!!!!!! !!!!!! !!!!!!!!!!!!!!!!!!!!!!!!! College of Health and Human Services Occupational Therapy Department Fieldwork Manual

College of Health and Human Services Occupational Therapy Department Fieldwork Manual Jean MacLachlan, PhD Candidate, OTR/L Academic Fieldwork Coordinator HB 302 978.542.7009 jmaclachlan@salemstate.edu Occupational Therapy Fieldwork Manual Page 1

Table of Contents 2. SSU OT Fieldwork 1. Introduction... Level I Fieldwork Courses... Level II Fieldwork Courses... Purpose of Fieldwork... 3. Roles and Responsibilities in Fieldwork Role Delineation of OTA s and OTR's... 22 Role of Academic Fieldwork Coordinator... 23 Role of Facility Fieldwork Educator... 23 Student Role and Responsibilities... 24 4. Level I Fieldwork Expectations... 27 Level 1 Student Objectives... 28 Absentee Policy for Level 1 Fieldwork... 31 Completion of Level 1 Fieldwork... 31 Failing Level 1Fieldwork... 31 5. Level II Fieldwork Expectations... 31 Objectives... 32 Absentee Policy for Level II Fieldwork... 36 Completion of Level II Fieldwork... 36 Failing Level II Fieldwork... 31 6. Documentation CORI... 37 Liability Insurance... 37 Immunization Records... 37 Valid CPR Card... 37 HIPPA Certificate AOTA Membership ADA/Student Disclosure Personal Data Form Authorization for Disclosure of Health Care Information OSHA Training Occupational Therapy Fieldwork Manual Page 2

7. Fieldwork Site Requirements 8. General Fieldwork Polices and Procedures (Level I & Level II) 11. Appendix Process for Requesting Sites Obtaining Reservations Fieldwork Cancellations Health Insurance/Health Forms ADA/Student Disclosure 9. Felony Statement 10. NBCOT Certification Appendix A: The Purpose and Value of Occupational Therapy Fieldwork Education Appendix B: ACOTE Standards of Accreditation Appendix C: SSU Professional Behaviors Assessment and Action Plan Appendix D: HIPPA Guidelines for Fieldwork Appendix E: OT Practice Framework for Occupational Therapy (AOTA) Appendix F: The American Occupational Therapy Association Code of Ethics Appendix G: Level II Fieldwork Data Form (AOTA) Appendix H: Student Personal Data Sheet (AOTA) Appendix I: Level II Fieldwork Performance Evaluation (FWPE) for the Occupational Therapist Appendix J: Level II Student Evaluation of Fieldwork Experience (AOTA) Appendix K: SSU Health Form Appendix L: Self-Assessment Tool for Fieldwork Educator Competency Appendix M: Fieldwork Experience Assessment Tool (FEAT) Appendix N: COE Level I & Level II Fieldwork Guidelines Occupational Therapy Fieldwork Manual Page 3

1. Introduction The fieldwork experience has been an integral part of occupational therapy (OT) education since 1923 when the first essentials were written. Three months of clinical internship were required at that time and by 1935, the fieldwork requirement was increased to nine months. The fieldwork component of OT education was changed back to six months in 1973 and has remained unchanged since that time (COE, 1991). Many OT programs offer an optional third internship to further develop clinical skills in a community or specialty area of practice. Fieldwork education offers challenging and unique opportunities for students to foster clinical reasoning skills in a variety of settings and with multiple client populations. The fieldwork component of the Salem State University (SSU) Occupational Therapy Program allows students the opportunity to choose a full-time or part-time option for level II fieldwork in keeping with our mission statement and the program s commitment to adult education and to life-long learning. 2. SSU OT Fieldwork Level I Fieldwork Courses Students enrolled in the occupational therapy curriculum at SSU will participate in four, twenty-hour, level I observation experiences. Level I fieldwork is completed as part of four OT Analysis and Intervention courses. The psychosocial level I occurs in OCT 407N and the physical dysfunction level I occurs in OCT 413, both of which are during the undergraduate portion of the curriculum. The pediatric level I fieldwork experience occurs during OCT 715 and the geriatric/community level I fieldwork observation occurs during OCT 720, both of which occur in the graduate portion of the curriculum. Upon completion of all core and professional level courses up through OCT 802, students will choose one, full-time twelve-week Level II fieldwork internship in a specified area of choice. Students may complete the internship on a part-time basis but will be required to continue with course work during the fall semester. Students must choose level II experiences that are diverse from their current OTA work environment. This allows students to expand skills and ideas in a variety of practice arenas. Students will complete a two-credit fieldwork seminar during this third year summer semester and return to campus in the evening for this seminar. During the fall semester of the third and final year of the program, students will complete OCT 900, OCT 910, & OCT 920. The final level II fieldwork is completed in the spring semester of the final academic year in a second area of choice (unrelated to present work population) and may Occupational Therapy Fieldwork Manual Page 4

