Maximizing your Fieldwork Experience, a Fieldwork Educator and Former Student Perspective

Maximizing your Fieldwork Experience, a Fieldwork Educator and Former Student PerspectiveChristine DeFiglio, OTR OT Student Clinical Coordinator, Kessler Institute for Rehabilitation

Anthony Castronovo, MS, OTRKessler Institute for Rehabilitation

Catherine Colucci, MA, OTRUMDNJ- Director Proposed OTA ProgramObjectivesIdentify roles and responsibilities of the fieldwork student and educatorTo understand the key elements for a successful fieldwork experienceIdentify strategies for establishment of a collaborative fieldwork educator and student relationshipTo understand the expectations for and characteristics of a successful fieldwork student

What is Fieldwork?The purpose of fieldwork education is to propel each generation of OT practioners from the role of a student to that of a practioner. Through the fieldwork experience, future practioners achieve competence in applying the OT process and using evidence base interventions to meet the OT needs of a diverse client population. (AOTA, 2009)

The transition from classroom to clinic is one of the most challenging experiences you as a student will have

The routine of clinical practice is one of discovery and learning from clients, and testing out ones own clinical judgment's

This can be accomplished along with fieldwork educators during your affiliationsThere is no substitute for the experience gained in the practice settings of occupational therapists

Fieldwork Educator RoleFacilitator of the fieldwork processSupport for the studentProvide guidelinesCreates and adapts the learning environmentEncourages dialogueChallenges students thinking

Student RoleEffective communicationKeep treatment individualized. (Every client is unique)Flexible Open to feedbackOpen mindedTake initiativeUtilize good time management skillsUtilize resources effectively Safety always a priority!!

Facilitator of the fieldwork ProcessThe facilitator is a teacherObserve, assess and gives feedbackFacilitates understanding of evaluations and interventions from an occupation based perspectiveCreates assignments that incorporate the principles of occupation based practiceFacilitates ability to analyze interventions in terms of preparatory, purposeful and occupation based practiceCoachSupportThe fieldwork educator takes a personal interest in the student and offers leadership, guidance and advice on issues encountered during fieldworkThe FWE nurtures and supports the student, providing information, role modeling, teaching and counseling, to open doors that provide students with as many opportunities as possible

Provides GuidelinesEstablishes the role of the student in the site settingProvides expectations and responsibilitiesEstablishes goalsEstablishes learning objectives

Ex: orientation, weekly responsibilities, weekly evaluationCreates a learning environmentIn order to create the best learning environment for a student, the FWE needs to understand the students learning style

Learning style refers to the characteristic ways in which individuals collect, organize and transform data into useful information

Understanding the learning style can shape the course of the affiliation

Types of Learning styles Visual/Non verbal learner Pictures and designs, Videos/charts

Tactile/Kinesthetic LearnerHands on

Visual/VerbalWritten words, handouts, note taking

Auditory/Verbal LearnerOral strategies, tape recorder, discussion

WHAT TYPE OF LEARNER ARE YOU?

Encourages DialogueCommunication between the student and FWE is extremely importantFWE encourages participation in supervisionAsks probing or thought provoking questionsGives constructive criticism

Key Components to a Successful Fieldwork ExperienceCommunication

Professionalism

Self Direction

Clinical ReasoningCommunicationEffectively communicate both verbally and non verballyUse appropriate language/ spelling based on site requirementsSeek/accept feedbackFeedback is a crucial motivating factor in learningReviews level of performance, strengths, areas to grow, where to improve performance or change behaviors, review barriers to achieving goals

CommunicationUtilize logs or journalsFWEs cannot read mindsUtilize weekly and daily supervision sessionsCommunicate with other therapists and disciplines at your site

DO NOT EXPECT TO KNOW EVERYTHING!!!

Collaboration Between FWE and FWSFieldwork Feedback ToolPoorGoodFairGreatWeek: (#) _________ Goals Met (#) _________ Goals Not Met (#) _________ This week was:Comments:____________________________________________________________________________________________________________________________________________________________Positive Experiences: ____________________________________________________________________________________________________________________________________________________________Challenging Experiences:____________________________________________________________________________________________________________________________________________________________Plan for improving and/or developing:____________________________________________________________________________________________________________________________________________________________AdequateToo MuchToo LittleSupervision provided is: Comments: ____________________________________________________________________________________________________________________________________________________________Collaboration Between FWE and FWSGoals for next week: ________________________________________________________________________________________________________________________________________________________________________________________________________________________See additional comments/goals on backAdditional Forms/Pages are attached

Student Signature: _____________________________________ Date: ________________Fieldwork Educator Signature: ___________________________ Date: ________________Academic Fieldwork Coordinator Signature: ________________ Date: ________________Note: This form is to be completed collaboratively each week by student and supervisor. Formal, regular scheduled, weekly supervisory meetings are recommended. Please contact the Academic Coordinator in the event of unsatisfactory fieldwork performance or experience.

