express your remorse and unmotivated self then another different song to cheer you up out of that slump.  Listening to music always has that connection to one's soul.  It hooks deep and fishes out those bad feelings and can patch it up nicely with warm, positive ones.  

Here is a list of some moving songs I like and recommend (may contain Japanese songs):

1.  Closer To The Edge by 30 Seconds to Mars - a song about determination in life and looking past your regrets.

2.  What Doesn't Kill You (Makes You Stronger) by Kelly Clarkson - definitely one of those songs to pump up your day with self confidence

3.  Firework by Katy Perry - an uplifting song on inner beauty and potential.

4.  Unwritten by Natasha Bedingfield - I heard this song first from a shampoo commercial and got hooked!  It's about taking the future into your hands.

5. What A Wonderful World by Louis Armstrong - quite an old song that will make you reflect on the bigger picture of everything. You'll be thankful for the small things that make up your life.

6. It's My Life by Bon Jovi - it's a lovely rock song about following your will and pursuing life with unrelented passion.

7. Have A Nice Day by Bon Jovi - another Bon Jovi song that string up the daily dose of courage you need.
8. Defying Gravity (from Wicked) by Idina Menzel and Kristin Chenoweth - from a broadway musicale about fighting for what you believe in.  There is  a Glee version but I prefer this better.

9. One Step At A Time by Jordin Sparks - a song about reaching your goal by taking one small step after another.

10. Skyscraper by Demi Lovato - Demi's comeback song rising up after failing many times

11. Who You Are by Jessie J - a very powerful song speaking of loving yourself as you are.

12. The Climb by Miley Cyrus - Disney Miley's song on facing obstacles in life.  

13. Try by Pink - a new song by Pink about taking chances in love.

14. When You Believe by Whitney Houston and Mariah Carey - a classic song by two unbeatable divas of our time regarding having faith.

15. Bad Day by Daniel Powter - probably the most famous song in the list if I might say so. The most empathetic song in the list too. Who would've thought it was released a decade ago?  

16. Complain by David Archuleta - a song from Archie's 2nd album which moves you to action.  

17.  That's The Way It Is by Celine Dion - a love song released almost 15 years ago that never fails to uplift my mood.  It's about not giving up and working hard in your relationship.

18.  Chances Are by Five for Fighting - actually a love song but speaks of taking chances on life.

19.  Warattetainda by Ikimonogakari  LYRICS TRANSLATION - a song that describes strongly moving into an optimistic future .

20. Dareka ga by Puffy AmiYumi  LYRICS TRANSLATION - a popular song from the anime Naruto that speaks of supporting each other in fretful times.

21. Muteki no Kimi by Fukuyama Masaharu  LYRICS TRANSLATION - a song by my favorite J-artist about independent women and their courageous souls.

22. Against Wind by Akutagawa Jirou - a song from the anime Prince of Tennis about adversity and how you could overcome it.

23. Brave by Sara Bareilles - a fairly new song about standing up for yourself.  The video is quite interesting as well like here "Uncharted" one.

24.  Makenaide by ZARD  LYRICS TRANSLATION - an old Japanese song from the 90s about not giving up.

25. Uncharted by Sara Bareilles - I love this song!  It speaks of moving forward from where you are now to your goal.  

4. Do something productive

Unbeknownst to many, accomplishing a little task everyday could greatly improve your disposition.  Setting a small goal such as arranging your clothes in the closet or trimming your house plants and finishing it can help you feel fulfilled throughout the day.  Take a moment to think about the time when you are in an upsetting mood, then you engaged yourself into something that produced results. There is a certain satisfaction in that. The feeling is small but its effect in your soul resounds through your body - like a raindrop creating a ripple in a larger body of water.  Start by doing small things a day then proceed to bigger tasks to complete.

5. Keep a hobby

There is nothing comparable to immersing yourself in things in which you can express yourself freely. In the midst of the almost maddening effects of the slump, you'll find that engaging in your hobbies will keep you sane.  It is entirely different from other activities which we "put effort" in most of the time, as the motive to do them comes intrinsically.  The motivation to do them comes out naturally as though the hobby was already part of you even before you were born.  Thus, we rather than expending energy and getting tired, we become emotionally charged when we do our hobbies.  If you don't happen to have one or feel like you need a hobby change, then try looking at the community board and find something that may pique your interest.  

