2002 LEVEL II FIELDWORK MANUAL

FIELDWORK EDUCATORSFieldwork LEVEL II and OTD Doctoral Experiential Component MANUAL

WASHINGTON UNIVERSITY SCHOOL OF MEDICINE

PROGRAM IN OCCUPATIONAL THERAPY

St Louis, MO

Table of Contents

AOTA Position Paper: Fieldwork Level II and OT Students (2012)…………………….……..3 - 5

· Requirements for Level II Fieldwork & Doctoral Experiential Component………………………...6

· Prerequisites for Fieldwork Coursework………………………………………………………………6

· Timeline Requirements………………………………………………………………………….…..….7

· Level II Fieldwork Objectives………………………………….…….……………………………….…8

· ACOTE Standards for Level II Fieldwork…………………………………………………………9 - 10

· Supervision Requirements on Level II FW …………………………… ……………………...……..11

· Typical Dates for Fieldwork..…….………………………….…….………………………….…….....11

· Evaluation Methods & Grading for FW Level II …………………………. ………………………….12

· OTD Doctoral Experiential Component Objectives……………………………………………….…13

· ACOTE Standards for the OTD Doctoral Experiential Component…………..………………13 – 14

· Special Circumstances for Doctoral Experiential Components……………………………… 14 -15

· Supervision Requirements for the OTD Doctoral Experiential Component……………..………..15

· Evaluation Methods and Grading for the OTD Doctoral Experiential Component…………….....15

· Preparing for Fieldwork and Doctoral Experiential Component.…………………………...….…. 16

· Accommodations on Fieldwork…………………………………………………………………….…..16

· Attendance…………………………………………………………………………………………..16 – 17

· Attendance in the Absence of the FW Educator………………………………………………….….17

· Correspondence Between the University and the Fieldwork Site.………….………………….…..17

· Correspondence Between the University and the Student…….……………………………………18

· Health Insurance Coverage……………………………………………………………………..…18 - 19

· HIPAA……………………………………………………………………………………………..…19 – 20

· Performance Problems on Fieldwork and Development Plan……………………………..……….21

· Withdrawal and Failure from Fieldwork II Experience…………………………………………….....22

· Withdrawal and Failure from the OTD Doctoral Experiential Component …………………...……23

· What Happens If (various questions) ……………………………………………………....……24 - 28

· Hints for a Successful Fieldwork Experience….……………………………………..…… ……28 - 29

· ASD Tips for A Successful Experience……………………………………..……………...…………30

· The Effective vs. Challenging Student……………………………………………………..........30 - 32

FORMS for FIELDWORK and OTD DOCTORAL EXPERIENTIAL COMPONENT

· Appendix A: Level II Fieldwork Mid-Term for the Occupational Therapy Student………....33 - 37

· Appendix B: Student Evaluation of the Fieldwork Experience …….……...….…………..…38 - 45

· Appendix C: Weekly Review Forms …………………………………………………...............46 - 47

· Appendix D: AOTA FW Performance Evaluation (PDF copy)………………………….…… 48 - 55

· Appendix E: OTD Doctoral Experiential Component Plan D-4..………………………..……56 - 58

· Appendix F: OTD Doctoral Experiential Component Learning Plan & Evaluation D-6…... 59 - 62

Fieldwork Level II and Occupational Therapy Students:

A Position Paper (2012)

The purpose of this paper is to define the Level II fieldwork experience and to clarify the appropriate conditions and principles that must exist to ensure that interventions completed by Level II fieldwork students are of the quality and sophistication necessary to be clinically beneficial to the client. When appropriately supervised, adhering to professional and practice principles, and in conjunction with other regulatory and payer requirements, the American Occupational Therapy Association (AOTA) considers that students at this level of education are providing occupational therapy interventions that are skilled according to their professional education level of practice.

AOTA asserts that Level II occupational therapy fieldwork students may provide occupational therapy services under the supervision of a qualified occupational therapist in compliance with state and federal regulations. Occupational therapy assistant fieldwork students may provide occupational therapy services under the supervision of a qualified occupational therapist or occupational therapy assistant under the supervision of an occupational therapist in compliance with state and federal regulations.

Occupational therapy Level II fieldwork students are those individuals who are currently enrolled in an occupational therapy or occupational therapy assistant program accredited, approved, or pending accreditation by the Accreditation Council for Occupational Therapy Education (ACOTE; 2012a, 2012b, 2012c). At this point in their professional education, students have completed necessary and relevant didactic coursework that has prepared them for the field experience.

The fieldwork Level II experience is an integral and crucial part of the overall educational experience that allows the student an opportunity to apply theory and techniques acquired through the classroom and Level I fieldwork learning. Level II fieldwork provides an in-depth experience in delivering occupational therapy services to clients, focusing on the application of evidence based purposeful and meaningful occupations, administration, and management of occupational therapy services. The experience provides the student with the opportunity to carry out professional responsibilities under supervision and to observe professional role models in the field (ACOTE, 2012a, 2012b, 2012c).

The academic program and the supervising OT practitioner are responsible for ensuring that the type and amount of supervision meets the needs of the student and ensures the safety of all stakeholders. The following General Principles represent the minimum criteria that must be present during a Level II fieldwork experience to ensure the quality of services being provided by the Level II student practitioner: ¹

a. The student is supervised by a currently licensed or credentialed occupational therapy practitioner who has a minimum of 1 year of practice experience subsequent to initial certification and is adequately prepared to serve as a fieldwork educator.

¹When the term occupational therapy practitioner is used in this document, it refers to both occupational therapists and occupational therapy assistants (AOTA, 2006).

b. Occupational therapy students will be supervised by an occupational therapist.

Occupational therapy assistant students will be supervised by an occupational therapist or an occupational therapy assistant in partnership with the occupational therapist who is supervising the occupational therapy assistant (AOTA, 2009).

c. Occupational therapy services provided by students under the supervision of a qualified practitioner will be billed as services provided by the supervising licensed occupational therapy practitioner.

d. Supervision of occupational therapy and occupational therapy assistant students in fieldwork Level II settings will be of the quality and scope to ensure protection of consumers and provide opportunities for appropriate role modeling of occupational therapy practice.

e. The supervising occupational therapist and/or occupational therapy assistant must recognize when direct versus indirect supervision is needed and ensure that supervision supports the student’s current and developing levels of competence with the occupational therapy process.

f. Supervision should initially be direct and in line of sight and gradually decrease to less direct supervision as is appropriate depending on the

•Competence and confidence of the student,

•Complexity of client needs,

•Number and diversity of clients,

•Role of occupational therapy and related services,

•Type of practice setting,

•Requirements of the practice setting, and

•Other regulatory requirements. (ACOTE, 2012a, 2012b, 2012c)

g. In all cases, the occupational therapist assumes ultimate responsibility for all aspects of occupational therapy service delivery and is accountable for the safety and effectiveness of the occupational therapy service delivery process involving the student. This also includes provision of services provided by an occupational therapy assistant student under the supervision of an occupational therapy assistant (AOTA, 2009).

h. In settings where occupational therapy practitioners are not employed,

1. Students should be supervised daily on site by another professional familiar with the role of occupational therapy in collaboration with an occupational therapy practitioner (see b above).

2. Occupational therapy practitioners must provide direct supervision for a minimum of 8 hours per week and be available through a variety of other contact measures throughout the workday. The occupational therapist or occupational therapy assistant (under the supervision of an occupational therapist) must have three years of practice experience to provide this type of supervision (ACOTE, 2012a, 2012b, 2012c).

i. All state licensure policies and regulations regarding student supervision will be followed including the ability of the occupational therapy assistant to serve as fieldwork educator.

j. Student supervision and reimbursement policies and regulations set forth by third-party payers will be followed.

It is the professional and ethical responsibility of occupational therapy practitioners to be knowledgeable of and adhere to applicable state and federal laws, and payer rules and regulations related to fieldwork education.

References

Accreditation Council for Occupational Therapy Education. (2012a). Accreditation standards for a doctoral-degree-level educational program for the occupational therapist. American Journal of Occupational Therapy, 66.

Accreditation Council for Occupational Therapy Education. (2012b). Accreditation standards for a master’s-degree-level educational program for the Occupational Therapist. American Journal of Occupational Therapy, 66.

Accreditation Council for Occupational Therapy Education. (2012c). Accreditation standards for an educational program for the occupational therapy assistant. American Journal of Occupational Therapy, 66.

