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Master of Occupational TherapyFIELDWORK EXPERIENCE MANUALGretchen Reeks, MA, LOTR, C/NDTAcademic Fieldwork Coordinator (AFWC)Assistant Professorgreeks@lsuhsc.eduOffice: (318) 813-2953Fax: (318) 813-3001Revised: 08.16.2016AOTA’s Centennial Vision“We envision that occupational therapy is a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society’s occupational needs.”* The material contained herein is subject to change from time to time. The Occupational Therapy Program reserves the right to alter or amend the terms, conditions and requirements as necessary.** LSU HEALTH-S MOT students are responsible for understanding information in this manual.LSU HEALTH-S OT Program Mission StatementThe Program in OT at LSU HEALTH-S subscribes to a three-fold mission. First, to educate students to become reflective and empathetic practitioners who provide excellent quality care while maintaining high ethical standards. These practitioners will be able to collaborate with clients, family members and other healthcare providers. Second, to foster scholarly development through a spirit of inquiry that will result in intellectual growth and lifelong learning. Scholarly development will promote research in order to enrich and validate the knowledge base of occupational therapy. Third, to provide service through varied delivery models, to people in Louisiana, the nation and the world, to enhance occupational performance.ResourcesAccreditation Council for OT Education (ACOTE): Educate/Accredit.aspx American Occupational Therapy Association (AOTA): Canadian Association of Occupational Therapy (CAOT): caot.ca FIELDWORK WIKI: Louisiana Occupational Therapy Association (LOTA): Louisiana State Board of Medical Examiners: (LSBME): lsbme. LSU HEALTH-Shreveport: sh.lsuhsc.edu Master of Occupational Therapy Program: Office of Legal Affairs (Affiliation Agreements for Fieldwork): Board for Certification in Occupational Therapy (NBCOT): AcknowledgementsThe LSUHSC-Shreveport Program in Occupational Therapy would like to recognize the following universities for their contributions to this Fieldwork Experience Manual:Colorado State University: Gulf Coast University: Jose State University: of North Dakota: University School of Medicine in St. Louis: OF CONTENTSSECTION 1. STUDENT FORMS 1.1 Master of Occupational Therapy Student Verification of OT Program Policies 5 1.2 Master of Occupational Therapy Student Acknowledgement of Ethical Practice 5 1.3 Master of Occupational Therapy Student Verification of Understanding 51.4 Master of Occupational Therapy Student Waiver 51.5 Master of Occupational Therapy Student Contact Information 6 1.6 Academic Fieldwork Coordinator Contact Information 6 SECTION 2. FIELDWORK2.1 Required Fieldwork Documentation 72.2 Medical Insurance 72.3 Cardiopulmonary Resuscitation 72.4 Health Information 72.5 Immunizations 72.6 Drug Screen 72.7 Criminal Background Check 82.8 Criminal Background Re-Check 82.9 Fieldwork Policy Forms 82.10 Incident Reports 82.11 Worker’s Compensation 92.12 Blood Pressure/Pulse and Universal Precautions 92.13 Americans with Disabilities Act 92.14 Cost of Fieldwork 92.15 Professional Appearance 92.16 Social Networking 92.17 Computer Use 102.18 Electronic Communication 102.19 Fieldwork Cancellation 102.20 Change in Medical Status 102.21 Accident Reports 102.22 Vacation Days 102.23 ACOTE Attendance Requirements 102.24 Attendance During Fieldwork Experiences 102.25 Ethical Standards 112.26 LSU Health–S E-Mail 112.27 Electronic Devices 112.28 Inclement Weather 112.29 The Family Educational Rights & Privacy Act 11SECTION 3. FW I3.1 Purpose of FW I 123.2 Master of Occupational Therapy Student Evaluation of Fieldwork I Site 12 3.3 Fieldwork I Evaluation of the Master of Occupational Therapy Student 12 SECTION 4. FW II4.1 Purpose of Fieldwork II 134.2 Fieldwork II Participants Rules & Responsibilities 13 4.3 Master of Occupational Therapy Student Fieldwork II Site Selection Process 164.4 Master of Occupational Therapy Student Fieldwork II Site Selection Request Form 174.5 Fieldwork Syllabus 174.6 Independent Study 21 SECTION 5. BECOMING A PROFESSIONAL5.1 Graduation 225.2 National Board of Certification in Occupational Therapy 225.3 Temporary Licensure 235.4 Alumni 235.5 Transcript Request 23SECTION 6. PHILOSOPHY OF FIELDWORK EDUCATION6.1 Accreditation Council of Occupational Therapy Education 246.2 Student Responsibilities Agreement 246.3 Student Fieldwork Professional Behaviors 256.4 Academic Fieldwork Site Selection 25APPENDICESAppendix 1 ACOTE Fieldwork Education Standards 26Appendix 2 ACOTE Fieldwork Standards 27Appendix 3 MOTS Request for FW Experience 28 Appendix 4 Fieldwork I Sample Letter 29Appendix 5 Fieldwork Commitment Form 32Appendix 6 Fieldwork I MOT Student Objectives 33Appendix 7 Fieldwork I MOTS Evaluation of Site 34Appendix 8 Fieldwork I FE Evaluation of MOTS 36Appendix 9 Fieldwork II Sample Letter 39Appendix 10 Fieldwork II MOTS Objectives 43Appendix 11 Fieldwork II First Rotation Three Week Check-In 44Appendix 12 Fieldwork II Midterm (Both Rotations) 45Appendix 13 Fieldwork II Second Rotation Three Week Check-In 46Appendix 14 Weekly Collaboration Form 47Appendix 15 Fieldwork II AOTA Fieldwork Performance Evaluation 48Appendix 16 Fieldwork II Expanded Rubric 56Appendix 17 Fieldwork II Student Evaluation of the Fieldwork Experience 59Appendix 18 Fieldwork Experience Assessment Tool 67Appendix 19 Learning Contract Guidelines 72Appendix 20 Independent Study Objectives Form 75Appendix 21 Independent Study Contract 76SECTION 1. MASTER OF OCCUPATIONAL THERAPY STUDENT (MOTS) FORMS1.1 MOTS Verification of Occupational Therapy Program Policies By my signature below, I attest that I have received a copy of the Occupational Therapy (OT) program policies and guidelines. I understand that I must have knowledge and familiarity of said policies and agree to abide by the regulations as stated while I am on or off campus. I understand that this policy supersedes any policy that an externship site might give to me. I understand I am bound by the policies and procedures provided in the fieldwork (FW) syllabus, current school catalog, OT program student policy, SAHP student policy, and LSU Health institution policies. I also understand this is a dynamic document and is subject to review and revision as indicated by the changing needs of the OT program.1.2 MOTS Acknowledgement of Ethical PracticeBy my signature below, I attest that I have read and understand the American Occupational Therapy Association (AOTA) Code of Ethics. I also agree to transmit the values and beliefs that enable ethical practice, and to develop professionalism and competence in occupational therapy as identified by the Accreditation Council for Occupational Therapy Education (ACOTE). I am aware that it is my duty to read and comprehend the terms of these documents.1.3 MOTS Verification of UnderstandingBy my signature below, I attest that I have read and understand the policies in this manual and agree to take responsibility for my actions as outlined in the Fieldwork Manual. All MOT students are expected to read and abide by the policies contained in this manual. The person listed for emergencies will be contacted upon discretion of the Academic Fieldwork Coordinator (AFWC) and Program Director (PD). A successful FW experience is dependent on the application of course work, intentional learning and initiated communication with the FW educator (FE) and AFWC.Upon completion of reading this manual and acceptance of these policies, please sign and date this page. The signed copy is placed in the AFWC’s mailbox and retained in your student file. This manual is a guide for fieldwork. The AFWC is available to clarify any information. 1.4 MOTS Waiver By my signature below, I agree to the checked applicable statement (s)_______ I grant permission to the AFWC to call my emergency contacts at her own discretion._______ I grant permission for the AFWC to give out my name, address, email, and phone number to FW educators needing to contact me._______ I grant permission for the AFWC to give out my address, email, and phone number to my classmates._______ I grant permission for the AFWC to give out my name, address, email, and phone number to potential job recruiters wanting to contact me.Signature: ___________________________________________ Date: _____________________Printed Name: ________________________________________1.5 MOTS Contact InformationMOTS Contact InformationPrinted Name: _____________________________________________________________________Cell Phone (include area code) ________________________________________________________LSU email: ________________________________ other email: ____________________________Emergency ContactsName: ____________________________________________________________________________Relationship: ______________________________ Phone: _________________________________Name: ___________________________________________________________________________Relationship: _______________________________ Phone: ________________________________ 1.6 AFWC Contact InformationFW students should seek to develop open lines of communication with their immediate FE and concerns should be addressed directly to this person. If students have concerns in which the FE are unable to adequately address, or which go beyond the scope of the FW site, the student should contact the LSU AFWC. Professor Gretchen Reeks, MA, LOTR, C/NDT Email: greeks@lsuhsc.edu Office phone: 318.813.2953Cell phone: 318.453.4448 Fax: 318.813.3001Louisiana State University Health – ShreveportSchool of Allied Health ProfessionsProgram in Occupational Therapy1450 Claiborne AvenueShreveport, LA 71103You may email or text me. Please be sure to indicate if an immediate email reply or telephone call is required. Also, indicate if the call should be made to your home, cell phone or to the fieldwork site. Be sure to include the phone numbers in your email. I will attempt to return all calls in a timely manner. SECTION 2. FIELDWORK2.1 Required FW DocumentationStudents are required to provide proof of each of the following categories: medical insurance, professional liability insurance, CPR, health information, drug screen, and criminal background check. Students will not be permitted to begin FW if current proof of each is not on file. Failure to start FW on the designated date may result in the student being withdrawn from that placement, the loss of that specific placement opportunity, and delay in graduation. It is the student’s responsibility to provide one copy of each document to the OT Program Administrative Assistant, and keep one copy in their FW portfolio.2.2 Medical InsuranceStudents are required to carry their own medical insurance coverage, in the event of an injury while on fieldwork. The insurance must be applicable for coverage throughout all fieldwork experiences. The cost of emergency and medical care is the responsibility of the student or the student insurance provider. 2.3 Cardiopulmonary Resuscitation Certification (CPR): Required for infant, child and adult.Prior to any type of FW, students are required to provide proof of current CPR for Health Care Providers certification. CPR certification must be current though the completion of FW II. Training is available from LSU Health-S, the American Heart Association, the Red Cross, and most local hospitals. 2.4 Health InformationAll students have access to an electronic copy of their immunization records. Please request this information from Shauntee Gee (Shauntee.Gee@) or Hazel Alexander (Hazel.Alexander@). You may also call the Occupational Health Department at 318.675.6281. It is the student’s responsibility to meet site-specific immunization requirements. The AOTA data form has this information, and the student may also email the site fieldwork coordinator. 2.5 Immunizations and/or screening tests include:Positive Rubella (German Measles) Titer Test or Immunization and Positive Rubeola (Measles) Titer Test or Immunization.Positive Varicella (Chicken Pox, Herpes Zoster) Titer Test or Immunization or validation of having Chicken Pox.Current Tetanus booster (within 10 years).Mantoux TB screening test within 1 year of application and yearly thereafter. A positive Mantoux test result must be followed up with a chest x-ray and verification of inactive status.Yearly evidence of TB mask fit/check.Evidence of Hepatitis B Vaccine series completed or initiated, positive titer or a student signed waiver. Hepatitis B (HB) Vaccine is given as a series of 3 immunizations, with the final 2 given 1 and 6 months following the initial immunization. A student who does not wish to take or who is unable to take the immunization is required to sign a waiver for the Hepatitis B Vaccine series.2.6 Drug screenLSU Health Shreveport requires all incoming students to complete a Drug Test and authorize release of test results as a condition of initial and continued admission to the university. This step is part of the pre-registration task list of duties for admission to the University. Students incur no cost through the university’s vendor. Incoming students complete the “Student Candidate Agreement and Authorization for Alcohol and Drug Test” form and return the form to the Office of Admissions and Records. Once received, a test packet will be mailed to the student. Remember to bring a photo. Within several days the Alcohol and Drug Test results are reported to the Human Resources Department and then to the Office of Admissions and Record. Should there be questions about the test results, the incoming student will be contacted by the Human Resources Officer. 2.7 Criminal Background CheckLSU Health Shreveport requires all incoming students to complete a criminal background check through our vendor. This step is part of the pre-registration task list. Incoming students assume responsibility for the cost of this service (approximately $100). An e-mail request is sent to incoming students outlining the procedure for initiating the request to conduct the background check. Incoming students should anticipate an email from “Application Station” which will arrive shortly after the Office of Admissions and Records receives your signed attached documents. Once received, incoming students should promptly open the “Application Station” email which will direct them through the steps and complete of the process. The turnaround time to complete the background check can be up to 10 days. Criminal background check results are posted to the vendors secure website in a tamper-proof environment where the incoming student, as well as the Director of Admissions and Records, can review the results. Confidentiality regarding this process is protected by the Office of Student Affairs. Results of the check are forwarded to the LSU Health Shreveport's Department of Human Resources and become part of the student’s permanent academic record. Incoming students are encouraged to secure their user name and PIN number created to initiate the check since most likely they will need access to a copy at a later time during their time as a student with LSU Health Shreveport and beyond. Should any questionable, illegal or negative indicators appear on the check, the Director of Admissions and Records will confer with the Program Director and Associate Dean for Academic Affairs regarding the most appropriate course of action to take. Many considerations are weighed including the effect of state and national licensure. Incoming students who fail to report a potentially negative incident prior to the background check may be denied admission to the program and admission to the University. Any student whose background check yields negative information will be required to meet and review the processes for prescreening through NBCOT and the LA OT Licensure Board to determine if the identified offense(s) will prevent the student from sitting for the NBCOT exam or from obtaining a license to practice. 2.8 Criminal Background Re-CheckThis is the original background check requested during the pre-registration time period.You are responsible for your User ID and PIN number. Contact the SAHP Office of Admissions and Records for a criminal background re-checkYou may also go to the Office of Admissions and Records with your photo ID and receive a copy of the report.? ?Or you may contact the Certiphi Request Line: 1.800.260.1680 to request a hard copy.No results, User ID’s or PINS are retained in the Office of Student Affairs.Students have unlimited, 24-hour online access to their check up to one year from the time the report was completed at: .Students may not participate in any FW or community activity until these are completed. A copy must be given to the AFWC one month prior to FW start date. Keep the original in your FW Portfolio.Any student whose background check yields negative information will be required to meet and review the processes for prescreening through NBCOT and the LA OT Licensure Board to determine if the identified offense(s) will prevent the student from sitting for the NBCOT exam or from obtaining a license to practice. 2.9 FW Policy FormsRead, sign and turn in to the AFWC: MOTS Verification of OT Program Policies; MOTS Acknowledgment of Ethical Practice; MOTS Verification of Understanding; MOTS Waiver and MOTS contact/emergency contact information. This is due week 3 of the first fall semester. If these forms are not completed the student will not be able to participate in any course related activities that involve patient/ client contact in or out of the classroom.2.10 Incident Reports An on-site incident must comply with sites written policies and the student must immediately notify the AFWC. Your personal medical insurance is the primary policy for any injury you incur. 2.11 Worker’s CompensationStudents do not qualify for worker’s compensation. An on-site incident must comply with sites written policies and the student must immediately notify the AFWC. Your personal medical insurance is the primary policy for any injury you incur. 2.12 Blood Pressure/Pulse and Universal PrecautionsPrior to any FW experience, students are instructed by LSU HEALTH-S in blood pressure/pulse and universal precautions. 2.13 Americans with Disabilities Act (ADA)The School of Allied Health Professions seeks to comply with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act by providing reasonable accommodations to students with documented disabilities. Students must register with the Office of Student Affairs to request disability-related accommodations, and are responsible for providing documentation of a disability. Costs associated with documentation of a disability are the responsibility of the student.For further information contact Melissa Greaves: 318.813.2908 HYPERLINK "mailto:mgreav@lsuhsc.edu" mgreav@lsuhsc.eduStudents with identified disabilities are strongly encouraged to initiate a discussion with the AFWC during the second semester of the program to discuss their needs for accommodations within the FW settings. This should allow sufficient time for the student to become well informed of his/her rights and to determine if and what information s/he wishes to disclose to the FE. If a student would like to request ADA accommodations for FW, the appropriate documents must be submitted to the AWFC from the Office of Student Affairs. Students may not ask for accommodations once the FW placement has begun. The FW courses will not provide accommodations without prior knowledge. Students who choose not to disclose such information may be in jeopardy of failing.2.14 Cost of FieldworkStudents financially assume the costs that accompany all FW experiences. The cost includes full tuition per FW course and all other site-specific fees. Additional expenses may consist of: housing, meals, transportation, travel, parking, materials for projects, scrubs, uniforms, etc. The LSU HEALTH web page has the specific tuition/fee schedule for each semester: Professional Appearance Students are required to dress as designated by the assigned fieldwork facility. In the absence of a facility dress code, the OT Program dress code is in effect at all times that the student is in the fieldwork facility. In all instances the student must wear a name badge. Full-length pants must meet malleoli. Axilla must be covered. Undergarments must be worn and may not be visible. No facial piercings or jewelry. Tattoos covered at all times. Excellent personal hygiene is expected including hair, facial hair and nails: no longer than ? inch; no artificial nails. Hair must be pulled back and out of face and eyes. Chewing gum or tobacco is strictly prohibited.2.16 Social NetworkingMany potential employers go to social networking sites to see what you have posted. It is important that you avoid posts or photos on Facebook, Twitter, etc. about your FW experiences. Here are some specifics:1. Please do not ask any of your FE’s to “friend” you. This puts everyone in an awkward situation. If you mutually decide to do this after the FW, that is a personal choice.2. Do not list names of supervisors, comments or criticism about sites.3. It is a HIPAA violation if you mention a client with enough information that the person might be identified. 