In higher education, accreditation has been used to maintain the quality of education at universities and their schools by setting standards of education. Both the World Federation of Occupational Therapists and the Accreditation Council of Occupational Therapy Education set standards of occupational therapy (OT) education so that educational programs can graduate practitioners with the needed "tools" for effective practice in OT. To explore the issue of differences and commonalities between the ACOTE and the WFOT standards of education, and how they may affect graduating therapists, three studies were conducted.

The first study consisted of a literature review related to: higher education in the United States, occupational therapy standards of education in the US, the World Federation of Occupational Therapists' standards of education, the cross-countries challenges and adaptation of foreign healthcare workers. The Second Study applied the WFOT Revised Standards of occupational therapy education to a selected sample of OT schools in the US, to investigate to what extent do OT schools in the US meet the WFOT Standards? And to what extent do OT curricula in the US emphasize the substantial knowledge, skills and attitudes outlined in the WFOT Revised Standards? Five OT Schools in the US participated. On average, all the universities covered 87% of the WFOT competencies at the Knowledge, Skills, and Attitude levels, ranging from 77% to 90%. The universities combined coverage to Knowledge was 88%, Skills was 85%, and Attitudes was 80%. The third study explored the challenges and adaptation of occupational therapists who practice in foreign countries; the perceptions of occupational therapists to their readiness to practice OT in a different country. Seven occupational therapists were interviewed. Three main themes emerged from analyzing the interviews, they were: general challenges while working in a foreign country; OT-related challenges; and issues related to occupational therapy education, several subthemes emerged as well. This dissertation contributed to OT literature by comparing standards of education of the ACOTE and the WFOT. Also by bringing attention to the challenges that occupational therapists face when moving to foreign countries and how they adapt to these challenges.