be completed on a full or part-time basis for a total of 480 hours. A second, two credit fieldwork seminar will be completed by each student prior to graduation. Students must attend fieldwork seminar to pass their level II internships. Level II Fieldwork Courses OCT 850 Level II Fieldwork and Seminar A (MS Final Year-Summer) The first level II fieldwork internship and seminar will provide students with practical skills and knowledge for participation in and successful completion of level II fieldwork. Students will complete a 480-hour internship (or 12 weeks full time) within a chosen clinical setting in conjunction with a fieldwork seminar. Students will discuss and integrate clinical experiences with academic ideologies. Focus of study will include student assessment tools, facility requirements and expectations, and review of concepts pertaining to professionalism that foster competence for entry-level occupational therapy practice. This seminar will be hybrid requiring an online component as well as in person meetings. OCT 960 Level II Fieldwork and Seminar B (MS Final Year-Spring) This final level II fieldwork internship and seminar is designed to provide students with practical skills and knowledge for fieldwork and for entry-level practice. Students will complete their second internship (480 clinical hours or 12 weeks full time) within a chosen clinical setting in conjunction with a seminar. Students will examine and discuss concepts learned throughout the curriculum with focus spent on preparation and review for the NBCOT examination, professionalism, civic and professional responsibilities, advocacy and their role as future leaders. This seminar will be hybrid requiring an online component as well as in person meetings. ***NOTE: Students are able to complete level II fieldwork requirements up to two years after completion of the final OT course before it may affect the student s eligibility to sit for the NBCOT board examination. Purpose of Fieldwork The purpose of fieldwork is to provide occupational therapy students with opportunities to evaluate theory, develop critical thinking skills, refine documentation, enhance interpersonal relationships, utilize problem solving strategies, and gain additional insight into one s personal learning style that will benefit the individual and the profession. The integration of these learning experiences combined with occupational therapy coursework serve as determinants of a competent, entry-level clinician. (Please refer to Appendix A Occupational Therapy Fieldwork Manual Page 5

for AOTA Purpose) Role Delineation of OTA s and OTR s Students come to the SSU OT program with occupational therapy experience. OT assistants are technicians that work to carry out the treatment plan of a registered therapist. Students enrolled in the program are beginning a transition towards becoming a registered therapist through academic course work and fieldwork experiences. It is essential that students adopt an advanced theoretical approach/framework during this transition in their education. Students will question and explore why certain treatment strategies are implemented based on a variety of factors. It is critical to student development to view each client from a holistic perspective. This means considering physical, cognitive, social, psychological, emotional, sensory, cultural, and environmental factors when developing treatment plans. Students must adhere to the Occupational Therapy Practice Framework as a guide when completing all treatment plans. 3. Roles and Responsibilities in Fieldwork As a registered clinician students will attain greater insight into the problem solving process. This includes: Interpreting medical diagnoses while understanding the impact of the disease process Acknowledging how specific disease process, diagnosis, social, cultural and environmental issues impact a client s life Understanding the value of diversity and cultural differences Exploring the theoretical model of occupation and its importance in client care Determining what questions to think about in regards to seeing the entire client picture Choosing and implementing specific assessments Developing treatment plans based on your findings Implementing treatment strategies that will best meet the needs of your client Re-assessing clients to determine if treatment strategies are working and goals are being accomplished Understanding the value of on-going client, family, and community education Investigating how the family, team members, client, and additional factors can affect treatment outcome Determine appropriate discharge planning and continued treatment options along the client care continuum. Occupational Therapy Fieldwork Manual Page 6

Role of Academic Fieldwork Coordinator It is the role of the Academic Fieldwork Coordinator (AFC) to act as a liaison between the student and the fieldwork educator at the facility. The fieldwork coordinator works with the student to determine the most appropriate fieldwork placement that will meet his/her needs. The fieldwork coordinator is responsible for visiting prospective fieldwork sites, establishing relationships with facilities, obtaining a formal contract, data form and facility objectives, educating fieldwork educators, preparing essential documentation for internships, and communicating essential information pertaining to the SSU Occupational Therapy Program. Role of Facility Fieldwork Educator It is the role of the fieldwork educator to act as mentor and guide during the student s clinical experience. It is essential that students communicate all needs to the supervisor in a responsible and professional manner. The supervisor is responsible for orienting the student to the facility, and reviewing facility policies, procedures, and expectations for the fieldwork experience. The supervisor will oversee all written documentation and interactions with clients, family and team members. It is the supervisor s responsibility to inform the student about special projects and assignments related specifically to that fieldwork experience. The supervisor is also responsible for both informal and formal evaluations and communicating student progress with the student and the academic institution. Student Role and Responsibilities The student from the Salem State University OT Program enters the fieldwork internship with a different perspective than the average student that graduates from alternative entry-level OT degree programs. Students embark on fieldwork with a variety of unique and established skills that need to be fostered and strengthened. As an outcome, the faculty expects that students will integrate new academic knowledge with previously attained skills. Students will demonstrate the ability to reflect this knowledge through verbal communication, written documentation, and professional conduct. In relation to fieldwork specifics, students will work closely with the Academic Fieldwork Coordinator when determining the appropriateness and availability of a fieldwork site. The student is responsible for obtaining health insurance, paying all fieldwork and professional liability fees, obtaining an annual physical examination, maintaining a current and valid Occupational Therapy Fieldwork Manual Page 7

