A few helpful hints for students!

Before Fieldwork:

• Ask your facility for more information (i.e., dress code, parking, lunch, common diagnoses, common treatments, etc.)
• Plan for all financial responsibilities (i.e., housing, food, travel)
• Complete all immunizations. This includes taking care of routine doctor/dental visits that are necessary. 
• Review your fieldwork manual 
• Save facility numbers in cell phone
 - just in case of an emergency.

*Once you start your fieldwork experience, save time by filling out your student evaluation forms early!!! You can start listing diagnoses, treatments, assessments, etc. 

AOTA's Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services

From personal experience, I was sent to my first Level I fieldwork experience without a clear understanding of expected roles and responsibilities of an occupational therapist and assistant. This made it difficult for me to comprehend the dynamic the therapy team shared.

It may be beneficial for students to read over this document before heading out to Level I fieldwork. It outlines important aspects of the roles and responsibilities of occupational therapists, assistants, and aides.

You can find more information here!

Reflective Journaling

We believe reflection following experiences has the potential to bring value and meaning to certain moments in our lives! Allowing ourselves the time to think back on experiences give us the learn from mistakes, reflect on high points of the experience, brainstorm different approaches, and so on!

"Reflective journaling is helpful for developing procedural reasoning, to understand the diagnosis and treatment techniques from the perspective of known categories or methodologies... Journaling as a tool to promote reflective learning helps students bridge the gaps between theory, academic knowledge, and practice, allowing them to analyze a situation, gain insights, and dialogue with educators... This article helps to illustrate a constructivist learning approach in which clinical reasoning skills are developed through reflective writing paired with discussion (Hanson, Larsen, & Nielsen, 2011)."




Hanson, D., Larsen, J., & Nielsen, S. (2011, April 25). Reflective writing in Level II fieldwork, A tool to promote clinical reasoning. OT Practice, 11-15. 

You can find this article in the OT Practice, April 25th 2011 Edition.

How to make a manual for Level II fieldwork students at your facility.

AOTA recommends that the student manual includes the following:

1. Orientation Outline
2. Assignments
3. Safety Procedures/Codes
4. Behavioral Objectives
5. Week-by-Week Schedule of Responsibilities
6. Patient Confidentiality Information (Patient Rights)
7. Guidelines for Documentation:
• Completed samples of all forms
• Acceptable medical abbreviations
• Discharge plan
• Billing 
• Dictation Directions, if applicable.
8. The Occupational Therapy Practice Framework: Domain and Process

Other helpful information you may want to include:

1. Department Information
• Policy and procedures
• Mission statement
• Organizational chart
• Essential job functions
• Dress code
2. Regularly Scheduled Meetings:
3. Special Client Related Groups\Programs
4. Patient Confidentiality Information (Patient Rights)
5. Guidelines for Documentation
6. Responsibilities of:
• Fieldwork educator
• Student
• Fieldwork coordinator (if position exists)
7. Performance Evaluation
8. Procedure and guidelines used in the evaluation of
• Student
• Fieldwork Educator
• Fieldwork Experience
  
  

Material for your student manual can be gathered from other sources within your facility (e.g., employee handbooks, Human Resources Department, etc.) 


Click here to learn more!

Expected supervision on Level II fieldwork.

Directing

During this phase your FW Educator will most likely be working very closely with you, and take responsibility for setting the daily schedule and routine.  Based upon your readiness, your CI will determine when you will work closely with others, and/or assume specific tasks.  At this time you must be able to vocalize when you are unaware of a term, procedure, concept, or theory base that may be used at this facility.  A competent individual is able to identify areas of strengths as well as challenges, and is willing to take initiative to constantly improve as a practitioner.  It is suggested that you self-identify your learning goals and objectives, and a plan of action to achieve those goals.  In order to enhance their valuable fieldwork experience, students must be accountable for their actions and learning experience.  It is important you are able to provide feedback to your CI throughout your fieldwork experience as well as receive feedback.

