Student Name_Gareth Loosle___________________________________ Date 12/8/17

OCCUPATIONAL THERAPY STUDENT PERFORMANCE ASSESSMENT

Assessment Competency Exam

Competency Components Not Observed or Adequate High Level of

Interview: Overall score 95/100 95% = 71.25/75 pts Skill Performed Skill Skill N/A
Ineffectively Demonstrated Demonstrated
1. Preparation X
2. **Arrives at appointment on time
3. **Prepares Interview materials in advance X
4. **Establishes appropriate interview environment X
Interview Administration: X
5. **Introduces self to client, which includes acknowledging
client’s name, introducing self, and stating purpose of the
interview in clear understandable language
6. **Establishes rapport with client +1
7. Explores and discusses client’s priorities and concerns X
regarding the reason for a referral to occupational
therapy
8. Performance demonstrates preparation and familiarity X
with the interview format
9. **Performs Interview in correct format and covers all X
parts of interview adequately
10. Demonstrates the ability to paraphrase and reflect +1
client’s content and feelings
11. Asks additional open and/ or clarifying questions when X
client gives short or vague responses
12. Is able to refocus client back to interviewing topic in a +1
respectful manner
13. Utilizes understandable language; Explains jargon as X
appropriate
14. Avoids giving advice & uses silence appropriately X
15. Demonstrates appropriate body language - which X
includes appropriate eye contact, personal space, facial
expression, gestures, postural orientation, speaking
volume and modulation
16. Demonstrates appropriate interest and energy level in X
response client’s behavior
17. Acknowledges changes in client’s affect, mood, and X
body language
18. Effectively responds to client’s affect, mood, and body X
language
19. **Briefly summarizes client’s responses at the end of the x
interview
20. Gives client final opportunity to ask questions X
21. Informs client what the next steps of the intervention X
process can or will be
22. Ends interview on a positive note and provides a sense X
of closure
X
23. **Coordinates test materials effectively during interview
24. **Uses allotted time effectively X
Scoring: X
25. **Scores recorded correctly in form and accurately
reflects results of the interview.
11/21/2018
Student Name_Gareth Loosle___________________________________ Date 12/8/17

Overall rating of Student’s Assessment Competency Level Skills do not meet Skills meet Skills exceed
(Circle One) competency competency competency
requirements requirements requirements

To pass this competency exam, a student must competently perform 8 of the 10 (shaded/**) interview skills described above

Grading: 92/100 is earned if all skill items are marked “adequate skill demonstrated”. ½-4 points will be added for each “high level of skill”
marked. However, the maximum number of points that can be earned for this component of the OTSPA is 100/100. ½-4 points will subtracted
for each skill item marked “Not observed/Performed ineffectively”.

Comments:

Interview: Overall score 95/100 95% = 71.25/75 pts

You did a good job of summarizing her thoughts as well as pulling her back as she was very talkative. You also used humor as a
great tool for rapport.

11/21/2018