Florence Cheong & Lim Hua Beng

WFOT Delegate & 2nd Alternate Delegate
Singapore Association of Occupational Therapists
florence_cheong@ttsh.com.sg
huabeng.lim@singaporetech.edu.sg
Contributions from Jessica Hooi, Patrick Ker and SAOT Council

Adapting Pre-registration
Occupational Therapy Education
Adapting PracticeOccupational Therapy Mental
Health Program

Singapore Association of Occupational Therapists

Age

%

Gender%Nationality%

Settings%

20 - 29

33.6

Male

16.3

Singapore/ Resident

83.3 Acute Hospitals

35.7

30 – 3944.9

Female83.7

Non-citizen

16.2 Community Hospitals

13.3

40 – 49

16.6

Community Agencies

22.5

50 – 59

4.1

Private Practices

13.3

60 and above

0.8

Registration Type%OT Qualifications%

Academic Institution

0.9

Employment

%

Full

90.6

Singapore

60.8 Government/ Agencies 1.2

Full Time

79.5

Conditional

9.0

Australia

12.9

Part Time

7.4

Restricted

0.2

India

6.0

Retired/Studies

13.1

Temporary

0.2

Others20.31304 Registered Occupational Therapists in Singapore (31 December 2020)
6.3% annual growth from 2019 to 2020

Singapore Association of Occupational Therapists

• Cover COVID-19 wards• Provide service to patientsdischarge to Rehab Wards
Soh Yan Ming, Principal Occupational Therapist &Head, Occupational Therapy,
Tan Tock Seng Hospital Rehab Services
Return to work focused session with Mr Sarker who
underwent 5-month hospitalization with COVID-19
complications
Soh Yan Ming undertook a 6 week clinicaleducation placement with Ota Sensei
Sapporo Medical University Hospital, 2005
Singapore Association of Occupational Therapists• 66,478 total cases• 6 in ICU• 631 in Hospitals• 1490 in Community Facilities• 66, 719 Discharged• 241 cases, 235 local, 6 imported• 81% of population fully vaccinated• 83% one dose• 55 demised

Singapore Association of Occupational Therapists

Update on local COVID-19 situation and vaccination progress (MOH, 2021)
https://www.moh.gov.sg/news-highlights/details/update-on-local-covid-19-situation-and-vaccination-progress-(6-sep2021)

• Academic Year (AY) 2020 cohort (Sept 2020) experienced orientationand education fully during COVID-19 phase• AY2019 cohort online experienced one trimester in normal times• No delay in graduation• Clinical Placement Education for AY2017 cohort reduced from 1200 to1100 hours

Singapore Association of Occupational Therapists

Module Delivery &Assessment
Clinical Practice
Education
Research
Singapore Association of Occupational Therapists• Social Distancing• Assessment & Exams• Unable to commence• Delayed• Low caseload• Tele-rehab?

• Data collection impacted• Following MOE social distancing rules for Institutions of Higher Learning:• SIT Cohort Size ≈ 110 students• Lectures, Tutorials, Seminars online• Laboratory (but class size < 50)• Conversion of content online• Synchronous and Asynchronous Lectures (Zoom/MS Teams) housed within LMS System (Brightspace)• University provided faculty with subscriptions and training• Problem Based and Team Based Learning trialed on line

• Application for accreditation body’s accommodation for increased online
content/module• University’s teaching and learning unit surveys student on on-line learning
Singapore Association of Occupational Therapists

Ensuring
all have
ACCESS• Written Assessments/Exams went online with lockdown browser
and respondus monitor• Use of platforms on Brightspace, Learning Catalytics, Gradescope• OSCE and Practical Examinations continued with precautions:• Scheduling• Initially using external examiners from one clinical setting• All examiners, students, standardized patients need to undergo antigen rapid
test
Singapore Association of Occupational Therapists

• Resequencing of curriculum• Coordinated by MOH with specific contact person• Healthcare faculty and students were one of the first to be
vaccinated in Jan 2021
• MOH assisted in PPE procurement• Liaison with Education Development Office, Early
Childhood Development Agency, Agency of Integrated
Care• Students rostered for Regular Routine Testing• Student Engagement• Students only delayed by one block in 2020
• Implementation of Entrustable Professional Activities
delayedSingapore Association of Occupational Therapists

