Salem State College Schools of Human Services Occupational Therapy Department

Salem State College Schools of Human Services Occupational Therapy Department Promoting Effective Learning Experiences during Fieldwork for the Adult Learner 2007-2008 1

Table of Contents Introduction Pg.3 Literature Review (Adult Learning Theory) Pg. 4 Crist-Commentary: Realizing the Vision Through Fieldwork Education Pg. 5A Musselman-Achieving AOTA s Centennial Vision: The Role of Educators Pg. 5B The Adult Learner in the Classroom & Clinic (Power Point Presentation-Slides) Pg. 6 The Salem State College Student Pg. 15 o SSC OT Program Objectives Pg. 18 o The SSC OT Curriculum (Combined BS/MS) Pg. 28 Attaining a Successful Experience With Level I Fieldwork Pg. 31 o SSC OT Level I Objectives Pg. 32 o Level I Assessment Pg. 33 Attaining a Successful Experience with Level II Fieldwork Pg. 35 o SSC Level II Objectives Pg. 36 o Level II Student Evaluation (AOTA FWPE) Pg. 41 Conclusion Pg. 42 References Pg. 43 2

Introduction The number of adult learners in occupational therapy programs is increasing. Older students have unique learning needs, pre-established learning styles, are personally vested and motivated, have a focused purpose of learning, and bring unique life experiences to their learning environment. As occupational therapists we have the ability and responsibility to utilize our distinctive skills to provide the most effective classroom and clinical learning environment possible. Occupational therapists have distinctive skills that differentiate us from other healthcare providers. OT s are able to adapt the environment to fit a client s physical and/or sensory needs, perform activity analysis to suit a client s cognitive abilities, anticipate potential obstacles and provide options for achievement. In order to effectively utilize our skills and promote success and mastery, OT s need to understand the consumer of our services. Likewise, when teaching in a classroom or supervising at a fieldwork site, our consumer is the student, who often is an adult learner whose needs vary in several ways from the traditional student. For instance, these adult learners often have full or part-time jobs, children, responsibilities to elderly parents or relatives, financial obligations and commitments to community endeavors. The adult learner has unique life experiences to bring to the classroom and oftentimes a stronger sense of identity, has a more focused sense of purpose and direction, different time and personal constraints, motivations and learning styles versus the needs of the younger, more traditional student. The various and diverse attributes of adult learners should compel educators and fieldwork supervisors to adapt to the unique learning styles of these older students. This workbook reviews some theories of adult education, ways to facilitate adult learning, strategies that approach different learning styles, and guidelines for effective instruction and supervision. Thank you for taking time to educate students from Salem State College. Your efforts are invaluable. Please contact me with any questions or concerns. Jeanne Corcoran, CAGS, OTR/L 3

Literature Laher, S. (2007). Reflections on teaching undergraduate psychology to part-time adult students. Southern African Journal of Psychology. 37(2), 383-388. This study from South Africa looked at the characteristics of adult learners versus traditional students. The study reviewed three theoretical models that support the author s findings about adult learners in the classroom setting. These theories include andragogy, transformative learning theory, and cognitive theory. Andragogy- Defined as the science of teaching adult learners with focus on the individual needs of the adult learner. Andragogy proposes the following assumptions about adult learners. These include: -Adult students are more responsible, self directed and independent -Adult students have a larger knowledge base and more skills to draw from -Adult students are more willing to learn. This is based on developmental and real-life responsibilities. -Adult students are more open to problem-centered learning relevant to their current life situation-thus a stronger need to know the reasons for knowing something -Adult student are more intentionally motivated Transformative Learning- A theory that proposes how to effect change on an individual s frame of reference. The focus of transformative learning is on changing the ways in which adult learners learn, making them aware of their learning and making them critically reflect on their experience in order to become more autonomous thinkers. Cognitive theory- This theory stresses the need to consider the context or environment within which the learner functions. 4