CPR card and completing all necessary forms prior to the fieldwork experience. CORI background checks, drug testing, flu shots and other trainings (HIPAA, Blood Bourne pathogens, etc.) may, at times, be required by a facility before beginning an internship. Trainings and tests are the responsibility of each student, as required by the individual fieldwork setting. In addition, students may be required to participate in a fieldwork interview and be responsible for contacting prospective fieldwork sites one month in advance to confirm dates, time, and place. The student is a representative of Salem State University and will maintain a professional appearance and professional conduct while abiding by the AOTA Code of Ethics (Please see Appendix F). A high standard of professional conduct is expected from all students that enter into this program. Your past experience in the field should reflect this knowledge during your internships. Students are responsible for their own transportation to and from the fieldwork site and for finding their own housing. You must adhere to all policies and procedures established by the fieldwork site as well as established university policy. The student will work daily with the fieldwork educator to participate in client screening and chart reviews, obtaining data for assessment and treatment planning, implementing treatment plans and alternative strategies, and following facility specific documentation guidelines. Students will participate in medical rounds, team, family, and client care meetings, attend educational rounds, and present projects and case reviews as indicated by the facility. The student is responsible for meeting formally at least once a week with his/her immediate fieldwork educator. At times, problems, complications and conflicts do arise. It will be important to address these issues of concern immediately with the fieldwork educator. The student may contact the academic fieldwork coordinator at any time with questions or concerns pertaining to the fieldwork internship. It is important to remember that fieldwork will provide a unique opportunity for you to enhance your skills to become a competent entry-level occupational therapy practitioner. 4. Level I Fieldwork Expectations Level I fieldwork is designed to assist students in becoming familiar with hospital, clinic, school, and community settings, client care, and the treatment planning and implementation process. Level I fieldwork will Occupational Therapy Fieldwork Manual Page 8

occur on a part-time basis and schedules will be determined between the student and the fieldwork educator. Four twenty hour, Level I internships will be set up in the areas of psychosocial, physical dysfunction, pediatric and geriatric areas of practice. A community placement in at least one of these four areas will be encouraged during the level one experience Participation in a community practice area in occupational therapy is vital to your development as a clinician. Level 1 Student Objectives Students participating in a level I internship will: Conduct self in a professional manner as demonstrated by: appropriate appearance and demeanor, positive and effective communication skills sound judgment and ethical decision making ability dependability taking initiative accepting professional responsibilities utilization of clinical reasoning skills Attain an appreciation for diverse cultures and various client populations in need of occupational therapy services. Interact in a professional manner with multiple interdisciplinary team members and co-workers associated with the fieldwork setting. Demonstrate the ability to reflect on observations made related to each clinical situation both verbally, and in journal writing. Conduct interviews with a variety of clients with different diagnoses in diverse clinical settings. Identify specific client problem areas related to performance areas, performance components, and performance contexts. Observe a variety of client assessments specific to the facility and discuss with OTR appropriate occupational therapy intervention options. Abide by all facility policies and procedures and complete orientation process as indicated. Adhere to occupational therapy supervisor guidelines when conversing with clients (facility specific). Develop an appreciation of the environmental impact on client treatment and how the pragmatics of the therapeutic process affects treatment outcome. Acknowledge the complexities of client insurance coverage guidelines, time frames, and all additional documentation needed for the delivery of occupational therapy service. Demonstrate the ability to ask sound and appropriate questions that will aid in the formation of clinical knowledge. Occupational Therapy Fieldwork Manual Page 9

Attend orientation to facility following all safety guidelines and precautions, and attend all required facility educational opportunities as indicated to enrich the fieldwork experience. Complete all performance evaluations and assignments upon the conclusion of each fieldwork experience. At the conclusion of each Level I experience students will be required to complete a self-evaluation. In addition, each supervisor will complete a formal evaluation of the student s performance at the completion of the Level I internship. See the level I evaluation form located on the subsequent page. Absentee Policy for Level I Fieldwork If a student is absent from scheduled fieldwork hours, those hours must be rescheduled by the student and made-up to complete all fieldwork hours, prior to exam week to complete the internship and receive full credit for the internship hours. Completion of Level I Fieldwork Successful completion of each level I internship includes: Completion of 20 hours of observation, as documented by the level I fieldwork educator on the Level I Fieldwork Student Performance Evaluation Satisfactorily meet the level I fieldwork objectives, as documented by the fieldwork educator on the Fieldwork Student Performance Evaluation Completion of fieldwork assignments, as documented within the associated OT Analysis and Intervention course syllabi Level I fieldwork must be completed each semester in order to move forward in the curriculum. Students will receive an incomplete grade and will not be able to move forward in subsequent course work until the requirement for the fieldwork is fulfilled. Failing Level I Fieldwork If the fieldwork educator fails a student at their level I fieldwork placement, a meeting will occur between the student, fieldwork educator, and the AFC (in person or by telephone). An additional project or fieldwork placement may be indicated. Academic probation may result in a student failing a level I fieldwork placement. In addition, a professional development plan may be indicated. The Professional Behaviors Action Plan may be found in Appendix P. 4. Level II Fieldwork Occupational Therapy Fieldwork Manual Page 10