• Guided by MOH and IRB guidance on research activities• Data collection stalled• Unable to collect data F2F with patients and in the community in 2020
• Interviews were conducted online for qualitative research• Some student research projects converted to systematic reviews• Cessation of F2F student activities with some online activities• SAOTSC activities went online

Singapore Association of Occupational Therapists

• SAOT and other associations dialogued with MOH during this Covid-19 circuit
breaker in 2020
• SAOT has been our essential link and very active voice to MOH and Chief Allied
Health Office (CAHO)• For SAOT, advocacy has taken place through CAHO. One such achievement is theresumption of critical HDB EASE installations which had stopped when the circuit
breaker started, as contractors were not able to enter residents’ premises due tosafe management measures. This impacted the discharges of patients who
required the home modifications to be installed before they discharge home.
• MOH and CAHO emails out guidances to allied health professionals promptly
Singapore Association of Occupational Therapists• Launched Telehealth Practice Guidelines in April 2020
• Launched SAOT Resource Paper on Home Environmental Safety & EASE
Applications during Enhanced Safe Distancing & Public Health Measuresin April 2020
• Special Interest Group sharing on managing stress and burnout inhealthcare professionals during Covid

Singapore Association of Occupational Therapists

2020 :• Segregation, split teams• WFH if possible• PPE : N95 and eye protection• Zoom meetings• OTs supported :••••national swabbing efforts @ screening centres
basic medical care @ foreigner workers’ dormitories and community
isolation facilities
manning the National Care Helplinedeveloping brochures on how to spend time meaningfully during COVID

2021 :• Vaccinations at the workplace• Rostered Routine Testing every 14 days

Singapore Association of Occupational Therapists

2021:• Inpatients to have masks on (except for medical/dental assessment
and provision of treatment/therapy)• Stopping of group therapy activities• Restrictions for home visits• Tele or remote consultations are encouraged when possible• Antigen Rapid Testing (ART) for caregivers who come to hospitals for
caregiver trainings
Singapore Association of Occupational Therapists

NUH OT Brochure

Singapore Association of Occupational Therapists

Objectives• Educate migrant workers on safe lifting techniques for back care at work
• Engage the migrant workers in dance incorporating safe lifting techniquesand simple stretches and/or activities of daily living (ADL)• Engage migrant workers in cognitive stimulating games for cognitiveand social interactions
Activities• Education on safe lifting techniques at work
• Engagement in cognitive stimulating games and promoting social interactions (e.g. Sudoku, Jenga, Uno, etc)
• Introduction of activity / game box for all to use (i.e. donated games)• Development of activity booklet (e.g. cognitive stimulating games, relaxation techniques, useful resources,
etc)
Outcome Measures• Participants’ overall mood were generally more positive than negative (i.e. very happy and happy 85%)
• Participants feedback were generally positive and most enjoyed the dancing portions and games
Singapore Association of Occupational Therapists

• Adherence to safety measure advisories from health authorities• Meetings moved online• Work in split teams• Working from home when possible• Full PPE when needed• Vaccinations at the workplace• Routine Testing every 7-14 days
Singapore Association of Occupational Therapists

• Move part of the therapy services to tele-practice mode
• Increase in consultative roles as well towards caregivers and otherstakeholders in client care
• Reduction in number of clients in group therapy session• Reduction of home visits on needs and priority basis• Regular Antigen Rapid Testing (ART)• For OTs
• For Visitors• For Caregivers

Singapore Association of Occupational Therapists

• Continuous Professional Development, training programmes (courses andlectures) have moved online and responses have been good. Participants foronline lectures (organised by PGAHI for allied health professionals and OTs) havemore than doubled compared to physical lectures.

National CARE Helpline“Virtual Ward Rounds”• Face to face therapy services weresuspended during lockdown period• OTs who worked in the mental healthsetting and could not provide face toface therapy services, assisted inmanning of the National CARE
Helpline• OTs together with their multidisciplinary
team conducted virtual reviews sessions
for nursing homes they are supporting• Provide emotional and psychologicalsupport to those affected by the
COVID-19 pandemic.

