peer assessor with occupational therapist

The College regularly assesses the practice of occupational therapists. If the assessment finds gaps in an occupational therapist's knowledge, skills, and judgment, the College works with them and provides tools and resources for meeting the Essential Competencies and Standards of Practice.

Resuming Suspended Peer and Practice Assessments

The College will be resuming the peer and practice assessments that were suspended at the beginning of this year due to the COVID-19 pandemic. Affected registrants have been contacted by phone with more information to follow in a letter. It is anticipated that these assessments will be completed by the end of 2020.

Learn more about the upcoming competency assessment process here.

How does the College select occupational therapists for competency assessment?

For the 2019/20 registration year, the College randomly selected occupational therapists to participate in an on-site peer and practice assessment. This means that experienced occupational therapists with training from the College will visit each of the selected occupational therapists where they work. This person is called a peer assessor. The peer assessor will review clinical records, ask questions, and prepare a report for the Quality Assurance Committee of the College.

For the 2019/20 registration year, the selection process took place in December 2019. The College randomly selected occupational therapists who:

  • work in clinical practice
  • have been registered with the College for at least 5 years
  • have never been selected before.
For future years, the College is developing a more efficient and effective process for selecting occupational therapists who would benefit from an in-depth assessment of their skills and knowledge. View a backgrounder document on the project currently underway.

What if I am selected but cannot participate?

If you are selected but feel you have good reasons why you cannot take part in a peer and practice assessment at this time, contact the Manager, Quality Assurance program as soon as you can:

Seema Sindwani, Manager, QA
Email: ssindwani@coto.org
In Toronto: 416-214-1177, ext. 227
Toll-free: 1-800-890-6570 ext. 227

Requests for deferral are granted on a case by case basis.

View the Request for Deferral Form.

What is involved in peer and practice assessment?

  1. The occupational therapist completes a questionnaire. This gives the College and the peer assessor general information about the occupational therapist’s practice and role. The peer assessor does not have any other advance information about the occupational therapist.

  2. The peer assessor reviews up to 5 of the occupational therapist’s discharged charts.

  3. The peer assessor interviews the occupational therapist on-site. The interview questions are based on cases and situations that the assessor has reviewed in the charts. Here is an example of some questions an assessor might ask about a case where a client has been referred to the occupational therapist:

    Describe the steps you took to determine the appropriateness of this referral. How did you screen the referral? How did you determine you had the knowledge, skills, and judgment required to accept the referral? How did you explain your scope of practice and role to the client?



Where does the assessment take place and for how long?

The peer and practice assessment takes place at the occupational therapist’s place of work. If the occupational therapist is in private practice, the assessment may take place in the occupational therapist’s home or another location.

Occupational therapists can use an alternate location such as a library or community centre. Wherever it takes place, the occupational therapist should ensure complete privacy for the assessment.

Occupational therapists should plan to set aside about five hours for the assessment.

Does the College cover any costs related to the peer and practice assessment?

No. As members of a regulated health profession, occupational therapists have a responsibility to demonstrate they are meeting the Essential Competencies and Standards of Practice and that they have the knowledge, skills, and judgment to practice competently.

Who are the College’s peer assessors?

These are experienced occupational therapists who work in various practice areas, including acute care, vocational rehabilitation, mental health and addiction, and paediatrics. They have been trained by the College to conduct peer and practice assessments.

There are six peer assessors, located in Kitchener, Guelph, Toronto, Etobicoke and Barrie.

Do occupational therapists need to tell their employer they are taking part in a peer and practice assessment?

No. Occupational therapists are not required to inform their employer, although some may have to so that they can get access to discharged client charts. Employers are required by law to provide this access for peer and practice assessments.

Occupational therapists can ask the College for a letter to give to their employer requesting access to discharged clinical records.

What happens after a peer and practice assessment?


The peer assessor prepares a report for the College’s Quality Assurance Committee. Based on the report, the Committee decides whether the occupational therapist is practicing competently and meeting the Essential Competencies and Standards of Practice. The Committee can take any of the following actions, which are ordered from the least serious to the most serious:

  1. Take no action

    If the Committee has no concerns about an occupational therapist’s practice, the Committee does nothing further and the competency assessment process is concluded.

  2. Take no action but provide a recommendation

    If the Committee has no concerns about an occupational therapist’s practice, they may still recommend a voluntary activity such as reviewing the Standards for Record Keeping. At this point the process is concluded.

  3. Issue a Specified Continuing Education or Remediation Program (SCERP)

    If the Committee finds there are gaps in an occupational therapist’s knowledge, skills, or judgment, they will require the occupational therapist to participate in a form of education or remediation called a SCERP.

    For example, the Committee may direct an occupational therapist to review a College standard, such as the Standards for Consent. The occupational therapist must then write a reflective paper in which they think about how to improve their practice. In this example, the paper should outline how the occupational therapist will incorporate an informed consent process into their practice.

    The reflective paper would have a due date and would be reviewed by the College.

    The purpose of a SCERP is to give the occupational therapist the opportunity to show that they have engaged in a learning process and improved their practice. This aids the occupational therapist’s own professional growth and protects the clients they serve and people they work with.

    SCERPs ordered by the Quality Assurance Committee are not posted on the College’s Public Register.

  4. Require another peer and practice assessment

    If the Committee needs more information to make a fair decision, they can order another peer and practice assessment.

  5. Impose terms on an occupational therapist’s practice

    If the Committee finds that an occupational therapist’s lack of knowledge, skills, or judgment could pose a risk to the public, it can place restrictions on the occupational therapist's practice. These terms are placed on the occupational therapist’s practice and posted on the Public Register.

    An example of restricted practice would be requiring the occupational therapist to be supervised when they perform certain tasks. Another example would be requiring the occupational therapist to remain in a certain area of practice until they show improvement.

    The occupational therapist would also participate in a specified continuing education or remediation program (SCERP).

  6. Refer the occupational therapist to the Inquiries, Complaints and Reports Committee

    The Committee may find that the occupational therapist has engaged in professional misconduct. This could happen, for example, if the occupational therapist did not respond to the College after repeated attempts to have them take part in the Quality Assurance program, or they did not comply with the orders of the Quality Assurance Committee.
How does the Quality Assurance Committee make decisions?

The Committee reviews all the information from the peer and practice assessment. If a Committee member believes they may know the occupational therapist and have a conflict, they must declare this and not take part in the discussion.

In making decisions, the Committee takes into account:

  • the level of risk to the public
  • whether the occupational therapist responded to the College in a timely manner throughout the process
  • the occupational therapist’s history with the College, as this may show where the occupational therapist has ongoing challenges.
The Committee may also compare the occupational therapist’s case to other decisions they have made to ensure they are being fair.

In 2019 decisions issued by the Quality Assurance Committee included:

  • Review of the Standards for Record Keeping
  • Review of the Standards for Consent
  • Implementation of the Conscious Decision-making approach when considering options and risks when making professional decisions; and
  • Reminders of proper designation for use of the protected title of occupational therapist: OT Reg. (Ont.)
View the College's Essential Competencies and Standards of Practice.