Occupational Therapy Fieldwork Educator's Manual San José State ...
Transcript of Occupational Therapy Fieldwork Educator's Manual San José State ...
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OccupationalTherapyFieldworkEducator’sManualSanJoséStateUniversityIntroductionFieldworkeducationisthetimeforstudentstodevelopaprofessionalidentitybyapplyingtheknowledgeandskillslearnedinschooltoauthenticpracticesituationswithclients,families,andcolleagues.Thefieldworkexperiencealsohelpsthestudentdevelopcollaborative,reflectiveandethicalpractice,alongwithmanagerial,andleadershipskillsthatareimportantasanentry-levelpractitioner.Fieldworkeducatorssupportstudentsbymodelingprofessionalbehaviors,fosteringcriticalreasoningskillsthroughtheiradvancedpracticeunderstanding,givingstudentsprogressivelymorechallengingexperiencesandresponsibility,andprovidingcriticalfeedback.Weappreciatethatthefieldworkeducatorisnotdriventomentorshipbyaspirationsofprestigeormonetarygain.However,therearerewardsofmentoringLevelIandLevelIIfieldworkstudentsthatextendtothefieldworkeducatorthatincludetheknowledgeofsupportingprofessionaldevelopmentofthenextgenerationofoccupationaltherapypractitionersandbyenhancingtheirknowledgeofcurrentpracticetrendsaswellasevidence-basedpractice.Inaddition,thefieldworkeducator’seffortforsupervisingLevelIIstudentsisrecognizedbytheNationalBoardforCertificationinOccupationalTherapy(NBCOT)asmeetingcontinuingeducationrequirements.ThismanualisdesignedtogiveyouinformationtohelpyouworkwithourLevelIIstudents.ThedescriptionsareadaptedinpartfromtheEssentialGuidetoOccupationalTherapyFieldworkEducation(Costa,2004),andtheCOEGuidelinesforanOccupationalTherapyFieldworkExperience–LevelII(AOTA,2013).Wethankyouforyourimportantcontributiontooccupationaltherapyeducation,andyourcommitmenttothesuccessofourstudents.ContactUsWerecognizethatthedevelopmentofdiverseandrelevantfieldworkprogramsisdependentuponsuccessfulcollaborationbetweentheacademicprogramandthefieldworkeducator.Consistentandtimelycommunicationisnecessarybetweenthefieldworkeducator(s),andtheacademicfieldworkcoordinatoratSanJoseStateUniversity.If,atanytimeduringthestudent’sfieldworkexperienceyouhaveanyquestionsand/orconcerns,pleasecontacttheacademicfieldworkcoordinatorat:ph:408-924-3078,fax:408.924.3088orcinna.hunter@sjsu.eduforassistance.SJSUFieldworkParticipants Thefollowingdescriptionsoutlinetherolesandresponsibilitiesofeachparticipantinthefieldworkexperience.ThesedescriptionsareadaptedinpartfromtheCOEGuidetoFieldworkEducation(AOTA,2013),andtheEssentialGuidetoOccupationalTherapyFieldworkEducation(Costa,2004).
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TheacademicfieldworkcoordinatoristhefacultypersonfromtheSanJoseStateUniversityOccupationalTherapyprogramwhoservesasaliaisonbetweentheacademicsetting,thefieldworksite,andthestudent.Theprimaryresponsibilitiesoftheacademicfieldworkcoordinatorare:• Assignmentofeligiblestudentstoafieldworkexperienceandconfirmationofassignmentin
writingtoeachfieldworksite• Initiationandmaintenanceofwrittencontractsorlettersofagreementbetweenthe
educationalinstitutionandthefieldworksite*• Maintenanceofcurrentfilesoneachfieldworksite,includinguptodatefieldworkdataforms,
andfacilityforms• Identificationofnewsitesforfieldworkplacement• Orientationofstudentstothepurposeofthefieldworkexperience,instructingthemontheir
rolesandresponsibilities,andprovidingthemwithanyrequiredforms• Collaborationwiththefieldworkplacementsite,includingprovidinginformationonpoliciesfor
withdrawalorfailureofastudent• Communicationthroughuseofforms,studentinformationpackets,written,andverbalor
electroniccommunicationtechniquestothefieldworksite.*AcontractorfacilityagreementbetweentheUniversityandtheclinicalsitemustbeinplacebeforebeginninganystudentplacement.Theacademicfieldworkcoordinatorwillinitiatethecontract/MemorandaofUnderstanding(MOU)processwithyou.Thecontractmustbesignedbytheappropriateauthorityatyourfacilityandreturnedtotheinstitutionforprocessing.YouwillalsobeemailedaFieldworkDataForm,whichrequestsgeneralinformationaboutyourfacility,thesetting,clientpopulationserved,assessmentsandinterventions,theoreticalmodels,prerequisitesforthestudentprogram,studentinformation,andstaffingprofile.Thisformistobecompletedandreturnedtotheacademicfieldworkcoordinator.Theinformationprovidedonthisformservesasadatabaseregardingyourfacility.Thestudentshaveaccesstothisinformationinpreparationforthefieldworkexperience.Theclinicalfieldworkcoordinator,alsoknownasthestudentcoordinator,istheindividualattheclinicalsiteresponsiblefortheadministrativefunctionsofthesite'sfieldworkprogram.Dependingonsiteregulationsand/orbusinessmodel,theownerorfieldworkeducatormayalsobetheindividualdesignatedtoperformthesefunctions.Theadministrativedutiesoftheclinicalfieldworkcoordinatorinclude: • Collaboratingwithacademicfieldworkcoordinatorforthedevelopmentandimplementation,
(andwhennecessary,revision)ofameaningfulfieldworkprogram• Preparing,maintaining,andsendingtotheacademicfieldworkcoordinatorinformationabout
thefieldworkplacementsite,includingifthefacilitybelongstoalargerorganization,and/orfacility-specificapplicationrequirements
• Establishingastudentfieldworkprogram,usuallyincollaborationwithotherstaff,whichincludesobjectivesofthefieldworkexperienceandstudentmanualwithgoals,expectations,assignments,andadditionalfieldworkprogramrequirements
• Obtainingfromtheacademicprogrampolicypertainingtowithdrawalofastudentfromthefieldworkexperience
• Schedulingstudentsincollaborationwiththeacademicfieldworkcoordinator
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• Informingtheacademicfieldworkcoordinatorifstudentinterviewsarerequiredpriorto
confirmation• Notifyingtheacademicfieldworkcoordinatorofconfirmationofstudentplacement• Organizingstudent'sorientationtoclinicalsettingandprovidinginformationsuchashealth,
safetyandeducationrequirements,workhours,dresscode,andexpectations• Assigningstudentstoafieldworkeducatorandforwardingthisinformation(including
fieldworkeducatorcredentialsandlicensenumber)totheacademicfieldworkcoordinator• Meetingperiodicallywiththefieldworkeducator(s)andthestudenttoassessprogressand
discussanyissuesandorconcerns• Notifyingtheacademicfieldworkcoordinatorifconcernsarisewithastudentthatmightleadto
afailureorwithdrawalfromthefieldworkexperience• Reviewingmid-termandfinalevaluationswiththefieldworkeducatorandthestudent• Determiningthatfinalevaluationformsarecomplete,signed,andthattheoriginalsaremailed
totheacademicfieldworkcoordinator• Periodicallyreviewingcontractualagreementbetweenthefieldworksiteandtheacademic
institution,makingsuretheseagreementsaresignedandup-to-date.Thefieldworkeducator,clinicalsupervisor,preceptor,orstudentsupervisor,istheindividualresponsiblefordirectstudenttrainingatthefieldworkplacementsite.ForLevelIIfieldwork,theclinicalsupervisormustbearegisteredOccupationalTherapistwithaminimumofoneyearofclinicalexperienceinapracticesetting.Theresponsibilitiesofthefieldworkeducatorincludethefollowing:• Directday-to-daysupervisionofthestudent• Clearlydefiningexpectationstothestudent• Assigningclientstothestudent• SupervisingthestudentintheprovisionofOTservices(evaluation,intervention,
documentation,andoralreporting)• Assessingtheskillandknowledgelevelofthestudent• Meetingregularlywiththestudenttoreviewperformanceandprovidefeedback• Notifyingtheclinicalfieldworkcoordinatorandtheacademicfieldworkcoordinatorifthe
studentisnotmeetingexpectationsorproblemsarise• Evaluatingthestudentatmid-termandattheendofthefieldworkexperience,identifying
strengths,areastoworkon,andmethodstoachievesuccessinthese areas.