American Occupational Therapy Association. (2006). Policy 1.44: Categories of occupational therapy personnel. In Policy manual (2011 ed., pp. 33–34). Bethesda, MD: Author.

American Occupational Therapy Association. (2009). Guidelines for supervision, roles, and responsibilities during the delivery of occupational therapy services. American Journal of Occupational Therapy, 63, 797–803.

Authors

Debbie Amini, EdD, OTR/L, CHT, Chairperson, Commission on Practice

Jyothi Gupta, PhD, OTR/L, OT, Chairperson, Commission on Education

for

The Commission on Practice

Debbie Amini, EdD, OTR/L, CHT, Chairperson

and

The Commission on Education

Jyothi Gupta, PhD, OTR/L, OT, Chairperson

Adopted by the Representative Assembly Coordinating Council (RACC) for the

Representative Assembly, 2012 in response to RA Charge # 2011AprC26.

Note. This document is based on a 2010 Practice Advisory, “Services Provided by

Students in Fieldwork Level II Settings.” Prepared by a Commission on Practice and

Commission on Education Joint Task Force:

Debbie Amini, EdD, OTR/L, CHT, C/NDT

Janet V. DeLany, DEd, OTR/L, FAOTA

Debra J. Hanson, PhD, OTR

Susan M. Higgins, MA, OTR/L

Jeanette M. Justice, COTA/L

Linda Orr, MPA, OTR/L

To be published and copyrighted in 2012 by the American Occupational TherapyAssociation in the American Journal of Occupational Therapy, 66(6, Suppl.).

Requirements for Level II Fieldwork & OTD Doctoral Experiential Component

In accordance with the ACOTE Standards (2011), each MSOT student must successfully complete two Level II fieldwork experiences in order to complete the requirements for graduation from the Washington University Program in Occupational Therapy. Each OTD student must successfully complete two Level II fieldwork experiences and one 16 week Doctoral Experiential Component (referred to as the OTD Doctoral Experiential Component) in order to complete the requirements for graduation from the Washington University Program in Occupational Therapy. The Level II fieldwork and OTD Doctoral Experiential Component experiences are credited courses (6 credit hours each). It is highly recommended that students (MS and OTD) complete at least 1 clinically based FWII.

OT593A Fieldwork II This course provides fieldwork experience under the supervision of an occupational therapist. Students’ participation includes in-depth experience in delivering occupational therapy services to clients including evaluation, treatment and intervention. Students have the opportunity to practice in a variety of clinical or community based settings. During the fieldwork process, students are expected to assume increasing responsibilities related to patient or client care. The fieldwork experience is designed to promote clinical reasoning, professionalism and competency. Duration is 12 weeks.

OT 593B Fieldwork II

This course provides a second fieldwork experience under the supervision of an occupational therapist. Students’ participation includes in-depth experience in delivering occupational therapy services to clients including evaluation, treatment and intervention. Students have the opportunity to practice in a variety of clinical or community based settings. Because this is the second of two fieldwork II experiences, students are expected to build on their first fieldwork and assume increasing responsibilities related to patient or client care. The fieldwork experience is designed to progressively build competencies in clinical reasoning, professionalism and entry-level skills. Duration is 12 weeks.

OT 793C OTD Doctoral Experiential Component (OTD students only)

This course provides a customized experience specific to the doctoral pursuit of the student. Students may participate in research, policy, clinical practice, advocacy, teaching, etc. Students may or may not be supervised by an occupational therapist. Students are expected to achieve specific goals established by the student, the site supervisor, and the doctoral chair. Duration is 16 weeks.

Prerequisites for Fieldwork and Doctoral Experiential Component Coursework

· Level II Fieldwork: Must successfully complete all first and second year coursework prior to first Level II experience; including all Masters Project requirements.

· OTD Doctoral Experiential Component: Must successfully complete Level II fieldwork experiences (OT 593A & B) and all third year coursework prior to the Doctoral Experiential Component experience, including ALL Doctoral Project requirements.

· As stated in the ACOTE (2011) standards (C.2.0), both FW Level II experiences are to be completed prior to the OTD Doctoral Experiential Component. · No portion of a FWII experience or work experience will be substituted for the Doctoral Experiential Component.

· Each student MUST complete a competency requirement after completion of the 2nd FWII before beginning the Doctoral Experiential Component. Students will complete the NBCOT General Practice Entry Level Self-Assessment Tool online and send a PDF copy of it to Program’s Course Coordinator (Joanne Morrissey).

· The General Practice Entry Level Self-Assessment Tool can be found on the NBCOT website: www.nbcot.org.

· Certification Candidates tab/Entry-Level Self Assessment. You may choose to do any of the self-assessments but the OTR General Practice self – assessment is REQUIRED.

· The direct link is: https://secure.nbcot.org/ReadinessTools/Default.aspx?Testid=2Timeline Requirements

All students must successfully complete the required Level II Fieldwork and/or OTD Doctoral Experiential Component experiences within 12 months of completion of academic coursework. Failure to successfully complete the Level II experiences within the 12-month period will result in dismissal from the Program. Unforeseen circumstances may require a leave of absence or an extension to the fieldwork experience that may allow the 12-month time frame to be extended.

The Committee on Academic and Professional Evaluation of Students (CAPES) will determine the impact of a Leave of Absence or extension on the 12-month time frame for completion of the FW Level II and/or OTD Doctoral Experiential Component experiences. A leave of absence or an extension during Fieldwork must be approved by the CAPES.

LEVEL II FIELDWORK OBJECTIVES FOR WASHINGTON UNIVERSITY

Fieldwork is an integral part of the educational experience. It is during this time that the student gains the opportunity to “operationalize” their knowledge and be mentored in the process. Fieldwork is also the first time the student has responsibility for their own clients in which they demonstrate behaviors and ethical decision-making and use the evidence available of person, environment and occupational factors that help clients achieve their own goals. It is our objective for the students to engage in and demonstrate the capacity to practice in ways that support their clients in achieving quality of life through occupation.

The following objectives should set the tone for the fieldwork experience.

Students will (ACOTE 2011 standards are identified):

1. Demonstrate the ability to perform assessment and treatment planning processes consistent with the AOTA Practice Framework using the Models of Practice consistent with their educational preparation (ACOTE B.4.1, B.4.2, B.4.3, B.4.4).

2. Administer and interpret occupational performance based assessments at the individual outcome, program evaluation and program development levels in a skillful manner (B.4.4, B.5.1, B.7.5, and B.7.6).

3. Use evidence to inform practice on a consistent manner; including evidence based on experience, expert practitioners, from controlled studies, and from descriptive literature (B.8.3, B.6.6).

4. Work collaboratively with team members and occupational therapy assistants to plan, implement, and terminate interventions that address the occupational goals of the client (B.4.5, B.5.22, B.5.25. and B.5.27).

5. Implement interventions centered on occupation, participation and environment as client-centered care is planned and implemented (B.5.0, B.5.1).

6. Provide services focused on consumers and family to enable the client’s occupation and maximizing occupational performance once discharged (B.5.28)

7. Advocate for those who may be vulnerable or at risk with secondary conditions (B.2.9).

8. Use occupational histories to create occupational profiles to guide client-centered care (B.4.4).

9. Demonstrate a sensitivity to and inclusion of culture in the design of interventions (B.4.7).

10. Plan and implement assessment and intervention plans that demonstrate a balance of the person, occupation and environmental factors (B.5.1, B.5.2).

11. Transition clients from one service level to the next to insure an outcome of full participation and well being in addition to occupational performance goals (B.5.25, B.5.29).

12. Document occupation-based care plans, progress notes, goals and knowledge of billing methodologies that support occupational-based practice (B.4.10, B.5.32)

13. Treat a full client caseload, as defined by fieldwork site, by the end of experience.

14. Submit correct and complete documentation in a timely manner, according to policies and procedures of fieldwork site (B.5.32).

15. Consistently report to site on time.

16. Follow all policies and procedures as instructed by the fieldwork site and Washington University Program in Occupational Therapy.

17. Demonstrate initiative when exploring new learning opportunities.

18. Actively participate in the supervisory process.

19. Utilize treatment approaches that demonstrate in depth knowledge of the various frames of reference in Occupational Therapy practice.