According to Laher (2007), all three of these approaches consider the differences between the traditional student and the adult learner. Agreement exists that teaching adult learners requires a different approach. Laher (2007) also revealed four main differences between the adult learner and the traditional aged student. These include: 1) Maturity and Professionalism, adult learners attend classes with more regularity, tend to work together with the professor on issues such as lateness of assignments, missed classes and amount of work required. However, the adult learner may also be more critical if there are errors in the syllabus or assignment instructions, or voice concerns when exams are more difficult 2) Life Experience, adult learners have much more life experience and this leads to improved class discussion and are more likely to critically engage in the discussion as they relate it to their own experiences 3) Personal Commitments, adult learners tend to have work and family responsibilities. Electronic communication works best and allowing for flexibility with due dates is important to their success when schedules become overwhelming and 4) Anxiety, adult learners tend to be more anxious when it comes to assignments and exams. They place a more critical importance on succeeding at assignments, examinations and classroom tasks. Laher (2007) points out in this review of the literature several key points to consider when working with the adult learner. The best way to meet their needs is to understand them. 5

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The Salem State College OT Student The faculty members at Salem State College believe in the importance of making connections between theoretical knowledge and applicable practice situations. Theory is what drives the occupational therapy profession to adapt and change to the social, economic, and cultural needs of a population at any given time. In addition to theory, it is essential that the OT program provide an integrated approach to the intellectual and developmental needs of students and recognize their uniqueness. The faculty members also believe that students exposed to a curriculum that enhances community involvement through outreach programs and community internships will foster improved communications that benefit the student s professional skill development. Academic programs must prepare future practitioners to respond effectively to changes occurring in the profession and in society. Shaping a student s ability to apply theoretical principles is a primary focus at Salem State College. Student learning is facilitated in many ways and through multiple channels throughout the curriculum. Students will continuously grow and develop in their attainment of skills and knowledge as they travel through the program building meaningful connections from one semester to the next. Mattingly & Fleming refer to this as knowing more than we can tell. This tacit knowledge forms the base of all other thoughts and actions that comprise practice (Mattingly & Fleming, 1994). Occupational therapy assistants have acquired a level of tacit knowledge from previous classroom and clinical experiences. Upon completion of the program each student will enter the field at a novice level. In time, mastery and proficiency in clinical reasoning skills will be realized, tacit knowledge will be refined, and positions at an intermediate, proficient, and expert practitioner level will be attained. 15

The information presented to students in the curriculum is an important component to the learning process, but more importantly, the application of such knowledge needs to be experienced and applied in real life clinical settings. It is up to the faculty as well as clinical educators to provide opportunities for students that will foster skills resulting in them becoming independent, empathetic, and critical thinking practitioners. Occupational therapy practitioners learn early on in their academic preparation to view clients in a holistic manner. It is also imperative for educational institutions and clinical settings to embrace this concept of holism when mentoring future occupational therapy professionals. Faculty Approach & Assumptions about Teaching & Learning Occupational therapy students enrolled in the SSC Combined BS/MS OT Program will be acknowledged by faculty members for the professional skills and attributes that each student brings to class from their current scope of practice. Experiences shared from all domains of occupational therapy practice will benefit students as knowledge is shared and discussed with classmates throughout the curriculum. The faculty believes that OTA students come into the OT program with a generalized understanding as well as specific beliefs about the occupational therapy profession. They have developed their own sense of professional style, behavior, and attitude. However, occupational therapy assistants are not fully aware of why certain treatment implementation is needed and what should be addressed when problems or situations arise during the treatment process. Occupational therapy assistants carry out the treatment plan of the OTR but have not received the in-depth theoretical knowledge or refined their clinical reasoning abilities needed to understand the entire scope or rationale for client intervention. The problem solving approach is crucial in the development of the occupational therapist. A primary focus of the SSC OT curriculum will be to facilitate student awareness of the problem solving process as well as how to apply this specific skill when treating clients. 16

