Queens University School of Rehabilitation Therapy Occupational Therapy Program. M. Sc. OT FIELDWORK RESOURCE MANUAL

Queens University School of Rehabilitation Therapy Occupational Therapy Program M. Sc. OT FIELDWORK RESOURCE MANUAL For courses: OT 825, OT 851, OT 846, OT 847, OT 862, and OT 877 2014 2015 Susanne Murphy, MSc, OT Reg (Ont.) Lecturer, Fieldwork Coordinator (OT 846, OT 847 & OT 877) Megan Edeglow, MSc, OT Reg (Ont.) Lecturer (OT 862) Anne O Riordan, BSc.(O.T.) Lecturer, Clinical Educator OIPEP (OT 825) Teresa Long Fieldwork Assistant (All fieldwork courses) OT Program Fieldwork Contacts Phillip Wendt, MSc, OT Reg (Ont.) Lecturer, Fieldwork Coordinator (OT 847) Carol Mieras, MSc, OT Reg (Ont.) Lecturer (OT851) Donna O Connor, BSc. (O.T.), M.Ed. Professor (OT851) Phone and email contact information is available via the School of Rehabilitation Therapy website at www.rehab.queensu.ca Please be advised that your course coordinator has made every effort to ensure that this manual is up to date, complete and accurate; however, where University and/or School policy is concerned the student/preceptor is advised that official University, School of Graduate Studies and/or School of Rehabilitation Therapy Policy shall prevail over this manual. This manual replaces all previous versions. 1

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Table of Contents 1.0 M.Sc.OT Curriculum 7 1.1 Mission 7 1.2 OT Education Program Goals 7 1.3 OT Program Objectives 7 1.4 Educational Principles 8 1.5 Philosophy 8 1.6 Design 9 1.7 Educational Methodologies 12 1.8 Course outlines 14 2.0 Fieldwork Curriculum 21 2.1 Fieldwork Integration 21 2.2 Fieldwork Overview 23 2.3 Fieldwork Educators 23 2.4 Summary of Occupational Therapy Fieldwork Curriculum 24 2.5 Fieldwork Structure 24 2.6 Fieldwork Placement Application Process 26 2.7 Northern Placements 27 2.8 International Fieldwork Placements 28 2.9 Fieldwork Evaluation 28 2.10 Student Evaluation of Placement 29 2.11 Fieldwork Expenses 29 2.12 Students with Disabilities 29 2.13 Student Safety in Off-Campus Activities 30 3.0 Roles and Responsibilities of Fieldwork Stakeholders 33 3.1 The University Program Faculty 33 3.2 The Fieldwork Preceptors and Site Fieldwork Coordinators 33 3.3 The Student 34 4.0 Policies and Professionalism 37 4.1 Immunization 37 4.2 First Aid and CPR Training 37 4.3 Insurance Coverage 37 4.4 Student Injury While on Placement 38 4.5 Use of Personal Vehicles While on Placement 39 4.6 Attendance 39 4.7 Professional Image 41 4.8 Confidentiality & Professional Conduct 41 4.9 Ethics 46 4.10 Strikes 46 4.11 Criminal Reference Check 46 3

5.0 Academic Regulations 49 5.1 Procedures for Evaluations and Appeals 49 5.2 Policy on Failure/Withdrawal on Academic Grounds 49 5.3 Policy & Procedural notes regarding providing accommodation for students 49 who are not fully fluent in English 5.4 Withdrawal from Placement 49 5.5 Due Process 50 6.0 Student Assessment 53 6.1 Competency Based Fieldwork Evaluation for Occupational Therapy 53 6.2 Fieldwork Award Nomination Form 55 6.3 Concerns Exist Form 57 7.0 Preceptor Resources 61 7.1 Recommended Reading for Fieldwork Educators 61 7.2 Recommended Reading for Occupational Therapy Students 62 7.3 Articles Related to Fieldwork Education 62 References 65 Appendices Appendix A - Occupational Therapy Fieldwork Levels Appendix B - Fieldwork Course Descriptions Appendix C - Student Fieldwork Profile Appendix D - Canadian Guidelines for Fieldwork Education in Occupational Therapy (CGFEOT) and Fieldwork Site Profile (FS- PRO). Appendix E - COTO Standards for the Supervision of Students Appendix F - Guidelines for Short Term Accommodation Appendix G - International Fieldwork Placements Appendix H - Student Evaluation of Fieldwork Placement Appendix I - Teaching Affiliation Agreement Appendix J - CAOT Code of Ethics Appendix K - Immunization/First Aid/CPR Training Appendix L Postsecondary Student Unpaid Work Placement Workplace Insurance Claim Form Appendix M - Post-Activity Incident Report Appendix N - Occupational Therapy Statement of Confidentiality Appendix O - Evaluation of Competency across Fieldwork Levels Appendix P - Library Services for Health Sciences Faculty 4

Section 1 M.Sc.OT Curriculum 1.1 Mission 1.2 OT Education Program Goals 1.3 OT Program Objectives 1.4 Educational Principles 1.5 Philosophy 1.6 Design 1.7 Educational Methodologies 1.8 Course outlines 5