AccordingtotheCOEGuidelinesforanOccupationalTherapyFieldworkExperience–LevelII(2012):
TherearemultiplesourcesofsupervisionguidelinesthatareapplicabletoLevelIIfieldwork.Thefirstsourcesarestatelawsandstatepracticeactsthatgovernthepracticeofoccupationaltherapy.Thesedocumentswillspecifyifthereareanyspecificrequirementsforsupervisionthatneedtobeupheldinthatstate.AnothersourceofsupervisionguidelinesarefederalregulationssuchasMedicarethatspecifywhattypeofsupervisionmustbeprovidedtofieldworkstudentsincertainhealthcaresettingsandwithcertaintypesofMedicarecoverage.TheAOTAWebsiteisagoodsourceforthemostup-to-dateinformationonMedicareregulationsforstudentsupervision.TheACOTEStandardsspecifythatduringLevelIIfieldwork,studentsmustbesupervisedbyalicensedorcredentialedoccupationaltherapypractitionerwithatleast1yearofexperiencewhoisadequately
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preparedtoserveasafieldworkeducator.Further,theStandardsstatethatsupervisionshouldinitiallybedirect,andthenprogresstolessdirectsupervisionasispossiblegiventhedemandsofthefieldworksite,thecomplexityoftheclient’sconditionbeingtreated,andtheabilitiesofthefieldworkstudent.TheCOEandCommissiononPractice(COP)FieldworkLevelIIpositionpaper(COE/COP,2012)additionallyrecommendsthatsupervisionofoccupationaltherapy,andoccupationaltherapyassistantsinfieldworkLevelIIsettingswillbeofthequalityandscopetoensureprotectionofconsumersandprovideopportunitiesforappropriaterolemodelingofoccupationaltherapypracticeandthatthesupervisingoccupationaltherapistand/oroccupationaltherapyassistantmustrecognizewhendirectversusindirectsupervisionisneededandensurethatsupervisionsupportsthestudent’scurrentanddevelopinglevelsofcompetence.(COE/COP,2012)
Thestudentisexpectedtocollaboratewithboththeacademicfieldworkcoordinatorandthefieldworkeducatortoensurecompliancewithfieldworkexperiencerequirements.Specificresponsibilitiesinclude:• Attendingfieldworkorientationmeetingconductedbytheacademicfieldworkcoordinator,
whichprovidesadescriptionoffieldworkexpectations,registrationprocedures,policiesforwithdrawal,repetitionandgradingofthefieldworkexperience,certificationexaminationproceduresandlicensureprocedures
• Providingacompletedpersonaldatasheet,resume,andcopyofhealthrecordtoFieldworkCoordinator
• Completingallsiterequirements/preparationpriortocommencingthefieldworkexperience,andprovidingstudenthealthrecords,backgroundcheck(ifrequired),andCPRtrainingrecordstotheclinicalsetting
• Providingthecontactinformationforthestudent’sacademicadvisortothefieldworkeducator(s)
• Exhibitingprofessionalbehavioratalltimesduringtheclinicalaffiliation(i.e.arrivingtoworkontime,followingprotocolsasoutlinedbythefacility,communicatinginaprofessionalmannerwiththesupervisorandotherprofessionalstaffatthefieldworksite,takingresponsibilityforhis/herownworkschedule,completingrequiredassignmentsanddutiesinatimelymanner)
• Activeparticipationinthesupervisoryprocess,utilizingavailableresources,andtakingresponsibilityforhis/herownlearning
• Maintainingcopiesofperformanceevaluationformsandstudentevaluationsformsofthefieldworkplacement,andensuringthatthefinalevaluationshavebeenreceivedandreviewedbythefieldworkcoordinator
PalladinoandJeffries(2000)havedevelopedaworkbookdesignedtofacilitatestudentstakingresponsibilityforlearninginLevelIandLevelIIfieldwork.Thebookincludesmanyformswhichthestudent,clinicaloracademicsupervisorcanutilizetodocumentskills,knowledgeandclinicalexperience.Otherstudentresourcesinclude:OccupationalTherapyFieldworkSurvivalGuide(Napier-Tibere&Haroun,2004),andTheSuccessfulOccupationalTherapyFieldworkStudent(Sladyk,2002).
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SJSUOccupationalTherapyCurriculum,ThemesandStudentObjectivesThecurriculumisorganizedaroundthecoreprincipleofparticipationinoccupationtopromotehealth,wellbeing,andsocialinclusion.Thecurriculumisdesignedtoenablestudentstoacquiretheknowledgeandcompetenciesnecessarytobecomequalifiedasageneralistinoccupationaltherapypracticewithinfoursemestersofgraduateacademicstudyandsixmonthsofsupervisedfieldworkexperience. Alifespanorientationtooccupationaltherapypracticewaschosenratherthanorganizationaccordingtotraditionalpracticeareasinordertoemphasizetheholisticnatureofcontemporarypractice.Coursecontentaddressingprofessionalbehaviorsandresearch/evidence-basedpracticeprovidedthroughoutthecurriculumassistsstudentsinadvancingcriticalanalysisandleadershipskills.Thecurriculumiscomposedofsixclusters:
1. Occupation—thecoreoftheprofession2. Foundationsforoccupationaltherapypractice3. Professionaldevelopment4. PracticeintheCommunity5. Researchandknowledgedevelopment6. Practiceofoccupationaltherapy.
Sixcurricularthreadsreflectknowledgeandskillsthatrunthroughallcoursesinthecurriculum.Theyincludethefollowing:
1. Integratingaffectiveexperiences:Skillsinperceiving,understanding,andrespondingtotheemotionalcontextsofinteractionsandperformanceofselfandothers
2. Embracingdiversity:Self-reflectionandawarenessofone’sownidentity,values,attitudes,andprejudices.Skillsinperceiving,understanding,respecting,andrespondingtoothers’diverseexperiences,values,attitudes,andprejudices
3. Developingprofessionalidentity&leadershipcapacity:Understandingoneselfasaprofessionalthroughself-reflection,developmentofprofessionalbehaviorsandengagementinprofessionalactivities
4. Becomingcreatorsofknowledge:Understandingthedevelopmentofknowledgeandhowonecancontributetotheevolutionofknowledge.Beaself-directed,independentlearnerandscholar
5. Understandinghumansasoccupationalbeings:Knowledgeofthecomplexityanduniquenessofoccupationinthehumanexperienceandthefacilitationofoccupationalparticipation
6. Engagingandservingcommunitiesofpractice,scholarship,andlearning:Connecting,collaborating,andservingdepartment,university,local,andglobalcommunities.