The program at Salem State College is an extension of basic occupational therapy skills and knowledge that were obtained by students during previous coursework and clinical experiences. Each student has a unique educational background and diverse working knowledge. This knowledge and skill level creates a distinct perspective and advantage to students learning the problem identification, assessment/evaluation, and intervention process. The fieldwork educator/supervisor is an essential team member for the development and refinement of skills for students from Salem State College. Understanding the needs of adult learners will be critical to the success of the internship for all involved. 17

SSC OT Program Objectives (Combined BS/MS) 1. Design, develop, and implement an occupational therapy program that endorses and educates students about the occupational therapy practice framework, articulating the core principles and constructs as the language of the occupational therapy profession. 2. Design, develop, and implement an occupational therapy program that encourages a student-centered learning model; one that promotes further construction of skills and knowledge attained from previous OTA educational and work experience while stimulating new learning and cognitive capabilities. 3. Design, develop, and implement an educational model that acknowledges and develops in its students a passion and commitment to the occupational therapy profession, while building on the commitment and goal of becoming or remaining a life-long learner. 4. Design, develop, and implement the Master of Science occupational therapy program that incorporates flexible alternatives to meet program objectives for the adult learner; developed through class assignments and fieldwork opportunities that will promote independent thinking and problem solving capabilities through broad and diverse academic and clinical realms. 5. Design, develop, and implement a Master of Science degree program for occupational therapy assistants that broaden and advance the multiple skills required by students to be competent entry-level practitioners. 6. Design, develop, and implement a Master of Science degree program for occupational therapy assistants that promote an impassioned commitment to cultural, educational and civic leadership responsibilities within and outside of the occupational therapy profession. 7. Design, develop, and implement an occupational therapy program that emphasizes learning from a generalized versus specialized perspective, offering students a broad exposure to multiple service delivery models, treatment contexts, and practice domains including emerging practice arenas. Student Attainment Objectives Strand # 1 Professional Development Encouraging development of professionalism is an essential component of the Occupational Therapy Program at Salem State College. To be a competent practitioner, students must display specific behaviors that are expected and required of them. Occupational therapists must be dependable, act professional, show empathy and concern 18

for others, be cooperative in one to one and in group situations, appear organized, demonstrate an ability to take initiative, demonstrate excellent verbal and written communication skills, and employ clinical reasoning in therapeutic and non-therapeutic situations. In addition, professionalism requires that the practitioner attain greater knowledge about state, national, and international Occupational Therapy Associations, policies, regulations, and legal and ethical positions. Professional development includes being committed to the profession through continuing education opportunities and acknowledgement of life-long professional responsibilities. This may include but not be limited to student supervision, OTA/OT partnerships, consumer advocacy, research, entrepreneurial pursuits, management, education, and the demonstration of outcome analysis in all OT practice arenas. Developing an awareness of professional behaviors is a key strand emphasized in the SSC OT curriculum. Strand # 1 Professional Development Upon completion of the Salem State College Occupational Therapy Program, students will be able to: Demonstrate proficient oral and written communication skills in a professional manner when interacting with clients, family members and significant others, colleagues, health providers, and members of the public. Show competency in basic computer use and acknowledge state, national and international resources via the Internet and in participation in computer enhanced coursework. Display an understanding of the importance of being dependable and working cohesively with others for benefit to the consumer and family, colleagues, and professional organizations. Exhibit a complete understanding of the referral process and additional resources available for the development of holistic and client-centered and occupationally based intervention plans. Display an understanding of the implications and effects that federal and state regulatory and legislative bodies have on practice and acknowledge national and state requirements for OT credentialing. Demonstrate knowledge of reimbursement mechanisms and value the importance of OT professional documents such as the AOTA Code of Ethics, Core Values, Uniform Terminology, and AOTA Standards of Practice. Reveal to educators, supervisors, colleagues, and classmates, effective use of time management skills, the ability to be organized and set priorities, and maintain timely record keeping while managing caseload assignment. 19