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1.0 M.Sc.OT Curriculum 1.1 Mission OT Education Program Mission The mission of the Queen s Occupational Therapy education program is to prepare OT professionals who continually strive for the highest standards of professional practice as they prepare for roles as experts in enabling occupation, demonstrating strong clinical reasoning, evidence-based practice and innovative leadership with a special attention to community development. 1.2 OT Education Program Goals Congruent with the OT Program s mission is the goal that the education program prepares students for the many roles as experts in enabling occupation that exist within the professional domain. Students are introduced to knowledge and practice related to the roles outlined in the Profile of Occupational Therapists in Canada [2012](Canadian Association of Occupational Therapists [CAOT], 2012): communicator, professional, scholarly practitioner, collaborator, change agent, practice manager and expert in enabling occupation. Graduates are educated for roles in direct service delivery, subject to local credentialing requirements. The Program also aims to prepare students to pursue advanced education and training that will further enable and support them to move to proficient practice. Consistent with the Program mission is the goal of creating an innovative curriculum and learning environment that contributes to shaping the practice environment and future roles of occupational therapists. As innovative leaders who strive for the highest practice standards, graduates are encouraged to demonstrate professional behaviours that express integrity, curiosity, innovation, critical thinking, a strong professional identity, and a commitment to social justice. The Program prepares graduates to provide leadership in a collaborative manner within complex and ever changing health care and practice environments. The Program at Queen s University attends specifically to the education of professionals for community practice. 1.3 OT Program Objectives Consistent with the Program mission and goals, it is expected that graduates of the OT Program will demonstrate knowledge, skills, and competencies that are grounded in the ability to interpret, apply, critique, and show empathy and self-knowledge related to the following areas: Occupational therapy, occupational justice and related theory. Disability theory and experience. Occupation across the lifespan. Cultural competence and respect for diversity and inclusion. The interdependence of the determinants of occupation. The individual and enablement of occupation within the context of physical, social, cultural and institutional environments. Assessment of occupational performance strengths and problems. The contribution of published literature to evidence based practice in occupational therapy. Enabling interventions aimed to facilitate client autonomy and improve transactions between person, occupation, and environment. The development of occupationally just communities. Advanced communication skills that promote collaboration at the individual, team, group and systems levels. Critical thinking and clinical reasoning. 7

Leadership, including the ability to initiate, respond and adapt to change. The Program s educational mission, goals and objective are closely related. The mission statement and accompanying goals place a strong emphasis on preparing occupational therapists for roles as experts in enabling occupation and as leaders in broadening, complex and ever-changing health care practice environments. In order to meet the educational mission, the Program objectives explicitly identify the actions and behaviours that define the OT Program s view of preparing experts in enabling occupation and leaders in occupational therapy. It is acknowledged that while the most fundamental goal of the OT Program is to prepare students to become occupational therapists for direct service delivery, the curriculum must also lay the foundation for their ability to pursue the multiple, important, but advanced roles fulfilled by occupational therapists, including that of academic leader. A key message sent to students through the Program curriculum is that this learning experience is only the beginning of their life-long education as occupational therapists. 1.4 Educational Principles The Program s educational organizing principles are as follows: Integrative, combining the conceptual and practice theories of the physical and social sciences with the conceptual and practice theories of occupation therapy. Progressive, offering learning experiences that are offered in a logical developmental learning sequence. Diverse, learning experiences that prepare graduates who demonstrate the broad range of complex and sophisticated professional attitudes, knowledge, skills and behaviours forming entry level CAOT competencies. Dynamic, responding in a timely manner to changes in health care systems and practices. Integrated, offering specific opportunities to integrate academic and fieldwork learning experiences. Interdependent, creating and nurturing a team learning environment. Collaborative, encouraging collaborative interprofessional, client-centred practice. Responsive, attentive in a timely manner to the learning needs of students of the program. Respectful of, and values diversity and inclusivity in the student body. 1.5 Philosophy Educational Values We believe that: The process of becoming an occupational therapist involves life-long learning that begins rather than ends, with the Master s degree; Learning occurs best when it is undertaken in an active partnership among students, instructors and community members; The learning of clinical skills must be based on a strong foundation of theoretical knowledge and evidence-based practice; In order to be effective occupational therapists, individuals need to be independent, critical thinkers and self-directed lifelong learners through reflective practices; In order to be effective in the broadening, complex and ever changing practice environments, occupational therapist require strong interprofessional communication skills. Therapeutic Values We believe that: People with disabilities are entitled to full participation in Canadian society; Health is experienced as a balance of meaningful occupation in the areas of self-care, productivity and leisure; A client-centred approach to service delivery is most effective when clients are acknowledged as being the best sources of information about their function and the goals of therapy; People seeking occupational therapy services are unique individuals who can only be fully 8