2.17 Computer UseComputers are to be used for professional work/school. Checking personal email is strictly prohibited during FW hours.2.18 Electronic CommunicationElectronic communications devices (cellular phones, beepers, hand-held computers, blackberry’s, iPods, pagers, etc.) must be silenced and not used (including text messaging) during all FW experiences.Phones and pagers are considered distractions to the learning environment. They should be turned off and out of sight. Appropriate accommodations will be considered if the student notifies the AFWC and FW educator of any extenuating circumstances.2.19 Fieldwork CancellationA FW site may need to cancel a confirmed placement. If a cancellation occurs, the AFWC will notify the student. The AFWC and student will discuss alternative options and reschedule the FW experience.2.20 Change in Medical StatusIf a student has a change in their medical status while enrolled in the OT academic courses, they must notify the AFWC immediately. This is necessary so the student can plan for and make decisions for course completion. Any student who is pregnant will be required to have a letter from her physician stating she is capable of assuming the normal clinical duties of an MOT student. 2.21 Accident ReportsIn the event of an accident, personal injury, or injury to a client while on fieldwork or at an off-campus site for another class, the student will report the accident or injury to her/his immediate supervisor at the site and complete the necessary paperwork for that organization. In addition, the student will notify the AFWC immediately.2.22 Vacation Days are not permittedThe LSU HEALTH-S academic holidays do not apply to FW students. Do not plan family trips, weddings or other scheduled holidays to interrupt a FW experience or to closely coincide with the expected completion date of the FW course. 2.23 ACOTE Attendance RequirementsThe Accreditation Council for Occupational Therapy Education requires a minimum of 24 weeks of Fieldwork II (C.1.13). 2.24 Attendance during Fieldwork ExperiencesThe LSUHEALTH-S catalog policy: “Students are expected to attend all scheduled course-related class meetings, clinical and laboratory sessions in each course. Excessive absence, regardless of the cause thereof, may be construed as sufficient reason for considering a student as academically deficient. Determination of the number of absences which may be interpreted as excessive is determined separately by each program.”The AFWC and FE must be notified in writing of any request for an excused absence. Students should plan on each rotation including a 40 hour work week, with several hours each evening devoted to reflection, research, and preparation for the next day. Students are expected to be in attendance during the hours that their FE works. Actual days of the week and exact number of hours of work per week will vary, depending on the schedule of the FE to whom the student is assigned. The Monday through Friday 8 hour work day is mandatory and any modification of this time must be approved by the AFWC. Upon completion of each FW II, a total of 470 hours must be met.Excused absence: illness, accident, medical emergency, or death in the immediate family.? Immediate family includes grandparents, parents, siblings, spouse, children, and in-laws.? ?Absences or loss of time beyond two days during each 12-week FW II must be made up. School districts or state and federal agencies may have additional holidays, which along with illness, count toward two days of absence.Unexcused absence: an absence, which does not meet the definition of excused absence. Unexcused absences are unacceptable. Any time missed must be made up. Violation of this policy may result in a failing grade for the course.2.25 LSU HEALTH and AOTA’s Ethical StandardsStudents are responsible for learning about and upholding the ethical standards of the LSU Health-S pertaining to research, as well as the ethical standards of the American Occupational Therapy Association (AOTA) encompassed in the AOTA Code of Ethics. It is imperative that students take these responsibilities seriously as evidence of a serious breach in research ethics or in the AOTA Code of Ethics may precipitate immediate dismissal of a student from the program. Students are also directed to the AOTA Code of Ethics. This code includes occupational therapy students in its definition of personnel and is based on seven principles, each of which bears implications for student conduct. LSU HEALTH-S E-MailA large portion of communication with students happens through the LSU HEALTH-S email, not your personal e-mail accounts. Students are expected to check their LSU e-mail regularly, and to keep their mailboxes “clean” so that efficient communication between students and AFWC can take place. If e-mail cannot be delivered to a student due to a full e-mail box, the AFWC is not responsible for attempts to deliver the communication.2.27 Electronic DevicesElectronic communications devices (cellular phones, beepers, hand-held computers, blackberry’s, iPods, pagers, etc.) must be silenced and not used (including text messaging) during all fieldwork experiences.2.28 Inclement WeatherStudents are responsible to plan ahead for travel needs during inclement weather. Unless the assigned fieldwork placement is closed due to inclement weather, the student is expected to report to their FW site. If the assigned FW site is closed due to inclement weather, the student is required to make up these missed days. (Weekends or extend FW dates). The AFWC must be notified with number of missed days and the plan of action to make-up the missed days. Closure of LSU Health-S due to inclement weather does not relieve the student of the responsibility to report for duty.2.29 The Family Educational Rights and Privacy Act (FERPA)FERPA affords students certain rights with respect to the educational records. The LSU Health-S Student Handbook, (page 8) further defines this policy and procedure.SECTION 3. FIELDWORK I (FW I)3.1 Purpose of FW I The ACOTE Standards for FW I explain that the goal is to “introduce students to the FW experience, to apply knowledge to practice, and to develop understanding of the needs of clients”. This experience offers students the opportunity to translate theory into practice, and enriches the didactic coursework through directed observation and participation in selected aspects of the occupational therapy process (ACOTE C.1.8). OT services in a variety of settings with a variety of populations are offered. The concepts of occupation-based practice, client-centered practice, evidence-based practice and adaptation across the lifespan are supported by the FW experience.FW I introduces the MOTS to a variety of settings in which OT’s work. FW I experiences are designed in a developmental learning continuum. Each course builds on the previous, moving from simple to complex with the learning activities. FW I educators are qualified occupational therapists (ACOTE C.1.9). These FW I experiences will occur in conjunction with the didactic coursework in the curriculum (i.e. FW I in pediatrics while taking pediatric course (ACOTE C.1.8). FW I placements are made by the AFWC. The course learning objectives are compiled by the course instructor. The AFWC and course instructor discuss these objectives to coordinate the FW I sites that best meet these objectives. The AFWC will coordinate these objectives with the individual site and FE. The FE’s are in agreement with the plan set by the AFWC and course instructor prior to the MOTS placement.FW I experiences are selected each semester based on the course objectives and site’s ability to carry out the specific academic and clinical requirements. At a minimum, students will complete 24 hours in an outpatient orthopedic site, 40 hours in a pediatric site, 40 hours in an adult rehabilitation site, and 40 hours in an older adult site that has as its focus psychological and social factors that influence the engagement in occupation. (ACOTE C.1.7)The course instructor will facilitate discussions and design class assignments to support the course objectives, listed on the syllabi. The FE will evaluate the student in the areas of clinical application of knowledge, professional behavior, observation skills, and performance skills. The final grade from this experience, assignments, and classroom participation will be given by the course instructor.3.2 MOTS Evaluation of the FW I Site (FW WIKI)The MOTS will evaluate the FW I SITE and FE using the LSU OT Program SEFWE for FW I. The MOTS will review this form with the FE after the FE has given the MOTS their evaluation. Both will sign and the MOTS will bring back to the AFWC. (ACOTE C.1.10) 3.3 FW Educator Evaluation of the MOTS (FW WIKI)The MOTS is evaluated by the FE for professional behaviors and skills using the LSU OT Program Evaluation Form. On the last day of the FW I, the FE will review this document with the MOTS and both will sign. (ACOTE C.1.10) The MOTS will bring the evaluation form to the AFWC in the envelope provided by the AFWC, with the FE’s signature on the envelope seal. The student who earns a score of 1 in any area must meet with the AFWC and develop a remediation plan. The MOTS is responsible for scheduling a meeting with the AFWC and collaborating on a plan for improvement which addresses the identified areas. SECTION 4. FIELDWORK II4.1 Purpose of FW IIFieldwork plays an integral part of the educational experience by allowing the student to integrate classroom learning into clinical experience under the mentorship of an occupational therapist. During FW II experiences, students are introduced to the responsibility of evaluation, intervention, and management of OT services for their own clients. FW II placements are designed to develop competent, entry-level, generalist occupational therapists that promote clinical reasoning and reflective practice. The goal of FW II is to provide an in-depth experience in OT services that supports the curriculum design, with a focus on client-centered and evidence-based practice, as well as ethical decision-making (ACOTE C.1.11). Each semester the AFWC provides lectures to review the process and procedures of transitioning from academia to FW.Enrollment in the two FW II courses (OCCT 6911 and OCCT 6913) follows successful completion of all other academic requirements of the occupational therapy curriculum. During the FW II courses, the MOTS transitions into the role of student occupational therapist. Students actively participate in all aspects of the delivery of occupational therapy services, from referral to screening/evaluation/intervention and discontinuation of services. Emphasis is placed on the use of occupation that is purposeful and meaningful to clients and is based on evidence. Clinical reasoning and reflective practice skills are developed, as well as the values and beliefs that guide ethical practice and the development of professionalism (ACOTE C.1.11). MOTS’s are also exposed to various aspects of administration and management of occupational therapy services. Student learning outcomes are generalized outcomes that guide the FW experience, and are complemented by the specific objectives and activities that reflect the uniqueness of each FW placement.Each rotation is a full-time, 12-week placement, for a total of 24 weeks of FW II experience (ACOTE C.1.13). Actual days of the week and exact number of hours of work per week will vary, depending on the schedule of the FE to whom the MOTS is assigned. Students should plan on each FW course including a 40 hour work week, which may include weekend days and holidays, with several hours devoted to reflection, research, and preparation each evening. Students are strongly advised to NOT maintain outside employment during this last critical phase of their professional preparation. The Program in OT follows AOTA’s suggested FW II dates: . International FW experiences are not available at this time, per the policy of the LSU HEALTH-S Legal Affairs Department (C.1.19). Prior to MOTS placement, the AFWC review the AOTA Data form and the FW site coordinator to corroborate that the MOTS will be supervised by a currently licensed OT who has a minimum of 1 year full-time of practice experience subsequent to the initial certification and who is adequately prepared to serve as an FE. The AFWC updates the AOTA Data forms and staff profile with the FW coordinator via email or phone. A FW II MOTS at the FW site may collaborate with the FE to update the AOTA Data form. The AFWC also coordinates and invites the FE’s to attend the annual the AOTA FWECP Certification course offered by Bossier Parish Community College-OTA Program and LSU HEALTH-OT Program (ACOTE C.1.14 and C.1.17). The student FW office houses FW site files that contain: SEFWE forms and AOTA FW DATA forms. Students are encouraged to review the FW files: AOTA Data Form, SEFWE, talk with faculty and review the FW web page to assist with their FW site selection. After the MOTS reviews these files, the student schedules a meeting with the AFWC to begin the FW site selection process. Students are required to make an appointment with the AFWC to explore FW opportunities and partner student learning with site expectations. The purpose of this meeting is to review with the MOTS the FW site information and to guide the student with self-reflection to determine best learning match. This meeting also ensures that the MOTS is exposed to a variety of OT practice settings serving clients experiencing a variety of physical and psychosocial occupational performance issues across the life span (ACOTE C.1.12). The request to the FW site for MOTS placement is made only by the AFWC. The AFWC monitors student progress by contacting both the MOTS and FE at week 3 and midterm. The FE is and MOTS have the opportunity to contact the AFWC if there are any concerns at any point during the FW. Students are required to complete written questions at week 3 and email to AFWC. The AFWC also contacts the FE (phone or email) regarding the student’s professionalism and overall progress. At midterm the AFWC contacts both the FE and MOTS. If there are no concerns then the FE is asked to email the AFWC a general status report about the MOTS performance. The FW II MOTS is invited by the AFWC to attend a for a small group discussion. Prior to this group discussion the MOTS emails the AFWC the written assignment that guides the conversation. Students are also offered the opportunity to have a 1:1 conversation with the AFWC if needed. The FE evaluates the MOTS at mid-term and upon completion of the rotation using AOTA’s FWPE. Upon the successful completion of the final FW II rotation, the student is eligible to sit for the national certification examination and to apply for licensure to practice as an occupational therapist. At this point, students have transitioned through the roles of occupational therapy student to student occupational therapist to entry-level occupational therapist.4.2 FW II Participants Roles and Responsibilities FW education is accomplished through the collaborative efforts of the AFWC, FE and MOTS. The following is a brief description of the roles and responsibilities of each.Academic Fieldwork Coordinator (AFWC)The AFWC is the faculty member responsible for the program’s compliance with Accreditation Council for Occupational Therapy Education FW education requirements Section C (C.1.0 - C.1.19). The AFWC is responsible for the development and monitoring of the FW education program. Responsibilities include, but are not limited to:(C1.1, C.1.5, C.1.14)) selecting FW sites that reflect the OT program curriculum design through email of phone conversations with the FE and updating the AOTA Data form and staff profile (ensures licensed OT has 1 year full-time practice experience). This strengthens/supports the FW experience, curriculum design and student learning outcomes. (C.1.2) establishing the fact that the memoranda of understanding is current prior to FW MOTS placement.(C.1.6) maintaining the process for FW site selection. The formal approval between the university and the FW site is approved by both parties, signed by individuals who are authorized by each institution to sign this legally binding contract on behalf of that institution. Either party may initiate the contract, which covers both FW I and FW II. The MOU’s are reviewed at least every 5 years. The Deans Office maintains the MOU files. The contract contents include: each parties responsibility, liability insurance requirements, pre-requisite requirements, mutual Indemnity, terms and termination of agreement and forms for onboarding process. During this process there is collaboration with the FW site to update site objectives and site AOTA Data forms.(C. 1.3) annually update the FW office files (AOTA Data Form, SEFWE) and FW Manual (C.1.12, C.1.13) each semester guide students to the purpose and process of FW expectations and assign eligible students to FW experience. AFWC will reassign MOTS FW per departmental policies.(C.1.11) annually offer the AOTA FWECP course for FE’s to promote clinical reasoning and reflective practice. as-needed communication with each MOTS and FE (email, phone, ).maintaining FW files the documentation of FW supervision effectiveness: Student Evaluation of Fieldwork Experience (SEFWE).(C.1.10, C.1.15) maintaining in AFWC office the formal evaluation of student performance: AOTA Fieldwork Performance Evaluation for the Occupational Therapy Student (AOTA FWPE) and FW I LSU FE evaluations of MOTS.Assignment of final grade for the FW courses.