Singapore Association of Occupational Therapists• Able to provide timely inputs andrecommendations to nursing home staff
despite restrictions in on-site visits• Supports safety management measures
introduced by the ministries by reducing
cross centres face to face interactions

Taking Outpatient Services Online

Bringing the Profession Together• Started support groups online forclients who are/have• Working• Stopped work temporarily due tothe pandemic• SAOT organised a online Special
Interest Group for healthcare
professionals in Oct 2020

• Job exploration and stress management
online groups for clients were also
startedSingapore Association of Occupational Therapists“Preventing stress and burnout inhealthcare professionals during theCovid-19 pandemic, focusing on selfcare techniques and practice ofmindfulness.”• Our colleagues from the Singapore
Physiotherapy Association joined us inthis talk as well.

“A Balancing Act”
OTs continues to be creative and adapt
their service delivery mode andintervention plans to balance between
adhering to the escalation and deescalation of safety management
measures and to the importance inmaintaining momentum of therapy.

Singapore Association of Occupational Therapists

Singapore Association of Occupational Therapists

Florence Cheong & Lim Hua Beng
WFOT Delegate & 2nd Alternate Delegate
Singapore Association of Occupational Therapists
florence_cheong@ttsh.com.sg
huabeng.lim@singaporetech.edu.sg
Contributions from Jessica Hooi, Patrick Ker and SAOT Council

Adapting Pre-registration
Occupational Therapy Education

Adapting PracticeOccupational Therapy Mental
Health Program

Singapore Association of Occupational Therapists

First confirmed case:Jan 23, 2020

First cluster: Feb 4,
2020

DORSCON Orange:
Feb 7, 2020

First two deaths:
Mar 21, 2020

Circuit Breaker: Apr
7, 2020

Phase One
Reopening: Jun 2,
2020

Phase Two
Reopening: Jun 19,
2020

Vaccination Drive
Kickoff: Dec 21, 2020

Phase Three
Reopening: Dec 28,
2020

First case of COVID19 re-infection: 6
Feb, 2020

First fully-vaccinatedcase: 29 Apr, 2021

Phase 2 (Heightened
Alert): 16 May, 2021

Phase 3 (Heightened
Alert) Step One: 14Jun, 2021

Phase 3 (Heightened
Alert) Step Two: 21Jun, 2021

PM Lee announced
COVID-19 endemic:
31 May, 2021

Phase 2 (Heightened
Alert): 20 July, 2021

Phase 2
Transitioning out of
Phase 2:7 Aug, 2021

Singapore Association of Occupational Therapists(Adapted from Slide of A/Prof Isaac Sia)• 66,478 total cases••••

6 in ICU
631 in Hospitals
1490 in Community Facilities
66, 719 Discharged• 241 cases, 235 local, 6 imported• 81% of population fully vaccinated• 83% one dose• 55 demised

Singapore Association of Occupational Therapists

Update on local COVID-19 situation and vaccination progress (MOH, 2021)
https://www.moh.gov.sg/news-highlights/details/update-on-local-covid-19-situation-and-vaccination-progress-(6-sep2021)

• Vaccination• Contact tracing aided by Trace
Together App/Token• Rapid Ring Fencing of Clusters• Regular Routine Testing• Mask• Self responsibility

Singapore Association of Occupational Therapists• Academic Year (AY) 2020 cohort (Sept 2020) experienced orientationand education fully during COVID-19 phase• AY2019 cohort online experienced one trimester in normal times• No delay in graduation• Clinical Placement Education for AY2017 cohort reduced from 1200 to1100 hours

Singapore Association of Occupational Therapists

Module Delivery &Assessment
Clinical Practice
Education
Research
Singapore Association of Occupational Therapists• Social Distancing• Assessment & Exams• Unable to commence• Delayed• Low caseload• Tele-rehab?