understood in the context of their relationships, homes, families and communities; The practice of occupational therapy requires a thorough understanding of the integration and interdependence of the many dimensions of the human being; Occupational therapy services are delivered across the spectrum from institutional to community services. Professional Values We believe: In the value of the broadly trained occupational therapist, who can apply occupational therapy theory and clinical reasoning to a wide variety of situations: We believe it is the responsibility of occupational therapists to be responsive to change in health care systems and practices; We adhere to the Code of Ethics of the Canadian Association of Occupational Therapists for guidance about the ethical practice of occupational therapy; We prepare students to be eligible to practice as an OT, subject to local credentialing requirements. 1.6 Design Master of Science Degree in Occupational Therapy Within the context of the changing health care environment, the OT of the future will be increasingly involved in initiatives requiring advanced judgment and reasoning skills. In addition to direct client care, skills will be focused towards indirect client care through consulting or managerial opportunities. There will also be a move to include a greater focus on community development and associated health related strategies to enhance health promotion and prevention among individuals and the broader community. The OT of the future will work within a diverse range of settings including the client s home, a rehabilitation centre, a long term care facility, a mental health facility, a school, a general hospital or community-based services. There will be a continued emphasis on self-employment, autonomous practice and leadership interactions. The attainment of professional credentials will take on increasing importance within the changing work environment. The MSc OT program prepares students to enter the OT profession. The program offers a dynamic curriculum that will meet and exceed professional and practice standards. It prepares students with graduate level knowledge, skills and professional behaviours required for practice in the contemporary health care arena. All students are expected to be registered on a full-time basis for two years (24 months). In order to meet the mission, aim and objectives, the program is organized into the following five themes: Educational and Professional Conceptual Frameworks The MSc OT curriculum consists of a combination of required academic courses, fieldwork, community development and a critical inquiry project. The curriculum is based on a recognized theoretical framework and taxonomy for occupational therapy, developed by Queen s occupational therapy faculty and colleagues (McColl, Law, Stewart, Doubt, Pollock & Krupa 2003). There is an emphasis on the integration of basic science and social science with theory and practice and a focus on what it means to be a professional within a rapidly changing health care system. Consequently it is expected that each course will build on the foundational material required for their course e.g. anatomy, physiology, psychology, sociology etc., to evaluate knowledge and practice within the context of current evidence, and will engage students in the application of this knowledge to their fieldwork and other health-related experiences. The intent is to encourage self-directed learning, transformative learning and reflective practitioner behaviours. Each course is mapped to the CAOT Profile of Occupational Therapy (CAOT, 2007) to ensure students learning reflects the expectations of a competent level of occupational therapy practice. 9

Profile of Practice of Occupational Therapists in Canada CAOT, 2012, p.2 The Queen s University Occupational Therapy Curriculum is organized according to the following five frameworks: 1. The theoretical basis of occupational therapy (McColl, Law, Stewart, Doubt, Pollock & Krupa, 2003); 2. Enabling Occupation: An Occupational Therapy Perspective (CAOT,1997) 3. Enabling Occupation II: Advancing an Occupational Therapy Vision for Health, Well-being and Justice through. Occupation (2007) 4. Profile of Practice of Occupational Therapists in Canada (2012) 5. Canadian Interprofessional Health Collaborative (CIHC), National Interprofessional Practice Education (IPE) Framework (2010) The MSc OT curriculum promotes increasing levels of complexity and understanding and thus we expect students to demonstrate higher levels of learning throughout the educational process. We also intend to capitalize on their considerable intellectual and reflective capabilities (gained through their undergraduate studies) immediately. For example, we expect students to engage in interpretation, application and critique as soon as they begin with coursework and we will expect the application of evidence in their practice upon graduation. 10

The program is organized into the following five themes: Fieldwork Courses OT 851 Therapeutic Relationships OT825 The Lived Experience of Disability OT 846 Fieldwork Determinants of Occupation I OT 847 Fieldwork Determinants of Occupation II OT 877 Advanced Practice OT 862 Community Development 11

The five theme areas are horizontally integrated, which allows students to start with the basic material and then progress to more complex ideas over the course of the two-year curriculum. Accompanying this integration is an increasing emphasis on the development of independent and self-directed learning. The themes are also vertically integrated thereby allowing students to clearly incorporate their academic and fieldwork experience. The curriculum is also inquiry-based in that the investigation of problems or key questions forms the basis for all course development. This progressive, integrated, inquiry-based curriculum allows for the development of increasing competencies in the field of OT and encourages deeper understanding of OT practice. All students emerge from the program with an in-depth exposure to the full spectrum of competencies identified in the CAOT Practice Profile (CAOT, 2007). All students develop skills and knowledge in the area of critical inquiry and evidence based practice, which serve as a foundation for all educational experiences in this curriculum. 1.7 Educational Methodologies We have developed the following educational methodologies and practices to enhance the intellectual development and educational experience of the student. We have approached the methods in a systematic manner, to encourage rigor and integration into the curriculum: A. Team Based Learning Team based learning is an educational strategy that uses the principles and procedures of highly effective teams to enhance student learning (Michaelsen, Knight & Fink, 2002). The instructional method makes full use of the strengths of each student team member, actively engages all team members in the learning process, and engenders a sense of responsibility in each student for self and group learning. In the OT Program this instructional strategy became particularly relevant as the enrolment significantly increased to 68-70 students annually. This strategy was evaluated as a way to maintain the active partnerships between students and between all students and faculty and as a means to capitalize on the strengths of the diversity of the student body. B. Ideas, Connections and Extensions (I-C-E) Model of Learning The pedagogical approach of I-C-E describes learning as a process that proceeds from novice (understanding ideas) to expert (making connections and extensions) and offers practical applications for the assessment of student learning (Fostaty Young & Wilson, 2000). The I-C-E model is particularly helpful because it moves the focus of student learning away from superficial approaches to learning (e.g., focusing on grades or on coverage of curriculum content) to increasing their understanding of assessments as supporting learning processes and deepening the levels of learning. C. Community Service Learning Community service learning involves intentional learning experiences that integrate meaningful community service to both strengthen communities and enrich the development of individual competencies and self-reflection (Eyler & Giles, 1999). The community service learning approach provides the pedagogical basis for the community development fieldwork placements. The community service learning approach supports the Program view that these placements are the vehicles to learn community development skills, to develop a growing sense of citizenship and occupational justice in our communities, and to apply these to make a meaningful difference through actions in the community. 12