(C.1.17) collaborating with the FE’s to develop instructional strategies: initial supervision is direct and then decreases to less supervision as appropriate for the setting; continuing education workshops, etc.assisting the MOTS and/or FE should concerns arise regarding the student’s performance, requirements of the fieldwork site, personality conflicts, etc. The AFWC is available to participate in telephone conferences or, if the site is within a “reasonable” drive from the University, the AFWC can attend an on-site conference. maintaining membership in the Louisiana FW Consortium, LOTA and AOTAupdating and managing the FW WIKI for FE’s and MOT’sFieldwork Educator (FE)The FE is a licensed OT who has a minimum of 1 year full-time practice experience subsequent to initial certification (C.1.14).The FW site may assign the administrative responsibilities to the FE or these responsibilities may be assigned to another FW site employee. The FE day-to-day supervisory responsibilities include, but are not limited to:collaborating with the AFWC in establishing FW site specific objectives, FW manual and maintaining the MOU’sorientating the student to pertinent departmental and organizational policies/ procedures and meetings/team rounds/conferences.reviewing with the MOTS: Learning objectives, learning expectations, projects and timelines. All documentation procedures and expectations. (evaluation, tx planning, discharge, billing).Model best practice with client-centered and evidence based at forefront.Assign clients with graded supervision matching the skill and clinical reasoning of the MOTS.supervising the student’s delivery of occupational therapy services, including documentation in all forms, and role of OTA’s and techs at site.conducting regular supervisory meetings, mid-term evaluation and final evaluation using the municating the student progress and evaluation results to AFWC at week 3,mid-term and the conclusion of the fieldwork experience, and at any time that concerns regarding the student’s performance may arise.mailing the original AOTA FWPE to AFWC when student has completed this FW II experience.FE’s provide learning opportunities to encourage students to transition classroom knowledge into the skills needed for entry-level practitioners. The FE is considered an important member of the education process. The AFWC offers seminars, WIKI resources, and phone/email collaboration to support best practice. FE’s clinical practice skills include competent/ ethical behavior; good communication skills and an understanding of the generational differences are key factors in site selection.The Program in OT encourages FE participation in national and state OT associations. Involvement with the OT program is done through on-site visits, telephone calls, email, etc. The AFWC initiates collaboration between the academic faculty and FE’s. This is accomplished through seminars, admission team interview participation, course laboratory experiences, lecture and discussion which review the academic curriculum and curriculum design and the FW site focus and scope of practice. Current practice trends, LSU HEALTH-S philosophy, mission and curriculum design is also reviewed. Resources are provided to support best practice in FW.The FE must meet state regulations governing practice and referrals from qualified physicians and from others seeking service in the medical, educational and broader human services community. The supervision ratio is either a 1:1 or 1:2 between FE and student. The FE provides ongoing graded supervision, weekly meetings and formal valuations at midterm and at the conclusion of the FW II experience. The AOTA Fieldwork Performance Evaluation (FWPE) is the assessment completed by the FE regarding each MOTS 12 week placement. The AFWC communicates with the FE throughout each student FW II rotation via telephone, electronically and/or FW site visits to ensure entry-level performance is achieved. At midterm the AFWC contacts the student and FE to discuss progress. The AFWC provides resources to the FE to support the development of supervisory skills, articles, resources, in-services. For example, decreasing supervision as the student demonstrates increased competence and performance.MOT StudentThe student collaborates with the FE and AFWC to ensure that the requirements of the FW experience are met. The student’s responsibilities include, but are not limited to:emailing the FW II site six weeks prior to start date to confirm the dates, time and meeting location of first day. Included in this email is the MOTS Personal Data Sheet.providing the FE proof of liability insurance, CPR certification, and immunizations, as well as any other documentation required by the placement (FW Portfolio).complying with all policies/procedures of the fieldwork site, unless specifically plying with all aspects of the Academic Code of Conduct, as defined in the LSU HEALTH-S Student Policies.notifying the FE of an absence. The MOTS will work all scheduled FW days, except in the case of unavoidable absences due to illness or death in the immediate family. Absences must be made up in a manner that is mutually agreeable to the FE, the MOTS and the AFWC.conducting her/himself in a professional manner, at all times.working the same hours as the FE, including weekends and holidays, unless otherwise determined by the FE and the AFWC.fulfilling all duties and assignments given by the FE within the specified time frame.actively and appropriately participate in the supervisory process; receiving and reflecting on constructive feedback from the FE and modifying behaviors pleting all assignments and from AFWC. This includes, but is not limited to active participation in , written collaborative assignments, and the LSU SEFWE. following the line of authority in the FW setting to discuss any problems or issues that may arise. Discussions should first be conducted with the FE. If resolution is not achieved with the FE, the student should attempt to resolve the issue with the FE and his/her supervisor. The AFWC is available to assist the student in planning how to approach the FE and/or supervisor, and how to express his/her concerns or issues. If problems or issues are not resolved at this level, the student may contact the PD.4.3 MOTS FW II Site Selection ProcessReview the list of sites: sh.lsuhsc.eduLSUHSC-Shreveport; Office of Legal Affairs /Affiliation Agreements FW criteria:One in state FW and one out of state. You may do both out of state.Rotations must be across the lifespan and in a variety of settingsAnalyze the fieldwork files in the FW officeAOTA Fieldwork Data FormStudent Evaluation of Fieldwork (SEFWE)Facility brochuresDevelop a list of questions and then make an appointment with the AFWC. Together, the AFWC and student will review the requested sites.To request a FW placement the MOT student will submit the form: Request for Fieldwork Experience, Level II to the AFWC. The AFWC will request a placement for you and once there is confirmation from the site, you will receive an confirmation email. When you have been confirmed for FW II placement, you will complete and turn in the Level II Fieldwork Assignment Agreement form to the AFWC.The AFWC will notify you of any changes or problems that may arise regarding fieldwork placement. Be sure to provide AFWC Coordinator with current phone number, e-mail address, and permanent address.4.4 MOTS FW Site Request Form For Courses: OCCT 6625, OCCT 6741, OCCT 6841, OCCT 6911, OCCT 6913, OCCT 6413 Resources: LSU/AOTA FW Rotation Schedule: OT FW WIKI: LSU HEALTH-S Contracts: FW II SyllabusCourse Instructor and AFWCProfessor Gretchen Reeks, MA, LOTR, C/NDTEmail: greeks@lsuhsc.eduWork: 318.813.2953 Fax: 318.813.3001 Emergency: 318.453.4448 LSUHSC-Shreveport FW WIKI: Course Pre-requisitesThe Professional Development Assessment (PDA) is conducted by all faculty members to determine the student’s readiness skills for FW II. The FW II courses are available to students who have earned a passing score on the PDA. Students who do not receive a passing score will not progress to FW II. The students’ academic advisor will inform the student of the P/F grade with the PDA. Students may not enroll in the FW II courses until all FW I course prerequisites are completed successfully.Students may not participate in the FW II courses until all prerequisite course work has been completed successfully with a passing grade. Course DescriptionsSpring Semester OCCT 6911 (9 credit hours) Fieldwork II: An in-depth experience in delivering occupational therapy services to clients. Students are supervised in a clinical setting full-time (40 hrs. per week) for 3 months. Summer Semester OCCT 6913 (6 credit hours) Fieldwork II: An in-depth experience in delivering occupational therapy services to clients. Students are supervised in a clinical setting full-time (40 hrs. per week) for 3 months. FW II Outcome ObjectivesThe MOT student will:consistently adhere to the AOTA Code of Ethics, safety regulations and use sound judgment.effectively communicate verbally and in writing the values and beliefs of the OT profession, and the role of the OT to clients, families, significant others, colleagues, service providers, and the public.focus on the application of purposeful and meaningful occupation and research, administration and management of OT services. develop occupation-based intervention plans and strategies, and demonstrate the ability to apply them to client situations.demonstrate the screening and evaluation tools used in OT practice, including assessments of occupational functioning, client factors, context, and determination of an occupational municate the role of the occupational therapist and occupational therapy assistants. apply principles of management and systems in the provision of OT services including timeliness, correct and complete documentation, adherence to policy and procedure, collaboration, delegation, program evaluation and supervision.utilize current research and professional literature to make informed evidence-based practice decisions.in all settings, understand and integrate psychosocial factors influencing engagement in occupation for the development of client-centered, meaningful, occupation-based outcomes.participate in the supervisory process; utilizing available resources, communicating assertively and respectfully, follow chain of command and responding appropriately to constructive feedback.assume a full client caseload, as defined by the FW site, by the end of the FW experience.follow all policies and procedures as directed by the FW site, FW manual and LSU HEALTH–S.submit correct and complete documentation in a timely manner. develop competent, entry-level, generalist competencies upon completion of the FW II plete and participate in all FW II assignments from AFWC.Professionalism: written, verbal and non-verbalCourse Requirements and Course GradeThe MOTS must complete a total of 12 weeks of full-time clinical FW experience per course. Each course must have a minimum of 470 hours.FW II takes place at 2 separate sites. This can be either one FW II in state and one FW II out of state, or both FW II’s out of state.FW II experiences are scheduled to assure that the MOTS is exposed to a variety of settings and to a variety of clients across the life span. An MOTS who does not complete or does not earn a passing score in the AOTA FWPE (score of 122 or above) for each of the two required FW II experiences (OCCT 6911 and OCCT 6913) will be ineligible to take the National Board for Certification in Occupational Therapy (NBCOT) certification exam.? All assignments requested from the AFWC must be completed in order to receive a passing grade on the AOTA FWPE. The AFWC will determine the course grade. FW II may be repeated one time only. Students who repeat a course but earn an unacceptable grade will be dismissed from the School and Program in OT.Students financially assume the costs that accompany all FW experiences. The cost includes full tuition per FW course and all other site-specific fees. Additional expenses may consist of: housing, meals, transportation, travel, parking, materials for projects, scrubs, uniforms, etc. Personal Data Sheet and FW Introduction Letter The MOTS will complete the FW letter and Personal Data Sheet 6 weeks prior to the start date of each FW II.The AFWC will contact the MOTS and FE at week 3 and midterm to discuss the learning opportunities and student performance. The LSU FW assignments are on the FW WIKI site. Each MOTS must complete these and email to the AFWC prior to the midterm collaborative FW call.As requested by the AFWC, the MOTS will assist the site FE with updating the AOTA DATA Form and Staff Profile. EvaluationThe FW II site experience is evaluated by the student, using the Student Evaluation for Fieldwork Experience (SEFWE) form. Students complete this form on SurveyMonkey. The AFWC will email each student this form in a PDF format. The MOTS prints, reviews, and signs with the FE, and then mails to the AFWC. This form is reviewed by the AFWC and a summary given to the academic faculty. The form is then placed in the site file in the FW office. Pre-FW students have access to this document when choosing a FW II placement.The MOTS performance will be evaluated by the FE using the AOTA Fieldwork Performance Evaluation for the Occupational Therapy Student (FWPE). The Fieldwork Educator completes the FWPE at midterm and at the completion of the FW. The original final FWPE is mailed to the AFWC by the FE.The FE mails the original AOTA FWPE to the LSU HEALTH-S AFWC. The SEFWE and AOTA FWPE forms should be mailed no later than one week after the student has completed the experience. Requirements for Pass on FWPE are: Rating of 3 or above for all Ethics and Safety items and an Overall Final Score of 122. Failure to achieve a score of 3 or 4 will be recorded as a failed FW II experience. Students who obtain a score of 122 or more, but do not have a 3 or 4 on the FWPE will earn a failed FW II experience.Failure Failure may occur any time throughout this FW experience. Immediate removal from the site and/or a failing grade may be given for any fieldwork placement for the following:Violation of patients’ rights, violation of the rights of others, violation of the AOTA Code of Ethics.Unprofessional behavior, unsafe practice, substance abuse, failure to complete any requirements.Continued unsatisfactory performance, insubordination, excessive tardiness, and/or risks to patient care.A final score below a “3” on items 1–3 of Section 1 of the FWPE (Fundamentals of Practice). Students need to refer to the School’s Policies and Procedures for Academic Misconduct, Dismissal, and Appeals for further information. In the event a student is dismissed from the School for misconduct, he or she is ineligible for readmission to the School.If the student does not meet the expectations of the FW II placement, they will earn a grade of “F”. Students who receive a failing grade or withdraw from a FW placement (per student, AFWC, or FE request) in one FW II experience may be given permission to take the course for a second time.?To be granted permission, the student must complete an action plan with specific strategies detailing the steps that will be taken to ensure that the student will be successful in subsequent FW experiences. No further FW placement will be provided until the AFWC and PD approve the student’s action plan.Termination will result in a grade of “F”. Receiving an “F” will be calculated into the student’s cumulative GPA. The student’s cumulative GPA must be at least 3.0 to be eligible for graduation. Students failing more than one fieldwork placement will be terminated from the program.? All fieldwork experiences must be completed within 24 weeks of fulfillment of didactic coursework. If a student is terminated and/or received an “F,” the student is subject to termination from the occupational therapy program. The student has the right to appeal this decision; refer to the student handbook for the appeals process. A student who has received an “F” and is allowed to remain in the program must submit an action plan to the AFWC describing how they will be successful on subsequent FW experiences. No further FW placement will be provided until the AFWC and PD approve the student’s action plan. Students who withdraw or fail a FW II experience must re-register for the course, and are responsible for the tuition associated with the FW II course. Withdrawal ProceduresStudents may withdraw in the first three weeks of each FW II experience. This withdrawal will earn them a grade of a “W,” and the student will be placed at a different site after completing an action plan that is approved by the AFWC. A student may only receive one “W” on FW II experiences. Receiving a “W” does not impact the student’s GPA. Receiving an “F” will be calculated into the student’s cumulative GPA. The student’s cumulative GPA must be at least 3.0 to be eligible for graduation. If either the student makes the decision to withdraw or if the AFWC/FE requests termination within the first three weeks, the student may be given permission to take the course for a second time. The withdrawal process is:The MOTS and FE will meet to determine the professional requirements that must be fulfilled prior to final exit.If the student requests withdrawal he/she will write a letter to the FE with a copy to the AFWC indicating reasons for withdrawal and the commitment to fulfill final requirements as determined by the facility.If the FE requests the student to be withdrawn from FW, a letter is written to the AFWC.The FE and student will schedule an exit interview. The FE will contact the AFWC after the exit interview. Failure to follow this process will result in a recorded grade of “F” on the MOTS academic record.The student will schedule an appointment with the AFWC after completing the entire withdrawal process.The student must contact the Registrar’s Office -Kim Carmen: Khatch@lsuhsc.edu (318.675.5207) to complete the required paperwork before leaving the Health Sciences Center. Failure to complete the withdrawal process will result in a block on the student’s academic record.If the student does not follow the stated withdrawal procedure or withdraws after the completion of week three, they will receive a failing grade. The FE may terminate at any time a student whose performance is not meeting competencies, or threatens the client’s treatment or safety. FW II Objectives: ACOTE StandardsThe 42 performance items listed on the AOTA FWPE are used as objectives to be met by all students during their FW II experiences. Sites are encouraged to collaborate with the AFWC in supplementing these with site specific objectives, site requirements and assignments. Available site specific objectives are filed in the FW files. See Appendix 1 for ACOTE FW Standards.Required Teaching and Learning ExperiencesFieldwork II is a practicum clinical experience. Students are strongly advised not to maintain outside employment during this last critical phase of their professional preparation. JustificationAccreditation Standards for a Master’s-Degree-Level Educational Program for the Occupational Therapist: Effective July 31, 2013, by The Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association (AOTA).Behavioral ObjectivesBehavioral objectives are developed by the FW Site in collaboration with the AFWC. The FW Site provides one copy of these objectives to the student. An additional copy is sent to the AFWC who is responsible for maintaining student fieldwork files. Students are strongly advised not to maintain outside employment during this last critical phase of their professional preparation. Relationship to the Curriculum DesignFW II provides students with in depth experiences in integrating theory, practice and developing skill in the delivery of occupational therapy services. Students have the opportunity to begin acting as change agents and exploring roles in research, administration and management of occupational therapy services.Student PerformanceDuring all FW experiences, students are expected to take an active part in their learning as well as the supervisory process by seeking and utilizing available resources to support their learning and client outcomes. The student is responsible for following the line of authority in the FW setting. Discussions should first be conducted with the FE. If resolution is not achieved with the FE, the MOTS should resolve the issue with the FE and her/his supervisor. The AFWC is available to assist the student in planning how to approach the FE and/or supervisor. If problems or issues are not resolved at this level, the student may contact the O.T. PD. If the student’s midterm performance score on the AOTA FWPE is an 89 or below the AFWC must be notified immediately. Any concerns at any point during the FW experience must immediately be brought to the attention of the AFWC. A