College of Health & Human Services Occupational Therapy Department Fieldwork Manual

Transcription

College of Health & Human Services
Occupational Therapy Department
Fieldwork Manual
Jean MacLachlan, PhD Candidate, OTR/L
Academic Fieldwork Coordinator
HB 302 (978) 542-7009
[email protected]
Occupational Therapy Fieldwork Manual
Revised 2014
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Table of Contents
1. Introduction .................................................................................................................
2. SSU OT Fieldwork
Level I Fieldwork Courses .....................................................................................
Level II Fieldwork Courses ....................................................................................
Purpose of Fieldwork .............................................................................................
3. Roles and Responsibilities in Fieldwork
Role Delineation of OTA’s and OTR's ..............................................................22
Role of Academic Fieldwork Coordinator .........................................................23
Role of Facility Fieldwork Educator ..................................................................23
Student Role and Responsibilities ......................................................................24
4. Level I Fieldwork
Expectations .......................................................................................................27
Level 1 Student Objectives ................................................................................28
Absentee Policy for Level 1 Fieldwork ..............................................................31
Completion of Level 1 Fieldwork ......................................................................31
Failing Level 1Fieldwork ...................................................................................31
5. Level II Fieldwork
Expectations .......................................................................................................31
Objectives ...........................................................................................................32
Absentee Policy for Level II Fieldwork .............................................................36
Completion of Level II Fieldwork......................................................................36
Failing Level II Fieldwork .................................................................................31
6. Documentation
CORI ..................................................................................................................37
Liability Insurance..............................................................................................37
Immunization Records .......................................................................................37
Valid CPR Card ..................................................................................................37
HIPPA Certificate
AOTA Membership
ADA/Student Disclosure
Personal Data Form
Authorization for Disclosure of Health Care Information
OSHA Training
7. Fieldwork Site Requirements
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8. General Fieldwork Polices and Procedures (Level I & Level II)
Process for Requesting Sites
Obtaining Reservations
Fieldwork Cancellations
Health Insurance/Health Forms
9. Felony Statement
10. NBCOT Certification
11. Appendix
Appendix A: The Purpose and Value of Occupational Therapy Fieldwork
Education
Appendix B: ACOTE Standards of Accreditation
Appendix C: SSU Professional Behaviors Assessment and Action Plan
Appendix D: HIPPA Guidelines for Fieldwork
Appendix E: OT Practice Framework for Occupational Therapy (AOTA)
Appendix F: The American Occupational Therapy Association Code of Ethics
Appendix G: Level II Fieldwork Data Form (AOTA)
Appendix H: Student Personal Data Sheet (AOTA)
Appendix I: Level II Fieldwork Performance Evaluation (FWPE) for the
Occupational Therapist
Appendix J: Level II Student Evaluation of Fieldwork Experience (AOTA)
Appendix K: SSU Health Form
Appendix L: Self-Assessment Tool for Fieldwork Educator Competency
Appendix M: Fieldwork Experience Assessment Tool (FEAT)
Appendix N: COE Level I & Level II Fieldwork Guidelines
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1. Introduction
The fieldwork experience has been an integral part of occupational therapy (OT) education
since 1923 when the first essentials were written. Three months of clinical internship were required
at that time and by 1935, the fieldwork requirement was increased to nine months. The fieldwork
component of OT education was changed back to six months in 1973 and has remained unchanged
since that time (COE, 1991). Many OT programs offer an optional third internship to further develop
clinical skills in a community or specialty area of practice.
Fieldwork education offers challenging and unique opportunities for students to foster clinical
reasoning skills in a variety of settings and with multiple client populations. The fieldwork
component of the Salem State University (SSU) Occupational Therapy Program allows students the
opportunity to choose a full-time or part-time option for level II fieldwork in keeping with our
mission statement and the program’s commitment to adult education and to life-long learning.
2. SSU OT Fieldwork
Level I Fieldwork Courses
Students enrolled in the occupational therapy curriculum at SSU will participate in four,
twenty-hour, level I observation experiences. Level I fieldwork is completed as part of four OT
Analysis and Intervention courses. The psychosocial level I occurs in OCT 407N and the physical
dysfunction level I occurs in OCT 413, both of which are during the undergraduate portion of the
curriculum. The pediatric level I fieldwork experience occurs during OCT 715 and the
geriatric/community level I fieldwork observation occurs during OCT 720, both of which occur in the
graduate portion of the curriculum.
Upon completion of all core and professional level courses up through OCT 802, students will
choose one, full-time twelve-week Level II fieldwork internship in a specified area of choice.