20. Demonstrate entry-level competencies for the practice setting.

21. Demonstrate professional behaviors consistently.

22. Achieve all additional objectives set by the specific fieldwork site.

ACOTE Standards (2011) for Level II Fieldwork

The Program in Occupational Therapy at Washington University follows all standards developed by the Accreditation Council for Occupational Therapy Education for fieldwork II. These standards serve as official policies of Washington University for level II fieldwork. ACOTE’s fieldwork Level II standards are outlined below.

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. It is recommended that the student be exposed to a variety of clients across the lifespan and to a variety of settings.

The program will:

C.1.11

Ensure that the fieldwork experience 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.

C.1.12

Provide Level II fieldwork in traditional and/or emerging settings, consistent with the curriculum design. In all settings, psychosocial factors influencing engagement in occupation must be understood and integrated for the development of client-centered, meaningful, occupation-based outcomes. The student can complete Level II fieldwork in a minimum of one setting if it is reflective of more than one practice area, or in a maximum of four different settings.

C.1.13

Require a minimum of 24 weeks’ full-time Level II fieldwork. This may be completed on a part-time basis, as defined by the fieldwork placement in accordance with the fieldwork placement’s usual and customary personnel policies, as long as it is at least 50% of an FTE at that site

C.1.14

Ensure 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 subsequent to initial certification and who is adequately prepared to serve as a fieldwork educator. The supervising therapist may be engaged by the fieldwork site or by the educational program.

C.1.15

C.1.16

C.1.17.

Document a mechanism for evaluating the effectiveness of supervision (e.g., student evaluation of fieldwork) and for providing resources for enhancing supervision (e.g., materials on supervisory skills, continuing education opportunities, articles on theory and practice).

Ensure that supervision provides protection of consumers and opportunities for appropriate role modeling of occupational therapy practice. Initially, supervision should be direct and then decrease to less direct supervision as appropriate for the setting, the severity of the client’s condition, and the ability of the student.

Ensure that supervision provided in a setting where no occupational therapy services exist includes a documented plan for provision of occupational therapy services and supervision by a currently licensed or otherwise regulated occupational therapist with at least 3 years’ full-time or its equivalent of professional experience. Supervision must include a minimum of 8 hours of direct supervision each week of the fieldwork experience. An occupational therapy supervisor must be available, via a variety of contact measures, to the student during all working hours. An on-site supervisor designee of another profession must be assigned while the occupational therapy supervisor is off site.

C.1.18

C.1.19

Document mechanisms for requiring formal evaluation of student performance on Level II fieldwork (e.g., the AOTA Fieldwork Performance Evaluation for the Occupational Therapy Student or equivalent).

Ensure that students attending Level II fieldwork outside the United States are supervised by an occupational therapist who graduated from a program approved by the World Federation of Occupational Therapists and has 1 year of experience in practice.

SUPERVISION REQUIREMENTS ON LEVEL II FIELDWORK

ACOTE standards (2011) for fieldwork are followed by Washington University. Supervision of the Level II fieldwork student must be provided by a currently licensed or otherwise regulated occupational therapist who has a minimum of one year full-time (or its equivalent) of practice experience subsequent to initial NBCOT certification and who is adequately prepared to serve as a fieldwork educator (C.1.14). Supervision may be shared between therapists or a collaborative model of supervision may be employed. The supervision model is determined by the fieldwork site.

According to the ACOTE standards (C.1.17), supervision provided in a setting where no occupational therapy services exist includes a documented plan for provision of occupational therapy services and supervision by a currently licensed or otherwise regulated occupational therapist with at least 3 years full-time or its equivalent of professional experience. Supervision must include a minimum of 8 hours of direct supervision each week of the fieldwork experience. An occupational therapy supervisor must be available, via a variety of contact measures, to the student during all working hours. An on-site supervisor designee of another profession must be assigned while the occupational therapy supervisor is off site.

Supervision for students performing international Level II fieldwork experiences must be provided by an occupational therapist who has graduated from a program approved by the World Federation of Occupational Therapists (WFOT). This therapist must have one year of experience in practice (C.1.19). A language barrier between the supervising therapist and student should not exist. At this time, Washington University Program in OT does not allow international fieldwork experiences

Supervision in the absence of the FW Educator:

For time to time the primary FW Educator may be off due to illness or vacation. All efforts should be made to ensure that the student have every opportunity to be at the FWII site in the absence of the primary FW Educator. The student should be assigned to another OT or a COTA whenever possible. The student shall not act independently but should have some level of supervision as required by the FW site. A new graduate OT or a COTA can serve as FW Educator for a temporary situation that requires the primary FW Educator to be off. The FW Educator should assign the student to another supervisor and make sure that the student is aware of the line of supervision and the duties he/she is to fulfill in the absence of the FW Educator. In some occasions, the student may be assigned to shadow another professional, i.e. PT, SLP, SW, for the day as long as the student is not expected to carry out the duties of an OT independently. Students may also be given time in the setting to work on a specific project.

Typical Dates for Fieldwork and Doctoral Experiential ComponentWUOT typically tries to follow the AOTA suggested FWII dates but appreciates sites being flexible with the dates to meet student needs

Level II – MSOT

1st Level II – OTD

Late June / early July - late September

late May – early August Late September – late December

2nd Level II – OTD 3rd year

Doctoral Experiential Component – OTD 3rd yearLate June / early July - late September

late September – late December

(+ 3 additional weeks to equal 16 weeks)Evaluation Methods & Grading for Fieldwork Level II Weekly Review Forms (Appendix C) should be completed weekly by the fieldwork supervisor and reviewed with the student. Weekly goals should be set based upon these updates. If problems develop, please contact the Academic Fieldwork Coordinator (AFC) immediately. These forms do not need to be sent to the AFC unless requested.The AOTA Fieldwork Performance Evaluation (FWPE) (Appendix F on separate PDF file) is completed at mid-term (6 weeks). The student completes the Student Evaluation of Fieldwork Mid-term Evaluation (Appendix A) at mid-term (6 weeks). The FWPE must be promptly sent (via fax or email) to the Academic Fieldwork Coordinator by the student or site. This should occur promptly as the Academic Fieldwork Coordinator must monitor student progress and assess the quality of the fieldwork education.

Students who are not demonstrating satisfactory performance by achieving a score of 90 points at mid-term must immediately contact the Academic Fieldwork Coordinator by phone for discussion

and a learning plan will be developed. This learning plan will be collaboratively developed between the site Fieldwork Educator, Academic Fieldwork Coordinator, and student.

The AOTA Fieldwork Performance Evaluation (FWPE) is also completed at the end of the Level II experience. The FW Educator is asked to fax the cover sheet and the score page to the AFC at the end of the FWII. The FW Educator will then mail the original FWPE and the original copy of the student’s final evaluation of the site. The cover sheet and score sheet serve as “proof” of passing so the AFC can enter the student’s grade.

The student completes the Student Evaluation of Fieldwork (Appendix B) at the end of the Level II experience.

These evaluations must be promptly sent to the Academic Fieldwork Coordinator by the site. This must occur promptly as the student must pass the first level II experience prior to beginning the second fieldwork II experience. We cannot send transcripts to NBCOT until we receive these evaluations after the final fieldwork experience.

Level II fieldwork is graded on a Pass/Fail basis. Students must meet the cut-off point of 122 points on the AOTA Fieldwork Performance Evaluation. The final grade for level II fieldwork will be assigned by the Academic Fieldwork Coordinator.

Do not send the Fieldwork Performance Evaluation to AOTA.

All students are encouraged to keep a copy of all weekly review forms, mid-term evaluations, final evaluations and learning plans for personal files. Please allow students to keep copies of these.

OTD DOCTORAL EXPERIENTIAL COMPONENT OBJECTIVES FOR WASHINGTON UNIVERSITY

The goal of the doctoral experiential component is to develop occupational therapists with advanced skills (those that are beyond a generalist level). The doctoral experiential component shall be an integral part of the program’s curriculum design and shall include an in-depth experience in one or more of the following: clinical practice skills, research skills, administration, leadership, program and policy development, advocacy, education, or theory development.

