AOTA's Code of Ethics

The Code of Ethics Standards was meant to address the most common ethical concerns of the occupational therapy profession in multiple settings such as research, practice, and education. This document pertains to occupational therapist in multiple roles, guides behavior, and informs therapists of their impact on clients (AOTA, 2010).

The AOTA Code of Ethics only covers its voluntary members (AOTA, 2010).
For the full (2010) version click here. Greater detail of the Code of Ethics Reference Guide to the Occupational Therapy Code of Ethics and Ethics Standards can be purchased through AOTA .

American Occupational Therapy Asociation (2010). Occupational therapy code of ethics and ethics standards. American Journal of Occupational Therapy, 64.

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.

Assessments: Part 1, Personality Assessments

Different personalities, learning styles, and expectations for supervision will vary for each unique student. It is important that both the student and the educator are familiar with the approach that is most effective for a student. For example, if the student is a visual learner, it may be beneficial for the educator to demonstrate a treatment activity before allowing the student to take charge.

Below are resources for personality assessments (related to the Myers & Briggs Type Indicator):

• http://www.capt.org/take-mbti-assessment/mbti.htm
• http://www.16personalities.com/free-personality-test
• http://www.humanmetrics.com/cgi-win/jtypes2.asp#questionnaire

Assessments: Part 2, Learning Style Assessments

Different personalities, learning styles, and expectations for supervision will vary for each unique student. It is important that both the student and the educator are familiar with the approach that is most effective for a student. For example, if the student is a visual learner, it may be beneficial for the educator to demonstrate a treatment activity before allowing the student to take charge.

Below are resources for learning style assessments!

• http://www.educationplanner.org/students/self-assessments/learning-styles.shtml
• http://www.edutopia.org/multiple-intelligences-learning-styles-quiz
• http://www.odessa.edu/dept/govt/dille/brian/courses/1100orientation/learningstyleinventory_survey.pdf

McHenry County College's Student Handbook & Fieldwork Manual

FIELDWORK POLICIES

Dress Code

Whenever students are present at a fieldwork they are expected to dress, appear, and act professionally.  Students are expected to follow the dress code of the academic program, or the facility (if specified) No shorts, jeans of any type, athletic or cargo pants, Capri pants, overalls,

sweatshirts, sleeveless shirts, shirts that reveal midriffs or thermal underwear shirts.  Shirts with tails should be tucked in.  Shirts without collars should not be mistaken for t- shirts.  Clothing should not restrict movement. If athletic shoes are worn, they must be specifically for fieldwork work, and therefore clean.  Athletic shoes should be all or predominantly white. No open-toed shoes, sandals, platform shoes or high heels are allowed.  Socks/hosiery are required.

Students should appear clean and well groomed. No dangling jewelry, perfume, colognes or body soaps / lotions with strong odors.  Facial hair should be well groomed. Students should be mindful of the negative impressions that may be created by excessive body piercing, tattoos, unnatural hair colors, or excessive makeup.

Depending on the facility, students may be required by the fieldwork site to have lab coats with them during fieldwork experiences (part and full time). A patch with the school logo is available to be attached to the left shoulder sleeve of a lab coat. The purchase of a lab coat is the responsibility of the student to purchase.

Transportation

Students are required to provide their own form of reliable transportation to and from fieldwork sites.

Nametags

Nametags should be worn at all times while at a Fieldwork site.The Department will supply the student with a nametag indicating the student’s name, and affiliation. In addition, some facilities may require the student to wear a nametag supplied by that facility.  Lost or damaged nametags must be replaced at the student’s expense.  

Attendance and Makeup

Assignments for Fieldwork Level II A and B (OTA 260 and OTA 265) are full time (typically 40 hours per week).  The student’s schedule is dictated by the fieldwork site and the Fieldwork

educator/ Fieldwork supervisor.  This may include weekend or evening work, or alternate work schedules (e.g. four, 10 hour days).  The student must observe policies of the facility regarding days off and holidays (including religious holidays).

Any special requests regarding time off must be approved by the Occupational Therapy Program Director and fieldwork site.  The fieldwork educator, fieldwork supervisor, and

Occupational Therapy Program Director retain the right to deny any request for time off.  Any time away from the clinic is required to be made up and must be approved by the site

and Occupational Therapy Program Director in advance (whenever possible).  Failure to notify the fieldwork site and the director of Fieldwork of any absence is considered a violation

of the Departmental policy.  In cases of illness, the student is expected to contact the fieldwork site prior to their scheduled arrival time to notify them of the illness.  The student is expected to

contact the Occupational Therapy Program Director to notify the them of the absence.  

Students are required to attend all scheduled fieldwork seminars.  Depending on the time and location, the student is expected to follow the policies of the assigned fieldwork site for

attendance in the clinic before and after the meeting.  Dates for the meetings will be given to the student and the fieldwork site before the start of the internship.  