Students may complete the internship on a part-time basis but will be required to continue with
course work during the fall semester. Students must choose level II experiences that are diverse from
their current OTA work environment. This allows students to expand skills and ideas in a variety of
practice arenas. Students will complete a two-credit fieldwork seminar during this third year summer
semester and return to campus in the evening for this seminar. During the fall semester of the third
and final year of the program, students will complete OCT 900, OCT 910, & OCT 920. The final
level II fieldwork is completed in the spring semester of the final academic year in a second area of
choice (unrelated to present work population) and may be completed on a full or part-time basis for a
total of 480 hours. A second, two credit fieldwork seminar will be completed by each student prior to
graduation. Students must attend fieldwork seminar to pass their level II internships.
Level II Fieldwork Courses
OCT 850 Level II Fieldwork and Seminar A (MS Final Year-Summer)
The first level II fieldwork internship and seminar will provide students with practical skills and
knowledge for participation in and successful completion of level II fieldwork. Students will
complete a 480-hour internship (or 12 weeks full time) within a chosen clinical setting in conjunction
with a fieldwork seminar. Students will discuss and integrate clinical experiences with academic
ideologies. Focus of study will include student assessment tools, facility requirements and
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expectations, and review of concepts pertaining to professionalism that foster competence for entrylevel occupational therapy practice. This seminar will be hybrid requiring an online component as
well as in person meetings.
OCT 960 Level II Fieldwork and Seminar B (MS Final Year-Spring)
This final level II fieldwork internship and seminar is designed to provide students with practical
skills and knowledge for fieldwork and for entry-level practice. Students will complete their second
internship (480 clinical hours or 12 weeks full time) within a chosen clinical setting in conjunction
with a seminar. Students will examine and discuss concepts learned throughout the curriculum with
focus spent on preparation and review for the NBCOT examination, professionalism, civic and
professional responsibilities, advocacy and their role as future leaders. This seminar will be hybrid
requiring an online component as well as in person meetings.
***NOTE: Students are able to complete level II fieldwork requirements up to two years after
completion of the final OT course before it may affect the student’s eligibility to sit for the
NBCOT board examination.
Purpose of Fieldwork
The purpose of fieldwork is to provide occupational therapy students with opportunities to
evaluate theory, develop critical thinking skills, refine documentation, enhance interpersonal
relationships, utilize problem solving strategies, and gain additional insight into one’s personal
learning style that will benefit the individual and the profession. The integration of these learning
experiences combined with occupational therapy coursework serve as determinants of a competent,
entry-level clinician. (Please refer to Appendix A for AOTA Purpose)
3. Roles and Responsibilities in Fieldwork
Role Delineation of OTA’s and OTR’s
Students come to the SSU OT program with occupational therapy experience. OT assistants
are technicians that work to carry out the treatment plan of a registered therapist. Students
enrolled in the program are beginning a transition towards becoming a registered therapist
through academic course work and fieldwork experiences. It is essential that students adopt
an advanced theoretical approach/framework during this transition in their education.
Students will question and explore why certain treatment strategies are implemented based on
a variety of factors. It is critical to student development to view each client from a holistic
perspective. This means considering physical, cognitive, social, psychological, emotional,
sensory, cultural, and environmental factors when developing treatment plans. Students must
adhere to the Occupational Therapy Practice Framework as a guide when completing all
treatment plans.
As a registered clinician students will attain greater insight into the problem solving process.
This includes:
 Interpreting medical diagnoses while understanding the impact of the disease process
 Acknowledging how specific disease process, diagnosis, social, cultural and
environmental issues impact a client’s life
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Understanding the value of diversity and cultural differences
Exploring the theoretical model of occupation and its importance in client care
Determining what questions to think about in regards to seeing the “entire client picture”
Choosing and implementing specific assessments
Developing treatment plans based on your findings
Implementing treatment strategies that will best meet the needs of your client
Re-assessing clients to determine if treatment strategies are working and goals are being
accomplished
 Understanding the value of on-going client, family, and community education
 Investigating how the family, team members, client, and additional factors can affect
treatment outcome
 Determine appropriate discharge planning and continued treatment options along the
client care continuum.
Role of Academic Fieldwork Coordinator
It is the role of the Academic Fieldwork Coordinator (AFC) to act as a liaison between the
student and the fieldwork educator at the facility. The fieldwork coordinator works with the
student to determine the most appropriate fieldwork placement that will meet his/her needs.
The fieldwork coordinator is responsible for visiting prospective fieldwork sites, establishing
relationships with facilities, obtaining a formal contract, data form and facility objectives,
educating fieldwork educators, preparing essential documentation for internships, and
communicating essential information pertaining to the SSU Occupational Therapy Program.