D. Transformative Learning Transformative learning is a pedagogical approach that involves students in rejecting unquestioned acceptance of information and knowledge by active processes of questioning, reflection on assumptions, and critically examining how individuals can improve the roles in their own lives and the lives of others (Cranton, 2006). The approach is committed to critical reflection and action with a view to creating an equitable world. Transformative learning methods are employed widely through the curriculum, but are perhaps most obvious in courses related to disability theory and lived experience, and community development where issues of equity and justice are central and guiding principles. E. Case-based Learning Case-based learning is an instructional approach that engages students in an interactive process of exploration and analysis of real-life situations (Herreid, 2007). Case-based learning is integrated into the OT Program curriculum because, much like OT practice, it engages students with complex occupationrelated situations where there is not always one solution, but rather multiple perspectives and contextual factors to be considered. In addition, it supports the development of empathy and respect for diversity in practice. Case-based learning is a relatively flexible approach that allows the mix of didactic instruction relevant to particular elements of cases along with student interaction and problem solving. It also allows for an attitude of appreciative inquiry that allows for identifying and capitalizing on the strengths that students bring to the learning situation. Finally, the development of meaningful cases has provided an important opportunity for integration between fieldwork and academic courses. F. Situated Learning Situated learning is grounded in the notion that knowledge is contextually situated and part of the activity, context, and culture in which it is being used (Lave & Wenger, 1991). Learning occurs when students are engaged in authentic learning activities in real-world contexts. Throughout the program, the fieldwork education placements offer students opportunities to engage in authentic learning opportunities in real life clinical and community settings. Learning is scaffolded as preceptors offer graded mentorship through the progression of level 1, 2, and 3 fieldwork placements. Students are encouraged to make explicit their theoretical and tacit knowledge in a real-world environment. Student assessment and feedback is embedded and integrated into fieldwork learning using the Competency Based Fieldwork Evaluation (CBFE) (Bossers, Miller, Polatajko & Hartley, 2007). G. Reflective Practice Reflective learning is founded on the view that reflective learning helps connect theory to practice, giving meaning to the practice experience (Killion & Todnem, 1991; Schon, 1987). Three types of reflective learning are essential: reflection-in-action, reflection-on-action, and reflection-for-action. Throughout our program, students are offered multiple opportunities for reflective learning (e.g., to give meaning to knowledge or experience; for example, OT821 reflection assignment), to increase self-awareness (for example, OT841 and the assignment on cultural self-awareness), and to promote critical thinking (for example, OT823 and the On-Line Reflective Journal) and empathy (for example, OT825 and Reflective Journal Assignment). 13

1.8 Course outlines Overview of Course Credits Courses offered within each theme in MSc (OT) program. Theme I Fundamentals of Occupational Therapy OT 823 Disability Theory OT 825 The Lived Experience of Disability (Fieldwork) OT 821 Occupational Therapy and Process and Professional Practice Theme II Determinants of Occupation OT 841 Socio-Cultural Determinants of Occupation OT 842 Environmental Determinants of Occupation OT 843 Physical Determinants of Occupation OT 844 Cognitive-Neuro Part I OT 845 Psycho-Emotional Determinants of Occupation OT 846 Determinants of Occupation I (Fieldwork) OT 847 Determinants of Occupation II (Fieldwork) OT 848 Cognitive-Neuro Part II Theme III Communication Skills OT 851 Therapeutic Relationships OT 852 Group Theory and Process OT 853 Coaching and Counseling for Occupational Change OT 854 System s Level Communication Theme IV Community Development OT 861 Community Development as Applied to Occupational Therapy OT 862 Community Development (Fieldwork) Theme V Critical Inquiry OT 871 Advanced Clinical Reasoning OT 875 Advanced Professional Practice OT 877 Advanced Practice (Fieldwork) OT 898 Critical Enquiry Project Credit (CR) 3 3 6 3 3 8 6 6 8 8 3 6 3 4 3 3 6 4 3 8 12 TOTAL NUMBER OF CREDITS 109 14