6. Self-reflect and move on

I confess to my abysmal habit of reflection.  Most especially towards myself.  I have always been delving in thoughts of queries and answers.  At times when I feel unmotivated, I try to look inside myself to find the reason as to why I am in such state.  Why do I feel down?  What events lead to me feeling suddenly unmotivated?  What did I do to remedy those?  If there weren't anything I can do about those things, then what am I supposed to do?  Those kinds of questions come up and somehow, through the long process of rationalizing with yourself, you'll be able to know just where you stand right now in life.  And from there, you'll pick up on your trail.

A beautiful art about self-reflection found in Incidental Comics!

7. Pray

I find that at times when everything just falls into chaos and that no matter what I do, I can't seem to relieve my restlessness, I pray.  When you've tried all of the things that can possibly cure your seasonal slump and still it won't go away, perhaps it's time to surrender your mind to a Higher Power.  You'll find the peace you need.


That's it for my 7 ways to motivating yourself. These are the things that work for an introvert like me.   I suggest browsing through the song list!  They are absolutely wonderful. And feel free to suggest things that work for you when you're unmotivated on the comment box!   I might try it out and see if it will fit for me too.  (*^_^*)

Here is a little advice I got from Aboriginal Day (@^ - ^@)

OTepp's Final Bow

For several years now, the Occupational Therapy examination and practice preparation (OTepp) project has assisted a multitude of internationally educated occupational therapists (IEOTs) seeking to enter the healthcare system in Canada.  OTepp has guided IEOTs to achieve the level of competency needed to enter occupational therapy practice here.  In fact, the program serves not only as a government funded program intended to develop IEOTs to the populace's liking but it also serves as a modern-day agora where OTs from all around the world can gather and illuminate each others' mind with cultural diversity.  Sadly, this wonderful program is in its last year.  

A farewell party was held at the Sheraton Vancouver Wall Centre Hotel in Burrard last July 16.  Most of the current students and even some former ones along with the McMaster University staff were present. It was nice to see and actually meet the people behind the voices during the online classes - Shami, Sue, Colleen and even Nancy to whom I was in contact with since I was an intern. (sorry if I missed some names) And even though I was only able to enroll for the 3rd and 4th module - which is the using evidence in practice and the clinical reasoning respectively - I was welcomed with much warmth.  

Here are some of the pictures from the party:  (courtesy of Miss Pinky Valerio)

Printed invitation for the farewell party

Sue Baptiste giving the opening speech

Group picture number 1!

Group picture number 2!

OTepp has made me realize a lot of things about the passion I pursue - that is occupational therapy.  Primarily, I realized that there is a huge difference of OT practice here and my home country, the Philippines.  Here in Canada, where the local communities play a big part in the overall country's development, an OT needs to know of the resources he/she can access in the community.  If you know your community well, you can better integrate the client into that community.  Like for example, what is the difference of a residential home versus an assisted living home?  And how would you utilize that resource in practice?  Subsequently, an OT does not only present literature as evidence of the management but he/she must also learn how to sift those articles to fineness.  With the lack of access to the large database during medical school, I am surprised how I even learned evidence-based practice.  I definitely learned a lot more about research in OTepp (inspite of the fact that we were best thesis in our year).   Lastly, I have realized that occupational therapy practice in the Philippines will remain stunted unless the government shifts its educational system to cater the Filipino mass.  I am quite inclined on the political situations happening in my home country since I entered College.  (Click this on my post about poverty and another Tagalog post about a 16 year old who committed suicide because of her tuition fee)  And it is easy to see how the social sciences have not grown that well for the past few decades.  What the Philippines needs is to have real identity through the social sciences.  Identity in which we can define the occupations every Filipino engages in.  This in turn will develop an occupational therapy of our own.  But yeah, maybe it's just me being too over reflective again.  Anyway, I think it's a nice brain candy.  