Create an individualized occupational therapy development plan that includes professional goals related to OT/OTA/student supervision, continuing education opportunities, state and national OT service opportunities, scholarly and research pursuits, entrepreneurial endeavors, and professional advocacy and marketing. Demonstrate initiative through the organization and implementation of a student OT conference illustrating scholarly and professional work to others within and outside of the OT profession. Create an appreciation and acceptance of traditional as well as emerging OT practice models to enhance the future growth and prosperity of the occupational therapy profession. Student Attainment Objectives Strand #2 Clinical Reasoning Mattingly & Fleming (1994) refer to clinical reasoning as the process used by practitioners to plan, direct, perform, and reflect on client care. Whenever one is engaged in thinking about, doing or planning occupational therapy services, he or she is involved in the clinical reasoning process. Clinical reasoning refers to the relationship that exists between formal theory and actual practice. It involves a total body process that uses our senses to help make clinical decisions. Fleming refers to this as knowing more than we can tell. This is referred to as tacit knowledge. It is the practical knowledge, the common sense knowledge or the intuitive knowledge that binds the theoretical components to the doing aspect of treatment (Mattingly & Fleming, 1994). The clinical reasoning process is complex and contains many components. The four major areas of clinical reasoning include: 1) Scientific reasoning-used to understand the condition affecting the individual and decide treatment interventions in the best interest of the client. 2) Narrative reasoning-goes beyond scientific reasoning by allowing the clinician to understand the meaning of the illness or disability from the client s perspective as you enter their life world. 3) Pragmatic reasoning-addresses the whole world in which therapy occurs. It considers the personal as well as the practice context in every given clinical situation. 4) Ethical reasoning-it asks what should be done. What is the eventual outcome? It deals with the ethical issues that are involved in the client experience. 20

Synthesis of all four processes occurs through two components of reasoning that are intertwined throughout the process. These types of reasoning are referred to as: 1) Interactive process-this involves doing with not doing to the client. It is a crucial process that clinicians use to gain the trust of their clients. It helps the clinician to enter the clients life world to help reduce performance deficits and promote meaningful experiences with each client. 2) Conditional process-refers to the flexibility needed by practitioners to modify treatments and interventions with changing conditions. Novice therapists tend to rely on a more systematic approach to treatment versus the expert clinician that quickly adapts to any given situation. Student Attainment Objectives Strand #2 Clinical Reasoning Students must develop an understanding of the clinical reasoning process to assist them in making competent and sound judgments when caring for clients. Understanding how the process applies to the entire scope of client treatment prepares them for their professional journey. 1) Scientific Reasoning Upon completion of the Salem State College Occupational Therapy Program, students will be able to: Enhance the ability to address problems from a logical and holistic perspective when assessing client performance areas, performance components, and performance contexts during the assessment/intervention process. Demonstrate an ability to apply and interpret frames of reference and models of practice to the evaluation and intervention process with clients. Display an ability to utilize standardized and non-standardized screening tools and employ information received from consultants, health professionals, and family/client/significant others to determine need for occupational therapy services. Select and administer a variety of standardized and non-standardized assessment tools using appropriate procedures and protocols that assist the clinician in fostering a creative problem solving approach. 21