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CurriculumLearningOutcomes
1. Demonstrateeffectiveoralandwrittencommunicationskills2. Demonstrateacapacityforproblemsolvingandcriticalanalysis3. Understandandbeabletoarticulatethenatureofoccupation,adaptiveskills,androles
ofproductiveliving4. Understandoccupationaltherapy’stheoreticalbaseandmodelsofpractice5. Articulatetheimportanceofhistoryandthephilosophicalbaseoftheprofession6. Demonstrateknowledgeandappreciationoftherolesofsociocultural,socioeconomic,
diversityfactors,andlifestylechoicesincontemporarysociety7. Demonstratetheabilitytoapplyoccupationaltherapytheory,andstandardizedand
non-standardizedevidence-basedassessmentsofclients’performanceinallareasofoccupationtoachieveexpectedoutcomesrelatedtooccupation
8. Provideoccupationally-basedinterventionsdeterminedbytheneedsoftheclientandtheevaluationdata,incollaborationwithmembersoftheinterventionteam(client,family,caregivers,andhealthcareproviders)
9. Demonstrateprofessionalbehaviorthatupholdstheethicalstandards,values,andattitudesoftheprofessioninestablishingandmaintainingatherapeuticrelationshipwithclients
10. Demonstratebasicqualitativeandquantitativeresearchskills11. Exhibittheabilitytouseappropriateadvocacyandeducationalmethodstoaddressthe
needsofconsumers12. Applyprinciplesofmanagementandservicedeliveryintheprovisionofoccupational
therapytoindividualsandorganizations.
LevelIIFieldworkStudentObjectivesDuringeachfieldworkexperience,thestudentwill:
1. Demonstrateappropriateworkplacebehaviorsatalltimes(gettingtoworkontime,adheringtofacilitydresscodes,aswellasfollowallproceduresdirectedbythefieldworksite)
2.Identifyhis/herprofessionalknowledge,skillsandbehaviors,andworktostrengthenperformance
3. Identifyhis/herownlearningstyleandusethefieldworkexperienceasalaboratorytocontinuetheeducationalprocessinoccupationaltherapypractice
4.Applyacademicknowledgetotheclinicalinterventionswithclients5.Recognizethetheoreticalinterventionmodelsusedintheassignedagencyand
applythesemodelsinpractice6.Collaboratewithhis/hersupervisorindevelopinglearningobjectivestomeet
his/herindividualneeds7.Assumeresponsibilitytoaccesstheresourcesnecessarytoplanningand
performingassignedduties8.Assumeincreasingamountsofresponsibilityforthecareofclients,gradually
requiringlesssupervision.Attheendofthefieldworkexperience,students
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shouldhavetheskillsofabeginningtherapistinthatsetting
9.Reportorallyondesignatedclientstosupervisor,occupationaltherapycolleagues,andotherstaffmembers
10.Submitcompleteandtimelydocumentation,adheringtocustomarypolicy(ies)ofthefieldworksite
11.Developinterpersonalrelationshipsconducivetotherapeuticgoalsonaone-toone(andgroupbasis,ifapplicable)
12.Utilizeconstructivefeedbacktodevelopaprofessionalidentitycongruentwiththeethicsofthehelpingprofessions,yetuniquetotheindividualpractitioner;and
13.MeetthespecificbehavioralobjectivesaswrittenbytheassignedagencyFieldworkProcessesTwolevelsoffieldworkeducationareestablishedintheStandardsofanAccreditedEducationalProgramfortheOccupationalTherapist(AccreditationCouncilforOccupationalTherapyEducation,2012).LevelIfieldworkisdesignedtodevelopabasiccomfortlevelwithandunderstandingoftheneedsoftheclients.LevelIIfieldworkisrequiredanddesignedtodevelopcompetent,entry-level,generalistoccupationaltherapists.LevelIIfieldwork:TheLevelIIfieldworkexperienceshallbeintegratedintotheprogram’scurriculumdesign,andshallincludeanin-depthexperienceindeliveringoccupationaltherapyservicestoclients.Studentswillfocusontheapplicationofpurposefulandmeaningfuloccupationandresearch,andtheadministrationandmanagementofoccupationaltherapyservices.Itisrecommendedthatthestudentbeexposedtoavarietyofclientsacrossthelifespanandtoavarietyofsettings.Thefieldworkexperienceshallbedesignedtopromoteclinicalreasoningandreflectivepractice.Itshouldalsotransmitthevaluesandbeliefsthatenableethicalpractice,andtodevelopprofessionalismandcompetence.TheSJSUOccupationalTherapyLevelIIfieldworkrequirementscorrespondwiththeAccreditationCouncilforOccupationalTherapyEducation(ACOTE)StandardsandInterpretiveGuide(AOTA,2011).StudentsarerequiredtocompleteaminimumofsixmonthsofLevelIIfieldwork;generally12weeksintwoclinicalsettingstotaling24weeksofmandatoryfull-timeexperience.ThestudentmaycompletetheLevelIIfieldworkexperienceinonlyonesettingoramaximumoffourdifferentsettings.Thismayalsobeonafullorpart-timebasis,butmaynotbelessthanhalftimeasdefinedbythefieldworksite.Thesettingsmaybetraditionaland/oremergingpracticesettings.Evenifthesettingisnotaclassicallydefinedpsychosocialplacement,psychologicalorsocialfactorsthatinfluenceclientengagementinoccupationshouldbeunderstoodandintegratedintothestudent’sexperience.AccordingtotheAccreditationCouncilforOccupationalTherapyEducation(ACOTE)StandardsandInterpretiveGuide(2011),“…onefieldworkexperience(eitherLevelIorLevelII)hasasitsfocuspsychologicalandsocialfactorsthatinfluenceengagementinoccupation.”