Perhaps we should trace back our roots for OT to thrive

Coming from a third world country myself, where the North American healthcare system seems more like fiction than reality, I feel relieved to know that there is an organization that can help you understand the complex framework of the health care.  And truthfully, with unintentionally jumping the first two modules due to complications with my documents, I have yet to completely understand how the health care system works.  I did a lot of self reads in order to properly engage myself in the online discussions; promptly following Shami's advise to improve my self-directed learning (aka assertive learning).  Still, when I reflect on the past year, I can't imagine starting from nowhere!  OTepp was my "start" sign on the game board of my career (and probably for most IEOTs as well).    

With OTepp's last curtain call, I bid the staff good luck with the program.  I pray you find alternative funding for this wonderful program.  And to those IEOTs I keep in touch with, may we meet in the health care world proudly carrying OTepp's legacy with us.

A Letter to My Wendy's Family

Dear My Wendy's Family,

It has been a long ten months since I have been welcomed in your home.  Although it seems to me that, I came as quickly as I had to leave.  I am writing this to all of you- crew members, shift supervisors and managers alike - to express my eternal gratitude for accepting me at Wendy's.  Since I landed in Canada last June 2012, I have been aggressively pursuing a job to fund my transition for occupational therapy practice here in Canada.  I felt hopeless and frustrated with the seemingly unlucky things that happened last year.  My diploma and other credentials were on hold because of my surname, two of my much anticipated volunteer works were pushed back and I literally had no money to invest in things that could start up my career as an occupational therapist here in Canada.  I felt utterly useless at home.  Looking even at the people who were carrying out their daily occupations made me miss my work as an occupational therapist. So when I was called in for an interview along with my little sister, Aiko, I was enthusiastic!  "This is it!", I thought.  I can earn money. Miraculously though, I wasn't just given a job; I was embraced wholly as part of a family.   The My Wendy's family.

And to my dear kin, I want to share the little achievements I have accomplished for the past year.  These are  the things that I proudly got from the opportunity you have given me.  First and foremost, I was able to reserve my spot for the National Occupational Therapy Certification Examination (NOTCE).  I had all my credentials assessed and I took an academic english test (TOEFL) in preparation for that.  Subsequently, I invested in books! Here are some of the books I have longed to own when I was still in med school.  Yep!  I have them now.

Latest editions of OT books I needed

Upper extremity rehab books that I wanted since internship

I was also able to buy myself a cellular phone to connect with my friends from far away.  But, needless to say, I am most proud of my decision to sponsor children from World Vision with my bi-weekly salary.  Much like Dave Thomas's Foundation for Adoption, I advocate for children as well.  My hard earned money is giving children in my parents's hometown a chance to have basic education.  They are given the privilege to have new bags, notepads and pencils that they normally can't afford every academic year.  Their washed away books can be replaced by new ones.  They can play in the fields and be kids as they should.  When Wendy's gave me this job, two kids are given back their childhood.  For that, I am evermore grateful.

Meet little Clarence

My Wendy's Family, I write this to you with heartfelt ardor. You have fostered in me qualities that every parent would be proud of. Each and everyone of you showed me the real light to seemingly jaded words like working hard, kindness and humility.  These are words that are used so casually today that it loses its essence.  You guys made me realize that we don't get paid just for every hour we stay there, we get paid for the value we bring to that hour.  And that surely, if you did your best and strive to improve, you will be rewarded. 

The fruit of hard labor! Yey!

I have learnt the true meaning of Dalai Lama's words, "Be kind whenever possible. It really is possible."  Customers love the service we give because of the kindness that flows in our smiles.  That simple hello with a bright smile is not just for show.  We are nice because we want to be nice.  And oh!  The things we do for even the most unreasonable requests by customers!  But that is real humility there.  Thinking less of how you could avoid getting responsibilities and focusing on giving the guests a positive experience. Everytime I work, I feel my name growing brighter by the second. (reference to 明美 - akemi)

With all that said, I close this letter with another thank you.  For having me, nurturing me to best that I can be and also for letting me go. I am sure that my ephemeral experience at Wendy's will permanently leave a mark on my life.  It will always be there - immutable, unshaken but magnificently resounding.  My time with you guys will be one of the many things that will shape my career; that I firmly believe.  I will be always proud to say that I have started out here in Wendy's Guildford.  Like this guy with a nice smile!

That serene smile catches everything I just wrote hahaha

Love,

Akemi