The student must successfully complete all coursework and Level II fieldwork and pass a competency requirement prior to the commencement of the doctoral experiential component. The specific content and format of the competency requirement is determined by the program. Examples include a written comprehensive exam, oral exam, NBCOT certification exam readiness tool, and the NBCOT practice exams. (ACOTE, 2011; Std C.2.0)

OTD Doctoral Experiential Component objectives are individualized to the learning needs and goals of the student. The Doctoral Chair, the occupational therapy doctoral student and the Doctoral Experiential Component site supervisor will determine the objectives for the Doctoral Doctoral Experiential Component experience. Development of these objectives should begin prior to contacting possible Doctoral Experiential Component sites via the D-4 form Part 1, The Doctoral Experiential Component Plan (in Appendix D). The D-4, Part 1: Doctoral Experiential Component Planning form outlining the area of focus, educational goals, and potential sites for the Doctoral Experiential Component will be due to Program’s Course Coordinator by Nov. 1st of the student’s 3rd year in the curriculum. The D-4, Part 2: Final Doctoral Experiential Component Request form listing the site or sites (2 maximum) that have agreed to work with the student on the Doctoral Experiential Component is due to the Program’s Course Coordinator by February 1 of the student’s 3rd year in the curriculum. The Course Coordinator will pass the form on to the FW Administrative Coordinator who will begin the contract negotiation process. A contract with an international site WILL NOT be initiated if this form is received after the February 1st deadline. Submission of the form does not guarantee the placement.

The objectives for the Doctoral Experiential Component are first developed by the Doctoral Chair prior to the student beginning the Doctoral Experiential Component experience and recorded on the D-6 form, “The Doctoral Experiential Component Objectives and Evaluation Form”. Objectives should be reviewed and finalized with the Doctoral Experiential Component site supervisor by the end of the second week of the Doctoral Experiential Component. A signed copy of the objectives must be sent to the program via the Program’s Course Coordinator via fax or email. The Course Coordinator will give the plan to the Doctoral Chair for signature. The Course Coordinator will keep the forms in the student’s file.

The D-6 form serves as the Evaluation for the OTD Doctoral Experiential Component.

OTD ACOTE (2011) Standards for the Doctoral Experiential Component

The Program in Occupational Therapy at Washington University follows all standards developed by the Accreditation Council for Occupational Therapy Education for the Doctoral Experiential Component (Doctoral Experiential Component). These standards serve as official policies of Washington University for the OTD Doctoral Experiential Component. ACOTE’s fieldwork Level II standards are outlined below.

C.2.1.Ensure that the doctoral experiential component is designed and administered by faculty and provided in setting(s) consistent with the program’s curriculum design, including individualized specific objectives and plans for supervision

C.2.2. Ensure that there is a memorandum of understanding (contract) that, at a minimum, includes individualized specific objectives, plans for supervision or mentoring, and responsibilities of all parties.

C.2.3.Require that the length of this doctoral experiential component be a minimum of 16 weeks (640 hours). This may be completed on a part-time basis and must be consistent with the individualized specific objectives and culminating project. No more than 20% (128 hours or 3 weeks) of the 640 hours can be completed outside the mentored practice setting(s). Prior fieldwork or work experience may not be substituted for this experiential component.

NOTE: In order for OTD students to complete the required 16 weeks of Doctoral Experiential Component following the 2nd FWII and prior to graduation date in mid-December, students have 2 options:

1st Option (most preferred): Individually negotiate an earlier start date with the summer FWII site AFTER the placement has been made. This will be done after asking and receiving permission in writing (email is acceptable) to do so from the AFC. Alternate FW dates have to be communicated in writing to the AFC and the Fieldwork Administrative Coordinator.

The student will complete the 16 week Doctoral Experiential Component following the end of the FWII and will complete the Doctoral Experiential Component prior to the date that final grades are due (typically mid to late December).

2nd option: Complete 3 weeks (120 hours – less than 20% of the 640 hours) of Doctoral Experiential Component following the graduation “ceremony” mid-May and prior to the beginning of the summer FWII. The student will complete this 3 week period at the Program in OT under the direction of their OTD mentor. Objectives for this 3 week period will prepare the student for the remainder of the Doctoral Experiential Component. The objectives will be recorded on the D-6 form Part A.

The student will have to complete the remaining 13 weeks BEFORE the end of the semester when grades are due (typically mid to late December).

C.2.4. Ensure that the student is mentored by an individual with expertise consistent with the student’s area of focus. The mentor does not have to be an occupational therapist.

C.2.5. Document a formal evaluation mechanism for objective assessment of the student’s performance during and at the completion of the doctoral experiential component.

SPECIAL CIRCUMSTANCES FOR DOCTORAL EXPERIENTIAL COMPONENTS

The OTD Doctoral Experiential Component may take place at a site where the student completed a FWII, but the experience will be designed totally separate and no FWII hours will count towards the OTD Doctoral Experiential Component.

The OTD Doctoral Experiential Component objectives are developed between the student, the site supervisor and the Doctoral Chair.

If a student has to complete the Doctoral Experiential Component on a part-time basis, the objectives and timelines for the experience will be reflected on the evaluation form (the D-6 form). Students will track their time on the Doctoral Experiential Component to ensure having the equivalent of 640 hours. The Committee on Academic and Professional Evaluation of Students (CAPES) will need to approve this plan and the student’s graduation date will be postponed one semester. All of this is will be explained to the student and all parties (site supervisor and the OTD mentor) will have to agree before allowing the Doctoral Experiential Component to be part-time. It will be the student’s responsibility to coordinate financial implications with Financial Aid if necessary.

In some cases, a work site may be used to satisfy the 16- week requirement, but typical work duties will not be considered as objectives for the Doctoral Experiential Component. Objectives for the Doctoral Experiential Component have to be additional activities conducted at the site. These objectives will be developed by the student, the OTD mentor and the site supervisor.

SUPERVISION REQUIREMENTS FOR THE OTD DOCTORAL EXPERIENTIAL COMPONENT

As stated in the 2011 ACOTE Standards (C.2.4), the OTD Doctoral Experiential Component student should be mentored by an individual with expertise consistent with the student’s area of focus. The mentor does not have to be an occupational therapist. The Student and the Doctoral Chair will plan the Doctoral Experiential component (OTD Doctoral Experiential Component) together through a thoughtful process. They will seek sites and mentors who will meet the goals the student has set for him/herself and the experience.

Many professionals are qualified to supervise OTD Doctoral Experiential Component students as they carry out research, program development, advocacy, teaching or policy work specific to their doctoral pursuits. The level and type of supervision will vary dependent upon the student’s competencies. The Doctoral Chair will be instrumental in helping the student find sites that may be able to accommodate a student. The student and the Doctoral Chair will use the D-4 form Part 1 to identify possible goals and objectives. The next step is to identify possible sites and contact them to see if the site and the mentor may be a good fit. During this process the Doctoral Chair and student will inquire about the prospective supervisor’s expertise and qualifications to ensure a good fit between the student’s interests and the prospective supervisor’s experience.

Part of the process is to seek out mentors in the area of the student’s interests and goals for their career. The OTD Doctoral Chair may know specific people or organizations that may want to work with the student. The mentor should have enough experience at the site to feel comfortable leading the student during the Doctoral Experiential Component.

The qualifications of the site supervisor/mentor are listed on the D-6 form. Examples of supervisors in the past few years are: Master’s in Social Work, PhD, OTD, MD.

Direct clinical practice activities performed by the OTD Doctoral Experiential Component student should be supervised by a professional who meets the state and national requirements to perform the area of practice. When the most appropriate professional to supervise students performing direct clinical practice activities is an occupational therapist, then the supervising occupational therapist must meet the state regulations and have a minimum of one year practice experience post initial NBCOT certification.

Evaluation Methods & Grading for the OTD Doctoral Experiential ComponentAn Doctoral Experiential Component Learning Plan and Evaluation – D-6(Appendix E) developed collaboratively between the student, doctoral chair, and Doctoral Experiential Component supervisor will guide the experience and serve as the evaluation method for the Doctoral Experiential Component. This evaluation should be performed at mid-term (6-8 weeks) and promptly sent to the AFC who will pass it on to the doctoral chair. The doctoral chair will spearhead remediation planning if needed. The Learning Plan should also be completed at the end of the Doctoral Experiential Component. The doctoral chair will be responsible for assigning the final grade for the Doctoral Experiential Component experience.

All students are encouraged to keep a copy of all mid-term evaluations, final evaluations and learning plans for their personal files. Please allow students to keep copies.

Preparing for Fieldwork and Doctoral Experiential Component

· Students will contact both fieldwork sites in March (for FW starting in May) and April (for FW starting in late June) to confirm placement and fieldwork dates. Students will ask the site for the supervisor’s name, but this may not be known at this early date. Each student will provide the name and contact information of the direct supervisor to the AFC via email during the first week of the FW.