• Data collection impacted• Following MOE social distancing rules for Institutions of Higher Learning:• SIT Occupational Therapy Cohort Size ≈ 110 students• Lectures, Tutorials, Seminars online• Laboratory (but class size < 50)• Conversion of content online• Synchronous and Asynchronous Lectures (Zoom/MS Teams) housed within LMS System (Brightspace)• University provided faculty with subscriptions and training• Problem Based and Team Based Learning trialed on line

• Application for accreditation body’s accommodation for increased online
content/module• University’s teaching and learning unit surveys student on on-line learning
Singapore Association of Occupational Therapists

Ensuring
all have
ACCESS• Written Assessments/Exams went online with lockdown browser
and respondus monitor• Use of platforms on Brightspace, Learning Catalytics, Gradescope• OSCE and Practical Examinations continued with precautions:• Scheduling• Initially using external examiners from one clinical setting• All examiners, students, standardized patients need to undergo antigen rapid
test
Singapore Association of Occupational Therapists

(Slide courtesy of SIT Clinical Practice Education Committee, A/Prof Rahizan)

Our Journey in 2021  from Phase 2 HA to HRW/HRA
Jan
Phase 3
MOH Cir.
3/2021(recovering from
CB, Phase 2)

Apr 28TTSH Cluster
Phase 2 HA
MOH Cir.
62,62A/2021

Confusion,
time lag incomms (SIT
before EDO)

cross-institution,
 cross-institution,
cross-teamcross-team
movement
movement
 ? No new posting perform high-risk to other institutions,procedures (and cross-campus
high-risk areas)
Posting to TTSH
 Entry swab for LTC ? Entry swab for HCIs
O/P only and 5
and LTCs 48 hours
days prior
prior? Prevailing AIC, SSA
circulars -> ? Needswab, deferment?

RRT
advis
ory

July 12 KTVClusterJune-July
Phase 2 HA
Phase 3
MOH Cir. 96/2021 Confusion,
MOH Cir.
+ email advisory time lag in
85/2021(for students) on comms (EDO
(recovering from 21 Julybefore SIT)
Phase 2 HA)

Uncertain start date of placement
Entry swab for HCIs and LTCs
changed to 72 hours prior? Categorisation of student
groups No washout ? But washout for previous
TTSH students – who?
Inpatients only -> changed toall settings at TTSH – which
institutions in TTSH campus?
All? Operationalising RRTCommunity cases SPIKE
HRW/HRA SMS  students
return to placements after
PH with SMS
Students sent home, but SIT
has just gotten the advisoryfrom MOH (little reaction
time)

Tightened protocol bysites on students with
PUQ – students on HBL
ECDA deferring
placements / HBL
HRA-related ART ? who to do – HCI or SIT
supervision. Students
be included with HCI
ART stations?

• Resequencing of curriculum• Coordinated by MOH with specific contact person• Healthcare faculty and students were one of the first to be
vaccinated in Jan 2021
• MOH assisted in PPE procurement• Liaison with Education Development Office, Early
Childhood Development Agency, Agency of Integrated
Care• Students rostered for Regular Routine Testing• Student Engagement• Students only delayed by one block in 2020
• Implementation of Entrustable Professional Activities
delayedSingapore Association of Occupational Therapists

• Guided by MOH and IRB guidance on research activities• Data collection stalled• Unable to collect data F2F with patients and in the community in 2020
• Interviews were conducted online for qualitative research• Some student research projects converted to systematic reviews• Cessation of F2F student activities with some online activities• SAOTSC activities went online

Singapore Association of Occupational Therapists

• Cover COVID-19 wards• Provide service to patientsdischarge to Rehab Wards

Soh Yan Ming as a student with Ota Sensei
Sapporo Medical University Hospital, 2005
Singapore Association of Occupational Therapists

Soh Yan Ming, Principal Occupational Therapist &Head, Occupational Therapy, Tan Tock Seng Hospital Rehab Services
Return to work focused session with Mr Sarker with underwent
5-month hospitalization with COVID-19 complications

• SAOT and other associations dialogued with MOH during this Covid-19 circuit
breaker in 2020
• SAOT has been our essential link and very active voice to MOH and Chief Allied
Health Office (CAHO)• For SAOT, advocacy has taken place through CAHO. One such achievement is theresumption of critical HDB EASE installations which had stopped when the circuit
breaker started, as contractors were not able to enter residents’ premises due tosafe management measures. This impacted the discharges of patients who
required the home modifications to be installed before they discharge home.
• MOH and CAHO emails out guidances to allied health professionals promptly
Singapore Association of Occupational Therapists• Launched Telehealth Practice Guidelines in April 2020
• Launched SAOT Resource Paper on Home Environmental Safety & EASE
Applications during Enhanced Safe Distancing & Public Health Measuresin April 2020
• Special Interest Group sharing on managing stress and burnout inhealthcare professionals during Covid