Expectations Students enrolled in the program are representatives of Salem State University. It is expected that OT students demonstrate professional behavior and a positive work ethic at all times. It is critical that students identify and understand their own specific areas of weakness and try to improve upon them throughout each internship experience. The skills and abilities demonstrated to others during these fieldwork internships could possibly lead to future job opportunities. During fieldwork, students are encouraged to maintain communication with faculty members. The faculty is available to assist students in meeting specific goals and to help guide you throughout the process. The faculty may assist each student with specific issues as well as to share with you positive moments, successes, or accomplishments. ***Note: All coursework, prerequisite and support courses must be completed with passing grades before level II fieldwork may begin. The only exception is that after the first Level II fieldwork placement, students will return to complete OCT 900, OCT 910 & OCT 920. Please see your advisor before beginning level II fieldworks to make sure that all requirements have been met.*** Level II Student Objectives Students completing the Salem State University Occupational Therapy Program will enter the Level II fieldwork experience with a global perspective of occupational therapy theory. Students will have acquired specific clinical knowledge needed to enter the field as an entry-level occupational therapy practitioner. Given the student's past occupational therapy experience, the program will build on existing knowledge that will foster growth and development in clinical reasoning, problem solving strategies, research, reflective inquiry, and professional development. Students will: 1. Demonstrate effective oral and written communication skills that reflect a sufficient understanding of the therapeutic process. 2. Exhibit proficient understanding of the AOTA Code of Ethics and Core Values. 3. Act in a professional manner with regards to issues of confidentiality, interpersonal communication, and self-representation. 4. Acknowledge the importance of occupational therapy professional Occupational Therapy Fieldwork Manual Page 11

development through self-reflection and related goal accomplishment. 5. Appreciate the value of community and display concern for social and health care issues of diverse populations. Specific Objectives: The occupational therapy student will be responsible for exhibiting the capability of performing comprehensive oral and written competence in regards to the following areas: 1. Referral 2. Evaluation 3. Treatment Planning 4. Treatment Intervention 5. Termination of Service 6. Service Management Referral: A referral for occupational therapy service is acknowledged through a written or verbal request. The clinician in accordance with AOTA guidelines and facility policy follows up on a referral for OT. Students will: 1. Adhere to all stated facility policies in regards to client referral. 2. Acquire the appropriate decision making skills necessary to facilitate a client evaluation order. 3. Complete all required verbal and written documentation as it pertains to the facility referral process. 4. Demonstrate the ability to responsibly refer clients to additional services as indicated. 5. Adhere to specific insurance coverage guidelines or additional facility related policies in respect to requesting evaluation orders. Evaluation: Occupational therapy evaluation is initiated once the referral process is complete. The evaluation process investigates a client through assessment of current and past medical history, examination of social, vocational, leisure pursuits and activities of daily living routine, observation of mobility skills and general movement of limbs, inspection of the sensory systems, and a profile of a client s psychological status. Specific problem areas are then identified and a Occupational Therapy Fieldwork Manual Page 12

course of action is established with specific treatment goals and intervention plan. Students will: 1. Adhere to specific facility procedures and in accordance with AOTA guidelines in relation to data collection, data analysis, treatment recommendations, and treatment interventions. 2. Demonstrate competence in selection and administration of specific evaluation tools per client need. 3. Effectively communicate to the client, family, and team, in both written and verbal form, the process and purpose of the evaluation and the rationale for the prescribed treatment. 4. Establish competency in interviewing and observation skills through standardized and non-standardized evaluations. 5. Adequately analyze and synthesize the data to formulate holistic treatment plans. Treatment Planning: The occupational therapy treatment planning process involves the identification of specific client goals that are measurable and the methods necessary to attain the goals. Students will: 1. Document, both short and long term goals that encompass the complete realm of occupational therapy philosophy and consider the individual needs of the client. 2. Identify, select, plan, prioritize, and adapt occupational therapy methods for the attainment of both short and long term goals. 3. Follow specific facility and OT Practice guidelines when formulating treatment plans. 4. Determine appropriate time frames for meeting specific treatment objectives. 5. Utilize critical thinking strategies and creative alternatives within facility and AOTA guidelines to implement, modify, or adapt the treatment plan or treatment methods for the betterment of the client. 6. Communicate clearly to the client, family and team, the time frame of the treatment plan, the specific problems identified, goals to be addressed, Occupational Therapy Fieldwork Manual Page 13