· Important: Confirm the requirements specific to that site: CPR certification, drug test, police background check, etc. Students will not be allowed to start fieldwork until all site requirements have been fulfilled. Students are required to follow all applicable rules and regulations of the fieldwork site. Some sites may have specific requirements regarding drug screening and or criminal background checks. It is the student’s responsibility to complete these requirements in accordance with the site’s procedures, including any related expenses (see page 4). It is in the students’ best interest to get most of the prerequisites done in St Louis prior to graduation and leaving town!

· Students will secure housing at least six-eight weeks prior to fieldwork.

· Three-four weeks prior to beginning the fieldwork, the student should contact the fieldwork site for more detailed information. If the student does not receive timely email answers, the student is expected to call the site!

· Find out work location, address, work days, hours, parking, lunch arrangements, etc.

· Ask specific dress code questions and begin to gather appropriate wardrobe.

· Students will complete CPR re-certification, drug test, background check and all site requirements. Students are to make sure that CPR certification will be current throughout BOTH Fieldworks and Doctoral Experiential Component.

· Students are expected to get adequate medical care and medications from Student Health prior to leaving for fieldwork.

· Students will gather all pertinent textbooks, journals, evaluation materials, etc. which could assist them on fieldwork.

· Students are to bring this Fieldwork Manual to fieldwork, share with their supervisor, and refer to it often.

Accommodations on Fieldwork

· Students who have documented disabilities requiring accommodations need to work with the AFC several months prior to the Fieldwork II placement to identify the specific reasonable accommodations needed in the fieldwork setting.

· Fieldwork placements will be made in sites that can meet the student’s accommodations.

· If new documented needs arise on fieldwork that necessitates further accommodations, the student MUST notify the AFC.

· The student with the AFC’s assistance / knowledge will then request these accommodations from the fieldwork site.

Attendance Policy

· Students must complete 12 weeks of full time fieldwork for each experience; therefore regular attendance is required.

· Student must promptly contact the fieldwork supervisor to report all absences or late arrivals. Students will follow the site’s procedures for time off.

· Washington University DOES NOT ALLOW scheduled “days off” from a fieldwork experience. Sick time and days off for personal needs are at the discretion of the fieldwork site. If time off for any reason is required, the fieldwork site may require that time is made up through overtime, alternative scheduling, extra assignments, etc.

· Student must contact the Academic Fieldwork Coordinator via email to inform of absences during the week the absence occurs.

· Failure to do so in a timely manner will result in the AFC adjusting the score for #39 on the FWPE.

· Students should not make decisions about their fieldwork timeline independent of the discussing the issues with the AFC.

· Students receiving legal notice of jury duty while on FWII or Doctoral Experiential Component should contact the AFC immediately. We will help the student request an extension or postponement of this obligation.

Attendance in the absence of the FW Educator:

· All efforts should be made to ensure that the student have every opportunity to be at the FWII site in the absence of the primary FW Educator.

· The student should be assigned to another OT or a COTA whenever possible. The student shall not act independently but should have some level of supervision as required by the FW site. A new graduate OT or a COTA can serve as FW Educator for a temporary situation that requires the primary FW Educator to be off.

· The FW Educator should make sure that the student is aware of the line of supervision and the duties he/she is to fulfill in the absence of the FW Educator.

· In some occasions, the student may be assigned to shadow another professional, i.e. PT, SLP, SW, for the day as long as the student is not expected to carry out the duties of an OT independently.

· Students may also be given time in the setting to work on a specific project.

Correspondence between the University and the Fieldwork Site

· Each site will be provided with a copy of:

· the AOTA Fieldwork Performance Evaluation

· the Student Midterm Evaluation of FW Site

· Student Final Evaluation of FW Site

· Weekly Progress Review forms

· Fieldwork objectives

· Program in OT catalog

· Student Professional Experience Record

· Student Personal Data Information form

· Student Immunization record

· Attestation that the student has completed a drug screen and a background check

· Some sites MAY require more recent drug screens and/or background checks. It is up to the student to know this and make sure these requirements are completed.

· If requested, the site will receive a letter stating that the student is covered through Washington University for liability purposes.

· The Academic Fieldwork Coordinator will contact the Fieldwork Educator periodically during the fieldwork to check on the student’s progression towards achieving the fieldwork objectives.

· The Academic Fieldwork Coordinator will make site visits to facilities in the metropolitan St. Louis area while the student is on fieldwork.

· The Academic Fieldwork Coordinator will collaborate with the site to maximize the learning process and troubleshoot any problems that may develop.

· FW Educators are invited to educational programs offered to fieldwork sites twice yearly through the Gateway OT Educational Council (GOTEC).

· FW Educators are encouraged to attend continuing education training on supervision strategies.

Correspondence between the University and the Student

· The Academic Fieldwork Coordinator (AFC) will contact students during the fieldwork for progress reports via e-mail, telephone, or in person.

· During the first week of fieldwork, each student will email the AFC with the following information: Name of Supervisor, email and/or phone number to reach supervisor.

· Students should contact the Academic Fieldwork Coordinator at midterm and any other times needed for discussion or problem solving. If a problem develops at any point, students must contact the AFC immediately.

· The AFC will communicate with students via their WU email accounts frequently during the FW experiences. Students will be asked to give periodic reports via email.

· Students must check and answer messages on their university e-mail account at least 2 times a week during fieldwork for electronic notifications from the university, AFC or the FW Administrative Assistant.

· Failure to be timely with correspondence will result in the AFC adjusting the score for #39 on the FWPE.

· The AFC will provide all students with phone numbers to use for phone contacts. The AFC will be available on evenings and weekends for phone contacts.

· Students will be provided an online survey link towards the end of each FWII. This survey will focus on the Academic Preparation for the particular fieldwork. This is a REQUIRED survey to complete! NO fieldwork grade will be posted for the student until the survey has been completed.

· Students’ WU email accounts remain active for ~ 2 months post graduation.

Health Insurance Coverage on Fieldwork (subject to updates annually)

· Health insurance benefits will remain the same if in St. Louis while on Fieldwork.

· Benefits on out-of-town Fieldwork include Emergency Room and Hospitalization. There is a $50.00 deductible and it is payable at 80%*.

· WUMS Student Health is always secondary to private insurance.

· You must notify Student Health of emergency room visits on the next working day. If closed, notify them the following working day.

· Emergency Room and Hospitalization are covered with a $50.00 deductible, payable at 80%.

· Benefits for outpatient care away from Student Health Services are only covered when referred by an emergency room.

· All hospital care expenses are covered at 80%.

· Students may purchase additional coverage by request information from Student Health at:

WUMS Student Health

660 So. Euclid, Campus Box 8030

St. Louis, MO 63110

Phone: 314-362-2346; Fax – 314-362-0058

· The effective dates of coverage by student health are matriculation through graduation. You are also covered 30 days past graduation (through January 2014 if MSOT or 3rd year OTDS) for Emergency Room and Hospitalization only with a $50 deductible and payable at 80%. No medication or outpatient care.

Student Health offers a Student Assistant Program (SAP) available for students away from the campus. This service includes professional counseling, legal and financial resources, referrals and help with issues such as academics, relationship problems, substance abuse, emotional problems, stress, etc. Information on accessing this service can be found on the Student Health website:

http://wusmhealth.wustl.edu/. Click on Mental Health Services (on the left side of the page) and there will be information on the SAP.

Important Information regarding international travel: When traveling out of the country, there is no medical coverage provided by the Student Health Service. Students are encouraged to take advantage of the very affordable medical plan for international travel. Information regarding travel insurance is available at the Student Health Service. Talk with the Student Health personnel!!!

*Students should refer to the Student Handbook or contact Student Health for the most up to date information!!

HIPAA

Refer to http://secpriv.wusm.wustl.edu for complete information on HIPAA.

Every student has completed HIPAA training at WUOT and is to comply with the HIPAA policies of the organization and Washington University while on Fieldwork Level I, II or OTD Doctoral Experiential Component. Students violating HIPAA while on Fieldwork Level I, II or OTD Doctoral Experiential Component will face sanctions from the organization and the university. The level of violation of HIPAA will be determined by the organization and WUOT. Students found in violation of HIPAA will be brought to the CAES committee and will face disciplinary action as determined by WUOT and the CAES committee.

