Fieldwork Educator: �Nuts and Bolts�2022

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Julie Jacob, MSOT, OTRL

Sheila Guiao, MSOT, OTRL

Wayne Doyle, DHSC, COTAL, PTA

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Housekeeping

• Audio settings
• Tech issues: seek assistance through…
• Questions
• Certificates

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Today’s Topics

• Purpose & Goals of Fieldwork
• Starting a Fieldwork Program
• Student Supervision
• Professional Behavior
• Feedback & Evaluation Tools
• Formal Evaluation
• Accommodations vs. Adjustments in Fieldwork

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Purpose & Goals of Fieldwork

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Purpose of Fieldwork Education

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Fieldwork Abbreviations

ACOTE = Accreditation Council of Occupational Therapy Education

FWEd = Fieldwork Educator

AFWC = Academic Fieldwork Coordinator

FWPE = Fieldwork Performance Evaluation

SEFWE = Student Evaluation of Fieldwork Experience

NBCOT = National Board for Certification in Occupational Therapy

EBP = Evidence-Based Practice

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Fieldwork Education Guidelines

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Fieldwork Settings

• Medical, educational, home & community-based programs

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• Emerging practice environments

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• AFWC has to ensure a VARIETY of types of experiences (Level I and Level II)

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What are the benefits of hosting students?

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Benefits of Hosting Students

• Exposure to current practice trends, EBP, and research
• 1 PDU for each week of fieldwork supervision provided toward NBCOT recertification & state licensure
• Recruitment of qualified personnel

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Who Can Supervise Students?

• Level I: A variety of qualified personnel.
• OT practitioners
• Teachers
• Nurses
• Social Workers
• Physical Therapists
• Physician’s assistants

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Who Can Supervise Students?

Level II: Primary supervisor must be OT practitioner who meets state regulations & has a minimum of 1 year practice experience subsequent to initial certification

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• OT Student: Occupational Therapist

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• OTA Student: Occupational Therapist or Occupational Therapy Assistant

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Other professionals can also participate in student supervision

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Level I Fieldwork Goals

• Help students develop a basic comfort level with evaluating and treating the needs of clients.

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• Offer hands-on experience before Level II Fieldwork.

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• Enrich didactic coursework through directed observation and participation in selected aspects of the OT process.

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• Objectives/projects vary by academic institution.

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Level II Fieldwork Goals

• Develop competent, entry-level, generalist (OT and OTA) skills.

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• Provide opportunities to integrate academic knowledge with the application of skills in a practice setting.

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• Full-time placement:
• OT: 12 weeks
• OTA: 8 weeks

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Psychosocial Requirement

• Standard C.1.7.
• At least one fieldwork (either Level 1 or Level 2) must address practice in behavioral health, or psychosocial and social factors influencing engagement in occupation.

• Standard C.1.3.
• ...Ensure that fieldwork objectives for all experiences include a psychosocial objective.

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Starting A Fieldwork Program

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Accreditation Requirements

ACOTE Standards�

• C.1.2 Criteria and Process for Selecting Fieldwork Sites
• Document the criteria and process for selecting fieldwork sites, to include maintaining memoranda of understanding, complying with all site requirements, maintaining site objectives and site data, and communicating this information to students prior to the start of the fieldwork experience.

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• C.1.3. Fieldwork Objectives
• Document that academic and fieldwork educators agree on established fieldwork objectives prior to the start of the fieldwork experience, and communicate with the student and fieldwork educator about progress and performance throughout the fieldwork experience. Ensure that fieldwork objectives for all experiences include a psychosocial objective.

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ACOTE Standards

• C.1.8. Qualified Level I Fieldwork Supervisors
• Ensure that personnel who supervise Level I fieldwork are informed of the curriculum and fieldwork program design and affirm their ability to support the fieldwork experience. This must occur prior to the onset of the Level I fieldwork. Examples include, but are not limited to, currently licensed or otherwise regulated occupational therapists and occupational therapy assistants, psychologists, physician assistants, teachers, social workers, physicians, speech language pathologists, nurses, and physical therapists.

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• C.1.11. Qualified Level II Fieldwork Supervisors
• Document and verify that the student is supervised by a currently licensed or otherwise regulated occupational therapist who has a minimum of 1 year full-time (or its equivalent) of practice experience as a licensed or otherwise regulated occupational therapist prior to the onset of the Level II fieldwork. Ensure that the student supervisor is adequately prepared to serve as a fieldwork educator prior to the Level II fieldwork. The supervising therapist may be engaged by the fieldwork site or by the educational program.