Course Outlines OT-821 Theoretical Basis of Occupational Therapy This course introduces the central construct of occupation, the relationship of occupation to health and well-being, models of occupation, processes of occupational change, and the historical development of occupational therapy theory. The course will examine occupational therapy practice in the context of the Canadian health care system, enablement and client-centered practice, professional identity and governance, professional ethics and the evolving public/private sector. The stages of the occupational therapy process and legitimate occupational therapy skills will also be introduced. OT-823 Disability Theory This course introduces the concepts of disability, citizenship and societal participation. Conceptual frameworks of disability and issues and implications of disability will be discussed along with Canadian health and social policies relating to people with disabilities. OT-825 The Lived Experience of Disability In this fieldwork course, pairs of first year students meet with a volunteer from the Kingston community who has a disability. The goal of this unique learning relationship is to improve students' understanding of disability and facilitate their embracing the concept of client-centred practice whereby a client's life experiences are acknowledged and they become partners in the occupational therapy process. OT-841 Socio-cultural Determinants of Occupation This course will examine the social and cultural nature of occupation. Students will analyze the relationship between occupation and such socio-cultural components as values and belief, time use, roles, habits, expectations and norms and explore how occupational therapy interventions based on this understanding could lead to changes in occupation. This course will also examine contemporary views of spirituality in occupation. The importance of occupations to society will also be addressed. OT-842 Environmental Determinants of Occupation This course will focus on the creation of healthy environments that enable client-centred occupations. Students will examine factors within the physical, social, cultural and institutional environments that affect occupation and how environmental modifications can lead to changes in occupation. They will gain experience with the knowledge and skills critical to effecting environmental change. OT-843 Physical Determinants of Occupation This course will introduce students to the study of movement of the human body as it relates to occupation. It will have an emphasis on biomechanics and the components of the motor system as determinants of motor performance in occupation. Evaluation methods and modalities used in physical rehabilitation will be studied. The course will also focus on the application of physical rehabilitation methods used in occupational therapy practice by understanding musculo-skeletal conditions and occupational therapy interventions at the level of impairment and activity limitations. OT 844 Cognitive Neuro Part I This course emphasizes the neuro-physiological organization of motor behaviour, sensory-motor integration, and the dynamic nature of the central nervous system. This course will provide a foundation for evaluating occupational performance from perception to action. It will focus on evaluation and intervention approaches for cognitive-perceptual and motor control problems at three levels: impairment, strategy and function. Attention will be given to secondary motor performance problems. 15

OT 848 Cognitive-Neuro Part II Using knowledge of human development and systems theory, this course builds on Cognitive- Neurological Determinants - Part I by providing students with the foundational knowledge to understand human development and to identify factors influencing performance and participation for children and adolescents who experience atypical development. Evaluation and intervention approaches at the level of impairment, activity limitations, and participation restrictions will be explored by considering the context of service provision and the diverse roles of Occupational Therapy practitioners in collaboration with families and other service providers. OT-845 Psycho-emotional Determinants of Occupation This course will focus on the psycho-emotional determinants of occupation as a framework for understanding how humans are inherently motivated for occupations. The intrinsic factors and learned responses associated with occupation will be examined and students will apply and evaluate applications of psycho-emotional theory in contemporary occupational therapy practice. OT-846 Determinants of Occupation I Students will complete two full-time (6-8 week) fieldwork experiences (OT-846 and OT-847) for practical professional experience. These courses will provide the opportunity within a practice setting to demonstrate the integration of OT skills with current OT theory and relevant supporting scientific knowledge. OT-847 Determinants of Occupation II Students will complete two full-time (6-8 week) fieldwork experiences (OT-846 and OT-847) for practical professional experience. These courses will provide the opportunity within a practice setting to demonstrate the integration of OT skills with current OT theory and relevant supporting scientific knowledge. OT-851 Therapeutic Relationship This fieldwork experience focuses on the development of communication skills within the context of client-centred occupational therapy practice. The critical elements of the therapeutic relationship will be developed through interviewing and assessment strategies. This course will make extensive use of supervised videotaping, and interaction with community volunteers through the Clinical Education Centre. In addition, students will gain experience in professional communication skills. OT-852 Group Theory and Process This course will examine group theory, process and application to occupational therapy practice. It will focus on groups both as a means to enabling occupational therapy change and as a means for working effectively in a complex health care system. Laboratory sessions will facilitate the development of effective techniques in group leadership and participation. OT-853 Coaching and Counseling for Occupational Change This half course consists of both theoretical background preparation and practical experiential learning opportunities to introduce occupational therapy students to selected talk- based interventions available for enabling occupational fulfillment and change (coaching, counseling and psychotherapy). OT-854 System s Level Communication The first part of this course will be devoted to the theory and practice of knowledge transfer and diffusion. Laboratory sessions will focus on strategies to: influence and change public attitudes to disability, communicate about professional practice, and transfer knowledge about evidence based practice. The second part will be devoted to the theory and practice of advocacy and negotiation. Laboratory sessions will address strategies to pursue systems level changes that will ultimately enhance occupation. 16