Role of Facility Fieldwork Educator
It is the role of the fieldwork educator to act as mentor and guide during the student’s clinical
experience. It is essential that students communicate all needs to the supervisor in a
responsible and professional manner. The supervisor is responsible for orienting the student
to the facility, and reviewing facility policies, procedures, and expectations for the fieldwork
experience. The supervisor will oversee all written documentation and interactions with
clients, family and team members. It is the supervisor’s responsibility to inform the student
about special projects and assignments related specifically to that fieldwork experience. The
supervisor is also responsible for both informal and formal evaluations and communicating
student progress with the student and the academic institution.
Student Role and Responsibilities
The student from the Salem State University OT Program enters the fieldwork internship with
a different perspective than the average student that graduates from alternative entry-level OT
degree programs. Students embark on fieldwork with a variety of unique and established
skills that need to be fostered and strengthened. As an outcome, the faculty expects that
students will integrate new academic knowledge with previously attained skills. Students will
demonstrate the ability to reflect this knowledge through verbal communication, written
documentation, and professional conduct.
In relation to fieldwork specifics, students will work closely with the Academic Fieldwork
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Coordinator when determining the appropriateness and availability of a fieldwork site. The
student is responsible for obtaining health insurance, paying all fieldwork and professional
liability fees, obtaining an annual physical examination, maintaining a current and valid CPR
card and completing all necessary forms prior to the fieldwork experience. CORI background
checks, drug testing, flu shots and other trainings (HIPAA, Blood Bourne pathogens, etc.)
may, at times, be required by a facility before beginning an internship. Trainings and tests are
the responsibility of each student, as required by the individual fieldwork setting. In addition,
students may be required to participate in a fieldwork interview and be responsible for
contacting prospective fieldwork sites one month in advance to confirm dates, time, and
place.
The student is a representative of Salem State University and will maintain a
professional appearance and professional conduct while abiding by the AOTA Code of
Ethics (Please see Appendix F). A high standard of professional conduct is expected from
all students that enter into this program. Your past experience in the field should reflect this
knowledge during your internships. Students are responsible for their own transportation to
and from the fieldwork site and for finding their own housing. You must adhere to all
policies and procedures established by the fieldwork site as well as established university
policy.
The student will work daily with the fieldwork educator to participate in client screening and
chart reviews, obtaining data for assessment and treatment planning, implementing treatment
plans and alternative strategies, and following facility specific documentation guidelines.
Students will participate in medical rounds, team, family, and client care meetings, attend
educational rounds, and present projects and case reviews as indicated by the facility.
The student is responsible for meeting formally at least once a week with his/her immediate
fieldwork educator. At times, problems, complications and conflicts do arise. It will be
important to address these issues of concern immediately with the fieldwork educator. The
student may contact the academic fieldwork coordinator at any time with questions or
concerns pertaining to the fieldwork internship. It is important to remember that fieldwork
will provide a unique opportunity for you to enhance your skills to become a competent entrylevel occupational therapy practitioner.
4. Level I Fieldwork
Expectations
Level I fieldwork is designed to assist students in becoming familiar with hospital, clinic,
school, and community settings, client care, and the treatment planning and implementation
process. Level I fieldwork will occur on a part-time basis and schedules will be determined
between the student and the fieldwork educator. Four twenty hour, Level I internships will be
set up in the areas of psychosocial, physical dysfunction, pediatric and geriatric areas of
practice. A community placement in at least one of these four areas will be encouraged
during the level one experience Participation in a community practice area in occupational
therapy is vital to your development as a clinician.
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Level 1 Student Objectives
Students participating in a level I internship will:
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Conduct self in a professional manner as demonstrated by:
 appropriate appearance and demeanor,
 positive and effective communication skills
 sound judgment and ethical decision making ability
 dependability
 taking initiative
 accepting professional responsibilities
 utilization of clinical reasoning skills
Attain an appreciation for diverse cultures and various client populations in need of
occupational therapy services.
Interact in a professional manner with multiple interdisciplinary team members and coworkers associated with the fieldwork setting.
Demonstrate the ability to reflect on observations made related to each clinical situation both
verbally, and in journal writing.
Conduct interviews with a variety of clients with different diagnoses in diverse clinical
settings.
Identify specific client problem areas related to performance areas, performance components,
and performance contexts.
Observe a variety of client assessments specific to the facility and discuss with OTR
appropriate occupational therapy intervention options.
Abide by all facility policies and procedures and complete orientation process as indicated.
Adhere to occupational therapy supervisor guidelines when conversing with clients (facility
specific).