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ACOTE Standards

• C.1.13. Level II Fieldwork Supervision
• Ensure that Level II fieldwork supervision is direct and then decreases to less direct supervision as appropriate for the setting, the severity of the client’s condition, and the ability of the student to support progression toward entry-level competence.

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• Key words = prior to start/onset

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Role of the �Academic Fieldwork Coordinator (AFWC)

• Responsible for the program’s compliance with the fieldwork requirements
• Must be a licensed or credentialed occupational therapy practitioner
• Fieldwork sites must reflect the sequence, depth, focus, and scope of content in the curriculum design

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Preparing to be a �Fieldwork Educator (FWEd)

• Have a desire to support the growth of future practitioners.
• Collaborate with academic program(s)
• Identify mentors within your facility or the profession
• Familiarize yourself with the objectives of the specific academic program & level of fieldwork.
• Familiarize yourself with the OT Practice Framework: Domain & Process (AOTA, 2020)

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Starting a Fieldwork Program

• Establish a fieldwork contract/student placement agreement
• Develop student resources:
• Fieldwork data form
• Site specific learning objectives
• Student manual
• Schedule of weekly activities
• Prepare a student orientation
• Most schools will provide a timeline of suggested experiences for the fieldwork (Level I or II)

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Creating a Fieldwork Manual

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Recommended Content for a Student Fieldwork Manual

• Orientation Outline and checklist
• Assignments
• Site Specific Objectives
• Week-by-Week Schedule of Responsibilities
• Patient Confidentiality Information (Patient Rights)
• Guidelines for Documentation (completed samples of forms, acceptable medical abbreviations, discharge plan, billing, dictation directions)
• The Occupational Therapy Practice Framework (4^th Edition) reference
• Have students help create and build upon!

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Continuing Education: Fieldwork Educator Role

• State conferences
• MOTEC Fieldwork Educator Days
• AOTA’s National Conference
• Attend AOTA’s Fieldwork Educator Certificate Workshop ($225/members, $359/nonmembers)

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Student Supervision

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Examine Your Own� Level II FW Experiences

• Positives: Can you recall some positive supervisory styles that your FW Educator used with you?
• Negatives: Can you recall some negative experiences or feelings that you felt your FW Educator could have facilitated better?

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Factors Affecting �Your Supervision Style

• Knowledge Base of student
• Prior experience or knowledge in that task
• Level I Fieldwork Experience
• Student Learning Style:
• hands on vs. visual vs. audio
• Motivation Level:
• Seek out what motivates this individual to succeed

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Working with Different Types of Students

• Silent Generation (1925 - 1942)
• Baby Boomers (1943 - 1960)
• Generation X (1961 - 1981)
• Millennials (1982 - 2005)
• Generation Z (2006 - 2015)

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Time frames vary among resources.

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Each generation has its own unique learning requirements.

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MOTEC: �Your Fieldwork Lifeline

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Professional Behaviors:

Fieldwork Students

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Professional Behaviors

• Academic Institution Initiatives:
• Formal self assessment
• Formal feedback as part of didactic course
• From instructor and/or peers
• Informal feedback
• Level I Fieldwork evaluations
• Specific section on the AOTA FWPE for Level II Fieldwork

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Professional Behavior Policies

• Include policies on the following in student manual & discuss during orientation

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• Professional Presentation (Dress Code)
• Cell Phone Use
• Social Media Use
• Confidentiality
• Others?

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Professional Behavior Concerns

• It is important to remember that professional behaviors make up a portion of a student’s performance during fieldwork (both Level I and Level II).

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• Any concerns related to professional behaviors should be communicated to the academic fieldwork coordinator.

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• Professional behavior concerns should also be addressed immediately with the student so they can make appropriate modifications.

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Student Feedback and Evaluation Tools

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Providing Student Feedback

• Begin positive
• Well-timed and expected: tell student when/how you will be giving them feedback
• When: after each session, before lunch, end of day, end of week
• How: verbally, written assessments, weekly logs

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Weekly Meeting Form

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Strengths

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Growth Areas

Goals/Assignments for next week

Feedback on Supervision

• Helpful vs. Unhelpful

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Suggestions for Providing Feedback I

• Be specific: based on first-hand or observed data, not another therapist, aide or front desk personnel
• Use the Behavior words in the feedback (3^rd person) Avoid “you” statements
• Specific Feedback

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Suggestions for Providing Feedback II

• Be certain your motive is to be helpful
• Phrase in descriptive, nonjudgmental language (use “I” statements)
• Be immediate
• Be private
• Avoid assumptions
• Clarify the students’ perceptions

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Suggestions for Providing Feedback III

• Suggested Statements
• Continue…comment on aspects of performance that were effective. Be specific, and describe impact. Highlight things you would like to see be done in the future. Make clear your expectations. (Give examples)

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• Start, or do more…Identify behavior the student knows how to do, could do, or could do more often.

