2014 Fieldwork Educator 2014 Fieldwork Educator Appreciation WorkshopAppreciation Workshop

Scoring the Fieldwork Performance Evaluation

Supporting the Struggling/Failing Student

Welcome & Introductions

0OTA Program Faculty0Community Educators

Session Objectives

0 Upon completion of the session, participants will be able to:0 Summarize the purposes of the AOTA Fieldwork Performance

Evaluation (FWPE) for the OTA student.0 Demonstrate an understanding of the FWPE scoring system

by accurately scoring sections of the tool based on case studies.

0 Write one site-specific fieldwork objective that meets the RUMBA test.

0 Identify a minimum of 3 strategies that could be incorporated into the fieldwork experience to support a struggling/failing student.

0 Locate additional fieldwork resources on the ACC OTA program website.

Part 1Scoring the Fieldwork Performance Evaluation

Discussion

0Community experiences with the FWPE0Faculty experiences with the FWPE

AOTA Fieldwork Performance Evaluation (FWPE) for the Occupational Therapy

Assistant Student0Document Highlights

0 Purposes0 Design of the FWPE0 Scoring System

0*Fundamentals of Practice (Ethics and Safety Items)0Midterm and Final Scores

0 Individualizing the FWPE

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Primary Purposes of the FWPEs

0Measures entry-level competence0 Designed to differentiate the competent student from

the incompetent student 0 Not designed to differentiate levels above entry-level

competence

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Purposes (continued)

0Provides student with accurate assessment of his or her competence for entry-level practice over time0 Growth occurs over time0 Midterm and final scores reflect this change0 Midterm scores: Satisfactory–unsatisfactory 0 Final scores: Pass–no pass

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Purposes (continued)

0Provides feedback to student0Provides opportunity for student self-assessment

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Design of the FWPEs

0The “doing” of the occupational therapy process is evaluated, not the individual tasks in isolation

0NOT all items are equal in level of difficulty (i.e., simple to complex)

0Evaluation is supplemented with development of site-specific objectives

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Scoring System of FWPE

0Each item must be scored0 *Ethics and safety items must be passed 0Each item rating recorded on Performance Rating

Summary Sheet 0All items summed up at midterm and final0Score compared to scales provided

Rating Scale ReviewRATING SCALE FOR STUDENT PERFORMANCE

4 — Exceeds Standards: Performance is highly skilled and self-initiated. This rating is rarely given and would represent the top 5% of all the students you have supervised.

3 — Meets Standards: Performance is consistent with entry-level practice. This rating is infrequently given at midterm and is a strong rating at final.

2 — Needs improvement: Performance is progressing but still needs improvement for entry-level practice. This is a realistic rating of performance at midterm, and some ratings of 2 may be reasonable at the final.

1 — Unsatisfactory: Performance is below standards and requires development for entry-level practice. This rating is given when there is a concern about performance.

Midterm and Final Scoresof the FWPE for the OTA

Overall Midterm Score

Satisfactory: 54 & above

Unsatisfactory: 53 & below

Overall Final Score

Pass: 70 & above

No Pass: 69 & below

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Individualizing the FWPE

0 Designed for additional objectives to be written to add clarification 0 Site-specific objectives 0 NOT supervisor-specific

0 If an item is very clear and meets the RUMBA test, then there is no need to write another objective:R = Is the objective relevant to the practice setting, and is it an

essential entry-level skill for the practice setting?U = Is the objective understandable to the student?M = Is the objective measurable? Can the performance be

measured? B = Is the objective behavioral? Can the objective be seen?A = Is the objective achievable within the desired time frame?

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Objectives: An Example From FWPE for the OT Student

016. Establishes accurate and appropriate plan 0 School—Provides behavioral-based, measurable OT

goals during IEP process0 Acute Care—Overall intervention plan is achievable

within client’s length of stay

Activity

0Take a moment to reflect on your practice setting.0Select one item from the FWPE.