Sanctions for Non-Compliance with HIPAA Policies

Washington University and its member organizations (collectively, “Washington University” or “WU”) are committed to conducting business in compliance with all applicable laws, regulations and WU policies. WU has adopted this policy regarding sanctions for violations by workforce members of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).

This Policy covers all workforce members within Washington University covered entity component parts whose actions or failures to act violate WU HIPAA policies. Workforce members include employees (both faculty and staff), appointees, volunteers, trainees (includes OT students) and other persons whose conduct, in the performance of work for Washington University, is under the direct control of the University whether or not they are paid by the University.

Sanctions for violations of HIPAA policies may include, without limitation, verbal counseling, written warning, suspension, and discharge. Sanctions may also be applied for failure to report a known or suspected HIPAA violation.

Factors in determining appropriate disciplinary action may include, but are not limited to:

· Whether the breach was intentional or inadvertent

· The nature of the breach, including whether the breach involved specially protected information such as HIV, psychiatric, substance abuse, or genetic data

· The magnitude of the breach, including the number of patients and the volume of protected health information accessed or disclosed

· Workforce member’s motive in accessing or disclosing protected health information

· Whether the workforce member has committed prior HIPAA violations

· Workforce member’s response or conduct during investigation

· Harm to the breach victim(s)

Investigation and Disciplinary Process:

Potential violations of the WU HIPAA Policy should be reported to the WU HIPAA Privacy Office. The HIPAA Privacy Office will notify the HIPAA Security Office if a violation of a HIPAA Security Policy is involved.

A workforce member who becomes aware of a potential violation should immediately notify his/her supervisor and/or the HIPAA Privacy Office.

Reports may also be made anonymously to the HIPAA Privacy Office (866-747-4975) or the WU Compliance Hotline (314-362-4998).

Upon notification of a potential violation of a WU HIPAA Policy, the HIPAA Privacy Office will investigate, review and assess the alleged violation. The investigation may necessitate, among other things, workforce member interviews, computer audit trails, telephone log reviews, etc. The HIPAA Privacy Office will determine whether and what

sanctions are appropriate in consultation with relevant administrators from the workforce member’s department or other business unit, Human Resources and/or the Office of the Executive Vice Chancellor & General Counsel, and the HIPAA Security Office if the matter involves a breach of the HIPAA Security Policy.

Disciplinary actions will be documented in writing and maintained in the appropriate personnel record. Disciplinary action may be appropriately delayed if the action could adversely affect or compromise patient care.

Last Revision Date: October 7, 2010

Performance Problems on Fieldwork

The student and/or fieldwork supervisor should contact the AFC as soon a concern arises with student performance or the mid-term evaluation does not meet the cut-off point for passing.

If possible, the AFC will visit the fieldwork site to discuss the problems and develop a plan. If the fieldwork location is not within travel distance for an on-site meeting, a telephone conference will be held between the student, Fieldwork Educator, and AFC.

A development plan will be designed by the AFC with collaboration from the student and the fieldwork supervisor. Any failing marks at mid-term will be reviewed through the CAPES process outlined in the Student Handbook.

Development Plan Example

If problems develop on fieldwork, the AFC will collaborate with the Fieldwork Educator and student. A development plan will be designed that outlines the development areas, describes the learning plan, and sets behavioral objectives. The student’s performance will be evaluated on a daily basis and written feedback provided. Below is an example.

Development Area

Learning Plan

Performance Objective by end of FW

1. Design evaluation plan that meets the referral source need’s and the patient’s needs.

1. Student will diagram an evaluation plan for all new rehab patients using the PEO framework.

2. Occupational history will be integrated into this PEO diagram.

3. Student will identify appropriate assessments that adequately address the PEO needs of the patient.

4. Student will prioritize the assessments for the patient.

5. Supervisor will review evaluation plan and provide specific feedback.

6. Student will modify plan based on supervisor feedback.

1. Evaluation plan will adequately address all PEO needs of the patient and meet the referral source needs.

Withdrawal from the Fieldwork II Experience

Withdrawals (either by the student or by the AFC) from the fieldwork Level II experience will be referred to the Committee on Academic and Professional Evaluation of Students (CAPES). The CAPES rules outlined in the Student Handbook will be followed.

Withdrawal of a Fieldwork II will result in the implementation of an individualized enabling plan at the Program in OT in St. Louis. This plan, and all steps of the plan, must be completed prior to completion of the program.

Subsequent fieldwork placements will be adjusted appropriately. The student will have to retake the Fieldwork II course (or portion of) as decided by the CAPES committee.

Withdrawals from a Fieldwork Level II assignment will be considered a “Fail”. The CAPES committee and the AFC will consider the circumstances for withdrawal prior to deciding on the grade or plan to complete the 12 weeks requirement. In most circumstances, the entire 12 week experience must be repeated.

Refer to the student handbook for specifics about grading policies, health insurance coverage, withdrawal timelines, and re-enrollment fees. Student loan repayment begins after six months of non-enrollment; therefore Student Financial Aid should be consulted.

Failure of Fieldwork II Experience

Students who fail a Fieldwork Level II (a failing grade at the final or termination by the site due to failing performance) will be referred to CAPES. The CAPES rules outlined in the Student Handbook will be followed.

Failure of a fieldwork Level II assignment will result in the implementation of an individualized enabling plan at the Program in OT in St. Louis or placement decided by CAPES and the AFC. This plan, and all steps of the plan, must be completed prior to completion of the program, whether it is another Level II fieldwork experience or doctoral level coursework (in the case of a doctoral student failing the first FWII).

Subsequent fieldwork placements will be adjusted appropriately. The student will have to retake the Fieldwork II course (or portion of) as decided by the CAPES committee. In most circumstances, the entire 12 week experience must be repeated.

Students are allowed to repeat only one failed fieldwork experience.

A “Fail” will be entered in the student’s grades. Refer to the student handbook for specifics about grading policies, health insurance coverage, withdrawal timelines, and re-enrollment fees. Student loan repayment begins after six months of non-enrollment; therefore Student Financial Aid should be consulted. After the course has been retaken, a passing grade will be given and an “R” will be reflected on the final transcript.

Failure of Two Fieldwork II Experiences

Students who fail two Fieldwork II experiences will face dismissal from the program. Refer to the student handbook. CAPES will make the final ruling regarding dismissal or other consequences.

Withdrawal from the OTD Doctoral Experiential Component

Withdrawals (either by the student or by the doctoral chair) from the OTD Doctoral Experiential Component experience will be referred to CAPES. The CAPES rules outlined in the Student Handbook will be followed.

Withdrawal (either by the student or by OTD chair) from the OTD Doctoral Experiential Component will result in the student and the doctoral chair developing an individualized plan to complete the Doctoral Experiential Component. This plan, and all steps of the plan, must be completed prior to completion of the program.

The doctoral chair must consult with the Associate Director of Professional Programs and CAPES before the student is able to continue in the Doctoral Experiential Component.

The student must retake the Doctoral Experiential Component (or portion of) as decided by the CAPES.

Withdrawals from an OTD Doctoral Experiential Component will be considered a “Fail”, except by decision of the CAPES. The CAPES and the doctoral chair will consider the circumstances for withdrawal prior to deciding on the grade or plan to complete the 16 weeks requirement.

Refer to the student handbook for specifics about grading policies, health insurance coverage, withdrawal timelines, and re-enrollment fees. Student loan repayment begins after six months of non-enrollment; therefore Student Financial Aid should be consulted.

Failure of the OTD Doctoral Experiential Component

Students who fail an OTD Doctoral Experiential Component (a failing grade at the final or termination by the site due to failing performance) will be referred to CAPES. The CAPES rules outlined in the Student Handbook will be followed.

Failure of an OTD Doctoral Experiential Component will result in the student and the doctoral chair developing an individualized plan to complete the Doctoral Experiential Component. This plan, and all steps of the plan, must be completed prior to completion of the program,

The doctoral chair must consult with the Associate Director of Professional Programs and CAPES before the student is able to continue in the Doctoral Experiential Component.

The student must retake the Doctoral Experiential Component (or portion of) as decided by the CAPES committee. Students are allowed to repeat only one failed OTD Doctoral Experiential Component.

A “Fail” will be entered in the student’s transcript. Refer to the student handbook for specifics about grading policies, health insurance coverage, withdrawal timelines, and re-enrollment fees. Student loan repayment begins after six months of non-enrollment; therefore Student Financial Aid should be consulted. After the course has been retaken, a passing grade will be given and an “R” will be reflected on the final transcript.