Discuss ways to adapt life skills, occupations, and the environment of clients that are served and demonstrate the ability to instruct client/caregivers/family members/significant others on compensatory strategies for task completion. 2) Narrative Reasoning Upon completion of the Salem State College Occupational Therapy Program, students will be able to: Display an appreciation for an individual s perception of illness or disease process and assist them to foster the promotion of health and wellness according to client need and respected culture and values. Create occupationally and goal priority-based intervention plans that meet the individual, life world, needs of the client while acknowledging the client as an active participant in the intervention and discharge planning process. Understand the importance of client-centered occupations associated with the intervention process before, during, and upon the discontinuation of occupational therapy service. Produce evidence-based intervention plans that attend to performance areas, performance components, and performance contexts that are meaningful for the client. 3) Pragmatic Reasoning Upon completion of the Salem State College Occupational Therapy Program, students will be able to: Demonstrate ability to use safety precautions in professional situations including during client screening, evaluation, and intervention process. Express the ability to collaborate with other professionals through documentation, oral communication, and client problem solving opportunities. Display an understanding of socioeconomic, cultural, education, and models of health care and the relationship to occupational therapy practice. Acknowledge the importance of the referral process to both internal as well as external specialists for assessment and intervention to best meet the needs of the client. Recognize treatment resources available in the environmental context; acknowledge reimbursement regulations, time constraints, and social and institutional constraints that may impact the client treatment process. 22

4) Ethical Reasoning Upon completion of the Salem State College Occupational Therapy Program, students will be able to: Develop an appreciation of OT practice trends while demonstrating a personal commitment and positive attitude towards the profession. Promote home and community services as an adjunct plan to support client adjustment to home or work setting, or alternative work or home situation. Display the ability to effectively communicate, educate, and train clients, family members, caregivers, or significant others in facilitating skills that will enhance occupational success, ensure safety and promote goal attainment. Demonstrate ability to plan appropriately for discharge from occupational therapy services and terminate services in a timely and cost effective manner as goals and objectives are attained. 5) Interactive Process Upon completion of the Salem State College Occupational Therapy Program, students will be able to: Display an understanding of the importance of doing with not doing to the client receiving occupational therapy services. Acknowledge the relevance of establishment of trust in the client-therapist relationship in order to reduce performance deficits and enhance meaningful life experiences. 6) Conditional Process Upon completion of the Salem State College Occupational Therapy Program, students will be able to: Develop an awareness of the importance of allowing for flexibility in clinical, professional, and non-professional situations, and the importance of making sound decisions within or outside of the practice environment, or in relationships with client, family, caregivers, and other professionals and or co-workers. 23

Strand # 3 Occupational Science Occupational Science defines the profession as an academic discipline. It is concerned with the study of the human as an occupational being. A complete understanding of the philosophy of occupational science is a core requirement of the Occupational Therapy Program at Salem State College and is accentuated in all professional courses. Providing students with a solid theoretical foundation in occupational science will enhance their perception of occupation and its association and vitality to client health, health prevention and wellness. The following occupational therapy student goals have emerged from this strand in the curriculum. Upon completion of the Salem State College Occupational Therapy Program students will be able to: Apply the theoretical foundations of occupational therapy while integrating the knowledge gained through the study of biological, behavioral, and health sciences in meeting the needs of diverse clients within the performance context of their unique physical, social and cultural environments. Utilize understanding of and appreciation for human occupation and develop culturally relevant, occupation-based, intervention plans. Integrate the frames of references and models to deliver occupational therapy service in traditional and emerging practice areas for individuals, groups and agencies. Demonstrate preparation in assessing, designing, implementing, modifying and terminating client-centered, evidence-based occupational therapy intervention. Utilize their knowledge of the determinants of occupational performance on human behavior to assess and foster client recovery. Relate knowledge of theories, models of practice and frames of reference to the models of health care, education, community and society as they relate to practice of occupational therapy. Develop an understanding of the importance of current policy issues that impact the health care system and its influence on the practice of occupational therapy. 24