0 Write one site-specific objective that reflects the unique nature of your practice setting.

0 Evaluate the objective to determine whether it meets the RUMBA test.

Additional Resources for Developing Site-Specific Objectives0Available to all practitioners through AOTA’s website:

http://www.aota.org/Education-Careers/Fieldwork/SiteObj.aspx

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Summary

0Evaluations designed to measure entry-level competence, NOT level of performance above competency

0OT practice examined as a generalist 0Evaluations reflect the occupational therapy process0Performance develops over time

Case Examples & DiscussionScoring the Fieldwork Performance Evaluation

Screening/Evaluation: Sandra, OTA Student

Intervention: David, OTA Student

Session Break

Part 2Supporting the Struggling/Failing Student

Why Do Students Struggle With/Fail the Fieldwork

Experience?0Community Insight0OTA Program Analysis

Why Do Students Struggle With/Fail the Fieldwork

Experience?0Community Insight

0 In your experience, why do students struggle/fail fieldwork?

Why Do Students Struggle With/Fail the Fieldwork

Experience?0OTA Program Analysis

0 Review of data over the past 5 years indicates the following reasons for failed fieldwork experiences:0 Interpersonal Issues/Professional Behavior Issues0Personal Life Issues0Clinical Performance Issues/Clinical Reasoning 0Academic Issues

Why Do Students Struggle With/Fail the Fieldwork

Experience?“Academic Reasons0Student struggles with content of practice area of placement0Poor learning strategies0Practice is limitedPersonal Reasons0Stress, depression, physical illness, learning disability0Having second thoughts about their career choice0Unprofessional behavior or unsafe with clients0Difficulty working with other people0Poor insight (student may blame you or others for failing)0Motivation or commitment to the learning process is lacking

Poor Teaching0Fieldwork educator unclear about objectives or teaching strategies0No orientation or needs assessment provided0No feedback/assistance provided when problems identified (or feedback and assistance provided too late)”

http://www.philau.edu/ot/download/OTlearning%20objectivesfailingastudent.pdf

Why Do Students Struggle With/Fail the Fieldwork

Experience?0 Early-Warning Signs

0 Rigidity in thinking0 Uncomfortable with the

ambiguity present in clinical reasoning

0 Lack of insight0 Difficulty

interpreting/incorporating feedback; unable to learn from errors

0 Externalizing issues0 Uncomfortable with physically

handling clients0 Low self-esteem (dependence

on external validation)

0 Early Warning Signs (cont.)0 Difficulty using supervision0 Inconsistent work

behaviors0 Personal life issues0 Passive attitude, difficulty

engaging0 Inconsistent work

performance0 Feeling

overwhelmed/stressed0 Unable to think on their feet0 Poor time management

skills

Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 201). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

Strategies to Support the Struggling/Failing Student

0Community Insight0 Based on your past experience, what strategies can you

share to support the struggling/failing student?

Additional Strategies:Utilize Resources

0Contact the school and begin to develop a collaborative plan as soon as possible.

Additional Strategies:Identify the Specific Problem0 Objectively evaluate the student’s performance and/or

behavior.0 Document concretely and objectively.0 Analyze to determine the type of issue with which the

student is struggling:0 Interpersonal Issues/Professional Behavior Issues0Personal Life Issues0Clinical Performance Issues/Clinical Reasoning 0Academic Issues0Other

0 Identifying the fundamental issue is a critical component in selecting an appropriate follow-up course of action.

Additional Strategies:Implement a Systematic Process

for Remediation1. Specifically identify the problem2. Give careful thought as to the importance of the problematic

behavior in the “big picture” of clinical success3. Meet with the student ; discuss and document:0 Your expectations 0 Any self-identified problems (student insight)0 Exactly what you need to see from the student(clear,

concrete expectations) as well as a timeline 0 Suggestions and/or resources to support improvement0 Student strategies for how the FWE can better support

his/her learning needs4. Meet with the student for a follow-up; document progress (or

lack thereof); modify plan as appropriate

Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 208). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

Additional Strategies:Implement a Systematic Process for RemediationMaintain contact with the school throughout the process,

the earlier the better0 Identify the steps you have taken and the results0 Request feedback/support as needed from the school0 In the event that the student is not making progress, the

school can be a valuable support for the FWE in considering any remaining options

Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 208). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

Additional Strategies:Consider a Learning Contract0Developed primarily by the student as a means to

facilitate self-directed learning0Used by some educators as a remedial tool; can also

be used for students who are successful in the learning environment

Costa, D. M. (2007). Clinical supervision in occupational therapy: A guide for fieldwork and practice (pp. 133-136). Bethesda, MD: AOTA Press.