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ThestudentshallbesupervisedbyanOccupationalTherapistwhomeetsstateregulationsforlicensure(withatleast1yearfull-timeoritsequivalentofpracticeexperiencesubsequenttoinitialcertification),andwhoispreparedtobeafieldworkeducator.Inasettingwherethereisnooccupationaltherapistonsite(ie,andemergingpracticesetting),theprogrammustdocumentthatthereisaplanfortheprovisionofoccupationaltherapyservices.On-sitesupervisionmustcomplywiththeplanandstatecredentialrequirements.Theoccupationaltherapistmusthaveatleast3-years’full-timeoritsequivalentofprofessionalexperience.Thestudentmustreceiveaminimumof8hoursofoccupationaltherapydirectsupervisionperweek,includingdirectobservationofclientinteraction.Additionally,theclinicalsupervisormustbereadilyavailableforcommunicationandconsultationduringworkhours,andtheremustbeanon-sitesupervisordesigneewhiletheoccupationaltherapistisof-site.Thesupervisordesigneemaybefromanotherprofession.Suchfieldworkshallnotexceed12weeks.Duringeachclinicalfieldworkexperience,thestudentisassignedanacademicadvisor.Thispersonmaybetheacademicfieldworkcoordinatororanotherfacultymemberfromtheacademicprogram.Theacademicadvisorisresponsibleforcheckingonthestudent'sstatusduringtheaffiliation.Typically,theacademicadvisorwillcontactthestudentandtheclinicalsupervisoratthemid-termofthefieldworkexperience.Ifproblemsorconcernsareexpressedatthetimeofcontact,itistheacademicadvisor'sresponsibilitytoprovidesuggestionsforresolutionandtofollow-upasappropriatewiththestudent,fieldworkeducator,andacademicfieldworkcoordinator.Studentsareexpectedtomeetallsiterequirementsfortheirinitialpreparationincludingbutnotlimitedtohealthrequirements(includingallvaccinationsandproofthereof),backgroundchecks,drugscreens,respiratorfittests,HIPPAandothersitetraining/orientationdocumentationattheircost(unlessthefacilityprovideson-sitepreparationactivities).Generally,thestudentisresponsibleforprovidingtheirhealthrecordsdirectlytotheclinicalsite.SJSUrequiresastudenthealthrecordtoinclude:Lastphysicalexamination,HepatitisBseries,MMR,ChickenPoxvaccinationortiter,Tetanusshot,currentCPR,HIPPA/InfectionControlModule(verifiedbyinstructorsignature).Bytheendofeachfieldworkexperience,thestudentisexpectedtobefunctioningwithentry-levelgeneralistskills.Studentshavetheoptionofcompletingathirdaffiliationinaspecialtyareaoftheirchoice.Ifastudentelectstocompleteathirdaffiliation,thedatesofhergraduationoreligibilitytositforthecertificationexammaybeaffected.Specialarrangementscanbemadeforastudenttocompletefieldworkonapart-timebasis.SchedulingandConfirmationofStudentsforLevelIIFieldwork:StudentsfromSJSUarescheduledforLevelIIfieldworkexperiencesonayear-roundbasis.Typically,schedulingdatesfollowthosesuggestedbyAOTA.However,thedatesforfieldworkaresubjecttonegotiationbetweenthefieldworkfacilityandSJSU.AlistofAOTA’ssuggesteddatesforfieldworkcanbefoundattheAOTAwebsite,http://www.AOTA.org.RequestsforplacementofstudentsforLevelIIfieldworkwillbeemailedtotheclinicalcoordinatoratthefieldworkfacility.LevelIIfieldworkrequestsaretypicallyemailed12-15monthsinadvanceofthetimebeingrequested.Therequestformasksthattheclinicalcoordinatorresponds,eitherbyacceptingorrejectingtherequest,andreturnsonecopyoftheformbyemailorfax(408-924-3088).
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Acommentsectionisprovidedforadditionalcommunication.Ifaninterviewisrequiredfothestudentpriortoconfirmationoftheplacement,thisshouldbenotedinthecommentsection.Thestudentwillberesponsibleforcontactingtheclinicalcoordinatorand/orfieldworkeducatortoarrangeanyinterviews.Itisimportanttorespondtofieldworkrequestsassoonaspossible.Ifthestudentisnotaccepted,anotherplacementwillbesought.Onceastudentisconfirmedbythefieldworksite,SJSUwillemailmaterialtothesitepriortothestudent’sarrival.Inaddition,SJSUwillsend,viaregularmailacoverletterofacceptanceandtheAOTAFieldworkPerformanceEvaluation(FWPE)tothefieldworksite(thisdocumentcannotbeemailed,orcopied).HolidaysandAbsencesforLevelIIFieldwork:Holidaysaregrantedtostudentsinaccordancewiththepoliciesofthefieldworkfacilitywherethestudentisplaced.Studentsfromourprogramareallowed3daysabsencewithoutpenaltyforillnessoremergenciesonly.These3daysarenotintendedforuseasvacationdays.ThestudentisrequiredtomakeuptimeiffourormoredaysoftheLevelIIFieldworkexperiencearemissed.Optionsformakingupthismissedtimeincludeweekendoreveninghours,ifappropriate,oradditionaldaysaddedtotheendofthefieldworkexperience.ThefieldworkcoordinatoratSJSUshouldbenotifiedifastudentisrequiredtoarrangemakeuptime.FailureorWithdrawalofaStudentfromFieldwork:Occasionallyastudentwillexperiencedifficultyinmeetingexpectationsduringthefieldworkaffiliation.Shouldthissituationarise,thefieldworkeducatorshouldcontactthestudent'sacademicadvisorortheacademicfieldworkcoordinatorassoonaspossible.Dependingupontheseverityandnatureoftheproblem(s),acorrectiveplanshouldbecollaborativelydevelopedforasatisfactoryresolution.Bloxton(2001)recommendsestablishingaformalcontracttoindicatetheseriousnessofthesituation,providecleartimeframes,defineconsequences,andclearlyspecifyexpectationsofstudentperformance.Fieldworkeducatorsareencouragedtoidentifyspecificobjectiveproblemareas,outlinestrategiesforimprovement,andestablishspecificweeklygoalsforthestudent.CompletionoftheAOTAFieldworkPerformanceEvaluation(FWPE)isausefultoolforidentifyingproblemareasanddefiningspecificexpectationsforsatisfactoryperformance.Allinformationpertainingtoproblemareasshouldbedocumentedinwriting.Theacademicadvisororacademicfieldworkcoordinatorcanprovidethefieldworkeducatorwithusefultoolstoworkwiththestudent.Ifastudentrepeatedlyfailstomeetfieldworkexpectations,theclinicalexperiencecanbediscontinued.Beforefailingastudent,theFWPEmustbefullycompleted,asobjectivelyaspossible,tobesurethatscoringindeedreflectsthatthestudenthasnotmetcriterionlevelsforpassingthefieldworkexperience.AsummaryletteroutliningthereasonsforthediscontinuationshouldbewrittenbythefieldworkeducatorandforwardedtotheacademicfieldworkcoordinatoralongwiththecompletedFWPE.Astudentcanbewithdrawnfromfieldworkbeforethecompletionofthe12weeksofaffiliationifperformanceorbehaviorproblemsaresubstantialenoughtowarrantearlydiscontinuance.Thefieldworkeducatorshouldcontacttheacademicfieldworkcoordinatorbeforediscussingtheoptionofextendingtheaffiliationwiththestudent.Thefieldworkeducator'sprimaryresponsibilityis