Strand # 4 Research Research is an essential component of the Occupational Therapy Curriculum at Salem State College and is incorporated into all courses throughout the program. Students will present a research paper or project at a student conference that will be held as part of their occupational therapy capstone course. The research component of the program will provide students with a general understanding of: 1) how the research process works, 2) the components of research, 3) how to implement a basic research design, and 4) comprehend the relevance of research in occupational therapy practice. The following occupational therapy student goals emerged from this strand in the curriculum. Upon completion of the Salem State College Occupational Therapy Program students and be able to: Demonstrate the ability to find and utilize appropriate national and international resources and professional literature for occupational therapy practice. Utilize and integrate their knowledge of quantitative and qualitative research designs to understand, create and critique beginning level research studies. Produce scholarly papers related to examples of scientific investigations or inquiry in occupational therapy practice settings. Understand the importance of research to the application of evidence-based intervention planning and practice. Students will actively participate in various professional settings that promote scholarly activities that contribute to the profession. Students will present a scholarly research project that meets the required components for publication. Critique and apply research findings to the practice of occupational therapy. Strand # 5 Educational Leadership Occupational therapists are teachers. To be an effective practitioner, an occupational therapist must educate all associated recipients of their care. This includes clients, family members of clientele, affiliates of alternative disciplines, and the general public. Occupational therapy education surrounds every aspect of clinical practice. The clinician utilizes educational methods to project messages and instructions pertaining to client care. Education occurs daily in the clinical setting and through many additional venues. Occupational therapists are taught to educate the public about the importance of our service, to educate colleagues and others about the theoretical principles that guide and develop the profession in a variety of ways. 25

Upon completion of the Salem State College Occupational Therapy Program students and be able to: Create and participate in learning opportunities that will enhance professional competency and efficiency Understand multiple learning theories and teaching methods that will foster critical thinking and skillful presentation ability Develop positive intra and interpersonal skills that will benefit self and community Articulate the founding core principles and theoretical framework of occupation to others in oral and in written format Understand multiple methods and tools that may be used to project new learning and establish areas of clinical expertise Create a professional development plan that acknowledges the areas of research, professional responsibility and accountability, education, and continued selfexploration and learning. Strand # 6 Civic Advancement An important aspect of student learning throughout the curriculum will include assignments and activities relating to community involvement & leadership, the promotion of OT practice, forming community partnerships and acknowledgement of civic duty and responsibility. Upon completion of the Salem State College Occupational Therapy Program students and be able to: Develop an appreciation for servicing multiple global communities that may benefit from Occupational Therapy intervention. Describe traditional and non-traditional realms of practice that may utilize occupational therapy services. Understand the complexities of cultural differences and the relationship of occupation to ethnicity. Acknowledge the necessity for practitioners to develop cultural competence and its vital role in clinical preparation and education. 26

Recognize the importance of promoting human rights, respect and equality to persons different from oneself. Identify methods that will promote understanding of diverse environments and cross-cultural relationships. Utilize local communities to service and promote occupational therapy as a unique and valuable discipline. Explain to community members in oral and written communication forms the benefits of providing occupational therapy services in current areas where no OT service is offered. Discover viable alternatives and methods to offer funding to prospective occupational therapy sites. Articulate the scope of professional values and ethics that supports development in emerging areas of OT practice. Develop partnerships with diverse communities outside of Salem State College that promotes collegiality and professional contacts. Support technology as an additional tool in the education for others on health prevention and wellness options. Examine research parameters and statistical measures for findings assessment and interpretation. 27