OT-861 Community Development Applied to Occupational Therapy This course critically examines the theoretical foundations and processes of working with communities through community development in order to enable occupation at the community level. Theories of community development, the process of engaging with communities, and skills required for community development will be explored as they pertain to occupational therapy. This course lays the theoretical foundation for the community development fieldwork placement, OT-862. OT-862 Community Development This fieldwork course will allow students to explore opportunities for the development of occupational therapy services in potential settings within the community. OT-871 Advanced Clinical Reasoning This course provides opportunities for students to develop advanced clinical reasoning skills applicable to all areas of occupational therapy practice. Based on the occupational therapy process, students will develop skills of critical thinking and inquiry. Prerequisites: all first-year courses and all second-year, fall-term courses or permission of the course coordinator. OT-875 Advanced Professional Practice This course is designed to provide students with opportunities to acquire an advanced understanding of the roles, rights and responsibilities incumbent with becoming an Occupational Therapist. Particular attention will be given to the legal and ethical parameters of practice, professional contributions and responsibilities within complex and changing environments and career development as advanced healthcare professionals. Course content is designed to be responsive to the shifting practice environment and offer students an opportunity to synthesize learning from other courses in the curriculum. OT-877 Advanced Practice The objective of this final fieldwork experience will be for students to consolidate professional practice skills necessary to function as autonomous, independent, reflective practitioners, who are able to cope with and be part of the changing health-care environments. OT-898 Critical Enquiry Project Students will acquire critical enquiry skills through learning modules; each containing components necessary for the completion of a critical enquiry project. Learning module topics include but are not limited to developing research questions, searching for evidence, appraising research evidence and outcome measures, appraising published research and study designs, and research ethics. The project is normally executed as a portfolio of assignments demonstrating the creation and pursuit of a research question. In some cases, learning objectives may be met by the completion of a research project under the guidance of a faculty supervisor. Information related to prerequisites and/or co-requisites may be found at the School of Graduate Studies website at http://www.queensu.ca/calendars/sgsr/occupational_therapy.html. 17

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Section 2 Fieldwork Curriculum 2.1 Fieldwork Integration 2.2 Fieldwork Overview 2.3 Fieldwork Educators 2.4 Summary of Occupational Therapy Fieldwork Curriculum 2.5 Fieldwork Structure 2.6 Fieldwork Placement Application Process 2.7 Northern Placements 2.8 International Fieldwork Placements 2.9 Fieldwork Evaluation 2.10 Student Evaluation of Placement 2.11 Fieldwork Expenses 2.12 Students with Disabilities 2.13 Student Safety in Off-Campus Activities 19

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2.0 Fieldwork Curriculum Fieldwork education is an essential component of an occupational therapy professional educational program and comprises approximately one-third of the curriculum. It is a collaborative process that involves a variety of supervised field experiences related to the practice of occupational therapy. The aim is to integrate and apply academic and theoretical knowledge in a practice setting in the three domains of learning: skills, attitudes and knowledge, and to foster the development of clinical reasoning and professional identity (The Canadian University Fieldwork Educators Committee of the Association of Canadian Occupational Therapy Programs, 2010). Fieldwork education can be conceptualized as occurring in three major stages (levels 1, 2, and 3) along a continuum of professional development. See Appendix A. 2.1 Fieldwork Integration The fieldwork curriculum has been designed to integrate each of the fieldwork courses directly with a theoretical course. See Appendix B for OT846, OT847 and OT877 fieldwork course outlines. Students are able to use experiences and case studies from the practice setting to integrate concepts taught in the theory courses, with some assignments related to those settings. The related courses are as follows: Fieldwork Course Theory Course(s) OT 825 The Lived Experience of Disability OT 823 Disability Theory OT 851Therapeutic Relationships OT 851 Therapeutic Relationships (integrated theory) OT846 Fieldwork Determinants of Occupation I OT 841 Socio-cultural; OT 843 Physical; OT 821 Theory, Process, and Professional Practice; OT 823 Disability Theory OT847 Fieldwork Determinants of Occupation OT 845 Psycho-emotional; OT 842 Environmental; OT II 844/848 Cognitive- neurological I and II OT 877 Advanced Practice OT871 Clinical Reasoning and OT 875 Advanced Professional Practice OT862 Community Development OT861 Community Development as applied to Occupational Therapy Students participate in OT 825 - The Lived Experience of Disability over a 6 week period, meeting with a mentor from the community who has a health condition and teaches the students about effects of this health condition on his/her lifestyle. Students relate theoretical concepts from OT 823 Disability Theory to their experiences, and begin the process of self-reflection as a professional skill. Therapeutic Relationships, OT 851, takes place in the Glaxo Wellcome Clinical Education Centre. Students learn about professional communication and are able to apply their clinical skills by interviewing community volunteers, some of whom have disabilities, at the Centre. Theory and practice skills are combined within this course. The next two placements, OT 846 and 847 Determinants of Occupation I and II, take the form of two eight week full-time learning experiences at a variety of practice settings within and outside of the Queen s catchment area. In these practice environments, students integrate and apply theoretical concepts from all of the determinants courses. An Advanced Practice placement (OT 877) provides the students with an eight week full-time opportunity 21

