1. 2014 Fieldwork Educator Appreciation Workshop
Scoring the Fieldwork Performance Evaluation
Supporting the Struggling/Failing Student

2. Welcome & Introductions
OTA Program Faculty
Community Educators

3. Session Objectives
Upon completion of the session, participants will be able to:
Summarize the purposes of the AOTA Fieldwork Performance Evaluation (FWPE) for the OTA student.
Demonstrate an understanding of the FWPE scoring system by accurately scoring sections of the tool based on case studies.
Write one site-specific fieldwork objective that meets the RUMBA test.
Identify a minimum of 3 strategies that could be incorporated into the fieldwork experience to support a struggling/failing student.
Locate additional fieldwork resources on the ACC OTA program website.

4. Scoring the Fieldwork Performance Evaluation
Part 1
Scoring the Fieldwork Performance Evaluation

5. Discussion Community experiences with the FWPE
Faculty experiences with the FWPE

6. AOTA Fieldwork Performance Evaluation (FWPE) for the Occupational Therapy Assistant Student
Document Highlights
Purposes
Design of the FWPE
Scoring System
*Fundamentals of Practice (Ethics and Safety Items)
Midterm and Final Scores
Individualizing the FWPE

7. Primary Purposes of the FWPEs
Measures entry-level competence
Designed to differentiate the competent student from the incompetent student
Not designed to differentiate levels above entry-level competence

8. Purposes (continued)
Provides student with accurate assessment of his or her competence for entry-level practice over time
Growth occurs over time
Midterm and final scores reflect this change
Midterm scores: Satisfactory–unsatisfactory
Final scores: Pass–no pass

9. Purposes (continued) Provides feedback to student
Provides opportunity for student self-assessment

10. Design of the FWPEs
The “doing” of the occupational therapy process is evaluated, not the individual tasks in isolation
NOT all items are equal in level of difficulty (i.e., simple to complex)
Evaluation is supplemented with development of site-specific objectives

11. Scoring System of FWPE Each item must be scored
*Ethics and safety items must be passed
Each item rating recorded on Performance Rating Summary Sheet
All items summed up at midterm and final
Score compared to scales provided

12. Rating Scale Review
RATING 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.

13. Midterm and Final Scores of the FWPE for the OTA
Overall Midterm Score Satisfactory: 54 & above Unsatisfactory: 53 & below Overall Final Score Pass: 70 & above No Pass: 69 & below

14. Individualizing the FWPE
Designed for additional objectives to be written to add clarification
Site-specific objectives
NOT supervisor-specific
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?

15. Objectives: An Example From FWPE for the OT Student
16. Establishes accurate and appropriate plan
School—Provides behavioral-based, measurable OT goals during IEP process
Acute Care—Overall intervention plan is achievable within client’s length of stay

16. Activity Take a moment to reflect on your practice setting.
Select one item from the FWPE.
Write one site-specific objective that reflects the unique nature of your practice setting.
Evaluate the objective to determine whether it meets the RUMBA test.

17. Additional Resources for Developing Site-Specific Objectives
Available to all practitioners through AOTA’s website:

18. Summary
Evaluations designed to measure entry-level competence, NOT level of performance above competency
OT practice examined as a generalist
Evaluations reflect the occupational therapy process
Performance develops over time

19. Case Examples & Discussion
Scoring the Fieldwork Performance Evaluation
Screening/Evaluation: Sandra, OTA Student
Intervention: David, OTA Student

20. Session Break

21. Supporting the Struggling/Failing Student
Part 2
Supporting the Struggling/Failing Student

22. Why Do Students Struggle With/Fail the Fieldwork Experience?
Community Insight
OTA Program Analysis

23. Why Do Students Struggle With/Fail the Fieldwork Experience?
Community Insight
In your experience, why do students struggle/fail fieldwork?

24. Why Do Students Struggle With/Fail the Fieldwork Experience?
OTA Program Analysis
Review of data over the past 5 years indicates the following reasons for failed fieldwork experiences:
Interpersonal Issues/Professional Behavior Issues
Personal Life Issues
Clinical Performance Issues/Clinical Reasoning
Academic Issues

25. Why Do Students Struggle With/Fail the Fieldwork Experience?
“Academic Reasons
Student struggles with content of practice area of placement
Poor learning strategies
Practice is limited
Personal Reasons
Stress, depression, physical illness, learning disability
Having second thoughts about their career choice
Unprofessional behavior or unsafe with clients
Difficulty working with other people
Poor insight (student may blame you or others for failing)
Motivation or commitment to the learning process is lacking
Poor Teaching
Fieldwork educator unclear about objectives or teaching strategies
No orientation or needs assessment provided
No feedback/assistance provided when problems identified (or feedback and assistance provided too late)”

26. Why Do Students Struggle With/Fail the Fieldwork Experience?
Early-Warning Signs
Rigidity in thinking
Uncomfortable with the ambiguity present in clinical reasoning
Lack of insight
Difficulty interpreting/incorporating feedback; unable to learn from errors
Externalizing issues
Uncomfortable with physically handling clients
Low self-esteem (dependence on external validation)
Early Warning Signs (cont.)
Difficulty using supervision
Inconsistent work behaviors
Personal life issues
Passive attitude, difficulty engaging
Inconsistent work performance
Feeling overwhelmed/stressed
Unable to think on their feet
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.