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Suggestions for Providing Feedback IV

• Consider…Highlight a point of growth for the learner, a “doable” challenge for future interactions.

• Stop, or do less…Point out actions that were not helpful or could be harmful. Be specific, and indicate potential impact.

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Formal Evaluation

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AOTA FWPE:�Fieldwork Performance Evaluation

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FWPE Rating Scale

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NO HALF SCORES!!

FWPE – Total Scores

OT Students

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FWPE – Total Scores

OTA Students

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Learning Contracts

• Who writes them?
• Decide the “name” of the document
• Include:
• dates, outcomes, measurements, resources,
• processes/strategies, target date for completion,
• signatures from Student and FW Educator, AFWC

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Accommodations vs. Adjustments in

Fieldwork

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Accommodations

• “Reasonable” resources and services mandated by law to be made available to a student with a documented disability.
• Goal is to “level” the playing field, not to give an advantage to the student.

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Accommodation Laws

• Section 504 of the Rehab Act of 1973
• Applies to entities that are recipients of federal funds
• Prohibits discrimination on the basis of disability

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Accommodation Laws

• Americans with Disabilities Act of 1990 (ADA)
• Applies to public and private employers

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FERPA

Family Education Rights &Privacy Act

• applies to all institutions receiving federal funding
• protects privacy of student’s educational records
• prevents disclosure
• student signs waiver

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“Reasonable”

Accommodation

• Does not put an undue financial hardship on the facility.
• Does not change the overall requirements.
• Does not put a time commitment hardship on the facility.

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Who is Responsible

• Accommodations are a shared obligation between the student, fieldwork site, and the educational institute.

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Adjustments

• Adjustments are resources (that are not legally mandated) that are provided to all students (regardless of ability) by a fieldwork educator or fieldwork site to ensure a student’s success.

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Adjustment Examples

• A little extra time for documentation
• Allow time for prayer
• Making directions clear
• Providing feedback in multiple formats
• Ability to start day a little early to allow more time for chart reviews

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Key Takeaways

• Both accommodations and adjustments still hold all students to the required learning standards
• FWEd and students should discuss what is needed for a successful fieldwork

environment.

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Resources

• AOTA fieldwork education resources online: http://www.aota.org/Education-Careers/Fieldwork.aspx

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• NEOTEC:

http://neotecouncil.org/

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• Site-Specific Objectives Templates:

https://www.aota.org/Education-Careers/Fieldwork/SiteObj.aspx

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• AOTA Fieldwork Data Form Templates: https://www.aota.org/Education-Careers/Fieldwork/Supervisor.aspx

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References

Canavan, C., Holtman, M., Richmond, M., Katsufrakis, P. (2010). The quality of written comments on professional behaviors in a developmental multisource feedback program. Academic Medicine, 85 (10): 106-109.

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Cullen, M. W., Reed, D. A., Halvorsen, A. J., Wittich, C. M., Kreuziger, L. M. B., Keddis, M. T., ...Beckman, T. J. (2011). Selection criteria for internal medicine residency applicants and professionalism ratings during internship. Mayo Clinic Proceedings, 86(3), 197+.

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Ginsburg, S., Regehr, G., Lingard, L. (2004). Basing the evaluation of professionalism on observable behaviors: a cautionary tale. Academic Medicine, 79(10): S1 – S4.

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Evenson, M. E., Roberts, M., Kaldenberg, J., Barnes, M. A., & Ozelie, R. (2015). National survey of fieldwork educators: implications for occupational therapy education. AJOT: American Journal of Occupational Therapy, 69(S2).

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MacDonald, C., Cox, P., Bartlett, D., Houghton, P. (2002). Consensus on methods to foster physical therapy professional behaviors. Journal of Physical Therapy Education, 16(1): 27-36.

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Scheerer, C. (2003). Perceptions of effective professional behavior feedback: occupational therapy student voices. American Journal of Occupational Therapy, 57, 205 – 214.

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