to consolidate and core competencies for entry to practice and is linked with OT 875 Advanced Professional Practice. The Community Development (OT 862) placement provides students with a unique opportunity to work with communities to enable occupation. The Community Development course (OT 861) is taught concurrently with the fieldwork placement to provide an opportunity for students to integrate community development theory to practice. Students complete 2 days per week of the OT862 placement during the winter term and consolidate the placement with a 2 week full time placement block in April. All assignments in OT 861 are designed to facilitate the planning and implementation of the project to be done in the community development placement and to reflect on the application of principles and techniques learned in the course. 22

2.2 Fieldwork Overview Students complete a wide range of experiences in numerous health care practice environments. Every effort is made to ensure diversity in both practice environments and client conditions. All students are required to complete at least one fieldwork placement each in the areas of physical health and mental health. All students must complete a Community Development placement, which ensures exposure to a community practice environment and the opportunity to enable occupation at the level of a community. Following each fieldwork placement students complete a Fieldwork Placement Profile to identify the breadth of learning that occurs within the placement (See Appendix C - Student Fieldwork Profile). The fieldwork profile is based on both the Program s educational and professional conceptual frameworks and identifies the expected fieldwork learning during each fieldwork course. Students add the elements that they have experienced at the end of each fieldwork session. This logged information is used by the students to facilitate identification of strengths and gaps in their fieldwork experience that can be addressed in their learning objectives for upcoming placements. It also facilitates the matching process by the university fieldwork coordinator to ensure that students acquire a range of experiences. In 2003, the University Fieldwork Coordinators Committee (UFCC) of the Association of Canadian Occupational Therapy University Programs (ACOTUP) developed the Canadian Guidelines for Fieldwork Education in Occupational Therapy (CGFEOT) in consultation with fieldwork partners from across the country. These guidelines were revisited in 2010 and outline the vision for the promotion of excellence in fieldwork education (Appendix D). The guidelines also provide the Fieldwork Site Profile (FS-PRO), a document which outlines the site s fieldwork education programs and other useful information for placement selection and preparation. The FS-Pro is formally reviewed every five years by the Fieldwork Site Review committee, which is comprised of the Queen s Fieldwork Coordinator and a clinical representative. Informal site review takes place on an ongoing basis through regular site visits, preceptor contact, and student feedback. At least one site visit will be conducted within the five year review period. Students complete a fieldwork site evaluation at mid-term and final of each fieldwork course. Feedback is provided directly to the preceptor by the students and the site evaluation forms are reviewed by the fieldwork coordinators following each placement. Any concerns raised or highlighted are first followed up with the student. If further action is warranted the issue is brought to the Fieldwork Site Review Committee. 2.3 Fieldwork Educators Therapists must follow the standards from their respective regulatory body or professional association related to the supervision of students. Generally, it is required that the fieldwork educator complete one year of full-time practice and registration with the provincial regulatory organization prior to serving as a fieldwork educator. The occupational therapy program offers continuing education, support, and recognition for all fieldwork educators. Refer to Appendix E for the College of Occupational Therapists of Ontario (COTO) Standards for the Supervision of Students (COTO, 2011). 23

2.4 Summary of Occupational Therapy Fieldwork Curriculum Level Course Placement Sites Time Frame Hours I OT 825 Kingston community Fall Term 6 Lived Experience of Disability I OT 851 Glaxo Wellcome Clinical Fall Term 12 Therapeutic Relationships Education Centre II OT 846 All fieldwork sites Winter Term 300 Determinants of Occupation I II OT 847 All fieldwork sites Fall Term 300 Determinants of Occupation II III OT 862 Community sites Winter/Spring 185 Community Development 25 days III OT 877 Advanced Practice All fieldwork sites Spring Term 300 2.5 Fieldwork Structure Total Hours = 1103 Fieldwork placements are organized by the Fieldwork Coordinator and/or Course Coordinators in the Program. Settings include a variety of sites ranging from hospitals, clinics, community centres, private practices, schools, long term care facilities, nursing homes, and administrative and research settings. Some of the full-time fieldwork placements may be arranged by the National Fieldwork Placement Service (NFPS), a national service that matches available fieldwork placement offers from sites with student requests. The NFPS works with Fieldwork Coordinators from Occupational Therapy Programs across the country to provide equitable placement opportunities. Each university offering an Occupational Therapy Program has its own catchment area. The catchment area is designed to offer its designated university and students priority in fieldwork placements. This means that Queen s students have the first opportunity to apply for and be assigned a placement at a site within that catchment area. The relationship that exists between Queen s School of Rehabilitation Therapy and its catchment area sites is valued and reciprocal in nature. Clinicians from those sites have close communication with the Queen s Fieldwork Coordinators and are able to take advantage of educational opportunities offered by Queen s by attaining an Adjunct Status with the School. Student supervision in placements is one of the ways clinicians are granted this designation. In order to maintain this beneficial partnership, priority will be given to utilizing all existing placements in the Queen s catchment area. Please note that this area extends approximately west to Oshawa, north to Peterborough and east to Cornwall. Efforts will be made to accommodate students preferences, however all students must be prepared to accept assigned placements. To clarify, students should not expect that all or indeed any of their placements will be completed within the city of Kingston, and should be prepared to take advantage of placements in other cities within the catchment area or within Canada. **STUDENTS ARE NOT PERMITTED TO APPROACH FACILIITES OR THERAPISTS TO NEGOTIATE/SECURE THEIR OWN PLACEMENT. FAILURE TO FOLLOW THIS GUIDELINE MAY RESULT IN THE STUDENT BEING REMOVED FROM THE FIELDWORK LEARNING OPPORTUNITY.** 24