and methods to be utilized during occupational therapy treatment sessions. Treatment Intervention: Treatment intervention in occupational therapy refers to the use of specific methods or activities that will enhance, promote, or restore functional performance to clients afflicted with disability or illness, or may be utilized as a preventative means to prevent illness or disability. Student will: 1. Administer treatment interventions that promote purposeful and meaningful opportunities for the client to enhance goal achievement. 2. Adhere to all facility safety precautions and procedures when administering treatment interventions. 3. Monitor the client for signs of excessive pain, fatigue, or discomfort and adjust or modify the treatment session or plan accordingly. 4. Independently seek out or utilize appropriate resources and references in regards to treatment updates and options available. 5. Orient and instruct others regarding the treatment methods used that support the occupational therapy program. Termination of Service: Occupational therapy services are terminated when both short and long term goals are attained; service is transitioned to an alternative level such as long term care, out patient or home care, or when the client no longer receives benefit from the intervention. Student will: 1. Formulate discharge planning for clients in both verbal and written format in conjunction with facility policy and with OT Practice guidelines. 2. Demonstrate competency in creating discharge plans that transition client to the next setting and refer to appropriate agencies as indicated. 3. Appreciate the range of opportunities and services available to clients outside of the setting that are situated in the community. 4. Collaborate with client, family, or transitioning agency regarding current client status as well as establishing the follow through of interventions and goals as indicated. Occupational Therapy Fieldwork Manual Page 14

5. Develop problem solving skills necessary to terminate client services in the most appropriate time frame and in accordance with specific insurance guidelines. Service Management: Service management refers to the daily administration tasks associated with the facility that includes organization skills, time management, interpersonal communication and professional growth in regards to the delivery of occupational therapy service. Student will: 1. Report to facility in a timely fashion, plan daily schedule and assume daily work load in accordance with facility policy. 2. Conduct themselves in a professional manner at all times adhering to facility dress code, maintaining open communication with personnel, and abiding by all rules and policies set forth by the facility. 3. Maintain efficiency and safety in the work area including the upkeep of equipment and the organization of supplies. 4. Work collaboratively with their immediate supervisor to foster a positive learning experience and enhance professional growth. 5. Complete additional projects and or presentation assignments in accordance with specific internship objectives stated by the facility. 6. Participate in staff meetings, educational in-services, rounds, client care meetings, or discussions as outlined by the facility. Evaluation A copy of the AOTA Level II Fieldwork Performance Evaluation (FWPE) Form is located in Appendix I. Students should become familiar with the specific content areas that will be evaluated prior to beginning each internship. This evaluation form will be completed by the clinical supervisor at the halfway point and upon completion of the internship. In addition, the student evaluation of the facility will be completed during the final week of the internship. This data is essential for future students seeking fieldwork sites. This form may be found in Appendix J. Absentee Policy for Level II Fieldwork: Many fieldwork settings will allow 1-3 days of absence without having to make Occupational Therapy Fieldwork Manual Page 15

the time up. Students need to become familiar with each facility s policy. *NOTE: Up to 3 days can be taken for illness/family emergency. You are not entitled to 3 days off during fieldwork. Completion of Level II Fieldwork: Two level II fieldwork placements must be completed by each occupational therapy student prior to graduating. Each placement is completed for 12 weeks full time or 480 hours (if done on a part-time basis). Any part-time level II fieldwork must be at least 20 hours/week and the student must be available at least 3 week days/week. Successful completion of each level II fieldwork placement includes: Completion 12 weeks of full time fieldwork OR 480 hours of parttime fieldwork as documented by the Fieldwork Educator and Academic Fieldwork Coordinator Passing the AOTA Level II Fieldwork Performance Evaluation (FWPE) for the Occupational Therapist Passing of the seminar assignments attached to the level II fieldwork (A or B) as outlined in the course syllabi Failing Level II Fieldwork Failing a level II experience is a serious concern. Level II Fieldwork is the opportunity to put academic learning into practice. This application of knowledge and clinical reasoning are paramount to being a successful occupational therapist. If a student feels that some unusual or extreme circumstance related to the failure of the fieldwork experience occurred, an appeal may be made in writing to the OT Academic Review Committee within the OT Department. Generally, the Academic Fieldwork Coordinator will be part of this appeals process. If this appeals committee recommends a make-up affiliation, then a one-time only make-up affiliation will be scheduled by the Academic Fieldwork Coordinator. Remediation may be required before the student is allowed to retake a failed Fieldwork II or to advance to further scheduled fieldwork. Any further appeals must follow the student academic appeals procedure of the SSU Graduate school located at the following link: http:// catalog.salemstate.edu/content.php? catoid=20&navoid=2331#academic_appeal_procedure Note *****Any student that has been convicted of a prior felony may be Occupational Therapy Fieldwork Manual Page 16