written plan will be developed jointly by the FE, AFWC and MOTS. The plan includes a description of the problem, suggested learning strategies, outcomes measures, timelines and consequences of success or failure to meet timelines. The FE monitors the progress and provides written feedback for the student at daily/weekly meetings. AOTA’s Fieldwork Experience Assessment Tool (FEAT) may also be used to structure and promote FE/student communication on the learning experience. This tool enables the FW educator and student to reflect and create a plan. The student outcome is to develop clinical skills and appropriate professional behaviors. If the AFWC receives notification from the FE/Supervisor that student is demonstrating unprofessional behaviors, is not competent to perform assigned tasks, and/or is a safety risk to self, patients and/or staff, the FE and AFWC will counsel the student on corrective actions. A learning contract is established to attempt to remediate/correct the identified issues. The learning contract will include, but is not limited to: a description of the problem, suggested learning strategies, outcome measures, time lines, and consequences of success or failure to meet requirements set forth in the plan. The FE monitors the student’s progress and provides formal (written) and informal feedback to the student and AFWC at intervals established in the learning contract.If the student does not meet the expectations outlined in the learning contract the fieldwork placement will be terminated and the student will receive a grade of “F” for the placement. Students who receive a failing grade in one FW II will be re-scheduled, at the convenience of the AFWC, to repeat this FW II course. If the student fails again, they will not be scheduled for additional FW II experiences. Students must notify the AFWC prior to withdrawing from FW II. Any abandonment of one’s professional responsibilities to the patient and facility is considered a serious violation of professional ethics. The student will receive a failing grade if they leave a FW site without notifying AFWC.4.6 FW II Optional Independent Study (OCCT 6413: 3 credit hours) Optional Independent Study (IS) Fieldwork II: An in-depth experience in delivering occupational therapy services to clients. Students are supervised in a clinical setting full-time (40 hrs. per week) for 6 weeks. Course must be approved by AFWC and PD prior to MOTS registration. This FW allows students the opportunity for in-depth study in specialty practice areas. Written objectives are jointly established by the AFWC, MOTS and FW educator. Registration for this course is done with approval of the PD and AFWC. All FW II courses are graded by the FE using AOTA’s FWPE. All items in the Fundamentals of Practice section must be scored 3 or above on the final evaluation to pass fieldwork. A pass/fail grade is assigned by the AFWC.The Independent Study FW II process is listed below:MOTS will review the FW files and find a site that matches personal OT goals and objectivesMOTS makes an appointment with the AFWC to discuss learning goals and objectives. MOTS will complete the IS study form outlining their weekly learning objectives.MOTS completes the IS request forms and gives to AFWC.The AFWC will contact the FW site and review the timeline and objectives. The FW site will let AFWC know if this is doable.AFWC will let the MOTS know of the FW sites response. Modifications and/or site changes will be addressed as needed.Independent Study (IS) Level II Fieldwork Experience SyllabusAcademic Fieldwork CoordinatorProfessor Gretchen Reeks, MA, LOTR, C/NDTEmail: greeks@lsuhsc.eduWork: 318-813-2953Fax: 318-813-2957Emergency: 318-453-4448Course PrerequisitesThis course requires consent from the OT Program Director and AFWC and OT student has earned a passing grade on the LSU Professional Development Assessment (PDA). The Independent Study Student Contract and Student Learning Objectives must be completed prior to AFWC contacting FW site.All policies and procedures outlined in the FW II Syllabus applyCourse Description Summer Semester: OCCT 6413 (3 credit hours)Independent Study: The course credit, content, written objectives, and evaluation criteria will be jointly established by the student, AFWC, and FE. The IS course allows students the opportunity for in-depth study in an occupational therapy specialized practice area. This course requires consent from the OT Program Director and AFWC. (40 hours/week) for 6 weeks.Outcome ObjectivesThe MOT student will:Consistently adhere to the AOTA Code of Ethics, safety regulations, and use sound judgment in safetyEffectively communicate verbally and in writing articulate the values and beliefs of OT profession, and the role of the OT to clients, families, significant others, colleagues, service providers, and the publicDevelop occupationally-based intervention plans and strategies, and demonstrate the ability to apply them to client situationsDemonstrate the screening and evaluation tools used in OT practice, including assessments of occupational functioning, client factors, context, and determination of an occupational profileCommunicate the role of the occupational therapist and occupational therapy assistants. Apply principles of management and systems in the provision of OT services including timeliness, correct and complete documentation, adherence to policy and procedure, collaboration, delegation, program evaluation and supervision.Utilize current research and professional literature to make informed evidence-based practice decisions.In all settings, understand and integrate psychosocial factors influencing engagement in occupation for the development of client-centered, meaningful, occupation-based outcomes.Participate in the supervisory process; utilizing available resources, communicating assertively and respectfully, and responding appropriately to constructive feedback.Assume a full client caseload, as defined by the FW site, by the end of the FW experience.Follow all policies and procedures as directed by the fieldwork site and LSU HEALTH–S.Submit correct and complete documentation in a timely manner. Develop competent, entry-level, generalist competencies upon completion of the FW II plete and participate in all FW II assignments from AFWCPersonal Data SheetStudents will complete the Personal Data Sheet for each FW placement and email it to the FE 6 weeks before the start date.Attendance and AbsencesStudents are required to be in attendance during the hours that their FW educator works. Actual days of the week and exact number of hours of work per week will vary, depending on the schedule of the FW Educator to whom the student is assigned. Students should plan on each rotation including a 40 hour work week, with several hours each evening devoted to reflection, research, and preparation for the next day. There are no allowed absences during this 6 week rotation. Any missed days must be made-up at the convenience of the FE.Correspondence with ACOTE StandardsSection C.1.1-1.7 and C.1.11-1.19SECTION 5. BECOMING A PROFESSIONAL5.1 GraduationDuring the second FW II rotation you will receive emails from LSU regarding the OT Program FW Seminar and Hooding Ceremony as well as information about the day of graduation. The graduation dates are this website: lsuhscshreveport.edu/registrar5.2 National Board for Certification in Occupational Therapy (NBCOT) The FE completes the AOTA FWPE mails to the AFWC.The MOTS completes all assignments and mails a copy of the SEFWE to the AFWC. The AFWC posts a passing grade. The MOTS completes their portion of the Academic Credential Verification Form (ACVF, found on NBCOT web site), signs it, scans it, and emails it to Program Director (PD). PD verifies that the MOTS has passed FW and completes the rest of the form and sends to NBCOT.Once the NBCOT has the ACVF, the MOTS can complete application to take the NBCOT exam, and receives a date to take the exam.With evidence of having the exam scheduled, the MOTS can then apply for temporary license with the Louisiana Board of Medical Examiners.The MOTS may take the NBCOT exam before or after graduation, but the LSU Health Registrar will not sent transcripts to NBCOT until the Monday following graduation. NBCOT will release exam grade to student once it receives the official transcript from the Registrar.After NBCOT receives the official transcripts, the ACVF is no longer required to schedule the exam (if a student wanted to wait until after graduation to start working).AOTA EXAM PREP: EXAM PREP: Temporary Licensure You will work under the supervision of an OTR. In Louisiana, you may obtain a temporary license after you have scheduled your exam with NBCOT. For more information on getting license in Louisiana: following concerning temporary licensure is from AOTA:Many, but not all states allow practitioners to practice on a temporary license or limited permit while waiting to take or receive the results of the certification exam. If you fail the exam, you may not be able to continue to practice. Each state OT regulatory agency should be consulted for specific requirements (2015). See more at: Alumni The Program in OT at LSU HEALTH-S is interested in where its graduates begin their professional careers. Please contact the MOT Program Administrative Assistant: acoll2@lsuhsc.edu or 318.813.2950.5.5 Transcript Request Official LSU Health Sciences Center at Shreveport transcripts of an academic record may be ordered online through the National Student Clearinghouse:? are listed as LSU Health Sciences Center - Shreveport. The cost is $2 per copy plus a $2.25 per recipient processing fee.? By utilizing this online service, transcripts may be ordered around the clock and on weekends and holidays.? You can order as many transcripts as you like during a single session using a major credit card, and your card will only be charged after your order has been completed.? Order updates are available via mobile text message and will also be emailed to you.? You can track your order online using your email address and order number.? Your signed consent will be required to fulfill your transcript order.? For your convenience, a consent form will be generated for your order that you can approve instantly online.?Unofficial transcripts may be?accessed by logging onto the?PeopleSoft Academic Self Service portal?using your LSUHSC email user id and password.?For students/alumni that cannot access the PeopleSoft Academic Self Service portal to view their unofficial transcript, please?contact our office for assistance.?SECTION 6: PHILOSOPHY OF FIELDWORK EDUCATIONACOTE The LSU HEALTH-S Program in OT complies with the FW Educational Standards for a Master’s Degree Level Educational Program, established ACOTE and AOTA. FW sites are sufficient in number and types to meet the curriculum intent and design. A web page is listed below for complete sites offerings: seminars are held during the academic semesters to plan and discuss FW procedures. These seminars are mandatory for all students to participate in fieldwork. FW experiences are designed to provide students with multiple and varied opportunities to apply the knowledge and skills gained through didactic interactions and experiential learning experiences. Under the supervision of the FE’s, students identify clients' occupational performance issues and select appropriate theoretical frames of reference to screen and assess the clients. Students develop action plans with measurable goals and objectives that are matched to client-therapist agreed-upon targeted outcomes, carry out interventions, and plan for discontinuation of occupational therapy services and/or transition to other services. Within the fieldwork practice settings, students further develop the professional skills necessary for the establishment of effective client-therapist relationships and for successful collaboration with other members of the client's service delivery team.LSU Health-S academic coursework divides fieldwork education into two components, identified as “FW I” and “FW II”. ACOTE provides general guidelines regarding fieldwork education, but the specific nature and structure is determined by the academic faculty in collaboration with the FW educator. FW I may not be substituted for any part of FW II.6.2 Student Responsibility AgreementThe department only guarantees fieldwork placements that meet the AOTA standards and the department requirements. Students may request a specific placement, but the final decision is determined by availability of sites and will be made by the AFWC.Students must earn a successful completion of six (6) months of FW II, prior to graduation. Students may not participate in clinical or fieldwork courses until all prerequisite course work has been completed successfully. See “Provisions for Academic Progression” in general section of School of Allied Health Professions catalog.Students have the opportunity for an additional FW II experience through an Independent Study. This must approved by the OT Program Director and AFWC. The course credit, content, written objectives, and evaluation criteria are jointly established by the student and AFWC.A student who receives a grade of “Failure” in any FW II twice will be dismissed from the program regardless of the student’s cumulative grade point average. This requirement may be waived upon recommendation of the Department Head and approval of the Dean.All FW II requirements must be completed within 24 months following completion of didactic course work.One FW II placement must be scheduled outside of Louisiana. Students may complete both FW experiences out of state.Students assume their own financial responsibility for travel, living accommodations, etc. for each fieldwork placement. Very few facilities offer stipends, housing, or meals.After the paperwork has been completed and the FW site has been confirmed, there will be no changes in the placement. The FW sites are an integral part of the OT program, and the time the FE’s volunteer and dedicate to student clinical teaching is highly valued. It is disrespectful as well as unprofessional to withdraw from a FW commitment because a student prefers another site. This reflects poorly on the student as well as the university.If there is an emergency or dire circumstance, the student may request a change in writing to the AFWC indicating the reason for the change request. The request will be reviewed and the student will be notified in writing of the decision. A site may change areas of experience (e.g., from rehab to acute). This is not a reason for a student to request withdrawal from the placement contract.The MOTS assumes the responsibility to:Review FW files and consider all contingencies prior to selecting a FW site. Meet the prerequisite expectations of each facility.Submit Personal Data Sheet, letter of intent, and any required information to fieldwork educator 60 days prior to the scheduled starting date.Submit copies of liability insurance, health insurance, CPR, etc. information to department and fieldwork site prior to starting date, as well as any other forms required by the plete the SEFWE after each FW. Mail the original to the AFWC and leave one copy with your FW educator.Upon completion of fieldwork, please write a letter of appreciation to the OT FW Educator. Only the AFWC will contact FW sites for the purpose of setting up FW placements. All negotiating of FW II experiences will be done by the AFWC. No student may contact a site for the purpose of assessing the availability of a student placement or to secure a site for themselves or others.The student is responsible to contact the school when problems arise during fieldwork.6.3 Fieldwork Professional BehaviorsThe Program in OT values each FW as an opportunity for the students to demonstrate intentional learning under the supervision of an occupational therapist. Evaluation of student performance during FW experiences is an ongoing process. This occurs during supervisory sessions, both formal and informal, as well as during the processing of FW in the academic course work. The OT program utilizes an adaptation of the Professional Development Assessment ? (PDA) developed by Kasar, Clark, Watson, & Pfister (1996) to assess students’ professional behaviors. The OT faculty collaborates and assesses each student’s professional behaviors at the end of each semester. Each student is provided with written and verbal direct feedback regarding their professional behaviors in the classroom and in course related activities in various community settings. Students who do not receive ratings by faculty of a 3 or 4 in each area will work with their faculty advisor to determine strategies for achieving these expected ratings during the current semester. These strategies, expressed as personal objectives with timelines for achievement, will be documented. The form will be entered into the student’s file, with a copy provided to the student. Achievement of the objectives will be discussed at follow-up meetings between the student and his/her advisor. Failure to correct identified unprofessional behaviors will result in dismissal from the program and the student will not progress to FW II.6.4 Academic Fieldwork Site SelectionThe AFWC confirms that there is a current written contract in place between LSU and the site throughout the time that the student is on FW. The LSU Health-S Legal Affairs department initiates all contracts to each site, per the AFWC’s request. All original contracts are kept in the Legal Affairs Office with copies in the Allied Health’s Dean’s office. The Legal Affairs web page lists the current contracts with the contract expiration date. The AFWC reviews this site at the beginning of the fiscal year and requests contract renewals if needed. Contracts are reviewed at least every 5 years.The faculty and AFWC work closely to discuss and select FW sites that best support occupation-based practice and the curriculum design. Sites that meet the facility site selection criteria are used to support the didactic teachings. Students will not be placed at FW sites that do not support the LSU curriculum. FW site or educators that are under review for unethical practice will be eliminated from the site selection. The AFWC also collaborates with the site FW coordinator to update or complete forms electronically, on a site-visit, or on the phone. The AOTA Data Form is completed by the FW educator and provides comprehensive knowledge of the site’s FW philosophy. FW experiences are “a crucial part of professional preparation” (ACOTE), and sites are selected based on occupational therapy practice that best integrates with the LSU curriculum design. The FW site AOTA Data Forms are reviewed by AFWC prior to student placement. If this form is not current, the AFWC notifies the site and requests an update either electronically or verbally. This form reveals current FW site current participation in a review process (i.e.: Joint Commission on Accreditation of Health Care Organizations), and also the philosophy of OT service delivery. The narrative section allows the FW educator to write about the OT department philosophy and services. This includes integrating client-centered practice, clinical reasoning and reflective practice as taught in the OT curriculum. Meaningful occupations should be a site recurring theme.Faculty/student evaluations may be informal: classroom discussion, graduation seminar or formal: Student Evaluation of Fieldwork Experience (SEFWE). Student feedback regarding FW sites is an important means of assisting students to develop the ability to critically analyze situations in a professional manner. It also provides the site and academic program with information on the program, clients, supervision and ability to integrate classroom knowledge into practical application. The AFWC conference calls are also incorporated into the site selection process. At the