Evaluating Training for Occupational Therapists and Clinical Psychologists to Deliver Vocational Rehabilitation Within a Clinical Trial: Mixed-Methods Study

Background Delayed return-to-work is common after serious injury. Vocational rehabilitation (VR) supports people to return to/remain in work. We developed training for occupational therapists (OTs) and clinical psychologists (CPs) to deliver a VR intervention (Return to Work After Trauma-ROWTATE) to UK trauma patients within a large-scale randomised controlled trial. Objectives Evaluate the training, OT/CP competence and confidence to deliver ROWTATE, attitudes/confidence in evidence-based practice (EBP). Methods Competency was assessed through Team Objective Structured Clinical Examination and two tasks (management plan, employer letter). Intraclass correlation coefficients (ICCs) estimated inter-rater reliability. Questionnaires measured EBP attitudes (EBPAS-36) and confidence (EPIC) pre and post-training and confidence in ROWTATE delivery post-training. Semi-structured interviews captured training experiences and confidence. Results 47 OTs and 16 CPs completed training. Competency scores were high (OT range=27.5–37.5; CP range=28.5–37; maximum=38). Inter-rater reliability was moderate (OT ICC=0.56, 95%CI 0.18,0.77; CP ICC=0.73, 95%CI −0.22,0.93). EBPAS-36 scores were high pre and post-training with no significant increase post-training. OT confidence in applying evidence (P = 0.01) and evaluating effect of their actions (P = 0.04) increased significantly post-training. OTs and CPs had high confidence (80–100% across questions) in delivering ROWTATE. Conclusions VR training resulted in high competency scores, improvements in EBP confidence and high confidence in delivering ROWTATE.