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patientcare.Theclinicianhasanethicalresponsibilitytoensurethewelfareoftheclientpopulationtheyareserving.Anystudentwhoputstheclientatsevereriskcanbeimmediatelyterminatedfromthefieldworkaffiliation.Typically,thebreachingofpatientconfidentialityorputtingapatientindangerofextremephysicalinjuryisjustificationforimmediatetermination.Thefieldworkeducatorshouldclearlyidentifyforeverystudentallfacilitypoliciesregardingpatientconfidentialityandsafety.Ifastudentdeviatesfromfacilitypolicy,awarningshouldbegivenalongwithadditionalclarificationofexpectations.Furthernegligenceonthepartofthestudentshouldresultindiscontinuation.Thefieldworkeducatorshouldimmediatelycontacttheacademicadvisororacademicfieldworkcoordinatoriftheseissuesariseduringthestudent’saffiliation.Writtendocumentationofstudent’sbehaviorshouldbeprovidedtotheacademicprogram.AmericanswithDisabilitiesAct-AccommodationsDuringFieldworkFortheoccupationaltherapystudentwithadisability,makingthetransitionfromtheacademictoclinicalsettingcanpresentcertainchallenges.TheAmericanswithDisabilitiesAct(ADA)of1990andtheRehabilitationActof1973werepassedtopreventdiscriminationagainstindividualswithdisabilities.Theselawsobligateeducationalinstitutionsto"providereasonableaccommodationsforastudent'sknowndisabilityinordertoprovideanequalopportunityforsuchastudenttoparticipateintheinstitution'sservices,programs,andactivities"(Bersch,1995,p.3).TheADAalsostatesthatplacesofpublicaccommodations(suchasahospital)mustprovidereasonableaccommodationstoallowindividualswithdisabilitiestoparticipateinitsprograms.Ifaclinicalsettingacceptsstudentinternsforfieldwork,thisisconsidereda"program"whichmustprovideaccesstothedisabled(Kornblau,1996).“Enteringintoacontractualagreementtoserveasafieldworksiteforanoccupationaltherapyeducationalprogrambindsthesitetothesamerulesandregulationsoftheeducationalinstitutionastheyrelatetostudentswithdisabilities.Thiscontractualagreementmakesthesiteanextensionoftheeducationalinstitution”(Wells&Hanebrink,1998,p.39).Therefore,itistheresponsibilityofboththeacademicprogramandtheclinicalfieldworksettingtoprovidereasonableaccommodationsforstudentswithdisabilities.TheAmericanswithDisabilitiesAmendmentActof2008amendedtheAmericanswithDisabilitiesAct(1990).However,itretainsthedefinitionof"individualwithadisability"asanypersonwhohasaphysicalormentalimpairment,whichsubstantiallylimitsoneormoreofsaidperson'smajorlifeactivities(thatincludestanding,lifting,bending,learning,reading,concentrating,thinking,communicating).Theindividualmusthavearecordofsuchimpairmentorbegenerallyregardedashavingsuchanimpairment.Someexamplesofphysicalandmentalhealthimpairmentsinclude,butarenotlimitedto:epilepsy,orthopedicdisorders/diseases/conditions,amputation,neurologicaldysfunction,visionorhearingdeficits,respiratoryorcardiovasculardysfunction,diabetes,mentalretardation,emotionalormentalillness,drugaddiction,andlearningdisabilities.Notincludedaretemporaryand/orminorimpairments.Atransitoryimpairmentisonethatisexpectedtolast6monthsorless.Anindividual'sprotectionundertheADAandRehabilitationActistriggeredwhenthatindividualidentifieshimself/herselfashavingadisabilityandneedingaccommodation.Withrespecttofieldworkeducationaccommodations,theinitialresponsibilityisonthestudenttoprovidenoticetotheappropriateparties(Bersch,1995).TheacademicfieldworkcoordinatormustabidebyprivacylawsandADAconfidentialityrequirementswhichprohibitschoolsfromdisclosinginformationaboutastudent'sdisability(Wells&Hanebrink,1998).Onceastudentdisclosesa
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disablingconditiontotheacademicfieldworkcoordinatorandtothefieldworkeducator/supervisor,itistheresponsibilityofbothsitestodevelopreasonableaccommodationsforthefieldworkexperience.Studentswhofailtodisclosetheirdisabilitiesforfeitthebenefitsthataccommodationsprovide(Kornblau,1995).Withoutneededaccommodations,thestudentfacesthepossibilityoffallingbehindorevenfailinganaffiliation.However,accommodationscannotberetroactivelyapplied.Reasonableaccommodationsarethosethatreasonablyandeffectivelyachievethegoalofequalopportunityforparticipation.Accommodationsmustbebasedonindividualneed,notoncategoriesofdisabilities.However,noaccommodationmustbeprovidediftodosowould"fundamentallyalterthenatureoftheprogramoreliminateessentialrequirementsofaprogramorlicensingprocess"(Bersch,1995,p.5).Jobdutiesthatarefundamentaltothepositionareconsidered"essentialjobfunctions."Essentialfunctionsmustbeperformed,withorwithouttheprovisionofaccommodations.Forexample,anOTR'sessentialfunctionsmightbeevaluatingpatients,developinginterventiongoalsandprograms,andreportinginteammeetings.Reasonableaccommodationsincludechangesintheworkenvironmentorthewayworkiscustomarilyperformedthatenablethedisabledindividualtoperformtheessentialfunctionsofthejob.Anexampleofareasonableaccommodationwouldbemodifiedworkschedulesorprovidingaquietspaceinwhichtocompletedocumentationrequirementsofthefacility.However,theclinicalsiteoreducationalprogramisnotrequiredtoprovideaccommodationsthatcauseunduehardship.Unduehardshipreferstoaccommodationsthatareunreasonablycostly,disruptive,orfundamentallyalterthenatureoroperationofthefacility(Kornblau,1995). Themostcriticalcomponentofprovidingsuccessfulaccommodationstodisabledstudentsisopencommunicationbetweenallconcernedparties.StudentswithdisabilitieswhoareenrolledintheOTprogramatSJSUareapprisedoftheirrightsforaccommodationsasoutlinedbytheADAandRehabilitationAct.TheOTDepartmentworkscloselywiththeAccessibleEducationCenter(AEC)oncampustohelpstudent'sidentifyspecialneedsandrequirements.Ourstudentsarestronglyencouragedtodisclosetheirdisabilitytothefieldworkeducatorpriortobeginningthefieldworkexperience.Theyareadvisedtodiscussandplanforaccommodationneedswiththeclinicalcoordinatorand/orfieldworkeducatorbeforestartingtheinternship.Ofcourse,specificaccommodationswillvarydependinguponthedisabilityandtheindividualneedsofthestudent.Asanexample,astudentwithchronicbackproblemsmaynotbeabletoperformmaximumassisttransfers.Areasonableaccommodationofthisdisabilitymightberequiringthestudenttodemonstrateadequateknowledgeofpropertransfertechniquebybeingabletotrainfamilymembersorguideotherstaffmembersinpropertransfertechnique.Reasonableaccommodationsforthestudentwithlearningdisabilitiesmightincludeprovidingaquietspacetodocument,permittingthestudenttoaudiotapesupervisorymeetings,orallowingextratime(whichdoesnotinterferewithessentialjobfunctions)tocompletenecessarypaperwork.Duringastudent'saffiliation,ifanyproblemsorquestionsarisewhichpertaintoprovidingaccommodations,thefieldworkeducator/supervisorshouldpromptlycontacttheacademicfieldworkcoordinator.Allconcernedpartiescanworkcollaborativelytoopenlinesofcommunication,proposesolutions,andfosteranenvironmentgearedtowardsuccess.