Failure of Two OTD Doctoral Experiential Components

Students who fail two OTD Doctoral Experiential Component experiences will face dismissal from the program. Refer to the student handbook. CAPES will make the final ruling regarding dismissal or other consequences.

General Suggestions to Fieldwork Issues

WHAT HAPPENS IF ………….

As students prepare for fieldwork, they often have a list a “what if” questions. The following list has been prepared as a quick reference for frequently asked questions.

What happens if…..

· Everything is fine:

Call or email your Academic Fieldwork Coordinator (AFC) at the school and tell her! A mid-term check-in is required. Mid-term check in can be a phone call or email to AFC. Use the toll-free line (800-279-3229) to touch base with the school. You will have the AFC’s phone numbers.

· I see unethical things going on:

Do not automatically assume that you have interpreted the observed situation accurately. Call a trusted mentor to discuss. This could be your AFC, an advisor at school, etc. Students should seek clarification on the issue from the fieldwork educator before drawing conclusions. Yes, this can be intimidating. If you determine that you need to take action, the questioning approach can be along the lines “I observed __________ yesterday and I am confused, I do not understand why that happened, could you please clarify for me?” If the answer to this query clears up your question, then no need to proceed further. If you are still not satisfied with the answer, there are several steps to take

· Ask again, just to make sure that you are certain about what you have seen

· Tell your fieldwork educator that you are feeling uncomfortable with the approach being used and would like to discuss the policy with the next up in the chain of command

· Discuss the situation with your AFC

· If all involved determine that the action is questionable or unethical, then your AFC will need to work with the site and you to determine what the next course of action should be. This could include but is not limited to changing of fieldwork educator, switching to another program at fieldwork site or removal from fieldwork site.

Dealing with questionable ethics is very difficult for anyone – student or practicing therapists. The above-described approach is direct and can be intimidating to carry through. Students must remember that they are learning how to be professionals, and one of the most important characteristics of any effective professional is the ability to address a situation openly and honestly.

· I get hurt or become sick:

· Should you get an injury or become ill while at work, first, follow the program/facility guidelines and obtain the appropriate medical services. If necessary and appropriate, contact family/friends etc.

· If you are hurt or become ill outside of fieldwork hours, first seek appropriate medical attention. After you have been cared for and the physician has instructed you on activity restrictions (if any) contact both your fieldwork educator and your AFC. The fieldwork educator and AFC will determine the impact of this illness or injury on the fieldwork experience.

· If you are using the school’s insurance plan as your medical coverage, you will need to contact your Student Health and let them know of the situation.

· Student Health: 314-362-3523.

· Contact the AFC the week of the illness or injury and let her know what happened, how you are and the impact this might have on your fieldwork experience.

· Should your fieldwork experience need to be delayed for any reason due to injury or illness– you, your fieldwork educator and the AFC will need to discuss possible options to make up time. Any changes in the fieldwork experience should involve a discussion with all parties; students should not make decisions about their fieldwork timeline independent of the school.

· I have a family emergency:

· If you are contacted about an emergency at work, talk with your fieldwork educator about your needs and concerns. Together you will need to determine, for the immediate future, what the plan of action will be.

· If you are contacted about an emergency after work hours and cannot make it to work the next day, contact your fieldwork educator either at home or first thing in the morning. If possible, it is best to talk directly with the fieldwork educator and not leave a message. If you need to leave a message, call back later to make sure that the message was received.

· At some point contact school and inform them of the situation. If you are unable to call the school, ask your fieldwork educator to contact the school for you. Once the situation has stabilized, contact your AFC to discuss how long you need to be away from fieldwork and other pertinent information. The school and the fieldwork site will make decisions on what will happen with the fieldwork experience after discussion with the student.

· There is a natural disaster or emergency situation at my fieldwork site:

· Seek shelter, following the policies and procedures of the fieldwork site.

· Seek medical attention as needed. Follow same steps as described above if you are injured.

· If/when possible get word to family and school to let them know what has happened and your condition.

· There is a labor strike:

· Contact the AFC and follow procedures as directed:

· If your fieldwork educator is going in to work, make plans to go into work as well. BUT, if at any point in time you feel that you are not physically safe, turn back and do not attempt to cross the picket lines.

· If it appears that the strike will be lasting an indefinite period of time, you, your fieldwork instructor and AFC will talk about the future of your fieldwork at this site and discuss alternatives.

· I do not like my Fieldwork Educator:

In a working relationship, personal feelings about a co-worker or fieldwork educator need to be kept in check. You may have different views about politics, religion, life choices, etc., but these are personal opinions that should not enter into a working relationship. Is it easy to ignore? No. BUT, especially for a student, you are not there to debate the pros and cons of the latest Supreme Court decision. You are at the fieldwork site to learn. The first thing that you need to figure out is if you can learn from your fieldwork educator. If the answer is yes, then, you need to overcome your own personal feelings about subject matter that doesn’t relate to the fieldwork experience and forge ahead with the learning opportunity you have been given.

As with most difficult situations, the best approach (and often times the most intimidating) is the direct approach. Talk with your fieldwork educator about your concerns of student/fieldwork educator compatibility. Give that fieldwork educator the opportunity to make some changes. Consider your role in the relationship, be prepared to get constructive feedback on your working style and be prepared to make changes in your approach to the fieldwork experience.

Keep in mind that this fieldwork experience is not forever and if you can make it work then do that. If you feel like you and your fieldwork educator really cannot get along, then explore other options. If another fieldwork educator is available, consider requesting a change. Remember, just as you want to know what you are doing right or wrong, your fieldwork educator needs to get that feedback as well. Do not show up one day requesting a change in fieldwork educators. Make sure that you have gone through the proper channels that your fieldwork educator is aware of your frustrations and agrees that this is the best idea in order for you to have a successful experience.

Contact the AFC if problems persist. Do not wait until the problem is insurmountable and you are at risk of failing the fieldwork experience.

· There are other students at this site and I do not get along with one/some/all of them:

This is a working relationship. You should handle the situation just like you would if you were an employee. Try to find common areas or interests for you and the other student to explore. If you find there is nothing in common, or your work styles do not mesh and you are having difficulty getting your job done, discuss with your fieldwork educator. Again, you do not have to personally like someone to work effectively with them.

· I am concerned about the competence of my Fieldwork Educator:

This is not an easy situation. The first thing you need to figure out is can you learn in that environment. If you can learn and contribute to the setting, then see if you can make it work for the remainder of your experience. If you do not think you can learn in the practice environment there are some options.

· First: Your fieldwork educator needs to know that you have concerns. Do not surprise him/her with the fact that you are not happy. You do not have to say, “I think you are incompetent”, but you do need to address the issue. You can ask questions such as “I’m not sure I understand the rationale behind that approach, could you explain” or “I have read about ____, which is different that what you are doing, can you help me understand the differences?” You may find that you have underestimated the fieldwork educator, or that you do not have a full grasp of the situation.

· Next, contact the AFC and explain your concerns and efforts to remediate the situation. If, after discussion with your fieldwork educator and AFC, you still feel that you cannot learn in the current environment, a change in fieldwork educators can be requested if one is available, or request a withdrawal all together from the experience. The AFC should be involved in any discussions to change the AFC. Withdrawal from an experience has many ramifications and is not something that a student on fieldwork can decide without discussion with the fieldwork educator and AFC.

· My Fieldwork Educator quits while I am there:

Do not panic! Most places will develop a back up plan for situations like this. Either there is another therapist that you can work with or they have another location within their system that you can transfer to. Your fieldwork educator should contact the AFC at your school to inform them of the situation and to review options for the continuation of your fieldwork experience.

· My fieldwork site does not practice OT the way I was taught:

All practitioners are called on to follow the Standards Practice as outlined in The Guide to Occupational Therapy Practice (AOTA, 1998) and Occupational Therapy Practice Framework: Domain and Process, 2nd ed (AOTA 2008). Within this framework, there is a lot of leeway in how services are actually delivered. If the fieldwork site does not practice OT the way you were taught, there are typically two reasons why. First, OT schools work very hard to provide you with training in the latest advances in OT. These advances are perfected in the practice setting. If WUOT did not teach you a particular approach or technique, it may be that the approach is new or in the process of being developed – a great opportunity for you to take advantage of while on fieldwork. Second, the philosophy towards client care may be very different at your fieldwork site when compared to your school. The WUOT Program has taught you to be very client centered and to use a PEOP approach when developing interventions. On the flip side your fieldwork site may practice through one frame of reference with all clients. For example, the therapists at your fieldwork site may have a biomechanical approach and use interventions such as exercising or cone placement. If you find yourself in this dilemma, discuss the differences in what you have been taught and what you are seeing in practice with both your fieldwork educator and your AFC. The information you get from the AFC and fieldwork educator should help you balance out the discrepancies you are seeing in practice.

