Ethical decision-making: Client refuses a home visit

Teacher Guidelines
Student Learning Objectives
Role Simulated Participant

📄 You can download the full simulation scenario in your preferred language below:

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🧩 Simulation Overview

The therapist makes a home visit, but the client does not want to receive the therapist. The client has just been discharged from the hospital, and the purpose of the visit is to find out how the client is coping at home. After home visit the therapist wants to discuss an ethical problem and solution with the employer. Resolving the ethical question: should the occupational therapist go home against the client’s will or should the therapist refrain from going, and is it then a case of abandonment? How does the student justify their decision, is it a legal problem or an ethical challenge?

Modality: Digital Learning outcomes:

Learning outcomes (simOT Framework)

Domain A: Knowledge and attitudes supporting OT competence
Domain B: Managing and conducting OT process	Apply skills in professional reasoning, problem solving, flexibility, creativity and critical thinking for reflecting on their own practice and making informed decisions throughout the OT process (B.1) Recognize, clarify, and resolve ethical issues and dilemmas that arise within professional relationships or within the OT process using reflection based on ethical frameworks (Code of ethics, Standards of practice, laws, and regulations) (B.3) Integrate varying perspectives in the ethics of clinical practice, occupational justice, and professional actions (B.3) Monitor safety and evaluate and reduce risks throughout the occupational therapy process and service delivery and during supervision, mentoring, teaching, and advising activities (B.3)
Domain C: Developing and maintaining professional relationships and partnerships
Domain D: Professional autonomy and continuous professional development
Domain E: Promoting and advocating for the enhancement of the profession and social change
Domain F: General professional skills and competencies	Respect laws, codes of ethics, rules and regulations that govern occupational therapy (F.2)

🛠️ Preparation for the Simulation

Prerequisites:

Competencies	Specific description of prior knowledge, attitudes and skills
A.1	Occupational therapists possess knowledge about occupation and humans as occupational beings
A.2	Occupational therapists possess knowledge about occupational therapy
B.1	Occupational therapists demonstrate competencies in professional reasoning during the occupational therapy process.
C.2	Occupational therapists demonstrate competencies in establishing trusted professional relationships and partnerships.
	The teacher should assess and compare the curricula to see at which stage of their studies the script is suitable for them (intermediate or advanced). It is assumed that the student has completed a foundation course in occupational therapy (usually this means the first year). Before participating in the scenario, the student has been taught and has acquired the knowledge (described here) needed to understand and complete the scenario tasks.

📦 Actions and Materials

Action	Materials
Instructions and preliminary information about the video available: electronically on the learning platform	Course content and materials (books) regarding contextual components. Simulated client profile; based on client information (health condition, occupational performance)
See the video script in the appendix

Learning objectives (observable behaviour)

Domain A
Domain B	The student will be able to apply clinical reasoning, problem solving, flexibility, creativity and critical thinking and make informed decisions throughout the occupational therapy process. The student relevant theoretical knowledge to support practice
Domain C
Domain D
Domain E
Domain F	The student will identify an ethical/legal problem. The student knows the legislation applicable to the occupational therapists work and is able to act in accordance with it. The student complies with the laws, ethical guidelines, rules, and regulations concerning occupational therapy. Encourage respect for the laws, ethics, rules and regulations governing occupational therapy. The student will understand the principles of professional ethics and understand how to demonstrate honesty and responsibility towards clients. The student should understand how to provide fair, ethical and respectful treatment to the client and be sensitive to bias, stereotypes and prejudice

Name	Maya
Age	31 years old
Sex	female
Personal factors	Client is not motivated to cooperate with the occupational therapist, alcohol problem and mental health problems.
Ethnicity and cultural context	Western European, Finnish
Reason the participant is seeking OT service and concerns related to engagement in occupations	Patient self-discharged from hospital, assessment of home situation and ability to carry out daily activities at home