Diagram 1 Queen s University Catchment Map 25

Overview of Queen s Fieldwork Curriculum Year One September-December January February March - July Coursework OT Theory Socio-Cultural Determinants Therapeutic Relationships Lived Experience Physical Determinants OT 846 Level I Fieldwork Determinants of Occupation I (8 weeks) Coursework Cog-Neuro Determinants Part I Environmental Determinants Psycho-Emotional Determinants Disability Theory Critical Inquiry Modules 2013-2014 Year Two September- October Coursework Group Theory Cog-Neuro part II Systems Level Communication October- December OT 847 Level Two Determinants of Occupation II (8 weeks) April OT862 Level Three Community Development (2 weeks full time) January- April Coursework Counselling Clinical Reasoning Community Development Community Development Fieldwork (2 days/week) Advanced Professional Practice June- August OT877 Level Three Advanced Practice Session A or Session B (8 weeks) 2.6 Fieldwork Placement Application Process Clinical Placement Express (CPX), a web-based resource that enables students to both view clinical placements opportunities and submit their placement preferences on-line. Matching is aided by the computer and students are automatically provided with their placement match, including site details and contact information. CPX also enables clinical sites to offer clinical placements directly through CPX, view placement offerings and update their site profiles on-line. In Catchment Application Process In catchment fieldwork placement offers are posted on the Clinical Placement Express (CPX) website for students to view prior to the application deadline. Students identify their placement preferences through Clinical Placement Express (CPX). Students 26

must enter at least three (3) preferences, and are encouraged to enter the maximum number of five (5) requests. Matching is completed electronically; however the university fieldwork coordinator will review student preferences to ensure students meet the fieldwork requirements (physical and mental health placements). The matching process is designed to ensure the most number of students receive their top choices. Placement allocation decisions will be final and a student that chooses to refuse a placement allocation will risk compromising their academic progress in the Program. Special consideration requests will be recognized only in the event of: a) Personal illness, disability or health condition accompanied by appropriate documentation. b) Parenting obligations. Special considerations will be reviewed by the fieldwork coordinator and students will be notified of approval or denial of this request. The student is required to submit a Request for Short Term Accommodation Form (refer to Appendix F). All dates in the fieldwork application and assignment processes will be provided to students by the fieldwork coordinator as soon as possible. Students are required to check their Queen s email account on a regular basis (daily is recommended) to ensure that they have current information. Students are expected to respond promptly to fieldwork coordinator correspondence as placement questions must often be addressed quickly. (i.e. placement opportunities may be missed if the fieldwork coordinator is unable to contact student). This responsibility continues during fieldwork placements as there may be issues relating to placements that are shared only via email (i.e. in recent years there have been directives relating to emergent infection control issues and/or mask fit testing). Students are responsible for contacting placement sites in an appropriate and timely fashion; at least 4 weeks before the start of placement. Letters of introduction form that first impression and begin the exchange of information. Be sure to request information regarding specific immunization requirements, flu shots, reading materials. Confirmation of student placement is made to the site by the National Fieldwork Placement Service, for out of catchment students or the Queen s University Fieldwork Coordinator for Queen s students. Out of catchment application process Students interested in applying to placements out of catchment, both in and out of province, must apply to the National Fieldwork Placement Service (NFPS), through the fieldwork coordinator. Applications can be found at www.nfps.ca and are to be submitted to the university fieldwork coordinator on or before the application deadline. Deadlines for application are set by NFPS and cannot be negotiated. There is a $150.00 (plus 13% HST) non-refundable fee to use this service which is incurred each time a student uses the service. Each student is responsible to pay for their application fee and may do so via the School s online payment system or by submitting payment with their application form to the main office at Louise D. Acton. Students can request up to three locations and sites during each application. It is recommended that students provide a range of geographic options as possible to ensure a successful match. Students will be notified of a successful match via email therefore it is essential for students to monitor their Queen s email account. Students have up to 72 hours to respond to a placement offer. Students are encouraged to read all of the NFPS policies at http://nfps.ca/english/placementpolicy.html. 2.7 Northern Placements Students may have the opportunity to apply for a fieldwork placement in Northern Ontario through the Northern Ontario School of Medicine (NOSM). This program was developed in order to provide fieldwork placements for rehabilitation science students, develop the skills of the regional preceptors as 27