A word of caution, if you are told “well this is how it’s done in the real world”, be careful. A good fieldwork site combines many different educational and treatment approaches; there is no one way to do the right thing. A good therapist will stay open to new ideas and treatment approaches throughout his/her career.

By the same token, you have to be ready to bend and mold yourself to the situation as appropriate. You may be very clear on how an activity or intervention should be performed and still be told that you need to modify your approach. If you find that you have difficulty modifying, consider that it may not be the fieldwork site that has a problem, it may be you.

If you find yourself in a situation where you cannot seem to resolve the differences in what you were taught and what is in practice on fieldwork, discuss your issues with your AFC and your fieldwork educator what options are available for the remainder of your experience.

· I am on a “non-traditional” fieldwork and the OT is not with me very often:

The Accreditation Council for Occupational Therapy Education (AOTA, 2006) states that for Level II experiences when an OT practitioner is not on site, a plan for the provision of occupational therapy services must be documented and provided to the student, school and fieldwork site. When on-site supervision is provided, it must be in accordance with the plan and meet state credentialing guidelines. In this type of setting, the OT student must receive a minimum of eight (8) hours of occupational therapy supervision per week. This includes direct observation of client interaction. During all working hours the occupational therapy fieldwork educator must be readily available for communication and/or consultation if needed. A “non-traditional” fieldwork should not last over twelve weeks (AOTA, 2006).

If you are working in a setting with part-time OT supervision, make sure that you know who to go to when you have OT questions. On a Level II fieldwork, the supervision plan should outline whom to contact when you have a question about service delivery and occupational therapy in general. Contact the AFC immediately if you are not receiving adequate mentoring and supervision.

· I am the primary caregiver for my (children, parents, grandparents, etc.). I have taken steps to make sure that they are taken care of while I’m on fieldwork, but sometimes they get sick and need me at home:

Situations like this warrant open and honest discussion with your fieldwork educator. Your fieldwork educator needs to know that you have outside obligations that may impact your attendance at fieldwork. Prior to talking with your fieldwork educator, prepare a list of options to cover your caregiver obligations should you not be able to leave work and prepare a list of options to get your work covered if you need to leave work. Such options can include but are not limited to, working on Saturdays, extended evening hours, and working beyond the planned 12 weeks. Share this information with your fieldwork educator, this type of planning shows them that you are committed to the fieldwork experience and want make sure that your participate as a full member of the team.

The WUOT Program policy on Level II fieldwork attendance does not allow for days off during the experience. Sick time and days off for personal needs are at the discretion of the fieldwork site. If time off for any reason is requested, the fieldwork site may require that that time is made up through overtime, alternative scheduling, extra assignments, etc.

· I do not agree with the marks that I’ve been given on my evaluation:

Evaluating a student on fieldwork is not easy. There is much time, thought and effort that goes into completing an evaluation. The fieldwork educator is the expert while on your fieldwork experience. His/her judgment needs to be respected. There is a reason why he/she has that opinion of you and your work, figure out why that is and move on from there.

In the event of a personality clash between student and fieldwork educator and either the student or fieldwork educator feels that the poor personal relationship might interfere with the evaluation of performance, the AFC should be contacted as soon as possible. A discussion should occur with all parties and an action plan developed to address the personality issues.

Hints for a Successful Fieldwork Experience

· Communication is vital. Do not be afraid to share your strengths and growth areas on day one. I highly encourage you to identify your own personal goals for this experience, and to share concerns you might have from the very beginning. If your supervisor is aware of your goals and your concerns, he/she can help you address those areas immediately and throughout your experience.

· Remember that, as a student, Level II is not an 8-5 kind of job. You will be expected to put in extra hours, it will take you longer to get some tasks done and you will probably be asked to do more work than some of the other staff. It won’t always be like this, but for now, this is your hands on learning time, take advantage of it!

· Take your books to your fieldwork site with you. You will still need to study throughout this experience.

· Relax, have fun, enjoy working with your clients!

The AOTA website Student section has many helpful resources developed by the Assembly of Student Delegates (ASD). Check it out!

What to Take with You/Useful Resources

· Social Security and picture identification.

· Health forms including immunizations, personal health insurance, and liability insurance.

· Some type of word processing program (i.e. computer).

· OT textbooks including: Trombly, Willard & Spackman, Quick Reference to OT, class notes, AJOT’s, other journals.

· Medical dictionary and reference to medical terminology.

· Other appropriate references for the setting (i.e. DSM-IV).

· Ask your particular site what they recommend.

Advice from Those Who Have Been There

· "Don’t expect to know everything. This is a learning experience--ask questions! Don’t be afraid to ask them."

· "Study up on things you don’t know or remember."

· "Use the therapist and resources available to you for optimal learning." Take the initiative for your own learning.

Time & Stress Management

· Make a schedule and write it down.

· Be sure to budget time for yourself.

· Know your limits.

· Make a "to do" list and prioritize the tasks.

· Do not be afraid to ask for help.

· Schedule "down time" everyday.

· Allow time for documentation throughout the day and be prepared to take work home with you.

· Allow time for research and study.

· Spend time with friends.

· Get away for lunch--to eat or take a walk.

· Eat healthy.

· Exercise.

· Get up a few minutes early.

· Allow adequate travel time.

ASD Tips for a Successful Experience

· Ask lots of questions, get to know your supervisor well and establish a good relationship with him/her.

· Have an open mind.

· Remember that you can learn from a less than optimal situation. Contact your academic fieldwork coordinator for ideas and suggestions.

· Be prepared to use Uniform Terminology.

· Have a file of sample groups or individual activities on hand.

· Make a calendar of due dates.

· Work with other disciplines to gain their perspectives and further your own learning.

· Show appreciation to the nursing staff, they are a great source of help.

· Talk with your supervisor.

· Do not tell your supervisor that you did not want to come to this site or that you are not going to practice in that area anyway...

· Be over prepared--have lots of ideas if something doesn’t work out.

· If away from home, take advantage of what the area has to offer.

· Be flexible with changing patients, times, problems, etc.

· If a facility has files of ideas, make copies and create references to take away with you.

· Know your facility expectations.

· Communicate with those around you.

· Be an active learner. Ultimately you, not your supervisor, are responsible for you fieldwork experience.

· Study and know specific theories used at the facility and know the treatment techniques guided by that theory."

Effective vs. Challenging student

Students bring many things with them to their fieldwork experience: books, notes, lab coats, etc. Perhaps two of the most important things a student brings to the placement are their personality and work ethic. Research has shown that students with a positive attitude towards their work are evaluated as having a higher degree of clinical skills than students with an expressed negative attitude. (Tickle-Degnen, 1999). How you approach your work significantly impacts how you and the outcome of your efforts are perceived.

Students are not expected to be “perfect.” They are expected to try hard, be academically prepared and ready to learn. The following comparison chart delineates the differences between an effective student and a challenging student. At any point in time a student could exhibit characteristics on either list. Students should strive to have more traits on the “effective” list, especially as the fieldwork progresses. (Figure 11-1) If you note that you are having problems, especially problems similar to the “challenging” student, talk with your fieldwork educator.

Comparison of characteristics of an effective student vs. a challenging student

Effective Student

Challenging Student

Asks questions, speaks to others

Withdrawn

Energetic, cheerful

Depressed attitude

Honest, forthright

Manipulative

Listens carefully to feedback and participates in the problem solving process

Has an excuse for most problems

Does not discuss the strengths and growth areas of others beyond appropriate conversations

Projects own problems onto others

Continuously monitors own performance and seeks feedback from a variety of sources

Poor insight

Develops personal system for organization of tasks and assignments

Poor organizational skills

Asks questions of others when needing assistance, independently monitors case load, assignments, etc

Requires a lot of outside pressure to keep up with minimum standards

Seeks feedback from supervisor, shows initiative in trying new tasks, aware of growth areas but not afraid to try new things