SSC OT UNDERGRADUATE PROGRAM FLOW SHEET 28

Program of Study MS Degree in Occupational Therapy Purpose: The focus of the occupational therapy program is to prepare the OTA adult learner for transition to a master s entry-level practitioner through a flexible, part-time evening program, which encompasses a philosophy of progressive education. This program will meet the standards, skills, values and ethics set forth by the Accreditation Council of Occupational Therapy Education (ACOTE). ACOTE is located at 4720 Montgomery Lane, P.O. Box 31220, Bethesda, MD 20824-1220. AOTA s telephone number is (301) 652-AOTA. Prerequisites: An Associates degree from an accredited college or university in Occupational Therapy with a minimum of 1 year of clinical experience, and a Bachelor of Science in Occupational Health Studies from Salem State College with a minimum of a 3.0 grade point average. In addition, the following master s prerequisite coursework must be successfully completed; OCT 611, OCT 613 and OCT 622. The Bachelor of Science in Occupational Health Studies provides theoretical knowledge and skills in occupational science, health, technology, wellness promotion, and activity analysis within a variety of multicultural arenas. The curriculum s emphasis is placed on a holistic client-centered approach to individuals across the developmental spectrum. PROGRAM REQUIREMENTS Credits Foundation Year Core Courses and Support Courses Total 68 Advanced Placement Credits 21 First Year- Bachelor of Science Degree OCT 400N Pathways for Occupational Therapy Practice 3 OCT 401 Effective Documentation in OT Practice 2 OCT 402 Critical Thinking & Professional Judgment 2 OCT 403 Activity, Methods & Media 3 OCT 404 Perceptual and Cognitive Disabilities 3 OCT 406 Conditions and Pathologies 3 OCT 408 Research, Writing & Learning I 3 OCT 411 Theoretical Principles of Occupation I 2 OCT 407N OT Analysis & Interventions I 4 OCT 412 Theoretical Principles of Occupation II 2 OCT 413 OT Analysis & Interventions II 4 Prerequisite Courses for Master of Science Degree (Total Credits - 120) OCT 611 Assistive Technologies 2 OCT 613 Policy & Practice 2 OCT 622 Civic Advancement and Administration I 2 Advanced Placement Credits 6 29

Second Year- Master of Science Degree OCT 712 Theoretical Principles of Occupation III 2 OCT 715 OT Analysis & Intervention III 4 OCT 800 Research, Writing and Learning II 2 OCT 718 Theoretical Principles of Occupation IV 2 OCT 720 OT Analysis & Intervention IV 4 OCT 802 Research, Writing and Learning III 2 Third Year- Master of Science Degree Electives (Up to 6 Credits) OCT 850 Level II Fieldwork & Seminar A 6 OCT 900 Civic Advancement & Administration II 2 OCT 910 Trends & Innovative Practice Arenas 3 OCT 920 Capstone Seminar in Professional Practice 3 OCT 960 Level II Fieldwork & Seminar B 6 *OCT 912 Special Topics in Occupational Therapy 3 *OCT 915 Thesis Seminar 3 *Note: Graduate students have the option of taking up to six additional credits of independent study with Department Chair approval. (Total Credits 42-48) 30

Attaining a Successful Experience with Level I Fieldwork Level I Fieldwork Level I fieldwork will begin in the spring semester in course OCT 407N (Psychosocial) of year one. The second placement in OCT 413 will occur in the summer (Physical Dysfunction), OCT 715 in the following fall semester (Pediatric) and OCT 720 (Geriatric) will be completed in the spring. 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 occur on a part-time basis and schedules will be determined between the student and the fieldwork supervisor. Four twenty hour, Level I internships will be set up in the areas of physical dysfunction, psychosocial dysfunction, geriatric and pediatric areas of practice. A community placement in at least one of these four areas will be encouraged during the level one experience. For example, students may choose to work with children at a YMCA for your pediatric Level I, or choose an assisted living center for your geriatric experience, a group home might be a choice for your psychosocial placement, or a sports clinic for physical dysfunction. These are just some examples whereby level I experience may be infused into community practice. Helpful Tips for the Fieldwork Supervisor for Level I Although SSC students are working professionals, it is expected that once committed to a schedule, they demonstrate professionalism and good time management skills Students that are OTA s have had several previous clinical experiences. It is expected that they will ask multiple questions about the population serviced and about the clinical setting Although this is strictly an observational internship, it is essential that SSC students be exposed to the evaluation and treatment planning process through discussions with the supervisor (s). This is one specific area that increased exposure is needed. Please feel free to have open discussions with level I students about the SSC curriculum, the academic strands in the program, the clinical reasoning process and what they have learned, the OT Practice Framework and hold general discussions about implementing occupation and the promotion of evidence-based practice. Challenge the level I student to problem solve-what is it that they are observing, have them identify problems, and ask how would they treat the problem. The students need to be questioned in the clinical settings especially during the level I process. Level I students will keep a reflective log. Please ask them to share with you their clinical and professional reflections. 31