forefront of this selection is the FE’s support of role modeling and commitment to student learning. The AFWC consults with the FE’s regarding compliance with ACOTE standards and understanding of the academic curriculum design. The AFWC encourages all FW educators to advance their clinical teaching skills by attending the AOTA Fieldwork Certificate Program. ACOTE FW Education: April 2016 Interpretive Guide VersionC.1.0 Fieldwork education is a crucial part of professional preparation and is best integrated as a component of the curriculum design. FW experiences should be implemented and evaluated for their effectiveness by the educational institution. The experience should provide the student with the opportunity to carry out professional responsibilities under supervision of a qualified OT practitioner serving as a role model. The AFWC is responsible for the program’s compliance with FW education requirements. The AFWC will:C.1.1 Ensure that the fieldwork program reflects the sequence and scope of content in the curriculum design in collaboration with faculty so that the FW experiences strengthen the ties between didactic and FW educationC.1.2 Document the criteria and process for selecting FW sites, to include maintaining memoranda of understanding, complying with all site requirements, maintaining site objectives and site data, and communicating this information to students.C.1.3 Demonstrate that academic and FW educators collaborate in establishing FW objectives and communicate with the student and FW educator about progress and performance during FW.C.1.4 Ensure that the ratio of FW educators to students enables proper supervision and the ability to provide frequent assessment of student progress in achieving stated FW objectives.C.1.5 Ensure that FW agreements are sufficient in scope and number to allow completion of graduation requirements in a timely manner in accordance with the policy adopted by the program as required by Standard A.4.14C.1.6 The program must have evidence of valid memoranda of understanding in effect and signed by both parties at the time the student is completing the Level I or Level II FW experience. Responsibilities of the sponsoring institution(s) and each FW site must be clearly documented in the memorandum of understandingC.1.7 Ensure that at least one FW experience (either Level I or Level II) has as its focus psychological and social factors that influence engagement in occupation.ACOTE FW I StandardsC.1.8.Ensure that Level I FW is integral to the program’s curriculum design and include experiences designed to enrich didactic coursework through directed observation and participation in selected aspects of the occupational therapy process.C.1.9Ensure that qualified personnel supervise Level I FW. Examples may include, but are not limited to, currently licensed or otherwise regulated occupational therapists and occupational therapy assistants, psychologists, physician assistants, teachers, social worker, nurses, and physical therapists.C.1.10Document all Level I FW experiences that are provided to students, including mechanisms for formal evaluation of student performance. Ensure that Level I FW is not substituted for any part of Level II FW. ACOTE Standards for Level II FieldworkThe Program in Occupational Therapy at LSUHSC-Shreveport follows all standards developed by the Accreditation Council for Occupational Therapy Education for Fieldwork II. These standards serve as official policies of LSUHSC-Shreveport FW II. The goal of Level II fieldwork is to develop competent, entry-level, generalist occupational therapists. Level II fieldwork must be integral to the program’s curriculum design, and must include an in-depth experience in delivering occupational therapy services to clients, focusing on the application of purposeful and meaningful occupation and research, administration, and management of occupational therapy services. It is recommended that the student be exposed to a variety of clients across the lifespan and to a variety of settings. C.1.11Ensure that the fieldwork experience is designed to promote clinical reasoning and reflective practice, to transmit the values and beliefs that enable ethical practice, and to develop professionalism and competence in career responsibilities. C.1.12Provide Level II fieldwork in traditional and/or emerging settings, consistent with the curriculum design. In all settings, psychosocial factors influencing engagement in occupation must be understood and integrated for the development of client-centered, meaningful, occupation-based outcomes. The student can complete Level II fieldwork in a minimum of one setting if it is reflective of more than one practice area, or in a maximum of four different settings.C.1.13Require a minimum of 24 weeks’ full-time Level II fieldwork. This may be completed on a part-time basis, as defined by the fieldwork placement in accordance with the fieldwork placement’s usual and customary personnel policies, as long as it is at least 50% of an FTE at that site.C.1.14Ensure that the student is supervised by a currently licensed or otherwise regulated occupational therapist who has a minimum of 1 year full-time (or its equivalent) of practice experience subsequent to initial certification and who is adequately prepared to serve as a fieldwork educator. The supervising therapist may be engaged by the fieldwork site or by the educational program.C.1.15Document a mechanism for evaluating the effectiveness of supervision (e.g., student evaluation of fieldwork) and for providing resources for enhancing supervision (e.g., materials on supervisory skills, continuing education opportunities, articles on theory and practice). C.1.16Ensure that supervision provides protection of consumers and opportunities for appropriate role modeling of occupational therapy practice. Initially, supervision should be direct and then decrease to less direct supervision as appropriate for the setting, the severity of the client’s condition, and the ability of the student.C.1.17Ensure that supervision provided in a setting where no occupational therapy services exist includes a documented plan for provision of occupational therapy services and supervision by a currently licensed or otherwise regulated occupational therapist with at least 3 years’ full-time or its equivalent of professional experience. Supervision must include a minimum of 8 hours of direct supervision each week of the fieldwork experience. An occupational therapy supervisor must be available, via a variety of contact measures, to the student during all working hours. An on-site supervisor designee of another profession must be assigned while the occupational therapy supervisor is off site.C.1.18Document mechanisms for requiring formal evaluation of student performance on Level II fieldwork (e.g., the AOTA Fieldwork Performance Evaluation for the Occupational Therapy Student or equivalent). C.1.19Ensure that students attending Level II fieldwork outside the United States are supervised by an occupational therapist who graduated from a program approved by the World Federation of Occupational Therapists and has 1 year of experience in practice.MOTS Request for FW ExperienceCircle: FW I or FW IIName: ___________________________________ Cell: __________________ Class of: ____________LSUHSC-S email: _____________________________ Non-LSU email: _________________________1st Rotation Request Dates: _____________________________________________2nd Rotation Request Dates: ____________________________________________From AOTA Data Form: facility name, OT contact name, email, and phone City/StateType of Setting Lifespan agesOne MOTS Site Specific Goal1st Rotation2nd RotationI understand that I will financially assume the costs that accompany all FW experiences. The cost includes full tuition per FW course and all other site-specific fees. Additional expenses may consist of: housing, meals, transportation, travel, parking, materials for projects, scrubs, uniforms, etc. The LSU HEALTH web page has the specific tuition/fee schedule for each semester: Printed Name: _____________________________________MOTS Signature: __________________________________ Date: _____________________Master of Occupational Therapy ProgramFW I Sample EmailInstructions for Completing Personal Data SheetThe Personal Data Sheet is similar to a brief autobiography and allows the fieldwork supervisor to know a little about you prior to your arrival. Complete one copy and save. Update this information for your next rotation/fieldwork educator. You will be responsible for including this completed copy with your letter of intent to be sent to the site not later than 40 days prior to the start date of the FW experience. This will enable the supervisor to select and plan learning experiences suited to your needs. Personal profile suggestionsSpecial Skills and Interests This can be anything special or unique to you.Previous Work Experience Jobs held that are relevant to OT and this FW experience.Additional Comments Look up the FW site on the Review the OT program. Is there something in particular you would like to learn about? For pediatric FW experience:Describe your experience with children For adult FW experience:Share any professional goals you might have to enhance your clinical reasoning and/or clinical skillsie: transfers, documentation, evaluations, hands-on experiencesMOTS Email to Fieldwork EducatorDate month/day/year(Press “Enter” 1 time)Inside Address (person to whom the letter is addressed)First and last name, followed by … PhD, LOTR, OTD, CHT (highest academic degree first). AOTA Data Form is a good resource (FW Office).Name of Facility (spell out)Street AddressCity, State, Zip Code(Press “Enter” 1 time)Body:Paragraph I: IntroductionThis letter is to confirm my Fieldwork Experience at your facility from ___, ___ (months, dates, year)Next sentence: I am a MOT student at Louisiana State University HEALTH – Shreveport.Catch their attention and tell them two-three sentences about yourself: research interests/projects? (Press “Enter” 1 time)Paragraph II: Interest and DesireTalk about why you’re interested in a FW experience at this particular facility. AOTA Data Form, SEFWE and www are good resources.Discuss something interesting (OT specific) from their web site or in the FW files that you would like to learn about.(Press “Enter” 1 time)Paragraph III: Questions?Dress code, parking, when and where to meet on the first day(Press “Enter” 1 time)Paragraph IV: ClosingI look forward to working with you and the staff at _____. Enclosed please find a copy of my personal data sheet.The LSUHSC-S FW program has “gone green.” I will bring with me my assignments and the FW I evaluation forms.Mention you will bring your Professional Portfolio with includes: CV, CPR, liability, etc.Identify clearly when and how you can be reached in your last sentence:I can be reached at (xxx) – xxx – xxxx and write your LSUHSC-S email address.(Press “Enter” 1 time)Typed signature line(Press “Enter” 1 time) Electronic signature, MOTSLSUHEALTH email addressCell phone (xxx) – xxx – xxxxLSUHSC-Shreveport Fieldwork Student Information SheetStudent Name: ____________________________________________________________________________(Last)(First) (MI)Other names used (maiden): ________________________ Date of birth: _______________________________ (Month) (Day) (Year)Phone (_______) ________________________ Cell Phone: (_______) ________________________________LSUHSC-S email: ____________________________________ Other email: ___________________________Shreveport address: _________________________________________________________________________Permanent Home Address: ___________________________________________________________________ Emergency contactName: ________________________________________ Relationship: ________________________________Phone number: _______________________Education InformationForeign languages: Read: _____________________Spoken: ___________________Expected date of conferred degree (Master of Occupational Therapy): ________________________________Universities and other degrees held i.e.: LSUBR, BS-Psychology, 2014Describe your preferred learning style:Consider this resource as a guide to help you: your preferred style of supervision:Consider this resource as a guide to help you: you require any reasonable accommodations (as defined by ADA to complete your fieldwork? Yes ___ No ___ If yes, please describe your accommodations request on a separate paper.Fieldwork Commitment FormBy my signature below, I attest that I will honor my commitment to this FW placement. Course Name and Number: _________________________________________________ Circle: FW I or FW II(FW I) ACOTE: …introduces students to the FW experience, to apply knowledge to practice, and to develop understanding of the needs of clients. (FW II) ACOTE: …the student will be exposed to a variety of clients across the lifespan and to a variety of settings. FW Dates/YearSite Name/Address /City/StateType of SettingLifespan ages 1.2.3.4._______________________________________________________________ _______________MOTS Printed name MOTS Signature Date_______________________________________________________________ _______________AFWC Printed name AFWC Signature DateLSUHSC FW I Student ObjectivesFW I experiences are designed to enrich didactic coursework through directed observation and participation in selected aspects of the occupational therapy process (C.1.8)The student will (ACOTE 2011 standards are identified):Provide the student with the opportunity to carry out professional responsibilities under supervision of a qualified occupational therapy practitioner serving as a role model (C.1.0).Adhere to the AOTA Code of Ethics and Ethics Standards and AOTA Standards of Practice during fieldwork education (B.9.1).Develop personal and professional abilities, competencies, and behaviors on fieldwork.Demonstrate effective oral communication skills and therapeutic use of self on fieldwork with clients and health care professionals in group and individual settings (B.5.7).Develop client observational skills (B.4.1).Experience the occupational therapy process and the role of occupational therapy in the fieldwork setting (C.1.8).Identify the purpose of common medical equipment/supplies in the fieldwork setting.Perform medical record review, apply medical terminology, and maintain written records as required of fieldwork setting (B.4.3, B.4.10).Understand the occupations of individuals and apply the PEO curriculum model in the fieldwork setting (B.2.11, C.1.8).Apply academic knowledge and practice skills learned in the classroom on fieldwork under the supervision of an occupational therapist (C.1.9).Identify personal knowledge and skills that need further development and direct further learning and growth (B.9.4).Begin to understand the role of other professionals on the team at fieldwork site.Identify interest areas for further fieldwork, research, and practice.Document a formal evaluation of the student’s performance (C.1.10).Use sound judgment in regard to safety of self and others and adhere to safety regulations throughout the occupational therapy process as appropriate to the setting and scope of practice (B.2.8). Master of Occupational Therapy Program STUDENT EVALUATION OF FW I EXPERIENCE (ACOTE C.1.10)Student Name: _________________________________________________ FW Dates: ____________________FW Educator Name: ______________________________?Credentials: __________ Membership: NBCOT AOTA OTAFacility Name: _______________________________________ Phone: ___________________ Fax: ________________ Facility Address: ____________________________City : _____________________ State: ________ Zip code: _________ACOTE B. 1.1, B.1.2, B.2.2, B.5.3Primary Diagnoses seen Therapeutic Intervention (Occupations) One example:Therapeutic Intervention (Activities) One example:Therapeutic Intervention (Preparatory methods and Preparatory Tasks) One example:ACOTE C.1.7FE and MOTS discussed the psychological and social factors that influence the engagement of occupation in this settingWrite the client case exampleCOMMENTSSIGNATURES__________________________________ ___________________________________________ ______________MOTS Printed Name MOTS Signature Date__________________________________ __________________________________________ ______________ OT FW Educator Printed Name OT FW Educator Signature???????? Date Master of Occupational Therapy Program STUDENT EVALUATION OF FW I EXPERIENCE (ACOTE C.1.10)Addendum: ACOTE StandardsC.1.10 Document all Level I Fieldwork experiences that are provided to students, including mechanisms for formal evaluation to students, including mechanisms for formal evaluation of student performance. B.1.1 Demonstrate knowledge and understanding of the structure and function of the human body to include the biological and physical sciences.B.1.2 Demonstrate knowledge and understanding of human development throughout the lifespan (infants, children, adolescents, adults, and older adults)B.2.2 Explain the meaning and dynamics of occupation and activity, including the interaction of areas of occupation, performance skills, performance patterns, activity demands, context(s), and environments, and client factorsB.5.3 Provide therapeutic use of occupation, exercises, and activities (occupation-based intervention, purposeful activity, preparatory methods).C.1.7 Ensure that at least one fieldwork experience has its focus psychological and social factors that influence engagement in occupation Master of Occupational Therapy Program FW EDUCATOR FW I EVALUATION of MOTS (ACOTE C.1.10)Student Name: _________________________________________________ FW Dates: __________________________Facility Name: ______________________________________________________________________________________FW Educator Name: ___________________________?Credentials: _____________ Membership: NBCOT AOTA __OTAFW Educator email: _____________________________ Phone: ________________________ Fax: __________________ Grading Criteria: 4 = exceeds standards: top 5% of all FW I students 3 = meets the criteria 2 = needs improvement: student is progressing 1 = unsatisfactory: student requires remediationI. PROFESSIONAL BEHAVIOR & ATTITUDE___ Adheres to AOTA OT Code of Ethics and Ethics Standards and AOTA Standards of Practice at all times. ACOTE B.9.1___Abides by setting guidelines. (dress code, punctuality, hygiene, hours, etc.)___Flexible and manages stressors in positive and constructive ways .(self-regulation)___Demonstrates an understanding of the ethical and practical considerations that affect health and wellness needs of those who are experiencing or are at risk for social injustice, occupational deprivation and disparity. ACOTE B.1.5___Accepts constructive feedback and modifies behavior. (follows up with positive action and takes responsibility) ACOTE B.9.6___Prepared with all proper forms and site requirements. ___Organizes time effectively and completes work within the set schedule. (time management)II. SAFETY ___Consistently adheres to safety regulations and anticipates potentially hazardous situations.___At all times uses good judgment in regard to safety of self and others. (asks if unsure) ACOTE B.2.8___Implements universal precautions during all client interactions. (including gait belts, body mechanics)___ Sets up the environment for safety before intervention (transfer, ADL, environment).MUNICATION AND CLINICAL REASONING___Clearly and confidently articulates the values and beliefs of OT and the value of occupation.___Consistently demonstrates professionalism: verbally, non-verbally and in writing. ___ Uses clinical reasoning to explain rationale for and use of compensatory strategies when desired life tasks cannot be performed. ACOTE B.2.10___ Demonstrates therapeutic use of self. ACOTE B.5.7___Interacts with clients in professional and therapeutic manner. (eye contact, tone of voice, etc.)