Develop an appreciation of the environmental impact on client treatment and how the
pragmatics of the therapeutic process affects treatment outcome.
Acknowledge the complexities of client insurance coverage guidelines, time frames, and all
additional documentation needed for the delivery of occupational therapy service.
Demonstrate the ability to ask sound and appropriate questions that will aid in the formation
of clinical knowledge.
Attend orientation to facility following all safety guidelines and precautions, and attend all
required facility educational opportunities as indicated to enrich the fieldwork experience.
Complete all performance evaluations and assignments upon the conclusion of each fieldwork
experience.
At the conclusion of each Level I experience students will be required to complete a selfevaluation. In addition, each supervisor will complete a formal evaluation of the student’s
performance at the completion of the Level I internship. See the level I evaluation form located on
the subsequent page.
Absentee Policy for Level I Fieldwork
If a student is absent from scheduled fieldwork hours, those hours must be re-scheduled by the
student and made-up to complete all fieldwork hours, prior to exam week to complete the internship
and receive full credit for the internship hours.
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Completion of Level I Fieldwork
Successful completion of each level I internship includes:
 Completion of 20 hours of observation, as documented by the level I fieldwork educator on
the Level I Fieldwork Student Performance Evaluation
 Satisfactorily meet the level I fieldwork objectives, as documented by the fieldwork educator
on the Fieldwork Student Performance Evaluation
 Completion of fieldwork assignments, as documented within the associated OT Analysis and
Intervention course syllabi
Level I fieldwork must be completed each semester in order to move forward in the curriculum.
Students will receive an incomplete grade and will not be able to move forward in subsequent
course work until the requirement for the fieldwork is fulfilled.
Failing Level I Fieldwork
If the fieldwork educator fails a student at their level I fieldwork placement, a meeting will occur
between the student, fieldwork educator, and the AFC (in person or by telephone). An additional
project or fieldwork placement may be indicated. Academic probation may result in a student failing
a level I fieldwork placement. In addition, a professional development plan may be indicated. The
Professional Behaviors Action Plan may be found in Appendix P.
4. Level II Fieldwork
Expectations
Students enrolled in the program are representatives of Salem State University. It is expected
that OT students demonstrate professional behavior and a positive work ethic at all times. It is
critical that students identify and understand their own specific areas of weakness and try to improve
upon them throughout each internship experience. The skills and abilities demonstrated to others
during these fieldwork internships could possibly lead to future job opportunities. During fieldwork,
students are encouraged to maintain communication with faculty members. The faculty is available
to assist students in meeting specific goals and to help guide you throughout the process. The faculty
may assist each student with specific issues as well as to share with you positive moments, successes,
or accomplishments.
***Note: All coursework, prerequisite and support courses must be completed with
passing grades before level II fieldwork may begin. The only exception is that after the first
Level II fieldwork placement, students will return to complete OCT 900, OCT 910 & OCT 920.
Please see your advisor before beginning level II fieldworks to make sure that all requirements
have been met.***
Level II Student Objectives
Students completing the Salem State University Occupational Therapy Program will enter the
Level II fieldwork experience with a global perspective of occupational therapy theory. Students will
have acquired specific clinical knowledge needed to enter the field as an entry-level occupational
therapy practitioner. Given the student's past occupational therapy experience, the program will build
on existing knowledge that will foster growth and development in clinical reasoning, problem solving
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strategies, research, reflective inquiry, and professional development.
Students will:
1. Demonstrate effective oral and written communication skills that reflect a sufficient
understanding of the therapeutic process.
2. Exhibit proficient understanding of the AOTA Code of Ethics and Core Values.
3. Act in a professional manner with regards to issues of confidentiality, interpersonal
communication, and self-representation.
4. Acknowledge the importance of occupational therapy professional development through selfreflection and related goal accomplishment.
5. Appreciate the value of community and display concern for social and health care issues of
diverse populations.
Specific Objectives:
The occupational therapy student will be responsible for exhibiting the capability of performing
comprehensive oral and written competence in regards to the following areas:
1.
2.
3.
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5.
6.
Referral
Evaluation
Treatment Planning
Treatment Intervention
Termination of Service
Service Management
Referral:
A referral for occupational therapy service is acknowledged through a written or verbal request. The
clinician in accordance with AOTA guidelines and facility policy follows up on a referral for OT.
Students will:
1. Adhere to all stated facility policies in regards to client referral.
2. Acquire the appropriate decision making skills necessary to facilitate a client evaluation order.
3. Complete all required verbal and written documentation as it pertains to the facility
process.
referral
4. Demonstrate the ability to responsibly refer clients to additional services as indicated.
5. Adhere to specific insurance coverage guidelines or additional facility related policies in
respect to requesting evaluation orders.