Students may be given the opportunity of attending a continuing education course, workshop, or in-service offered through their fieldwork site.  Attendance at these activities and makeup time is at the discretion of the fieldwork educator and fieldwork supervisor.  The Occupational Therapy Program Director, however, must be notified about any fieldwork education time the student misses due to these activities.

Temporary Accommodations

At times, students may experience a physical, medical, or psychological problem that does not qualify as a disability, but that could significantly impact the ability to complete the fieldwork portion of the OT program.  Students must provide written documentation of the health related limitation(s) from an appropriate health care provider.  Students must give appropriate

documentation to the Occupational Therapy Program Director and the fieldwork facility representative.  Fieldwork educator will work with the fieldwork site to determine whether strategies or accommodations may be developed that will allow the student to fully participate in the fieldwork education experience.  

The entire manual may be found here.

AOTA's Occupational Therapy Student's Fieldwork Experience

The Occupational Therapy Student’s Fieldwork Experience

Through the fieldwork experience, students learn to apply theoretical and scientific principles learned in the didactic portion of the academic program to address actual client needs and develop a professional identity as an occupational therapy practitioner within an interdisciplinary context.

The fieldwork educator should structure opportunities for informal and formal reflection with the student regarding the OT process in action with the client population.

The OT students should have the opportunity to develop increased knowledge, attitudes, and skills in advocacy, administration, management and scholarship. Skills in administration and management may be attained through the actual supervision of support staff, volunteers, or Level I Fieldwork students in certain tasks or work assignments and involvement in administrative/staff/team meetings.

Scholarship may be enhanced as students learn to use evidence to inform their professional decision making and to generate new evidence through independent or collaborative research at the fieldwork site. This may be accomplished through investigation of the effectiveness of an intervention, the reliability, validity or utility of assessment tools, and publication or presentation of scholarly work. Inter-professional practice competencies should be encouraged throughout the fieldwork experience through engagement of OT and OTA students in interactive learning with students of different professions.

Outcomes Desired

The fieldwork placements should provide the student with experience with various groups across the life span, persons with various psychosocial and physical performance challenges, and various service delivery models reflective of current practice in the profession.

Expectations of Occupational Therapy Fieldwork Students

Students are responsible for compliance with site requirements as specified in the fieldwork site student handbook developed by the fieldwork site and the affiliation agreement between the fieldwork site and the academic program. This typically includes completion of prerequisite requirements (health requirements, background checks, HIPAA training, orientation to site documentation system, etc.) and attention to state regulations impacting student provision of client services. In addition to providing the required occupational therapy services to clients, students are also responsible for active participation in the supervision process, which includes the creation, review, and completion of learning objectives; completion of assigned learning activities and assignments; proactive and ongoing communication with the assigned fieldwork educator; continual self-assessment and reflection; and participation in formal and informal assessments directed by the fieldwork educator. By the end of the fieldwork experience, the student should demonstrate the attitudes and skills of an entry-level practitioner, including assumption of responsibility for independent learning.

This information was taken from the AOTA website, found here!

AOTA's Occupational Therapy Fieldwork Education: Value and Purpose

Occupational Therapy Fieldwork Education: Value and Purpose for Fieldwork Students

Have you ever wondered about the benefits of sponsoring a fieldwork education program at your facility?

Here are a few mentioned by AOTA:

• Propel each generation of occupational therapy practitioners from the role of student to that of practitioner.
• Students learn to apply theoretical and scientific principles learned from their academic programs to address actual client needs within the context of authentic practice environments
• Provides opportunities for the student to develop advocacy, leadership, and managerial skills in a variety of practice settings.
• Recruitment of qualified occupational therapy personnel.

For more information, click here!

AOTA's Recommended Content for a Student Fieldwork Manual

Recommended Content for a Student Fieldwork Manual

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
9. Additional information that can gradually be added to the student manual
10. Organizational Chart of the Fieldwork Setting
11. History of the Fieldwork Setting
12. Department Information

• Policy and procedures
• Mission statement
• Organizational chart
• Essential job functions
• Dress code

13. Regularly Scheduled Meetings:

• Dates of meetings
• Purpose of meeting

14. Special Client Related Groups\Programs

• Purpose
• Referral system
• Operation
• Transport 

15. Patient Confidentiality Information (Patient Rights) 

16. Guidelines for Documentation 

17. Responsibilities of:

• Fieldwork educator Student
• Fieldwork coordinator (if position exists) 

18. Performance Evaluation 

19. Procedure and guidelines used in the evaluation of

• Student
• Fieldwork Educator
• Fieldwork Experience

See more details, click here!

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).

For more information, click here

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.