considered ineligible by NBCOT to sit for the examination and may also be unable to attain an occupational therapy license from the State Licensure Board. 6. Documentation Massachusetts Criminal Offender Record Information (CORI): A CORI is performed on every student in the occupational therapy program prior to attending a fieldwork placement. Students may not be allowed to attend fieldwork experiences if they have felony conviction(s) or open cases. Liability Insurance: Every student taking OCT courses must purchase Liability Insurance every fall from the Bursar s Office and provide a copy of their receipt to the Occupational Therapy Department Administrative Assistant. The Liability Insurance must be purchased every year a student is registered in the OCT courses until they have graduated. Without the Liability Insurance, a student will not be able to acquire or attend any fieldwork placements. Immunization Records: All students taking OCT courses must provide the SSU Counseling and Health Services with updated immunization records (including MMR, Hepatitis B, Chicken Pox & TB). To obtain forms, go to SSU counseling and health services website and click on Forms link. Immunization records, including Flu shots, MUST be updated yearly. Without immunization records completed and updated yearly, a student will not be able to acquire or attend any fieldwork placements. Valid CPR Card: All students taking OCT courses must maintain a valid CPR card until the complete all their OCT coursework, including their level II fieldwork placements. It is the student s responsibility to provide the Occupational Therapy Department Administrative Assistant with current copies of the CPR card. Without a current and valid CPR card a student may not be able to acquire or attend a fieldwork placement. HIPAA Certificate: All students participating in fieldwork must acquire a HIPAA certificate. They may use the following link: https:// www.citiprogramorg, to create an account and take the CITI Health Information Privacy and Security (HIPS) for Students and Instructors Basic Course. This course has five modules. Each module must be passed with at least an 80%. Upon completion, print the certificate and provide it to the Occupational Therapy Department Administrative Assistant. Without a current and valid HIPAA card a student may not be able to acquire or attend a fieldwork placement. AOTA Membership: All students taking OCT courses must provide a valid AOTA membership card to the Occupational Therapy Department Administrative Assistant each fall. Without a current and valid AOTA card a student will not be able to acquire or attend a fieldwork placement. Occupational Therapy Fieldwork Manual Page 17

Personal Data Form: All students taking OCT courses must complete a Personal Data Form every fall and to provide it to the Occupational Therapy Department Administrative Assistant. Authorization for Disclosure of Health Care Information: Every semester a student has fieldwork, the Authorization for Disclosure form will need to be signed so immunization and data records can be released to fieldwork settings. OSHA Training: Any student who has taken OSHA training with your employer, please provide us with a copy of the training certificate for your files. 7. Fieldwork Site Requirements It is the responsibility of the student to adhere to policies of each facility they attend. Including, but not limited to dress code, wearing of jewelry, exposure of tattoos, wearing of fake nails or keeping nails trimmed, etc. Some fieldwork settings will require their own Criminal Offender Record Information (CORI) check prior to starting at the facility. Facilities have the right to refuse students based on the CORI results. Some fieldwork settings require finger printing and drug testing **Students are responsible to pay for any additional background checks, drug testing, and/or finger printing required by fieldwork facilities. 8. General Fieldwork Policies and Procedures (Level I & Level II) Process for Requesting Sites Level I Students will meet with the fieldwork coordinator when beginning the professional aspect of the program after completion of all prerequisite course requirements. A plan for level I and level II will be established for each student. This is subject to change per discussion with the AFC. Level II The process for requesting fieldwork sites will be similar to requesting Level I sites. It will be mandatory to choose two fieldwork placements outside of your current realm of practice to ensure a holistic student experience and to assist you in preparing for the national certification examination. Occupational Therapy Fieldwork Manual Page 18

Level I Obtaining Reservations The AFC will notify each student verbally or through email of his/her level I placement. The AFC will try to accommodate each student s request. It is the student s responsibility to contact the Level I fieldwork educator to confirm the starting date and time. If students have specific sites that you would like the AFC to contact, please send an e-mail with requests. Please include the following information: Name of the facility Address Telephone number Contact person (if you know who it is) Type of facility (phys-dysfunction, hand clinic, school, etc.) Level II The Academic Fieldwork Coordinator will contact students by telephone or by email when a level II placement is secured. Include the same information as stated above when requesting a facility to contact for a Level II placement. Level II reservations for internships beginning in the summer and spring semesters will be coordinated through the AFC. Students will meet approximately 1-2 times per semester with the Academic Fieldwork Coordinator to review options and obtain the placement that will best fulfills his/her needs. Fieldwork Cancellations There are times when a facility may cancel an internship. This may be due to a variety of reasons. The reason that most often occurs is related to staffing changes at the facility. It is important to maintain an open attitude when it comes to fieldwork. Securing fieldwork placements is not an exact science. At times it may become a frustrating process. The AFC will work closely with the student to determine an alternative arrangement that will be most accommodating. It will be important to maintain this open attitude and be prepared ahead of time to "expect the unexpected" in regards to fieldwork. The student is expected to honor his or her commitment to the internship where he/she has been scheduled. At times, extraordinary circumstances do occur which may lead to a cancellation by the student. If this occurs the following steps must be taken. Occupational Therapy Fieldwork Manual Page 19