Coaching

Your CI may serve more as a coach, while still retaining ultimate responsibility in regards to all client care.  (Keep in mind that you are practicing under your CI’s license). During this stage your relationship shifts to allow for you to speak up about your ideas and clinical reasoning for what you are doing.  At times your CI may wait for you to speak up first, and then offer feedback.  Your CI will begin to assist you in differentiating your knowledge, and how to apply this knowledge into practice.  At this stage it is imperative that you demonstrate your ability to problem-solve, work independently, take responsibility as well as apply clinical reasoning skills in practice, and be able to articulate your thoughts in order to being to establish yourself as an entry-level practitioner.  As you are approaching the midterm point, it is strongly recommended that you perform a self-evaluation of your progress (including your patient care, clinical reasoning skills, treatment plans, etc.).  

These are some suggestions as to what you should be demonstrating at this point:

• Planning & setting your own schedule
• Identifying priorities & goals for your work with clients
• Expressing chosen methods or modalities to evaluate &/or address client problems
• Documenting your services with improved clarity, fluency, & organization
• Recognizing areas in which additional information/learning is necessary
• Seeking resources to address learning & growth needs

Supporting

Once you have begun to establish yourself as an emerging entry-level practitioner, your CI begins to provide more assurance and support in your decision-making processes, by becoming more of an active listener and facilitating your thought process.  The focus is shifted from specifics to the overall performance.  This is your opportunity to explore new ideas and concepts and the role of the occupational therapist in general.

Delegating

Now that you are demonstrating increased confidence and ability in skills, your CI will be delegating more responsibility.  Keep in mind that it is okay to take initiative in your learning experience, and that you do not necessarily always have to wait for your CI to inform you of what to do next, depending on the relationship you have established with your CI by this point.  By this phase you should be performing as an entry-level practitioner.  It is important that you are able to provide feedback on your experience.

For more details, click here

Reference:

From: Barnes, M.A., & Thornton, A.L. (2002). Supervision.  In K. Sladyk (2002). The Successful Occupational Therapy Fieldwork Student. Thorofare, NJ: Slack, Inc.

Student’s goals and objectives for Level II fieldwork.

Introduction/Overview

Level II fieldwork is “designed to promote clinical reasoning and reflective practice, to transmit the values and beliefs that enable ethical practice, and to develop professionalism and competence in career responsibilities” (ACOTE Standards, 2011). A minimum of 24 weeks’ full-time Level II fieldwork is required for eligibility to take the NBCOT examination.

“In all settings, psychosocial factors influencing engagement in occupation must be understood and integrated for the development of client-centered, meaningful, occupation-based outcomes” (ACOTE Standards, 2011).

“The goal of Level II fieldwork is to develop competent, entry-level, generalist occupational therapists. Level II fieldwork must be integral to the program’s curriculum design and must include an in-depth experience in delivering occupational therapy services to clients, focusing on the application of purposeful and meaningful occupation and research, administration, and management of occupational therapy services” (ACOTE Standards, 2011).

Level II Fieldwork is designed to facilitate the student’s transition to entry-level occupation-centered practice.  Integration of occupational science into entry-level occupational therapy knowledge and practice skills is a goal for students who graduate with the entry-level Master of Arts degree in Occupational Therapy from the University of Southern California.

The following overall objectives are based on the American Occupational Therapy Association’s Fieldwork Performance Evaluation for the Occupational Therapy Student (2002):

Fundamentals of Practice

Given an orientation to the organizational structure, policies, and procedures of the fieldwork setting and completion of basic occupational therapy coursework, the student will:

• adhere to AOTA Code of Ethics, state laws governing occupational therapy practice, and the fieldwork site’s policies and procedures.
• adhere to and utilize safety precautions and regulations, using sound safety judgment in all patient care situations.

