Maximizing your Fieldwork Experience, a Fieldwork Educator and Former Student Perspective Christine DeFiglio, OTR OT Student Clinical Coordinator, Kessler Institute for Rehabilitation Anthony Castronovo, MS, OTR Kessler Institute for Rehabilitation Catherine Colucci, MA, OTR UMDNJ- Director Proposed OTA Program

Objectives Identify roles and responsibilities of the fieldwork student and educator To understand the key elements for a successful fieldwork experience Identify strategies for establishment of a collaborative fieldwork educator and student relationship To 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 one’s own clinical judgment's This can be accomplished along with fieldwork educators during your affiliations

There is no substitute for the experience gained in the practice settings of occupational therapists

Fieldwork Educator Role Facilitator of the fieldwork process Support for the student Provide guidelines Creates and adapts the learning environment Encourages dialogue Challenges students thinking

Student Role Effective communication Keep treatment individualized. (Every client is unique) Flexible Open to feedback Open minded Take initiative Utilize good time management skills Utilize resources effectively Safety always a priority!!

Facilitator of the fieldwork Process The facilitator is a teacher Observe, assess and gives feedback Facilitates understanding of evaluations and interventions from an occupation based perspective Creates assignments that incorporate the principles of occupation based practice Facilitates ability to analyze interventions in terms of preparatory, purposeful and occupation based practice Coach

Support The fieldwork educator takes a personal interest in the student and offers leadership, guidance and advice on issues encountered during fieldwork The 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 Guidelines Establishes the role of the student in the site setting Provides expectations and responsibilities Establishes goals Establishes learning objectives Ex: orientation, weekly responsibilities, weekly evaluation

Creates a learning environment In 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 Learner Hands on Visual/Verbal Written words, handouts, note taking Auditory/Verbal Learner Oral strategies, tape recorder, discussion

WHAT TYPE OF LEARNER ARE YOU?

Encourages Dialogue Communication between the student and FWE is extremely important FWE encourages participation in supervision Asks probing or thought provoking questions Gives constructive criticism

Key Components to a Successful Fieldwork Experience Communication Professionalism Self Direction Clinical Reasoning

Communication Effectively communicate both verbally and non verbally Use appropriate language/ spelling based on site requirements Seek/accept feedback Feedback is a crucial motivating factor in learning Reviews level of performance, strengths, areas to grow, where to improve performance or change behaviors, review barriers to achieving goals

DO NOT EXPECT TO KNOW EVERYTHING!!! Communication Utilize logs or journals FWE’s cannot read minds Utilize weekly and daily supervision sessions Communicate with other therapists and disciplines at your site DO NOT EXPECT TO KNOW EVERYTHING!!!

Collaboration Between FWE and FWS Fieldwork Feedback Tool Poor Good Fair Great Week: (#) _________ Goals Met (#) _________ Goals Not Met (#) _________ This week was: Comments: ____________________________________________________________________________________________________________________________________________________________ Positive Experiences: ____________________________________________________________________________________________________________________________________________________________ Challenging Experiences: Plan for improving and/or developing: Adequate Too Much Too Little Supervision provided is: Comments: ____________________________________________________________________________________________________________________________________________________________

Collaboration Between FWE and FWS   Goals for next week: ________________________________________________________________________ See additional comments/goals on back Additional 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 FWS Weekly journal review based on current patient population or treatment techniques or activities ( evidence based research)

Professionalism Display consistent work behaviors Effective time management Positive interpersonal skills Demonstrate respect for diversity Professional dress and behavior Maintain rapport with clients/ families and other staff Respect HIPPA and confidentiality

SOCIAL NETWORKING and FIELDWORK Professionalism SOCIAL NETWORKING and FIELDWORK

Self Direction Awareness of ones own learning process and outcomes Responsible for learning abilities Self direction in performing learning activities and solving problems Learning with and through others Need to learn to identify problems and limitations in own knowledge Evidence based practice

Clinical Reasoning Development of analyses and self reflection as well as practice skills Move beyond technical skills Thinking and reasoning challenges across practice setting The 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 Reasoning Narrative Reasoning Consider and use interventions identified to be effective Science based Influenced by work setting Narrative Reasoning Personal approach to a clients individual situation Finding outs a clients story, COPM

Pragmatic Reasoning Ethical Reasoning Practicalities of service delivery Reimbursement, equipment, productivity standards Ethical Reasoning Ethical dilemmas

Interactive Reasoning Conditional Reasoning Building positive interpersonal relationships with clients Partner with client to identify problems and goals Therapeutic use of self Conditional Reasoning Blend of all reasoning Respond to challenging conditions Anticipate several different client outcomes

Strategies for success Volunteer 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 client’s needs and goals.

Strategies for Success Don’t expect to know everything, ask questions Use your FWE and resources available for optimal learning Take initiative for own learning, be an active learner Practice effective time management and stress management Allow time during the day for documentation, be prepared to bring work home Be flexible Know expectations Be open and receptive to learning new things

Strategies for success Know your setting! Acute Sub acute Long term care Out patient

Red Flags

Attitude Professionalism Communication (verbal and non-verbal) Safety issues (transfers, body mechanics, vital signs, following precautions) Competence in basic skills (ADL’s, MMT, ROM, transfers)

QUESTIONS????

References Barnes, 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.

References AOTA. (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 Information Christine DeFiglio: cdefiglio@kessler-rehab.com Anthony Castronovo: acastronovo@selectmedical.com Catherine Colucci: Colucccn@umdnj.edu