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PreparingforyourstudentTheEssentialGuidetoFieldworkEducation-ResourcesforEducatorsandPractitioners(Costa,2015)talksaboutsupervisionas: a process aimedatensuringthesafeandeffectivedeliveryofoccupationaltherapyservicesandfosteringprofessionalcompetenceand development. This is acooperativeprocessinwhichtwoormorepeopleparticipateinajointefforttoestablish,maintain,andorelevatealevelofcompetenceandperformance.Supervisionisbasedonmutualunderstandingbetweenthesupervisorandthesuperviseeabouteachother’scompetence,experience,education,andcredentials.Itfostersgrowthanddevelopment,promoteseffectiveutilizationofresources,encouragescreativityandinnovation,andprovideseducationandsupporttoachieveagoal.FieldworkeducatorswhoareresponsibleforsupervisingLevelIIfieldworkinternsmustmeetstateandfederalregulationsthatdefineandgovernpractice.Theymusthaveatleast1yearofpracticeexperienceafterbeinginitiallycertified.Inaddition,theymustbepreparedtotakeontheroleofsupervisingfieldworkstudents.Clinical supervision of fieldwork students is considered a vital aspect of occupational therapy training. Thefieldworkexperienceshouldbedesignedtoprovideongoingsupportforstudentdevelopmentincluding:Guidedandgradedlearningexperiencesthatfosterstudentperformanceandclinicalreasoningskills,specificsitelearningobjectives,consistentformalandinformalevaluationofthestudent’sperformance,andongoingcollaborationwiththeacademicfieldworkcoordinator.Thestudentshouldhavetheopportunitytoparticipateinallaspectsofclientcarecustomaryatthatfacility.Differentapproachestosupervisionmaybeindicatedfordifferentstudents.Also,differentsupervisorsmaygravitatetowardsaparticularstyleorapproach.Thereisnosinglecorrectwaytohandleeveryproblemorsituation.Severalauthorshaveidentifiedcertaintechniquesorapproaches,whichareusefulforsupervisingstudents.Thefollowingsectionoffersabriefdescriptionofsuggestedapproachesandprovidesreferencesforfurtherinquiry.ApproachestoClinicalSupervision:Variousmodelsofoccupationaltherapyclinicalsupervisionhavebeendescribedintheliterature.Schwartz(1984)describedamethodofsupervisionofOTstudentsonclinicalaffiliationbasedonstagesofpersonalitydevelopment(conscientious,explorer,andachiever).Schwartzproposesthat"knowledgeofastudent'sdevelopmentallevelcanaidtheclinicalsupervisorindesigningandfosteringthelearningexperience"(p.393).FrumandOpacich(1987)describefourelementsessentialtothesupervisoryprocess:thesupervisor,thesupervisee,therelationshipbetweentheseindividuals,and theenvironmentinwhichthisinteractionisoccurring.TheFrumandOpacichmodeldescribesstudentsduringfieldworkasgoingthroughthreedevelopmentalstages:stagnation,confusion,andintegration.Theclinicalsupervisorfunctionstoenhancestudents’growthwithineachdevelopmentalstage,promotetransitionfromonestagetoanother,andevaluateperformance.
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GarrettandSchkade(1995)proposetheuseoftheOccupationalAdaptationModelofProfessionalDevelopment(OAMPD)asaframeworkfordescribingandunderstandingtheprocessthroughwhichstudentsachieveidentifiedfieldworkobjectives.Thismodeldescribesthreeclassesofadaptiveresponsebehaviorsavailableforstudentuse:primitive,transitional,andmature.Despitedifferentconceptualframeworks,allofthesesuggestedsupervisionmodelsidentifythefieldworkeducator’sroleascriticalinfacilitatingstudentdevelopmentduringthetransitionfromclassroomtoclinicalsetting.Knowledgerelatedtothestudent'scognitivedevelopment,personalitydevelopment,oradaptiveresponsebehaviorsmayenablethesupervisortodesigninterventionstoadaptthefieldworkexperiencethatenhancesstudentclinicalgrowthanddevelopment.DefiningtheCharacteristicsofanEffectiveFieldworkEducatorSeveralreferencesintheoccupationaltherapyliteraturediscussclinicalsupervisionandeducation,includingtheidentificationofthecharacteristicsofaneffectiveclinicalsupervisor.Someofthesereferencesarelistedinthebibliography.Ataseriesofmeetings,SanJoseStateUniversityOccupationalTherapyClinicalCouncilmembersdevelopedalistofcharacteristicsoftheeffectivefieldworkeducator.Thesearenotnecessarilytheirown,nornecessarilydifferentfromthoseintheliterature,butrepresentativeoftheirpersonalexperience.ThisinformationwascompiledbyJeanStill,MS,OTR,aformerFieldworkCoordinatoratSanJoseStateUniversity,andwasprovidedinapreviousOTFieldworkSupervisors’Manual(1991).Thisisbynomeansanexhaustivelist,norisitintendedtointimidatethenovicesupervisor.Itisaguidetohelpinidentifyingstrengthsandweaknesses,andcharacteristicsareidentified,notnecessarilyinorderofimportance:
1. GoodCommunicator-activelistener;asksopen-endedquestions;encouragesproblemsolving;givesconstructive,timelyfeedback,bothverballyandwritten;openandhonest.
2. Supportive/Sensitive-encouragesquestioning;enthusiastic;honest;objective;rewardsgoodperformance;empathetic;flexible;abletorecognizestudentsneedsandadjustsstructuretomeetthem;allowsthestudentspaceforreflection(AppendixA)
3. Guidesthelearningprocess-fromsimpletocomplex,realisticassignments;willingtoshareknowledgeandresources;abletoexplainclinicalreasoning;encouragesproblemsolving;motivatesstudenttogrowandlearn;abletousediverseteachingstrategies;recognizesdifferentlearningstylesandadjustsaccordingly
4. Organized-objectivesareclearandrealistic;providesadequatestructure;setsasidetimeforsupervisionandrespectsthattime;preparesforsupervisionsessions.
5. Competentclinician-servesasapositiverolemodel;knowslimitations;reliableandprompt;keepsup-to-datebyreadingprofessionalliteratureandattendingworkshops.
ProvidingFeedbacktotheStudentandtheSchoolTheAOTAFieldworkPerformanceEvaluation(FWPE)istobecompletedbythefieldworkeducator(s).ThestudentmustcompletetheAOTAStudentEvaluationofFieldworkExperience(SEFWE).TheFWPEmustbecompletedbothat6and12weeks(midtermandfinal).Ifthefieldworkeducatorhasconcernsatmidterm,itmaybehelpfultoinformallyscoretheFWPEagainat8and10weeks.Thishelpsclarifygainsthestudenthasmadeandcanbeusedtosetminimumstandardsofperformancethatmustbemetbytheconclusionoftheexperience.Thisfosterscommunication
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withthestudentandhelpstoavoidunanticipatedresultswhentheevaluationisscoredforthefinaltimeattheconclusionofthe12-weekfieldworkexperience.TheSEFWEwasdesignedtoallowstudentstoprovidefeedbackabouttheirfieldworkexperiencetothefieldworkeducator,theacademicfieldworkcoordinatorandotherstudentsinthefieldworkprogram.TheSEFWEshouldbecompletedbythelastdayoftheclinicalexperience.Theformhasthestudentdiscussthestructureofthefieldworkprogram(i.e.orientation,assignments,descriptionofcaseload,therapeuticinterventions,anddiagnosticcategories).Perceptionsofsupervision,perceptionsofacademicpreparation,andrecommendationsforchangesorimprovementstotheoverallfieldworkprogramarealsodiscussed. ThestudentisexpectedtocompletetheSEFWEpriortothefinalmeetingwithherclinicalsupervisor.Thestudentshareshis/herfeedbackwiththefieldworkeducator(s)andboth/allpartiessigntheform.Onecopyremainsatthefieldworksite,andonecopyisreturnedtotheacademicprogram.Ameetingbetweenthestudentandfieldworkeducator(s)shouldbescheduledforreviewofbothforms.BoththestudentandtheclinicalsupervisormustsigntheFWPEandtheSEFWE.Theoriginalsofeachformaretobemailedtotheacademicfieldworkcoordinator(OTDepartment—SJSU).Copiesoftheseformsshouldbekeptbyboththeclinicalcoordinator,andthestudent.ItisrecommendedthataletterbeattachedtothefinalFWPEthatsummarizesthestudent'sperformanceduringthefieldworkexperience.Thepracticesettingandclientpopulationshouldbeidentifiedandthestudent'sparticularstrengthsandareasforimprovementdescribed.GradingforLevelIIfieldworkiscredit/nocreditatSJSU.SJSUusestheAOTAFieldworkPerformanceEvaluation(FWPE)forthefieldworkeducatortoevaluatestudentperformanceinLevelIIfieldwork.TheprimarypurposeoftheFWPEistomeasureentry-levelcompetenceoftheoccupationaltherapystudent.Theevaluationisdesignedtomeasurethespecificoccupationaltherapyprocessandwasnotdesignedtomeasurethespecificoccupationaltherapytasksinisolation.Thefieldworkeducator(s)completesandsubmitstheFWPEtotheacademicfieldworkcoordinatoratthecompletionoftheinternship. ResourcesforFieldworkEducatorsModelsofFieldworkEducation-SupervisionApproachesHistorically,occupationaltherapistshaveusedaone-to-oneapproachwhich,accordingtoTheEssentialGuidetoOccupationalTherapyFieldworkEducation(Costa,2015)isalsotermedthe‘TraditionalApprenticeshipModel”(p.12)tofieldworksupervision.Inthismoretraditionalmodel,onefieldworkeducatormodelsexpectedbehaviorsandcompetenciesforonestudent.Thestudentgraduallyassumesgreaterresponsibilityforclientcare.Thisapproachtosupervisionhasbecomelessviableinmanycurrentfieldworksettings.Thisisdueprimarilytothetremendousimpactofmanagedcareonhealthcaredeliverysystemsaswellasthedramaticincreaseinthenumbersofoccupationaltherapystudentsneedingfieldworkplacements(Cohn&Crist,1995).Themanagedcaresystemhashadaprofoundimpactonthehealthcareprovider'spracticeenvironment.Toreducecostsandstreamlineservices,healthcareorganizations(i.e.hospitals,privatepractices)havereducedworkforces,tightenedthescopeofservice,andredesigned