Contact the AFC to explain the situation. There may be an alternative solution to the problem that may avoid an unnecessary cancellation. If the circumstances warrant cancellation, a formal letter must be written to the OT undergraduate committee stating the reasons for the cancellation and any steps that were taken to avoid the cancellation. A decision to cancel will then be made by the committee if the cancellation is warranted. You will receive written notice within two weeks of your submission to the committee. If permission to cancel is granted, the student will write an additional letter to the facility explaining the reasons for cancellation and express regret for not fulfilling the commitment. Before the letter is sent to the facility it must be reviewed by the AFC. Options for an alternative placement and time will be discussed once the letter has been mailed to the facility. If the petition to cancel the fieldwork placement is denied, the student will be expected to report to the scheduled facility at the stated beginning date and time. Failure to do so will only delay the ability to meet certification examination deadlines. It is imperative that students work closely with the AFC regarding any issues or concerns regarding fieldwork placements. Health Insurance/Health Forms Massachusetts State Law requires that all students enrolled in at least 75 percent of a full-time course load at an institution of higher learning in Massachusetts must participate in a student health insurance program or in a health insurance plan with comparable coverage. Please see the following link for additional information: https://www.salemstate.edu/4928.php ADA/Student Disclosure Students have the right, under the Family Educational Rights and Privacy Act to have access to their educational records and to prevent disclosure of their contents to third parties without formal authorization. Records may be requested in writing through the Registrar s Office. The Occupational Therapy Department faculty may discuss a student s academic and fieldwork performance with potential employers and others, only if the student has given formal, written permission to do so. Such disclosure occurs only in the best interest of the student and is used to benefit his or her educational experience. Occupational Therapy Fieldwork Manual Page 20

Students with special needs (physical, mental and or learning disabilities) who may need accommodations related to completing academic or fieldwork requirements are responsible for discussing such needs with their academic advisor. Students needing assistance should contact the Disability Services Office at (978) 542-6217. Please refer to the Undergraduate Student Handbook for additional information. Financial Aid during Level II Fieldwork Fieldwork is comprised of six credits for each level II experience. Please contact the Financial Aid Department with additional questions in regards to credits and financial aid. The Financial Aid office may be reached at (978) 542-6112. 9. *****Felony Statement ***** Students meeting all academic and fieldwork requirements may be eligible to sit for the NBCOT Certification Examination and be allowed to obtain a state license to practice as a registered occupational therapist. Any student who has been convicted of a prior felony may be considered ineligible by NBCOT to sit for the examination and may also be unable to attain an occupational therapy license from the State Licensure Board. 10. NBCOT Certification Upon completion of Level II fieldwork (960 hours) and all academic course work requirements and graduation; students may be eligible to sit for the National Certification Examination through NBCOT. This examination is completed at a testing center such as Sylvan Learning Center and is available on demand. Please refer to the NBCOT website for additional specifics pertaining to the examination and location of testing sites. www.nbcot.org The National Board for Certification in Occupational Therapy, Inc. (NBCOT) administers the National Certification Examination for Occupational Therapy upon demand at assigned test centers. Sylvan Learning Center is listed as one of these test centers. These centers are located throughout Massachusetts. Course work and fieldwork requirements must be met before a student is eligible to sit for the examination. In addition, outstanding financial obligations to SSU must be cleared through the billing office prior to taking the examination. Students may find all necessary information and the test application at the NBCOT website at www.nbcot.org or send correspondence to: National Board for Certification of Occupational Therapists Occupational Therapy Fieldwork Manual Page 21

2/100 S Summit Ave, Gaithersburg, MD 20877 (301) 990-7979 Fax (301) 869-8492 Occupational Therapy Fieldwork Manual Page 22

11. Appendix (see following pages) The following documents listed below received permission to print status by the American Occupational Therapy Association - September 2007 Appendix A: The Purpose and Value of Occupational Therapy Fieldwork Education Appendix B: ACOTE Standards of Accreditation Appendix C: SSU Professional Behaviors Assessment and Action Plan Appendix D: HIPPA Guidelines for Fieldwork Appendix F: The American Occupational Therapy Association Code of Ethics Appendix G: Level II Fieldwork Data Form (AOTA) Appendix H: Student Personal Data Sheet (AOTA) Appendix I: Level II Fieldwork Performance Evaluation (FWPE) for the Occupational Therapist (AOTA) Appendix J: Level II Student Evaluation of Fieldwork Experience (AOTA) Appendix K: SSU Health Form Appendix L: Self-Assessment Tool for Fieldwork Educator Competency Appendix M: Fieldwork Experience Assessment Tool (FEAT) Appendix N: COE Level I and Level II Fieldwork Guidelines Occupational Therapy Fieldwork Manual Page 23

APPENDIX A Occupational Therapy Fieldwork Manual Page 24

APPENDIX B Occupational Therapy Fieldwork Manual Page 25

APPENDIX C Occupational Therapy Fieldwork Manual Page 26

Salem State University Schools of Human Services Professional Behaviors Assessment Student name: Faculty name: Course number: Student ID code: Semester: ( ) Midterm ( ) End of Semester Indicate the student s level of performance using the scale below. 1= Well Below Standards: Performance is weak in most required tasks and activities. Work is frequently unacceptable 2= Below Standards: Opportunity for improvement exist however student has not demonstrated adequate response to feedback. Work is occasionally unacceptable 3= Meets Standards: Carries out required tasks and activities. This rating represents good, solid performance and should be used more than all the others. 4= Exceeds Standards: Frequently carries out tasks and activities that surpass requirements. At times, performance is exceptional. 5= Far Exceeds Standards: Carries out tasks and activities in consistently outstanding fashion. Performance is the best that could be expected from any student. 1.Time management Skills Consider ability to arrive on time, complete assignments on time: Comments: 1 2 3 4 5 2. Organization Consider ability to set priorities, be organized, follow through with responsibilities Comments: 1 2 3 4 5 Occupational Therapy Fieldwork Manual Page 27

