Do current vocational evaluation practices in traumatic brain injury align with best practices? Strengths, challenges and recommendations

Abstract

Introduction To support implementation of the Inter-professional Guideline for Vocational Evaluation Following Traumatic Brain Injury we compared current practices to best practices as outlined in the guideline. Method We recruited health/vocational professionals who do vocational evaluation of traumatic brain injury survivors to participate in qualitative semi-structured interviews. We also conducted a document review of internal clinical and provincial workers’ compensation insurance documents. All data were analyzed using directed content analysis. Results Thirteen individuals participated and three types of documents were reviewed. Practices that were found to be frequently aligned with the Inter-professional Guideline for Vocational Evaluation Following Traumatic Brain Injury included: (a) identification of evaluation purpose; (b) obtaining informed consent; (c) gathering background information; (d) assessing persistent symptoms and abilities; (e) analyzing and synthesizing results; and (f) developing return to work recommendations. Practices partially aligned included: (a) incorporating the worker’s perspectives into the evaluation; (b) observing work behaviors in naturalistic settings (c) assessing available supports; and (d) assessing occupational/job demands in context. Practices that did not align with the guideline included: (a) evaluation of the workplace environment and workplace supports; (b) accommodation potential; and (c) assessment of workplace safety. Conclusion To support implementation of the guideline and enhance successful vocational outcomes, additional attention and resources should be dedicated to evaluating workplace-based factors and assessing workplace-based risks.