___Communicates effectively, asking relevant questions. (logical, accurate, timely appropriate)IV. EVALUATION AND SCREENING___Able to articulate clear & logical rationale for evaluation process. ___ Demonstrates knowledge and understanding of the structure and function of the human body. ACOTE B.1.1___ Demonstrates understanding about importance of obtaining sufficient/necessary information from relevant resources such as client, families, significant others, service providers, and records prior to & during evaluation process.___ Able to articulate the importance of adjusting/modifying assessment procedures based on client needs, behaviors, and cultural variables. V. INTERVENTION___Articulates a clear and logical rationale for intervention process.___Chooses therapeutic occupations, exercises, and activities that motivate and challenge clients to facilitate meeting established goals. ACOTE B.5.3___Able to modify task, approach, occupations, and environment to maximize client performance. ACOTE B.2.7___ Demonstrates ability to engage client in occupation-based therapeutic activities.VI.MANAGEMENT OF OCCUPATIONAL THERAPY SERVICES___Demonstrates through practice or discussion ability to assign appropriate responsibilities to the occupational therapy assistant and occupational therapy aide.___Demonstrates through practice or discussion ability to actively collaborate with OTA and other professionals. ACOTE B.5.25___ Collaborates with team throughout the OT process.FW Educator PLEASE CIRCLE OVERALL RECOMMENDED GRADE: PASS FAILMOTS Strengths MOTS Areas for ImprovementSignature’s________________________________ ___________________________________________ ______________MOTS Printed Name MOTS Signature Date_______________________________ __________________________________________ ______________ OT FW Educator Printed Name OT FW Educator Signature???????? Date Master of Occupational Therapy Program FW EDUCATOR FW I EVALUATION of MOTS (ACOTE C.1.10)Addendum: ACOTE StandardsC.1.10 Document all Level 1 Fieldwork experiences that are provided to students, including mechanisms for formal evaluation of student performance. B.1.1 Demonstrate knowledge and understanding of the structure and function of the human body to include the biological and physical sciences.B.1.5 Demonstrate an understanding of the ethical and practical considerations that affect the healthand wellness needs of those who are experiencing or are at risk for social injustice, occupational deprivation, and disparity in the receipt of services.B.2.7 Demonstrate task analysis in areas of occupation, performance skills, performance patterns, activity demands, context(s) end environments, and client factors to formulate an intervention plan.B.2.8 Use sound judgment in regard to safety of self and others and adhere to safety regulations throughout the occupational therapy process as appropriate to the setting and scope of practice.B.2.10 Use clinical reasoning to explain the rationale for and use of compensatory strategies when desired life tasks cannot be performed.B.5.25 Identify and demonstrate techniques in skills of supervision and collaboration with occupational therapy assistants and other professionals on therapeutic interventions.B.5.3 Provide therapeutic use of occupation, exercises, and activities (occupation-based intervention, purposeful activity, preparatory methods).B.5.7 Demonstrate therapeutic use of self, including one’s personality, insights, perceptions, and judgments, as part of the therapeutic process in both individual and group interaction.B.9.1 Demonstrate knowledge and understanding of the AOTA Occupational Therapy Code of Ethics and Ethics Standards and AOTA Standards of Practice and use them as a guide for ethical decision making in professional interactions, client interventions, and employment settings.B.9.6 Discuss and evaluate personal and professional abilities and competencies as they relate to job responsibilities.Fieldwork IIMaster of Occupational Therapy ProgramFW ContentFW LetterFW MOTS Information SheetImmunization RecordLiability InsuranceCPR CertificationDrug ScreenCriminal Background CheckMedical InsuranceResourceFW WIKI: weeks prior to each FW experience, the above content is emailed to the FW contact person, and cc’d to the AFWC.Save the original copy of the FW letter and FW information sheet, and modify as needed for each FW experience. LSUHSC-Shreveport MOT Student Information SheetStudent Name: ____________________________________________________________________________(Last)(First) (MI)Other names used (maiden): ____________________ Date of birth: ___________________________________ (Month) (Day) (Year)Phone (_______) __________________________ Cell Phone: (_______) ______________________________LSUHSC-S email: ___________________________ Other email: ____________________________________Shreveport address: _________________________________________________________________________Permanent Home Address: ___________________________________________________________________ Emergency contactName: __________________________ Relationship: _______________Phone number: __________________Education InformationForeign languages: Read: _____________________Spoken: ___________________Expected date of conferred degree (Master of Occupational Therapy): _____________________________Universities and other degrees held i.e.: BS in Psychology, LSUBR 2014Describe your preferred learning style: your preferred style of supervision: Do you require any reasonable accommodations as defined by ADA to complete FW? No ___Yes ___Describe the approved ADA accommodations (LSU Associate Dean) separate paper. FW I month/ day/ yearSite Information city / state / type of facility (LTAC, o/p peds, etc)FWclient age range, diagnosis, OT evaluations and tx techniquesFW IImonth/ day/ yearSite Information city / state / type of facility (LTAC, o/p peds, etc)FWclient age range, diagnosis, OT evaluations and tx techniquesMOTS FW II EmailDate: month, day , year(Press “Enter” 1 time)Inside Address (person to whom the letter is addressed)First and last name, followed by … PhD, LOTR, OTD, CHT, Sequence properly … highest academic degree first. Look in FW files or on the internet to help you find the most current information.Name of Facility (spell out)Street AddressCity, State, Zip Code(Press “Enter” 1 time)Body:Paragraph I: IntroductionThis letter is to confirm my FW II experience from ____, ____ (months, dates and year)I am a MOT student at Louisiana State University Health Science Center – Shreveport.In one or two sentences, tell them about yourself. What you like to do when you are not studying.(Press “Enter” 1 time)Paragraph II: Interest and DesireTalk about why you’re interested in a FW II experience at this facility.Look up facility on the web and talk about something interesting you found on this site that you would like to learn about (OT specific)Write one example that demonstrates your ability to be an adult learner.Write 2 specific OT learning goals you can accomplish at this site.(Press “Enter” 1 time)Paragraph III: Questions?Dress code, parking, when and where to meet on the first day(Press “Enter” 1 time)Paragraph IV: ClosingI look forward to working with you . Enclosed please find a copy of my personal data sheet, proof of health insurance, liability insurance, etc.”The LSUHSC_S FW program has “gone green.” I will bring with me the original AOTA Fieldwork Performance Evaluation, FWPE.Mention you will bring your Professional Portfolio with includes: CV, CPR, etc.Identify clearly when and how you can be reached in your last sentence:I can be reached at (xxx) – xxx –xxxx and write your LSUHSU-S email address.(Press “Enter” 1 time)Typed signature line (Press “Enter 1 time) Electronic Signature, MOTSLSUHSC email addressCell phone (xxx) – xxx –xxxxLSUHSC FW II Student ObjectivesStudents will (ACOTE 2011 standards are identified):Demonstrate the ability to perform assessment and treatment planning processes consistent with the AOTA Practice Framework using the Models of Practice consistent with their educational preparation (ACOTE B.4.1, B.4.2, B.4.3, B.4.4).Administer and interpret occupational performance based assessments at the individual outcome, program evaluation and program development levels in a skillful manner (B.4.4, B.5.1, B.7.5, and B.7.6).Use evidence to inform practice on a consistent manner; including evidence based on experience, expert practitioners, from controlled studies, and from descriptive literature (B.8.3, B.6.6).Work collaboratively with team members and occupational therapy assistants to plan, implement, and terminate interventions that address the occupational goals of the client (B.4.5, B.5.22, B.5.25. and B.5.27).Implement interventions centered on occupation, participation and environment as client-centered care is planned and implemented (B.5.0, B.5.1).Provide services focused on consumers and family to enable the client’s occupation and maximizing occupational performance once discharged (B.5.28)Advocate for those who may be vulnerable or at risk with secondary conditions (B.2.9).Use occupational histories to create occupational profiles to guide client-centered care (B.4.4).Demonstrate a sensitivity to and inclusion of culture in the design of interventions (B.4.7).Plan and implement assessment and intervention plans that demonstrate a balance of the person, occupation and environmental factors (B.5.1, B.5.2).Transition clients from one service level to the next to insure an outcome of full participation and well-being in addition to occupational performance goals (B.5.25, B.5.29).Document occupation-based care plans, progress notes, goals and knowledge of billing methodologies that support occupational-based practice (B.4.10, B.5.32).Treat a full client caseload, as defined by fieldwork site, by the end of experience.Submit correct and complete documentation in a timely manner, according to policies and procedures of fieldwork site (B.5.32).Consistently report to site on time.Follow all policies and procedures as instructed by the fieldwork site and LSUHSC-Shreveport Program in Occupational Therapy.Demonstrate initiative when exploring new learning opportunities.Actively participate in the supervisory process.Utilize treatment approaches that demonstrate in depth knowledge of the various frames of reference in Occupational Therapy practice.20. Demonstrate entry-level competencies for the practice setting. Demonstrate professional behaviors consistently. Achieve all additional objectives set by the specific fieldwork site.Document the effectiveness of supervision on the Student Evaluation of the Fieldwork Experience: SEFWE (C.1.15)Formal evaluation of student performance on AOTA Fieldwork Performance Evaluation: AOTA FWPE (C.1.18.)Develop professionalism, clinical reasoning, and reflective practice in all settings (C.1.11)Use sound judgment in regard to safety of self and others and adhere to safety regulations throughout the occupational therapy process as appropriate to the setting and scope of practice (B.2.8).Articulate to consumers, potential employers, colleagues, third-party payers, regulatory boards, policy makers, other audiences, and the general public both the unique nature of occupation as viewed by the profession of occupational therapy and the value of occupation to support performance, participation, health, and well-being (B.2.3).Explain the role of occupation in the promotion of health and prevention of disease and disability for the individual, family, and society (B.2.5).Use clinical reasoning to explain the rationale for and use of compensatory strategies when desired life tasks cannot be performed (B.2.10).FW II First RotationPlease complete this document at the end of Week 3Three Week FW II Check-InDate: ______________ MOTS: _____________________________ MOTS cell #: _____________________Facility Name: ____________________________________________________________________________FE: __________________________________________________ credentials: ________________________ FE email: _________________________________________ FE phone ______________________________Written ReportTime Management: write down your typical work day schedule (include all mtgs, documentation, client treatment, etc.)Discuss one “aha” moment while working with a client performing an occupation-based practice activity. The activity contextThe clients occupational profile, age, dx, socioeconomic, spiritual, socio-cultural, goals OBP activity and your perception of why it went wellAre you meeting weekly with your FW educator? How does this collaboration maximize your learning?General comments/concernsProfessor Reeks, MA, LOTRAcademic Fieldwork CoordinatorAssistant Professorgreeks@lsuhsc.eduOccupational Therapy Program1450 Claiborne AveShreveport, LA 71103Phone: 318-813-2953Fax: 318-813-3001lsuhscshreveport.edu/Mid -Term Conversation Both RotationsDate: ____________MOT Student: ________________________ Email: _________________Cell #: ___________________Facility Name: _________________________________________________________________________City, State_________________________ Phone: __________________Fax: _______________________FE: _____________________________________FE: professional credentials: _____________________FE Email: ___________________________________Phone: ______________ Text? (yes/no) _________Individual Written Assignment: email to me prior to conversation.ACOTE Standard C.1.12: In all settings, psychosocial factors influencing engagement in occupation must be understood and integrated for the development of client-centered, meaningful, occupation-based outcomes. Write one case example that meets this standard.What are your strengths at the FW site?What are the areas in which you need to improve?What is your plan to improve in these areas?How do you feel your midterm evaluation went? Please email me FWPE midterm scores once you receive them.AOTA FWPEMidterm ScoreFundamentals of PracticeAdheres to EthicsAdheres to Safety RegulationsUses Judgment in SafetyGroup Conversation: Please allow one hour for this meeting.Please share with the group: Type of setting, clients/ diagnoses Case story of OBPGeneral reflection about professional and personal growthGroup conversation Share experiences!What has been the best part of this FW?FW II Second RotationPlease email me this completed document at the end of Week 3Three Week FW II Check-InDate ___________ MOTS: _________________________________ MOTS cell#: _____________________Facility Name: ____________________________________________________________________________FE: __________________________________________________ Credentials: ________________________ FE email: _________________________________________ FE phone: _____________________________Written ReportDiscuss one case example of how you utilized evidence from published research to make an informed intervention decision. Three paragraphs…attach a copy of the evidence.FWPE standards #27 and #28: In this setting, discuss one example each of how you might assign appropriate responsibilities to:- The occupational therapy assistant- The occupational therapy aide In this setting, how do you define to clients and families the definition of OT…3 sentences max .General comments/concernsProfessor Reeks, MA, LOTR, C/NDTgreeks@lsuhsc.eduAcademic Fieldwork CoordinatorAssistant ProfessorOccupational Therapy Program1450 Claiborne AveShreveport, LA 71103Phone: 318-813-2953Fax: 318-813-3001lsuhscshreveport.edu/ahMOTS and Fieldwork Educator Weekly CollaborationMOTS: _____________________________ OT: ________________________ Date: _____________FW week: 1 2 3 4 5 6 7 8 9 10 11 12 (circle one) MOTs self-rating: _______ OT rating of MOTS: _______ (0 = poor & 10 = excellent) MOTS:What can you do now that you could not do before this FW week? 2. What area do you find the most puzzling or confusing? What would enhance your learning? What could you teach someone to do that you could not teach prior to this FW?MOTS goals for next week: OT goals for MOTS next week:AOTA FWPE Midterm Scores (week 6) Consistently adheres to ethics and safety precautions: _____ Consistently uses evidence based intervention: _____Articulates the roles the OTR and OTA: must be able discuss OTA role even if site does not employ an OTA: ______Consistently initiates collaboration with all team members: ______To Be Checked by the MOTS____ I agree with the above written statements.____ I do not agree with the above written statements. _____________________________________ ______________________________________________ MOT’s Signature Date Fieldwork Educator Signature DateConcerns: Please notify Professor Gretchen Reeks, MA, LOTR, C/NDT o: 318-813-2953 greeks@lsuhsc.edu Fieldwork II“Performance Evaluation for the Occupational Therapy Student”Expanded RubricFundamentals of PracticeAdheres consistently to the AOTA Code of Ethics and site policies and proceduresAdheres consistently to safety regulationsAnticipates potentially hazardous situations and takes steps to prevent accidentsConsistently follows universal precautions at all timesConsistently monitors client’s vital signs before, during, and after interventionsConsistently follows health and safety regulations posted at all work sitesUses sound judgment in regard to safety of self and others by consistently evaluating Environment is set up for safety before providing interventions with clients, including but not limited to transfer setup, shower safety, community outings and level of environmental rms patient of expectations for behavior and takes action or redirects inappropriate behavior Follows proper body mechanicsBasic TenetsClearly and confidently articulates the values and beliefs of the OT profession to clients, families, significant others, colleagues, service providers and the publicExplains clearly to families or significant others how client’s engagement in desired occupations and activities supports their quality of lifeClearly, confidently, and accurately articulates the value of occupation as a method and desired outcome of OT to clients, families, significant others, colleagues, service providers and the publicClearly explains the use of occupation to team members during co-treatmentsClearly, confidently and accurately communicates the roles of the OT and OTA to clients, families, significant others, colleagues, service providers and the publicClearly explains to client and significant others the reason for therapist change from OT to OTA. Collaborates with client, family and significant others throughout the OT processUses mutual goal setting with client and significant others to determine intervention priorities Incorporates client’s goals into all treatment plansDemonstrates interpersonal skills required to work effectively with an interdisciplinary team of professionals, family members, and employers while providing individualized, meaningful, and successful OT servicesEvaluation and ScreeningClearly explains to supervisor the sequence of his or her chosen evaluation methods and the rationale for the approachClearly explains to FE the chosen evaluation methods leading to the determination of eligibility for OT Can appropriately administer Cardinal Hill’s analysis and profileIdentifies the need for additional testing: ex. reflex testing, vestibular testing, oculomotor testing, dermatome testing, or sensory processingAccurately determines various community environments that would be appropriate to use when assessing participant’s performanceDetermines client’s occupational profile and performance through appropriate assessment methodsAccurately compares and contrasts the differences between what the participant says he or she can do and what he or she can doAssesses client factors and context(s) that support or hinder occupational performanceObtains sufficient and necessary information from relevant resources such as client, families, significant others, service providers