Level I 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. 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. 32

Level I Fieldwork Student Performance Evaluation Students Name: Fieldwork Supervisor: Name of Facility:_ Date of Performance Evaluation: Twenty Hours Completed: Yes No_ Fieldwork Type: Physical Dysfunction Psychosocial Dysfunction Pediatric Geriatric Emerging Practice Area (Community) Key: S+ Exceeds Expectation S Competence Demonstrated NI Needs Improvement N/0 Not Observed NE Needs Experience Professional Appearance/Demeanor Suitably Dressed for Facility Well Groomed Courteous/Pleasant Demonstrates Respect For Others Communication Skills Actively Seeks Feedback Demonstrates Assertiveness Active Listening Skills Demonstrated Verbal Communication Ability With Clients/Family members With Professionals Non-Judgmental, Culturally Sensitive Interacts With Clientele in a Caring Manner (shows empathy) Uses Appropriate Terminology/Language Works Cooperatively With Others at Facility Written Communication Skills Conduct Abides by OT Professional Code of Ethics Adheres To Facility Policies/Procedures Aware of Universal Precautions Aware of Safety Regulations Dependability On Time to Scheduled Site Calls When Late Follows Through With Responsibilities Given 33

Initiative Identifies Need To Obtain Additional Information Offers Own Thoughts and Ideas Uses Time Constructively Prioritizes Tasks Clinical Reasoning Asks Relevant Questions Makes Accurate Observations Recognizes and Identifies Problems Discusses Application of Theory to Intervention Discusses Solutions to Problems Ability to Analyze and Synthesize Information Demonstrates Awareness of the Importance of Occupation Expresses Knowledge of OT Practice Framework Professional Responsibility Demonstrates Awareness of Available Professional Resources i.e., Professional Organizations Demonstrates a Positive Attitude Toward Learning Seeks and Requests New Opportunities for Learning Please write a brief paragraph related to the strengths of the student and areas for suggested improvement. Please use the reverse side if you require additional space. Thank you. The student has successfully completed a twenty hour level I fieldwork assignment. Level I Fieldwork Supervisor Student Signature_ Date FORM BB JC 08/01 34

Attaining a Successful Experience with Level II Fieldwork Purpose of Level II 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. Level II Fieldwork Courses OCT 850 Level II Fieldwork A (MS Final Year-Summer) This 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 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. Pre-requisites: All OCT courses through OCT 802 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) within a chosen clinical setting in conjunction with this seminar. Students will examine and discuss concepts learned throughout the curriculum with focus spent on preparation and review for the NBCOT examination, interviewing skills, professionalism, civic and professional responsibilities, advocacy and their role as future leaders. Pre-requisites: All OCT courses through OCT 920 35

Level II Fieldwork Level II fieldwork will begin after the completion of OCT 802. Students will complete 480 hours of time in a fieldwork setting of choice during the summer months. Upon completion of Level II Fieldwork and Seminar A (OCT 850), students will return to school to complete courses OCT 900, 910, and 920 during the fall semester. Students will complete Level II Fieldwork and Seminar B (OCT 960) during the spring semester and become eligible for graduation. Level II Fieldwork Objectives Students completing the Salem State College 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. Salem State College Occupational Therapy Department Fieldwork Objectives 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 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 36

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. Referral: Students will: 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 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. 37

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 considers the individual needs of the client. Treatment Planning: Student will: 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, 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. 3) Adhere to all facility safety precautions and procedures when administering treatment interventions. 4) Monitor the client for signs of excessive pain, fatigue, or discomfort and adjust or modify the treatment session or plan accordingly. 38

5) Independently seek out or utilize appropriate resources and references in regards to treatment updates and options available. 6) 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. 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. 39