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programs.Whilethesechangeshavebeendesignedtoimprovethedeliveryofhealthcareservices,theyhavealsoresultedinrigorous,stressful,andfrequentlydisruptiveworkenvironments.Manyhealthcareprogramshavedissolved,merged,orreducedstaffingpatternsinordertoremaincompetitive(Brayman,1996).Asaresult,theroleofthefieldworkeducatorinthisnewhealthcaresettinghaschanged.CohnandCrist(1995)statethatfieldworkeducators"mustensurethatoccupationaltherapystudentsarewellpreparedtoreasonthroughthecomplexandchangingdemandsoftoday'shealthcareenvironment"(p.105).Theoccupationaltherapistworkinginthisnewenvironmentmustbepreparedtoadjusttoworkinginnewsettingswithdifferentpopulationsandmustbepreparedtoacquirenewskillsandadapttochangingtechnology(Brayman,1996).Thereisagreatdemandforoccupationaltherapyfieldworkplacements.Theincreasednumberofqualifiedoccupationaltherapystudents,andtheadditionofnewlydevelopedoccupationaltherapyeducationprogramsnationwide,hasmadeitdifficulttosecurefieldworkplacements(Hamlin,MacRae&DeBrakeleer,1995).Ourchanginghealthcaresystemhasplacedfurtherdemandsupontheavailabilityoffieldworksites.CohnandCrist(1995)statethat"astheessentialbridgebetweenacademicandservicedeliverysettings,fieldworkeducatorstakealeadingroleinshapingthefutureofourprofessionbyguidingnewgenerationsofoccupationaltherapiststhroughthesechangingtimes"(p.105).Severalalternativestothetraditionalone-to-onesupervisionmodelhavebeensuggested.Abriefdescriptionofsomealternativefieldworkeducationmodelsfollow.Youareencouragedtoreviewthisinformationandrefertothebibliographyforadditionalpublicationspertainingtothesealternativemodels. Inthe1:2Model(Costa,2015,p.12),thefieldworkeducator/supervisoroverseestwoormorestudentsatonetime.Thismodelmustbecarefullydesignedsothatthestudentsworkcloselytogether,collaboratingtosolveproblems.Thefieldworkeducatormustdevelopclearandconciseobjectives,teachproblemsolvingskills,andprovidelearningactivitiesforthestudentsthatwillfostercollaboration.Althoughatfirstthismodelmayseemmorelaborintensivetothefieldworkeducator,inactuality,thefieldworkeducatorfrequentlyspendslessoveralltimeinsupervisionthanintheone-to-onemodel.Thestudentsuseeachotherasresourcesbeforetakingissuestothefieldworkeducator. Feedbacktendstobenon-threateningandeasiertoacceptfromapeerthanfromasupervisor.Studentslearngreaterteamworkskillsandgainexpandedperspectiveastheyutilizeeachother’sknowledgebaseandproblemsolvingskills. Inthe2:1orSharedClinicalPlacementModel(Costa,2015,p.12),twofieldworkeducators/supervisorssharetheresponsibilityforprovidingsupervisiontooneormorestudents.Thismayinvolveonefieldworkeducatormentoringthestudentduringthefirstsixweeksofinternship,followedbyanothersupervisormentoringduringthelatterhalfoftheaffiliation.Part-timeOTRstaffmaysharesupervisionresponsibilitiesthroughouttheaffiliation.Studentshavetheopportunitytobeexposedtomultipleclinicalstylesandproblemsolvingapproaches.Thesupervisorshaveanopportunitytocollaboratewitheachotheroverproblemsthatariseandhavesomeonewithwhichtosharesupervisoryresponsibilities. The Role-Emerging Model (Costa, 2015) is used where occupational therapy services are in development. The fieldwork educator may be hired by the site, or the academic program. The fieldwork educator is generally not at the site on a regular basis, but other qualified staff provide the supervision when the occupational therapy fieldwork educator is not on-site (p.13). WhentheOTfieldworkeducatorispart-time,otherprofessionalstaffattheclinicalsettingmustassumesomedegreeof
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responsibilityforthesupervisionofthefieldworkstudent.Theoccupationaltherapyfieldworkeducatormustprovideaminimumof8hoursofdirectsupervisionandmustmeetwiththestudentweeklytodiscussprogress.BossersandHartley(1999)studiedstudents’reactionstofieldworkplacementswithpart-timesupervision.Theresultsofthisstudyfoundthatthepart-timesupervision/full-timestudent(PTT/FTS)modelinherentlychallengesthestudenttotakeresponsibilityfortheirownlearningneeds.Studentsperformedwellifthefollowingfactorswerepresent:•autonomy(studentneedstobeself-directed)•opportunitiesforhands-onpractice•positivestudent-educatorrelationship(p.131)Forthemodelofthepart-timesupervisortoworksuccessfully,non-OTpersonnelmustbeknowledgeableofOTservicesandmustcollaboratecloselywiththeclinicalsupervisor.Studentshavetheopportunitytoworkcloselywithotherdisciplinesanddevelopteam-buildingskills.Inaddition,provisionofOTserviceshasthepotentialtobeexpandedthroughinvolvementofafull-timestudentintheclinicalprogram.IntheCommunityBasedFieldworkModel,studentaffiliationsarearrangedincommunityagenciesthattypicallydonotemployanoccupationaltherapist.Often,afacultymemberoftheacademicprogramprovidessupervision.Thismodelmustbewellplannedandorganizedbeforeimplementation.Thefacultymemberandateamofstudentsgoouttoacommunitysettingandprovideservicestopersonswhodonothaveaccesstooccupationaltherapy.ThisisofteninitiatedasaLevelIfieldworkexperiencebutcandevelopintoaLevelIIfieldworkexperienceovertime.Studentshavetheopportunitytoworkcloselywithfacultysupervisors,andfacultyvaluetheopportunitytomodelprofessionalskillsandbehaviorstostudents.Occupationaltherapyservicesareexpandedtonewareas.Recipientcommunitiesandagenciesreportcontinuedinterestandsupportfortheseprograms(Rydeen,Kautzmann,Cowan&Benzing,1995).TheRemoteOTSupervisionModelissimilartothecommunity-basedmodel.Studentsareplacedinasettingthatdoesnothaveoccupationaltherapyservices.Acontractedoccupationaltherapistprovidessupervisiononaremotebasis.Thefieldworkprogrammustbedevelopedwhichclearlyguidesweeklylearningobjectives.Supervisionisprimarilyprovided"off-site"throughphonecalls.However,theclinicalsupervisormustprovideaminimum of 8 hours of direct supervision andmustmeetwiththestudentweeklytodiscussprogress.Frequently,morethanonestudentwillbeplacedintheaffiliationsetting.Studentsneedtobecarefullyscreenedforappropriatenessforthistypeofmodelandneedtobefullypreparedinadvanceofstartingtheaffiliation. Herge&Milbourne(1999)presentaself-directedlearningmodelforLevelIfieldwork.Inthismodelanon-OTprofessionalprovidedon-sitesupervisionandfacultymemberswerethefieldworkeducators.Studentswererequiredtodevelopalearningcontractwhichincludeslearningobjectives,resources,andstrategiestomeettheobjectives,evidenceofaccomplishment,atimeline,andadescriptionofthestudents’expectationsoftheoff-sitefieldworkeducatorandtheon-sitesupervisor.Themodelwasdesignedtofacilitatethestudent’scriticalthinkingskills,abilitytodefinegoalsandtomanagetimeeffectively(Herge&Milbourne,1999).Theauthorsfoundthatstudentsmovedfrompassiveparticipationtoinitiationandbecameleaderswithingroupmeetings.