and records before and during evaluationAdministers assessments in a uniform manner to ensure that findings are valid and reliableAccurately completes manual muscle testing range of motion, coordination and sensory testing according to standard guidelinesAdjusts or modifies the assessment procedures based on client’s needs, behaviors and cultureEffectively engages in “in the moment” reasoning to modify tasks as needed during the evaluation processInterprets evaluation results to determine client’s occupational performance strengths and challengesEstablishes an accurate and appropriate plan based on the evaluation results, through integrating multiple factors such as client’s priorities, context(s), theories and evidence based practiceConsistently selects appropriate intervention strategies for patient’s needs, prior lifestyle, and anticipated discharge Documents the results of the evaluation process and demonstrates objective measurement of client’s occupational performanceInterventionDiscusses rationale of intervention choices using motor learning principles and how every theory is appropriateUses evidence from published research and relevant resources to make informed intervention decisionsInitiates discussion with fieldwork educator and team members regarding the rationale intervention choicesChooses occupations that motivate and challenge clients incorporating client’s likes or hobbies into intervention strategiesProvides the necessary support to participants as they seek to gain, regain, or maintain their independence in chosen work, school, home and community environmentsSelects relevant occupations to facilitate clients meeting established goalsEffectively chooses activities to meet individual goals when leading groupsImplements intervention plans that are client centered, consistently incorporating client’s occupations and purposeful activities required in anticipated discharge environmentEffectively obtains access to community resources and assists participants in connecting with and using resourcesImplements intervention plans that are occupation based consistently selecting intervention activities that encompass the full scope of activities the patient will participate in on dischargeModifies task approach, occupations, and the environment to maximize client performanceEffectively selects and prepares physical environment before group to create a therapeutic milieu and to support maximum participation of group membersEngages in effective “in the moment” problem solving during intervention sessions to ensure safety and maximize functional outcomes of clientsUpdates, modifies, or terminates the intervention plan when patient has met goal or reached plateau and justifies reason for termination, ensuring that all possible intervention strategies have been consideredAccurately revises goals that correlate to the changes in the clients performance in a timely mannerAccurately completes all daily notes or weekly notes per department guidelines clearly identifying what occurred and how the participant performed in a manner that demonstrates the efficacy of interventionsManagement of OT ServicesDemonstrates through practice or discussion the ability to assign appropriate responsibilities to the OTA and OT aideDemonstrates through practice or discussion the ability to actively collaborate with the OTA regarding the need to update client’s goals as appropriateDemonstrates understanding of the costs and funding related to OT services at this site by planning appropriate interventions, goals, and intervention plans based on insurance coverage, client needs and departmental productivity standardsAccomplishes organizational goals by establishing priorities, developing strategies, and meeting deadlinesCompletes all paperwork and client care responsibilities, schedules client case load independently, and coordinates treatment schedules on staffing days and reports in staff meetingsAssists with patient coverage as indicated within the department and the teamConsistently comes prepared and on time to all meetingsProduces the volume of work required in the expected time frameCompletes client care, all paperwork, and related activities within an 88.5 hour dayCommunicationClearly and effectively communicates verbally and nonverbally with clients, families, significant others, colleagues, service providers and the publicDemonstrates congruency between actions and wordsProduces clear and accurate documentation according to site requirements accurately completing all paperwork within departmental guidelinesAll written communication is legible, using proper spelling, punctuation and grammarUses language appropriate to the recipient of the information, including but not limited to funding agencies and regulatory agenciesProfessional BehaviorsCollaborates with FE to maximize the learning experience and asks for clarification or assistance when neededTakes responsibility for attaining professional competence by seeking out learning opportunities and interactions Locates, effectively uses and initiates discussion about resources being used to guide own learningResponds constructively to feedback by accepting feedback and effectively incorporating into daily routineDemonstrates consistent work behaviors, including initiative, preparedness, dependability and work site maintenanceDemonstrates effective time management by following through with all assigned duties and responsibilitiesDemonstrates positive interpersonal skills, including but not limited to cooperation, flexibility, tact, and empathyDemonstrates respect for diversity factors of others, including but not limited to sociocultural, socioeconomic, spiritual and lifestyle choicesRespects others’ values and interests when they are different than own personal values and beliefsFWPE/OTS objectives contributed by the OT staffs of Springfield Hospital Center, Sykesville MD; Northwest Regional Educational Service District, Beaverton, OR; Memorial Hospital, Colorado Springs, CO; and the Center for Community Participation, Colorado State University, Fort Collins.Adapted from: The Essential Guide to Occupational Therapy – Fieldwork Education – Resources for Today’s Educators and Practitioners, edited by Donna M. Costa, MS, OTR/L, 2004 by The American Occupational Therapy Association, Inc.Adapted from: The Upstate New York Occupational Therapy Fieldwork Consortium, September 19, 2005, Margot Elacqua, (518) 2444524, The Sage Colleges, Troy, New York 12180Adapted from: Cardinal Hill Healthcare System: FW II Manual, November 13, 2013. Lexington, KY 40504 STUDENT EVALUATION OF THE FIELDWORK EXPERIENCE (SEFWE)Purpose: This evaluation serves as a tool for fieldwork sites, academic programs, and students. The main objectives of this evaluation are to: Enable the Fieldwork II student who is completing a placement at the site to evaluate and provide feedback to the supervisor and fieldwork setting;Enable academic programs, fieldwork sites, and fieldwork educators to benefit from student feedback in order to develop and refine their Fieldwork II programs;Ensure that all aspects of the fieldwork program reflect the sequence, depth, focus, and scope of content of the curriculum design;Provide objective information to students who are selecting sites for future Fieldwork II experiences; andProvide a means of evaluation to ensure that fieldwork is performed in settings that provide educational experiences applicable to the academic program.This form is designed to offer each program the opportunity to gather meaningful and useful information. Sections outlined with thick black double borders are designed to be customized by your program as needed. Pages involving evaluation of individual fieldwork educators have been positioned at the end of the form to allow academic programs to easily remove these pages before making them available for student review, if they choose to do so.STUDENT EVALUATION OF THE FIELDWORK EXPERIENCE (SEFWE)Instructions to the Student:Complete this STUDENT EVALUATION OF THE FIELDWORK EXPERIENCE (SEFWE) form before your final meeting with your fieldwork supervisor(s). It is imperative that you review the form with your supervisor and that both parties sign on page 1. Submit this form on Blackboard with your supervisor then print and sign page 1 to give to your Academic Fieldwork Supervisor. This information may be reviewed by future students as well. The evaluation of the student (FWPE) should be reviewed first, followed by the student’s evaluation of the fieldwork experience (SEFWE), allowing the student to be honest and constructive. Fieldwork Site FORMTEXT ????? Site Code FORMTEXT ?????Address FORMTEXT ?????Placement Dates: from Click here to enter a date.to Click here to enter a date.Order of Placement: FORMCHECKBOX First FORMCHECKBOX Second FORMCHECKBOX Third FORMCHECKBOX FourthLiving Accommodations: (include type, cost, location, condition, contact phone number if applicable) FORMTEXT ?????Public transportation in the area: FORMTEXT ?????Please enter your e-mail address here if you do not mind future students contacting you to ask you about your experience at this site: FORMTEXT ?????We have mutually shared and clarified this Student Evaluation of the Fieldwork Experience report._______________________________________ ________________________________________Student's Signature FW Educator's Signature_______________________________________ ________________________________________Student's Name (Please Print) FW Educator’s Name and credentials (Please Print) FW Educator’s years of experience ____________ ORIENTATIONIndicate your view of the orientation by checking "Satisfactory" (S) or "Needs Improvement” (I) regarding the three factors of adequacy, organization, and timeliness.PRIVATE TOPICAdequateOrganizedTimelyNASISISISite-specific fieldwork objectives FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Student supervision process FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Requirements/assignments for students FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Student schedule (daily/weekly/monthly) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Staff introductions FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Overview of physical facilities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Agency/Department mission FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Overview of organizational structure FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Services provided by the agency FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Agency/Department policies and procedures FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Role of other team members FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Documentation procedures FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Safety and emergency procedures FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Confidentiality/HIPAA FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX OSHA—Standard precautions FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Community resources for service recipients FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Department model of practice FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Role of occupational therapy services FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Methods for evaluating OT services FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Other FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Comments or suggestions regarding your orientation to this fieldwork placement: FORMTEXT ?????CASELOADList approximate number of each age List approximate number of each primarycategory in your caseload. condition/problem/diagnosis in your caseloadPRIVATE AgeNumberCondition/ProblemNumber0–3 years old FORMTEXT ??? FORMTEXT ????? FORMTEXT ???3–5 years old FORMTEXT ??? FORMTEXT ????? FORMTEXT ???6–12 years old FORMTEXT ??? FORMTEXT ????? FORMTEXT ???13–21 years old FORMTEXT ??? FORMTEXT ????? FORMTEXT ???22–65 years old FORMTEXT ??? FORMTEXT ????? FORMTEXT ???> 65 years old FORMTEXT ??? FORMTEXT ????? FORMTEXT ??? FORMTEXT ????? FORMTEXT ??? FORMTEXT ????? FORMTEXT ???OCCUPATIONAL THERAPY PROCESSIndicate the approximate number of screenings/evaluations you did and indicate their value to your learning experience by checking the appropriate number with 1 being least valuable and 5 being most valuable.RequiredHowEducational ValueYesNoMany123451. Client/patient screening FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 2. Client/patient evaluations (Use specific names of evaluations) FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 3. Written treatment/care plans FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 4. Discharge summary FORMCHECKBOX FORMCHECKBOX FORMTEXT ???? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX List major therapeutic interventions frequently used and indicate whether it was provided in group, individually, Co-Treatment, or consultation. List other professionals involved.Therapeutic InterventionsIndividualGroupCo-TxConsultationOccupation-based activity, i.e., play, shopping, ADL, IADL, work, school activities, etc. (within client’s own context with his or her goals)1. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 2. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 3. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 4. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Purposeful activity (therapeutic context leading to occupation)1. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 2. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 3. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 4. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Preparatory methods, i.e., sensory, PAMs, splinting, exercise, etc. (preparation for occupation-based activity)1. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 2. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 3. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 4. FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX THEORY—FRAMES OF REFERENCE—MODELS OF PRACTICEIndicate frequency of theory/frames of reference usedPRIVATE NeverRarelyOccasionallyFrequentlyModel of Human Occupation FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Occupational Adaptation FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Ecology of Human Performance FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Person–Environment–Occupation Model FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Biomechanical Frame of Reference FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Rehabilitation Frame of Reference FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Neurodevelopmental Theory FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Sensory Integration FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Behaviorism FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Cognitive-Behavioral Frame of Reference FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Cognitive Disability Frame of Reference FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Motor Learning Frame of Reference FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Coping Frame of Reference FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Other (list) FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FIELDWORK ASSIGNMENTSList the types of assignments required of you at this placement (check all that apply), and indicate their educational value (1 = not valuable ------- 5 = very valuable). Indicate if more than one required.12345NACase Study Applying the Practice Framework FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Evidence-based practice presentation topic: FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Revision of site-specific fieldwork objectives FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Program development topic: FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Research topic: FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Other: FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX ASPECTS OF THE ENVIRONMENTPRIVATE 1 = Rarely 2 = Occasionally 3 = Frequently 4 = Consistently 1 2 3 4Staff and administration demonstrated cultural sensitivity FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX The Practice Framework was integrated into practice FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Student work area/supplies/equipment were adequate FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Opportunities to collaborate with and/or supervise OTs, OTAs, and/or aides FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Opportunities to network with other professionals FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Opportunities to interact with other OT students FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Opportunities to interact with students from other disciplines FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Staff used a team approach to care FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Opportunities to observe role modeling of therapeutic relationships FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Opportunities to expand knowledge of community resources FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Opportunities to participate in research FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Additional educational opportunities (specify): FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX How would you describe the pace of this setting? (choose one) FORMCHECKBOX Slow FORMCHECKBOX Med FORMCHECKBOX FastTypes of documentation used in this setting: FORMTEXT ?????Ending student caseload expectation: FORMTEXT ???? # of clients per week or dayEnding student productivity expectation: FORMTEXT ????% per day (direct care)SUPERVISIONWhat was the primary model of supervision used? (check one) FORMCHECKBOX one supervisor : one student FORMCHECKBOX one supervisor : group of students FORMCHECKBOX two supervisors : one student FORMCHECKBOX one supervisor : two students FORMCHECKBOX distant supervision (primarily off-site) FORMCHECKBOX three or more supervisors : one student (count as supervisor if supervision occurred at least weekly)List fieldwork educators who participated in your learning experience.PRIVATE NameCredentialsFrequencyIndividualGroup1. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????2. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????3. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????4. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????5. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????SUMMARY PRIVATE 1 = Strongly disagree 2 = Disagree 3 = No Opinion 4 = Agree 5 = Strongly agree12345Expectations of fieldwork experience were clearly defined FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Expectations were challenging but not overwhelming FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Experiences supported student's professional development FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Experiences matched student's expectations FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX What particular qualities or personal performance skills do you feel that a student should have to function successfully on this fieldwork placement? FORMTEXT ?????What advice do you have for future students who wish to prepare for this placement?Study the following evaluations: FORMTEXT ?????Study the following intervention methods: FORMTEXT ?????Read up on the following in advance: FORMTEXT ?????Overall, what changes would you recommend in this Fieldwork II experience? FORMTEXT ?????Please feel free to add any further comments, descriptions, or information concerning your fieldwork at this center. FORMTEXT ?????Indicate the number that seems descriptive of each fieldwork educator. Please make a copy of this page for each individual.FIELDWORK EDUCATOR NAME: FORMTEXT ?????FIELDWORK EDUCATOR YEARS OF EXPERIENCE: FORMTEXT ?????PRIVATE 1 = Strongly Disagree 2 = Disagree 3 = No opinion 4 = Agree 5 = Strongly agree12345Provided ongoing positive feedback in a timely manner FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Provided ongoing constructive feedback in a timely manner FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Reviewed written work in a timely manner FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Made specific suggestions to student to improve performance FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Provided clear performance expectations FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Sequenced learning experiences to grade progression FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Used a variety of instructional strategies FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Taught knowledge and skills to facilitate learning and challenge student FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Identified resources to promote student development FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Presented clear explanations FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Facilitated student’s clinical reasoning FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Used a variety of supervisory approaches to facilitate student performance FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Elicited and responded to student feedback and concerns FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Adjusted responsibilities to facilitate student's growth FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Supervision changed as fieldwork progressed FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Provided a positive role model of professional behavior in practice FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Modeled and encouraged occupation-based practice FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Modeled and encouraged client-centered practice FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Modeled and encouraged evidence-based practice FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Frequency of meetings/types of meetings with supervisor (value/frequency): FORMTEXT ?????General comments on supervision: FORMTEXT ?????FIELDWORK EXPERIENCE ASSESSMENT TOOL (FEAT)Student’s name:Supervisor(s) names:Facility name:Fieldwork experience type (setting, population, level):Date:Week #:Context:The Fieldwork Experience Assessment Tool (FEAT) is the result of an American Occupational TherapyFoundation qualitative study completed by six occupational therapy programs across the United States and Puerto Rico. Data were collected from fieldwork students and fieldwork educators. In their interviews, students and fieldwork educators described fieldwork education in terms of a dynamic triad of interaction among the environment, the fieldwork educator, and the student. Interviewees indicated that a positive educational experience occurred when a balance existed among these three key components.Purpose:The FEAT identifies essential characteristics for each of the three key components. By providing aframework to explore the fieldwork experience, the FEAT can help students and fieldwork educators consider how to promote the best possible learning experience.The purpose of the FEAT is to contribute to student and fieldwork educator discussions, so that reflection and problem solving can occur to enhance the fieldwork experience. The tool is designed to both assess the balance of the three key components, and to facilitate discussion about student and fieldwork educator behaviors and attitudes, and environmental resources and challenges. By mutually identifying issues present during fieldwork, the fieldwork educator and student can use the FEAT as a tool to promote dialogue, and foster the identification of strategies to facilitate the just right challenge. The FEAT may be used early in fieldwork as a tool to promote dialogue, or at any time throughout fieldwork as the need for problem solving emerges.Directions:In the Assessment Section, the FEAT is organized according to the three key components:environment, fieldwork educator, and student. Under each component, essential characteristics and examples are listed. These examples are not all inclusive, and new descriptors may be added to individualize the tool for different settings. The fieldwork educator and student, either individually or together, should complete the FEAT by describing each component using the continuum provided at the top of each section (limited ? just right challenge ? excessive).Following the assessment portion of the FEAT, questions are provided to guide student and fieldwork educator discussion and problem solving. Collaboratively reflect upon the student and fieldwork educator descriptions on the FEAT to identify commonalities and differences between the two perspectives, and identify patterns across the key components. Based on these discussions, develop strategies for a more balanced fieldwork experience. Consider environmental experiences and resources; fieldwork educator attitudes, behaviors and professional attributes; and/or student attitudes and behaviors that could enhance the experience. The examples listed within each section are intended to guide discussion between the fieldwork educator and student in an effort to create a successful fieldwork experience. Additional elements may be identified and included according to the nature of the setting or the fieldwork process.A. Assessment SectionENVIRONMENTI. VARIETY OF EXPERIENCESDescriptions (Limited ? Just right challenge ? Excessive)A. Patients/Clients/DiagnosesDifferent diagnosesRange of abilities for given diagnosis (complexity, function, dysfunction)Diversity of clients, including socioeconomic &lifestyleB. Therapy approachesEngage in the entire therapy process (evaluation,planning, intervention, documentation)Learn about different roles of therapist (direct service, consultation, education & administration)Use variety of activities with clientsObserve and use different frames of reference/theoretical approachesUse occupation vs. exerciseC. Setting characteristicsPace (setting demands; caseload quantity)Delivery systemII. RESOURCESDescriptions (Limited ?? Just right challenge ?? Excessive)A. OT StaffSee others' strengths and stylesHave multiple role models, resources and supportB. Professional StaffObserve and hear a different perspective on clientsSee/experience cotreatments and team work to get whole person perspectiveHave others to share ideas and frustrationsC. OT StudentsAble to compare observations & experiencesExchange ideasFIELDWORK EDUCATORI. ATTITUDEDescriptions (Limited ? Just right challenge ? Excessive)A. Likes Teaching/Supervising StudentsDevote time, invests in studentsEnjoy mental workout, student enthusiasmB. Available/AccessibleTake timeC. SupportivePatientPositive and caringEncourages questionsEncourages development of individual styleFIELDWORK EDUCATOR (continued)D. OpenAcceptingAlternative methodsTo student requestsCommunicationE. Mutual RespectII. TEACHING STRATEGIESDescriptions (Limited ? Just right challenge ? Excessive)A. StructureOrganize information (set learning objectives,regular meetings)Introduce treatment (dialogue, observation, treatment, dialogue)Base structure on student needIdentify strategies for adjusting to treatment environmentB. Graded LearningExpose to practice (observe, model)Challenge student gradually (reduce direction, probing questions, independence)Base approach on student learning styleIndividualize based on student’s needsPromote independence (trial & error)C. Feedback/ ProcessingTimely, confirmingPositive and constructive (balance)Guide thinkingPromote clinical reasoningD. TeachingShare resources and knowledgeE. Team SkillsInclude student as part of teamIII. PROFESSIONAL ATTRIBUTESDescriptions (Limited ? Just right challenge ? Excessive)A. Role ModelSet good exampleEnthusiasm for OTReal personLifelong learningB. TeacherAble to share resources and knowledgeFIELDWORK STUDENTI. ATTITUDEDescriptions (Limited ? Just right challenge ? Excessive)A. Responsible for LearningActive learner (ask questions, consult)Prepare (review, read and research materials)Self direct (show initiative, is assertive)Learns from mistakes (self correct and grow)B. Open/ FlexibleSensitive to diversity (nonjudgmental)Responsive to client/consumer needsFlexible in thinking (make adjustments, try alternate approaches)C. ConfidentComfort in knowledge and abilitiesComfort with making and learning from mistakes(take risks, branch out)Comfort with independent practice (take responsibility)Comfort in receiving feedbackD. Responsive to SupervisionReceptive to feedback (open-minded, acceptcriticism)Open communication (two-way)II. LEARNING BEHAVIORSDescriptions (Limited ? Just right challenge ? Excessive)A. IndependentHave and use knowledge and skillsAssume responsibility of OT without needing directionIncorporate feedback into behavioral changesUse “down time” productivelyBecome part of teamB. ReflectionSelf (processes feelings, actions and feedback)With others (supervisor, peers others)C. Active in SupervisionCommunicate needs to supervisor (seek supervision for guidance and processing; express needs)Ask questionsB. Discussion Section: Questions to Facilitate Dialogue and Problem Solving1. A positive fieldwork experience includes a balance between the environment, fieldwork educator and student components. Collaboratively reflect upon the descriptions outlined by the student and fieldwork educator and identify perceptions mon perspectives between student and fieldwork educatorDifferent perspectives between student and fieldwork educatorEnvironmentFieldwork EducatorStudent2. What patterns are emerging across the three key components?What strategies or changes can be implemented to promote a successful fieldwork experience? Describe below:Components of aSuccessful FieldworkEnvironment, Fieldwork Educator and/or Student Strategies and Changes to Promote Successful Fieldwork Experience at this SettingEnvironmentExperiencesResourcesFieldwork EducatorAttitudesBehaviorsProfessional attributesStudentAttitudesBehaviorsThis Fieldwork Experience Assessment Tool (FEAT) was developed by The Fieldwork Research Team:Karen Atler, Karmen Brown, Lou Ann Griswold, Wendy Krupnick, Luz Muniz de Melendez and Patricia StutzTanenbaum Project funded by The American 1998; revised August 2001] FEAT 1Learning Contract GuidelinesPhilosophy:Self-directed learning is the educational ideal, which guides and informs the FW. Promoting a model of self-directed learning within the FW setting necessitates the establishment of a climate that is conducive to learning. The characteristics which promote an optimal learning climate are:CollaborationMutual RespectOpennessTrustFlexibilitySupportivenessA learning contract is a tool, which can facilitate the practical application of self-directed learning, and as such, it has particular relevance within the FW. To be effective, it must be a continuously negotiable working document between the FE educator and the student.Using a learning contract while on FW placements encourages the student to take an active role in all stages of their learning. It provides the student with the flexibility of individualizing their learning by establishing meaningful goals which reflect their own strengths and weaknesses.Within the context of the FW experience, the learning contract allows the student to blend the necessary objectives for practice education with their own personal learning goals. When the student is initially identifying their learning goals he/she needs to give careful consideration as to whether or not the desired outcomes are achievable objectives given the available resources and the need to meet the required practice education objectives on which the student will be assessed. The identified goals must also be consistent with the student’s current level of professional development and not be unrealistically high or low.A collaborative working relationship between the FW educator and the student is essential when using learning contracts. The process of negotiation and the formulation of a written agreement aim to make the responsibility of both parties explicit. It also clarifies and makes explicit the expectations that the FW educator has of the student and the expectations that the student has of themselves and of the FW educator, in relation to meeting learning needs. The skills of giving and receiving feedback enhance the working relationship and need to be nurtured during practice FW experience.Learning contracts need to be regularly reviewed to allow for changes as objectives are met and new learning objectives are developed. This is to acknowledge that learning is a dynamic process and that the learning environment can be both volatile and changeable. Regular professional and documented supervision with the FW educator provides a forum for the two-way negotiation that is needed to make changes and to acknowledge learning developments. It also provides a forum for feedback.The focus in self directed learning is on the facilitation of learning. It is intrinsic rewards such as a sense of achievement and increased self-esteem that are valued by the adult learner. To this end, the learning contract is a vehicle, which facilitates the development of intrinsic professional values for the student occupational therapist.Please note that a template for the Learning Contract is available to download from the Discipline’s website at educationWhat is a Learning Contract?It is a formalized written agreement between the student and their FW educator.It includes input from all parties (student, practice educator, and other staff).It gives responsibility to the student to be involved in their own learning.It focuses on learning opportunities.It is written from the students assessment form.It is a way of making the student’s own learning objectives (from their own assessment form) explicit.It states what the student’s learning objectives are.It considers whether the student’s learning objectives are achievable.It specifies what strategies and resources the student and practice educator will use to achieve the student’s learning objectives.It states the evidence the student will produce to show that they have achieved their learning objectives.It defines the timescale for the student’s achievement of their learning objectives.It aids the student’s assessment and achievement in the practice education experience.The learning contract has four sections:Learning Objectives (what the student intends to learn).Strategies and Resources (what the student intends to do and what facilities the student to achieve their learning objectives).Evidence and Validation (the evidence the student will produce to show that they have achieved their learning objectives and how their evidence will be validated). Timescale (when the student intends to have completed this piece of their learning).The process for negotiating a learning contract while on placement:Before the placement:The student sends his/ her FW letter, reviews the AOTA Data Form, SEFWE, and the Internet1st Week of Placement:The student should take the week to see what opportunities are available and to participate as possible.The student should make a list of the identified opportunities in the placement and of all the items they want/need to learn.The FW educator should make a list of all the available opportunities and their expectations of the students.End of 1st Week/Beginning of 2nd WeekThe student and the FW educator should have their first supervision session. Both the student and the practice educator should bring their lists to this negotiation meeting.Together, the student and the practice educator identify all the items, which are on all the lists and:Negotiate what the student’s learning needs are from these items (i.e. what do I need to learn?)Identify the resources to help the student learn this (i.e. how can I best learn this in this placement?)Identify the criteria by which the student will be able to show they have learnt this (i.e. what will I be able to do when I have learnt it?)Each Subsequent WeekDuring each weekly supervision meeting the student and the practice educator reflect on the week’s activities and then mark off items, which have been achieved on the contract.The student will find that using a reflective diary throughout the week helps this process immensely.Note that it is perfectly acceptable to write in learning that happened without planning. So, if something unexpectedly happened and you learned from the situation – write it in.Some prompting questions to help when trying to negotiate a learning contract (ask these about each item on the learning contract):What do you mean by this?Why do you want to learn this?Is this learning need essential/ achievable?How might you learn this?What resources are available to help you do this?How are you going to evaluate this?Why use a Learning Contract?At the end of the placement, the student’s learning contract provides evidence that the student has:Achieved their essential learning outcomes.May also have achieved some desirable learning outcomes.Passed their placement.The learning contract should be therefore be used to provide the evidence to write up the student’s final summative report.The student should keep a copy of all their learning contracts in their practice education portfolio. The student should review their learning contracts from previous placements prior to beginning their next placement, as a way to:Identify what strengths they will bring to their next placementIdentify their personal learning needs for their next placement (the things that the student is weaker on and that they need to work on.LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTERDepartment of Rehabilitation SciencesProgram in Occupational TherapyFW II 6-Week Independent Study Objectives for: (OT Specialty Area)FW Dates: ______________MOTS Name:_____________________________ Cell: _______________ Email: ______________________Learning ObjectiveActivities to Achieve ObjectiveTimeline for Each ObjectiveEvidence of Achievement of Learning ObjectiveWeek 1Week 2Week 3Week 4Week 5Week 6MOTS Signature: _______________________________________________ Date: _________________Faculty Signature: ______________________________________________ Date: _________________AFWC Signature: ________________________________________________ Date: _________________OCCT 6413FW II Independent Study Agreement and Learning ContractI acknowledge that significant time and expense has occurred to arrange this Independent Study.I understand that this requires added 3-hour tuition fee.I understand that the following courses are pre-requisites to this FW placement:OCCT 6911: Spring Semester (9 hours) OCCT 6913: Summer Semester (6 hours)I will complete the learning contract prior to the AFWC initiating placement.I therefore agree to complete the fieldwork.MOTS Printed Name: ______________________________________________ Date: ___________________MOTS Signature:___________________________________________________________________________Academic Fieldwork Coordinator: _____________________________________________________________Program Director Signature: _________________________________________________________________ FW Site: _________________________________________________________________________________Address: ________________________________________________________________________________City, State, Zip: ___________________________________________________________________________Phone Number: _______________________________ Fax: _____________________OT Contact at Site: ________________________________________ Credentials: _________________Dates of FW: ___________________________ Web site address: ___________________________________ ................
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