3. Engagement in the classroom experience Consider student s apparent level of interest, level of active participation while in class, Investment in class activities or group work Comments: 4. Self-Directed Learning Consider ability to take responsibility for own learning, demonstrate motivation Comments: 5. Reasoning/Problem Solving Consider ability to use self-reflection, willingness to ask questions: ability to analyze, synthesize And interpret information; understand the OT process Comments: 6. Written Communication Consider grammar, spelling, legibility, successful completion of written assignments and correct Use of APA format Comments: 7. Initiative Consider initiative, ability to seek and acquire information from a variety of sources. Comments: 8. Observation Skills Consider ability to discuss performance areas and performance components and to verbalize Perceptions regarding case studies or other in class activities Comments: 9. Participation in the teacher/student Process Consider ability to give, receive and respond to feedback; seek guidance when necessary; follow Proper channels. Comments: 10. Verbal communication and Interpersonal skills with students/teacher Consider ability to interact appropriately with individuals such as eye contact, empathy, limit Setting, respectfulness, use of authority, degree/quality of verbal interactions; use of body Language and non-verbal communication Comments: 1 2 3 4 5 5 5 5 5 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Occupational Therapy Fieldwork Manual Page 28

11. Professional and Personal Boundaries Consider ability to recognize/handle personal/professional frustrations, balance personal/professional obligations; handle responsibilities: work with others cooperatively considerately, effectively; responsive to social cues in the classroom Comments: 12. Use of professional terminology Consider ability to appropriately apply professional terminology ( such as Occupational Therapy Framework, appropriate medical acronyms, abbreviations) in written and oral communications Comments: Final score: ( ) Pass Student Signature ( ) Fail Faculty Signature Requirements for passing No more than one item below a 2, OR No more than two items below a 3 A Failing score requires completion of a Professional Behaviors Action Plan Until Professional Behaviors Action Plan is completed student will receive an Incomplete Grade for course and will not be able to register for the next group of courses 5 5 1 2 3 4 1 2 3 4 Occupational Therapy Fieldwork Manual Page 29

Salem State University Schools of Human Services Occupational Therapy Department Professional Behaviors Student Action Plan Student Name: Student ID: Probationary Semester PB Meeting Held With Faculty: Summarized Discussion/Current Professional Behavior Issues Targeted: 1) Time Management 2) Organization 3) Engagement in Class 4) Self-Directed Learning 5) Reasoning/Problem Solving 6) Written Communication 7) Initiative 8) Observation Skills 9) Teacher/Student Process 10) Verbal Communication Comments Occupational Therapy Fieldwork Manual Page 30

11) Prof/Personal Boundaries 12) Use Professional Language Additional Comments: Professional Behavior Action Plan: Time Line: Occupational Therapy Fieldwork Manual Page 31

Action Plan to take effect from date of signatures from both parties listed below: Faculty Signature/Advisor: Student Signature: Salem State University Schools of Human Services Occupational Therapy Department Professional Behaviors Student Action Plan Follow Up Meeting Student Name: Student ID: Probationary Semester PB Follow Up Meeting Held With Faculty: Summarized Discussion/Current Professional Behavior Goal Attainment: Recommendations: Removal from Probation/Goals Attained Extend Probationary Period Revise Action Plan Program Suspension Occupational Therapy Fieldwork Manual Page 32

Additional Comments Faculty Signature/Advisor: Student Signature: Occupational Therapy Fieldwork Manual Page 33

APPENDIX D Occupational Therapy Fieldwork Manual Page 34

Fact Sheet: HIPPA Privacy Rule Web Links AOTA Reimbursement and Regulatory Policy Department The HIPPA Privacy Rule establishes a federal requirement that most doctors, hospitals, and other health care providers (such as occupational therapists) obtain a patient's written consent before using or disclosing the patient's personal health information to carry out treatment, payment, or health care operations (TPO). Health care providers must comply with the HIPPA privacy rule by April 14, 2003. For more information, see the following Web sites: HIPAA Security Information Series: A set of 5 documents providing insight into the HIPAA security rule http://www.cms.hhs.gov/educationmaterials/ 04_SecurityMaterials.asp#TopOfPage Background and General Information http://www.hhs.gov/ocr/hipaa/bkgrnd.html The Final Privacy Rule http://www.hhs.gov/ocr/hipaa/finalreg.html U.S. Department of Health and Human Services: Administrative Simplification Privacy and Security http://www.cms.hhs.gov/hipaageninfo/04_privacystandards.asp#topofpage HHS Office of Civil Rights: HIPAA FAQs http://www.hhs.gov/hipaafaq/index.html HHS Fact Sheet on Final Privacy Rule - Summary http://www.hhs.gov/ocr/privacysummary.pdf University of Miami, School of Medicine, Privacy / Data Protection webpage http://privacy.med.miami.edu/index.htm Occupational Therapy Fieldwork Manual Page 35