Learning Contract

0 Provides learner with a sense of control over his/her own learning

0 Evaluative criteria established to determine whether learning occurred

0 Planning of experiences/activities becomes a collaborative effort between the student and educator

0 Allows student to develop ownership/commitment to learning needs

0 Control over learning may create anxiety/frustration for the student who is unfamiliar with self-directed/active learning

0 Time consuming to create0 Success of the contract

depends on the attitude of the educator and/or level of support from the site

0Pros 0Cons

Costa, D. M. (2007). Clinical supervision in occupational therapy: A guide for fieldwork and practice (pp. 133-136). Bethesda, MD: AOTA Press.

Developing a Learning Contract

1. Assess prior experiences and learning: “Where have I been?”

2. Identify current knowledge/skills: “Where am I now?”

3. Develop goals and objectives: “Where do I want to go next?”

4. Create a study plan to meet goals and objectives:“How will I get there?”

5. Identify resources: “What will I need to help me?”

6. Establish evaluative criteria: “How will I know that I have reached my goals?”

(Rose and Best (2005, p. 253) as cited in the text referenced below.)Costa, D. M. (2007). Clinical supervision in occupational therapy: A guide for fieldwork and practice (pp. 133-136). Bethesda, MD:

AOTA Press.

Additional Strategies Based on Type of Issue

0 Academic/Clinical Performance Issues 0 Suggest remedial resources (texts, in-services, etc.)0 Provide an opportunity for practice of skills0 Notify the school; discuss remedial activities

0 Interpersonal Issues/Professional Behavior Issues0 Provide direct feedback; role model appropriate/desired behaviors0 Consider role play for practice0 Outline clear expectations 0 Suggest remedial resources for skill development0 Implement a plan of correction

0 Personal Life Issues0 Maintain professional boundaries - direct the student to notify the school

(students have access to free counseling/supportive resources)0 Avoid becoming the student’s therapist, remember that the student must

meet learning objectives0 A note on program technical standards and accommodations…

Strategies for Prevention of Failure

0Notify school immediately should any potential issues arise

0Set clear expectations from day 10Provide routine feedback; request routine feedback

from the student0Provide progressive structure to outline the

experience0Structured plan for reduction of supervision/ensuring

student competency

Importance of Feedback0 Confirms areas of strength (affirming for those with low

self-esteem/confidence)0 Heightens student awareness of areas in need of attention 0 Identifies potential barriers to goal achievement/fieldwork

success0 Encourages alternative behaviors/actions0 Motivating factor for change0 Depending on delivery, can facilitate or hinder change0 Demonstrates commitment of the educator0 Clarifies whether there is a match between perceptions of

performance and expectations between the student and educator

Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 201). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

Case Examples & DiscussionStrategies to Support the Struggling/Failing Student

Coping Strategies for the FWE

0Seek support from the school and/or colleagues. 0 We are here to support you as well as the student!

0Remember that failure is not the end of the world (for you or for the student).

0Recognize that failing a student is a “higher form of caring, [involves] responsibility and accountability to the student, client, and the profession” (Turkett, 1987).

Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 201). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

Additional Fieldwork Resources

Available on the ACC OTA Program Website at:

http://www.austincc.edu/health/ota/fieldwork/educators/resources.php

BrainstormingIdeas for Upcoming Sessions

Session Wrap-UpReview of the Session Objectives

THANK YOUNot only for your attendance, but for your ongoing support.

We could not fulfill our roles as educators without you!

References

0Slides 6-10, 12-14, & 17 and Scoring Case Studies: AOTA’s Inservice In A Box: Understanding the OT/OTA Fieldwork Performance Evaluations. Available at http://www.aota.org/en/Education-Careers/Fieldwork/Supervisor/Inservice.aspx