Strategic direction 5: Assuring workforce competency, engagement and diversity

In addition to improving availability and accessibility of occupational therapists, workforce planning must ensure requirements are met for workforce competency, engagement and diversity. To do so, there is a need for strong and progressive regulatory mechanisms and human-resources governance and management practices to ensure the occupational therapy workforce: meets continuing competency standards; attains optimal performance, work engagement, and job satisfaction; is diverse to reflect and be acceptable to the populations served; and eliminates race, gender, or other demographic-based barriers to career opportunities, development or compensation.

Occupational therapists must meet and continuously maintain key competency and professional standards. Occupational therapists benefit from management practices that promote their effective recruitment, retention, performance, job satisfaction, and resilience (e.g., for reduced rates of burnout and attrition).


Identified weaknesses 9 16 17 23

  • The profession is not regulated in some contexts. WFOT’s data indicates that occupational therapists were required to be registered in only 81% of the 96 WFOT member organisations that responded to a 2022 human resources survey.
  • Where regulatory organisations exist, regulatory mechanisms may be limited in scope, for example, by lacking a requirement for evidence of continuing competency.
  • Few studies examine the impact of service-level human resource practices for the occupational therapy workforce, the engagement occupational therapists and their productivity.
  • Workforce data and research identify the need for a more diverse occupational therapy workforce, aligned with the populations served (e.g., in relation to race, ethnicity, or gender). For example, a study in the USA found that the occupational therapy profession was the least racially diverse among 10 health professions in the nation.47
  • Studies from a range of countries found substantive variations in compensation or career progression for occupational therapists based on characteristics such as gender or practice area.


Opportunities for advancement of occupational therapy

  • Workforce research indicates that factors affecting job satisfaction or attrition differ significantly among occupational therapists compared to other health professions, providing an opportunity for tailored human resources management.17
  • Occupational therapists increasingly transition to managerial positions at the service-unit or organizational level, or engage in (social) entrepreneurship roles;17 there is a room to strengthen, evaluate, and spread these initiatives.

Long-Term Goals (three cycles of four years)

  • New or strengthened regulatory mechanisms are the standard across nations and jurisdictions toward assuring the occupational therapy workforce continuously meets and maintains professional competency and practice standards.
  • Human resource and/or management strengthening programmes aimed at improving the performance, job satisfaction, recruitment and retention and resilience of the occupational therapy workforce are systematically delivered, assessed, and expanded as needed.
  • Increased diversity of the workforce and a systematic reduction in workforce inequalities based on gender, race, ethnicity, or other demographic-related variables is evident.


Short-Terms Goals (one cycle of four years)

  • Systematic processes are in place toward adding or strengthening regulatory mechanisms that assure minimum competency and practice standards, in countries or jurisdictions with underdeveloped occupational therapy workforce regulation.
  • Programmes (e.g., educational, continuing education, or certification) are initiated or strengthened for developing or assuring the development of occupational therapist management and human-resource management competencies.
  • Formal policies or programmes are developed, evaluated, and implemented for promoting the diversity, representativeness, and equity within the occupational therapy workforce.

The specific actions focus respectively on aspects of occupational therapy workforce governance, strengthening of the human resources and management practices and competencies, and improving representativeness and equity within the profession.


Develop or strengthen mechanisms that assure that occupational therapists continuously meet the key competency and practice standards.

a. Develop, strengthen, and update mechanisms (e.g., educational accreditation, national examinations, licensing, credentialing, renewal processes) for assuring occupational therapists initially and continuously meet key competency and practice standards.

b. Use uniform tools, standards, or taxonomies (e.g., Minimum Standards for the Education of Occupational Therapists, Rehabilitation Competency Framework) for profession-specific and cross-professional developments, such as in the design or revision of competency standards, accreditation processes, and scope-of-practice regulations.
c. Use evidence and engage in participatory processes to develop and continuously assess and update entry-to-practice and continuing competency standards and assurance mechanisms.
d. Evaluate the impact of changes in workforce governance or regulations in occupational therapy workforce competencies, performance, scope of practice, and client outcomes to inform further updates in requirements.
e. Improve the inter-operability of licensing requirements across jurisdictions within a nation, toward improved comparisons, mobility, or remote service delivery across jurisdictions.


Strengthen human resources management practices for improving the performance and job satisfaction of occupational therapists.

a. Develop, implement, and evaluate human resources and management practices aimed at improving the safety, performance, job satisfaction, recruitment and retention, and resilience of the occupational therapy workforce.

b. Evaluate human resource practices and compensation levels, including over time and compared to other professional groups for a given labour market and policy context.
c. Use standardized, behavioural, or observable workforce outcomes for assessing the impact of human resource management practices.
d. Develop competencies and mechanisms (e.g., organizational programmes, collaborative or peer-learning networks) for occupational therapists in managerial roles.


Improve the equitable diversity and representation of the occupational therapy workforce and foster acceptability by diverse communities, cultures and populations.

a. Monitor the diversity of the occupational therapy workforce to foster outreach to and acceptability of services in diverse communities, cultures, and populations.

b. Develop and evaluate mechanisms to eliminate inequalities in compensation, career progression and professional development opportunities within the occupational therapy workforce.
c. Develop and strengthen educational mechanisms (e.g., admission criteria, fieldwork placements, support programmes, accreditation mechanisms) for assuring a more diverse pool of occupational therapy students and graduates and their deployment onto serving a wider range of communities and cultures.