Singapore Association of Occupational Therapists

2020 :• Segregation, split teams• WFH if possible• PPE : N95 and eye protection• Zoom meetings• OTs supported :••••national swabbing efforts @ screening centres
basic medical care @ foreigner workers’ dormitories and community
isolation facilities
manning the National Care Helplinedeveloping brochures on how to spend time meaningfully during COVID

2021 :• Vaccinations at the workplace• Rostered Routine Testing every 14 days

Singapore Association of Occupational Therapists

2021:• Inpatients to have masks on (except for medical/dental assessment
and provision of treatment/therapy)• Stopping of group therapy activities• Restrictions for home visits• Tele or remote consultations are encouraged when possible• Antigen Rapid Testing (ART) for caregivers who come to hospitals for
caregiver trainings
Singapore Association of Occupational Therapists

NUH OT Brochure

Singapore Association of Occupational Therapists

Objectives• Educate migrant workers on safe lifting techniques for back care at work
• Engage the migrant workers in dance incorporating safe lifting techniquesand simple stretches and/or activities of daily living (ADL)• Engage migrant workers in cognitive stimulating games for cognitiveand social interactions
Activities• Education on safe lifting techniques at work
• Engagement in cognitive stimulating games and promoting social interactions (e.g. Sudoku, Jenga, Uno, etc)
• Introduction of activity / game box for all to use (i.e. donated games)• Development of activity booklet (e.g. cognitive stimulating games, relaxation techniques, useful resources,
etc)
Outcome Measures• Participants’ overall mood were generally more positive than negative (i.e. very happy and happy 85%)
• Participants feedback were generally positive and most enjoyed the dancing portions and games
Singapore Association of Occupational Therapists

• Adherence to safety measure advisories from health authorities• Meetings moved online• Work in split teams• Working from home when possible• Full PPE when needed• Vaccinations at the workplace• Routine Testing every 7-14 days
Singapore Association of Occupational Therapists

• Move part of the therapy services to tele-practice mode
• Increase in consultative roles as well towards caregivers and otherstakeholders in client care
• Reduction in number of clients in group therapy session• Reduction of home visits on needs and priority basis• Regular Antigen Rapid Testing (ART)• For OTs
• For Visitors• For Caregivers
Singapore Association of Occupational Therapists

• Continuous Professional Development, training programmes (courses andlectures) have moved online and responses have been good. Participants foronline lectures (organised by PGAHI for allied health professionals and OTs) havemore than doubled compared to physical lectures.

National CARE Helpline“Virtual Ward Rounds”• Face to face therapy services weresuspended during lockdown period• OTs who worked in the mental healthsetting and could not provide face toface therapy services, assisted inmanning of the National CARE
Helpline• OTs together with their multidisciplinary
team conducted virtual reviews sessions
for nursing homes they are supporting• Provide emotional and psychologicalsupport to those affected by the
COVID-19 pandemic.
Singapore Association of Occupational Therapists• Able to provide timely inputs andrecommendations to nursing home staff
despite restrictions in on-site visits• Supports safety management measures
introduced by the ministries by reducing
cross centres face to face interactions

Taking Outpatient Services Online

Bringing the Profession Together• Started support groups online forclients who are/have• Working• Stopped work temporarily due tothe pandemic• SAOT organised a online Special
Interest Group for healthcare
professionals in Oct 2020

• Job exploration and stress management
online groups for clients were also
startedSingapore Association of Occupational Therapists“Preventing stress and burnout inhealthcare professionals during theCovid-19 pandemic, focusing on selfcare techniques and practice ofmindfulness.”• Our colleagues from the Singapore
Physiotherapy Association joined us inthis talk as well.

“A Balancing Act”
OTs continues to be creative and adapt
their service delivery mode andintervention plans to balance between
adhering to the escalation and deescalation of safety management
measures and to the importance inmaintaining momentum of therapy.

Singapore Association of Occupational Therapists

Singapore Association of Occupational Therapists