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EstablishingaClinicalEducationProgramIfyouareconsideringstartingastudentfieldworkprogram,therearesomestepsyoushouldtakeinpreparation(adaptedfromtheGuidelinesforanOccupationalTherapyLevelIIFieldworkExperience–AOTA.Availableon-line.
• Conductananalysisoftheoccupationaltherapyprogram(s)atyourfacility,includingtypesofOTservicesprovided,clientpopulationandcaseload,andavailablelearningopportunities.
• Reviewthepotentialcostsandbenefitsofprovidingafieldworkeducationprogram• Assessyourfacility'sphilosophyandreceptivenesstowardastudentprogram.Doesyour
administrationsupportthedevelopmentofafieldworkprogram?• ContactAOTAandrequestacopyoftheCommissiononEducation:Guidelinesforan
OccupationalTherapyLevelIIFieldworkExperience.Thisresourceprovidesdetailedinformationpertainingtotheprovisionoffieldworkeducation.
Oncethesepreliminarystepshavebeentaken,contactanoccupationaltherapyeducationprogram(s).Letthemknowofyourinterestinprovidingfieldworkexperiencesfortheirstudents.DevelopingaStudentProgramThedevelopmentofastudentfieldworkprogramisthemostcriticalcomponentofestablishingasuccessfulfieldworkexperienceatyourfacility.Thefollowingstepsaresuggestedfordevelopingastudentprogram:
• Developperformanceobjectivesforyourstudents.Theseobjectivesserveseveralpurposes.Theyserveasaguideinplanninglearningexperiencesforthestudentandprovideinformationtothestudentregardingperformanceexpectations.YouneedtoconsidertheobjectivesidentifiedontheAOTAFieldworkEvaluationfortheOTsinceyouwillbeusingthisformtoevaluateyourstudents.
• Askyourself,“HowcanIachievetheseobjectives?”Whateducationalexperiencescanbeofferedthatwillleadtothestudentlearningexpectedskills?Identifygoalsandexpectedcompetenciesforthestudentonaweeklybasis.
• Thinkaboutyourevaluationofthestudent.Ifyourperformanceobjectivesareclearlydelineated,thejobofevaluatingthestudentisgreatlysimplified.Ifyouhavespecificobjectivesagainstwhichtomeasurethestudent’sachievement,youcaneffectivelycounselthestudentduringsupervisorymeetings.
• Developastudentmanualthatoutlinestheweeklyperformanceobjectives.Alsoincludegeneralinformationtoorientthestudenttopoliciesandproceduresofyourfacility.Itishelpfultoprovideinformationpertainingtoexpectationsofstudentbehavior,specificstudentresponsibilities,andanystudentassignments.Providesamplesofdocumentation,weeklyscheduling,thesupervisoryschedule,andpatientevaluationtools/testsusedatyourfacility.
• Developessentialfunctionsofthejobforastudentintern.Describethejobwithtermsstatingtaskstobeperformedversusmethodstoperformthetasks.Considerissuessuchasstaffandclientsafety,therapeuticinteractionanddocumentationneedswhenestablishingessentialsofthejob(Wells&Hanebrink,1998).Scott,Wells,andHanebrink(1997)provide
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examplesofhowessentialsmaybewrittenandresourcestoaddressissuesofprovidingequalopportunitytoallstudents.Developingessentialfunctionsofthejobwillhelpthefieldworksitetodetermineaccommodationsneededforpotentialstudents.AnexcellentresourcetoutilizefordevelopmentofastudentprogramisTheReferenceGuidetoFieldworkEducationandProgramDevelopment(PhiladelphiaRegionFieldworkConsortium,1997).
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AppendixAStudentManual:TheAmericanOccupationalTherapyAssociationrecommendsthefollowing
contentforastudentmanual(Costa,2015):
1. Orientationoutline
2. Assignments
3. Safetyproceduresandcodes
4. Behavioralobjectives
5. Week-by-weekscheduleofresponsibilities
6. Patientconfidentialityinformation(patientrights)
7. Guidelinesfordocumentation
• Samplesofforms
• Medicalterminology
• Billing
• Dischargeplanning
8. OccupationalTherapyPracticeFramework:DomainandProcess,3rdEdition
Therearealsorecommendationsforadditionalinformationthatcanbeaddedovertime,and/oras
yourprogramexpands(toincludebutnotlimitedto):
1. Organizationalchartofthefieldworksetting
2. Historyofthefieldworksetting
3. Departmentinformation
• Policiesandprocedures
• Essentialjobfunctions
• DressCode
4. Scheduleofmeetings
5. Specialtyprograms
6. Documentationguidelines
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AppendixB
Questionstopromotereflection(Canning,1991)
• Canyoutalkmoreaboutthat?
• Whydoyouthinkthathappens?
• Whatevidencedoyouhaveaboutthat?
• Whatdoesthisremindyouof?
• Whatifithappenedthisway?
• Doyouseeaconnectionbetweenthisand___________?
• Howelsecouldyouapproachthat?
• Whatdoyouwanttohappen?
• Howcouldyoudothat?
Affirmationsthatsupportreflection(Canning,1991)
• Youcanexperimentandexplore.Iwillhelpyou.
• Youcanlearnfromwhatdoesnotworkforyou.
• Youcanfindawaythatworksforyouwhenyouareready.
• Youcanchangeifyouwantto.
• Youcangrowatyourownpace.
• Youcanknowwhenyouneedandaskforhelp.
• Youcanfeelyourfeelings.
• Yourneedsandreflectionsareimportant.
• Iliketalkingtoyoulikethis.
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