27. Strategies to Support the Struggling/Failing Student
Community Insight
Based on your past experience, what strategies can you share to support the struggling/failing student?

28. Additional Strategies: Utilize Resources
Contact the school and begin to develop a collaborative plan as soon as possible.

29. Additional Strategies: Identify the Specific Problem
Objectively evaluate the student’s performance and/or behavior.
Document concretely and objectively.
Analyze to determine the type of issue with which the student is struggling:
Interpersonal Issues/Professional Behavior Issues
Personal Life Issues
Clinical Performance Issues/Clinical Reasoning
Academic Issues
Other
Identifying the fundamental issue is a critical component in selecting an appropriate follow-up course of action.

30. Additional Strategies: Implement a Systematic Process for Remediation
Specifically identify the problem
Give careful thought as to the importance of the problematic behavior in the “big picture” of clinical success
Meet with the student ; discuss and document:
Your expectations
Any self-identified problems (student insight)
Exactly what you need to see from the student(clear, concrete expectations) as well as a timeline
Suggestions and/or resources to support improvement
Student strategies for how the FWE can better support his/her learning needs
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.

31. Additional Strategies: Implement a Systematic Process for Remediation
Maintain contact with the school throughout the process, the earlier the better
Identify the steps you have taken and the results
Request feedback/support as needed from the school
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.

32. Additional Strategies: Consider a Learning Contract
Developed primarily by the student as a means to facilitate self-directed learning
Used 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 ). Bethesda, MD: AOTA Press.

33. Learning Contract Pros Cons
Provides learner with a sense of control over his/her own learning
Evaluative criteria established to determine whether learning occurred
Planning of experiences/activities becomes a collaborative effort between the student and educator
Allows student to develop ownership/commitment to learning needs
Control over learning may create anxiety/frustration for the student who is unfamiliar with self-directed/active learning
Time consuming to create
Success of the contract depends on the attitude of the educator and/or level of support from the site
Costa, D. M. (2007). Clinical supervision in occupational therapy: A guide for fieldwork and practice (pp ). Bethesda, MD: AOTA Press.

34. Developing a Learning Contract
Assess prior experiences and learning:
“Where have I been?”
Identify current knowledge/skills:
“Where am I now?”
Develop goals and objectives:
“Where do I want to go next?”
Create a study plan to meet goals and objectives:
“How will I get there?”
Identify resources:
“What will I need to help me?”
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 ). Bethesda, MD: AOTA Press.

35. Additional Strategies Based on Type of Issue
Academic/Clinical Performance Issues
Suggest remedial resources (texts, in-services, etc.)
Provide an opportunity for practice of skills
Notify the school; discuss remedial activities
Interpersonal Issues/Professional Behavior Issues
Provide direct feedback; role model appropriate/desired behaviors
Consider role play for practice
Outline clear expectations
Suggest remedial resources for skill development
Implement a plan of correction
Personal Life Issues
Maintain professional boundaries - direct the student to notify the school (students have access to free counseling/supportive resources)
Avoid becoming the student’s therapist, remember that the student must meet learning objectives
A note on program technical standards and accommodations…

36. Strategies for Prevention of Failure
Notify school immediately should any potential issues arise
Set clear expectations from day 1
Provide routine feedback; request routine feedback from the student
Provide progressive structure to outline the experience
Structured plan for reduction of supervision/ensuring student competency

37. Importance of Feedback
Confirms areas of strength (affirming for those with low self-esteem/confidence)
Heightens student awareness of areas in need of attention
Identifies potential barriers to goal achievement/fieldwork success
Encourages alternative behaviors/actions
Motivating factor for change
Depending on delivery, can facilitate or hinder change
Demonstrates commitment of the educator
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.

38. Case Examples & Discussion
Strategies to Support the Struggling/Failing Student

39. Coping Strategies for the FWE
Seek support from the school and/or colleagues.
We are here to support you as well as the student!
Remember that failure is not the end of the world (for you or for the student).
Recognize 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.

40. Additional Fieldwork Resources
Available on the ACC OTA Program Website at:

41. Ideas for Upcoming Sessions
Brainstorming
Ideas for Upcoming Sessions

42. Review of the Session Objectives
Session Wrap-Up
Review of the Session Objectives

43. THANK YOU Not only for your attendance, but for your ongoing support.
We could not fulfill our roles as educators without you!

44. References
Slides 6-10, 12-14, & 17 and Scoring Case Studies: AOTA’s Inservice In A Box: Understanding the OT/OTA Fieldwork Performance Evaluations. Available at