Background: Considerable controversy and limited information surrounds the use of performance-based functional assessments for determining an injured worker's ability to function at work.
Purpose: Amidst a variety of protocols, philosophies and tools, the key aspects of different assessment approaches are described and compared across a range of assessment provider organizations.
Method: Qualitative and quantitative strategies were used to generate an in-depth understanding of the different assessment practices among 23 Southern Ontario assessment providers.
Results: Assessment approaches share common elements and variations that can be described along the continua of five dimensions: nature of assessor-evaluee interactions, fixed or flexible protocol delivery, efforts to contextualize, perceptions and use of evidence, and provider organizational environment. These approach dimensions are offered as a focus for appraising practices.
Practice Implications: Assessors need to reflect upon to what extent they are using a whole person, client-centred approach directed by clinical reasoning amidst a market driven industry.
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