Collaboration between FWE and FWSWeekly journal review based on current patient population or treatment techniques or activities ( evidence based research)

ProfessionalismDisplay consistent work behaviorsEffective time managementPositive interpersonal skillsDemonstrate respect for diversityProfessional dress and behaviorMaintain rapport with clients/ families and other staffRespect HIPPA and confidentiality

ProfessionalismSOCIAL NETWORKING and FIELDWORK

Self DirectionAwareness of ones own learning process and outcomesResponsible for learning abilitiesSelf direction in performing learning activities and solving problemsLearning with and through othersNeed to learn to identify problems and limitations in own knowledgeEvidence based practiceClinical ReasoningDevelopment of analyses and self reflection as well as practice skillsMove beyond technical skillsThinking and reasoning challenges across practice settingThe process used by practioners to plan, direct, perform and reflect on client care

Clinical Reasoning is a skill that is ongoing throughout a lifetime of clinical practice

Procedural ReasoningConsider and use interventions identified to be effectiveScience basedInfluenced by work settingNarrative ReasoningPersonal approach to a clients individual situationFinding outs a clients story, COPM

Pragmatic ReasoningPracticalities of service deliveryReimbursement, equipment, productivity standardsEthical ReasoningEthical dilemmas

Interactive ReasoningBuilding positive interpersonal relationships with clientsPartner with client to identify problems and goalsTherapeutic use of selfConditional ReasoningBlend of all reasoningRespond to challenging conditionsAnticipate several different client outcomesStrategies for successVolunteer in the OT field

Prior to starting fieldwork -Review textbooks and material related to site - brush up on goal writing - Theories, frames of references - MMT, ROM - transfer techniques - medical terminology - clinical reasoning - diagnosis specific to site, code of ethics - Within the first week- review equipment supplies/activities to brainstorm treatment ideas based on your clients needs and goals.

Strategies for SuccessDont expect to know everything, ask questionsUse your FWE and resources available for optimal learningTake initiative for own learning, be an active learnerPractice effective time management and stress managementAllow time during the day for documentation, be prepared to bring work homeBe flexibleKnow expectationsBe open and receptive to learning new thingsStrategies for success Know your setting!AcuteSub acuteLong term careOut patient

Red Flags

Attitude ProfessionalismCommunication (verbal and non-verbal)Safety issues (transfers, body mechanics, vital signs, following precautions) Competence in basic skills (ADLs, MMT, ROM, transfers)

QUESTIONS????

ReferencesBarnes, M.A. & Thornton, A.L. Supervision. In Sladyk, K. (2002). The successful occupational therapy fieldwork student. Thorofare, NJ: Slack, Inc.

Futman, S.A., McCreedy, P., & Heisler, P. (1997). Student level II fieldwork failure: Strategies for intervention. American Journal of Occupational Therapy, 52(2), 143-149.

Richard, L.F. (2008). Exploring connections between theory and practice: Stories from fieldwork supervisors. Occupational Therapy in Mental Health, 24(2), 154-175.

Whitehouse, D. (2002). Fixing fieldwork problems. In Sladyk, K. (2002). The successful occupational therapy fieldwork student. Thorofare, NJ: Slack, Inc.

ReferencesAOTA. (2009), Occupational Therapy Fieldwork Education: Value and Purpose. American Journal of Occupational Therapy 63(Nov/Dec).

AOTA (2006). The Level II Fieldwork Survival Guide.

Tryssenaar, J, Perkins, J. ( 2001). From Student to therapist: Exploring the first year of practice. American Journal of Occupational Therapy (55) 1, 19-27.

Tannenbaum, H. (2009). Creating congruence between identities as a fieldwork educator and practitioner. [Special section]. The American Journal of Occupational Therapy, 19(2), 1-4.

Nolinske, Terrie. (1995). Multiple Mentoring Relationships Facilitate Learning during Fieldwork. The American Journal of Occupational Therapy, 49 (1), 39-43.

Contact InformationChristine DeFiglio: cdefiglio@kessler-rehab.com

Anthony Castronovo: acastronovo@selectmedical.com

Catherine Colucci: Colucccn@umdnj.edu