Basic Tenets of Occupational Therapy Practice

Given information learned from academic coursework, fieldwork educators and supervisors at the fieldwork site, the student will:

• articulate the values and beliefs of the occupational therapy profession, and clearly and confidently articulate the value of occupation.
• communicate the role and function of the occupational therapist and occupational therapy assistant to clients, colleagues, etc. in the fieldwork setting.
• collaborate with “client, family, and significant others throughout the occupational therapy process” (AOTA, 2002, p. 3).
• articulate theories and frames of reference guiding clinical reasoning and treatment implementation.

Evaluation and Screening

Given information learned from academic coursework, and an orientation to data gathering procedures and assessment techniques used in the fieldwork setting, the student will:

• utilize evaluation procedures and methods according to guidelines and standards of the setting.           
• collect and compile relevant data from client records, client, family, significant others and other service providers.
• analyze pertinent physical, emotional, social and environmental contexts that affect the assigned client’s occupations.
• select and administer a variety of appropriate assessment methods including observation of occupational performance while considering the client’s priorities, context(s), theories, and evidence-based practice.
• interpret evaluation results to determine an occupational profile, and establish treatment priorities and goals using the client’s occupational performance strengths and address challenges.
• document evaluations results in accordance with facility regulations and third-party reimbursement systems, demonstrating “objective assessment of the client’s occupational performance” (AOTA, 2002, p.4).

Intervention                  

Given an orientation to treatment philosophies, methods, available treatment options, information learned in academic coursework, and an assigned client caseload, the student will:

• utilize interventions informed by evidence, such as “published research and other relevant resources to make informed decisions” (AOTA, 2002, p. 4).
• initiate and implement treatment plans, selecting relevant therapeutic occupations that are client-centered and occupation-based, to encourage optimal occupational performance and facilitate achievement of treatment goals.
• modify task approach, occupations, and context, updating and modifying intervention based on client’s progress and occupational needs.

• terminate treatment collaborating with clients, families, associated agencies or services for continuity of care as needed.
• document client’s response to treatment in compliance with third party reimbursement systems in a manner that reflects progress and demonstrates continuing need for services.

Management of Occupational Therapy Services

Given information learned from academic coursework, and opportunities to contribute to the administrative functioning of the organization, the student will:

• collaborate with and assign appropriate tasks to occupational therapy assistants and aides.
• understand costs and funding relative to occupational therapy services at the practice site (i.e., billing procedures, scheduling, etc.)
• utilize administrative processes and managerial roles effectively and responsibly, respecting lines of authority.
• meet deadlines and “produce the volume of work required within an expected timeframe” (AOTA, 2002, p. 5).

Communication

Given the clinical standards and procedures for verbal and written communication, the student will:

• use effective interpersonal skills to communicate pertinent information to clients and family members.
• discuss progress with clients, families, significant others and service providers in language that is appropriate to the recipient of the information.
• produce written communication that is “legible, using proper spelling, punctuation, grammar” (AOTA, 2002, p. 6), and terminology.
• prepare oral and written reports with appropriate documentation according to the requirements of the facility and professional standards.

Professional Behaviors

Given the value and importance of the supervisory relationship in the learning experience, and the standards for professional behaviors, the student will:

• collaborate with supervisor(s), assuming an attitude toward the supervisory relationship conducive to learning, communication, and mutual respect.
• respond to feedback in a constructive and professional manner.
• modify behavior in response to supervision, incorporating feedback into future behavior.
• constructively share concerns and feelings regarding experience with supervisor/instructor
• initiate utilization of available resources in the fieldwork setting, “seeking out learning experiences and interactions with supervising therapist and others” (AOTA, 2002, p. 6).
• demonstrate consistent work behaviors including punctuality, time management, task completion, and work site maintenance.
• demonstrate respect for diversity, including but not limited to “socio-cultural, socioeconomic, spiritual, and lifestyle choices” (AOTA, 2002, p. 6).

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References:

American Occupational Therapy Association (2006).2006 accreditation standards for a master’s degree level educational program for the occupational therapist.  Bethesda, MD:  AOTA.

American Occupational Therapy Association (2002).Fieldwork performance evaluation for the occupational therapy student.Bethesda, MD: AOTA.