Evaluation:
Occupational therapy evaluation is initiated once the referral process is complete. The evaluation
process investigates a client through assessment of current and past medical history, examination of
social, vocational, leisure pursuits and activities of daily living routine, observation of mobility skills
and general movement of limbs, inspection of the sensory systems, and a profile of a client’s
psychological status. Specific problem areas are then identified and a course of action is established
with specific treatment goals and intervention plan.
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Students will:
1. Adhere to specific facility procedures and in accordance with AOTA guidelines in relation to
data collection, data analysis, treatment recommendations, and treatment interventions.
2. Demonstrate competence in selection and administration of specific evaluation tools per client
need.
3. Effectively communicate to the client, family, and team, in both written and verbal form, the
process and purpose of the evaluation and the rationale for the prescribed treatment.
4. Establish competency in interviewing and observation skills through standardized and nonstandardized evaluations.
5. Adequately analyze and synthesize the data to formulate holistic treatment plans.
Treatment Planning:
The occupational therapy treatment planning process involves the identification of specific client
goals that are measurable and the methods necessary to attain the goals.
Students will:
1. Document, both short and long term goals that encompass the complete realm of occupational
therapy philosophy and consider the individual needs of the client.
2. Identify, select, plan, prioritize, and adapt occupational therapy methods for the attainment of
both short and long term goals.
3. Follow specific facility and OT Practice guidelines when formulating treatment plans.
4. Determine appropriate time frames for meeting specific treatment objectives.
5. Utilize critical thinking strategies and creative alternatives within facility and AOTA
guidelines to implement, modify, or adapt the treatment plan or treatment methods for the
betterment of the client.
6. Communicate clearly to the client, family and team, the time frame of the treatment plan, the
specific problems identified, goals to be addressed, and methods to be utilized during
occupational therapy treatment sessions.
Treatment Intervention:
Treatment intervention in occupational therapy refers to the use of specific methods or activities that
will enhance, promote, or restore functional performance to clients afflicted with disability or illness,
or may be utilized as a preventative means to prevent illness or disability.
Student will:
1. Administer treatment interventions that promote purposeful and meaningful opportunities for
the client to enhance goal achievement.
2. Adhere to all facility safety precautions and procedures when administering treatment
interventions.
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3. Monitor the client for signs of excessive pain, fatigue, or discomfort and adjust or modify the
treatment session or plan accordingly.
4. Independently seek out or utilize appropriate resources and references in regards to treatment
updates and options available.
5. Orient and instruct others regarding the treatment methods used that support the occupational
therapy program.
Termination of Service:
Occupational therapy services are terminated when both short and long term goals are attained;
service is transitioned to an alternative level such as long term care, out patient or home care, or when
the client no longer receives benefit from the intervention.
Student will:
1. Formulate discharge planning for clients in both verbal and written format in conjunction with
facility policy and with OT Practice guidelines.
2. Demonstrate competency in creating discharge plans that transition client to the next
setting and refer to appropriate agencies as indicated.
3. Appreciate the range of opportunities and services available to clients outside of the
that are situated in the community.
setting
4. Collaborate with client, family, or transitioning agency regarding current client status as well
as establishing the follow through of interventions and goals as indicated.
5. Develop problem solving skills necessary to terminate client services in the most appropriate
time frame and in accordance with specific insurance guidelines.
Service Management:
Service management refers to the daily administration tasks associated with the facility that
includes organization skills, time management, interpersonal communication and professional growth
in regards to the delivery of occupational therapy service.
Student will:
1. Report to facility in a timely fashion, plan daily schedule and assume daily work load in
accordance with facility policy.
2. Conduct themselves in a professional manner at all times adhering to facility dress code,
maintaining open communication with personnel, and abiding by all rules and policies set
forth by the facility.
3. Maintain efficiency and safety in the work area including the upkeep of equipment and the
organization of supplies.
4. Work collaboratively with their immediate supervisor to foster a positive learning experience
and enhance professional growth.
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5. Complete additional projects and or presentation assignments in accordance with specific
internship objectives stated by the facility.
6. Participate in staff meetings, educational in-services, rounds, client care meetings, or
discussions as outlined by the facility.
Evaluation
A copy of the AOTA Level II Fieldwork Performance Evaluation (FWPE)
Form is located in Appendix I. Students should become familiar with the specific content areas that
will be evaluated prior to beginning each internship. This evaluation form will be completed by the
clinical supervisor at the halfway point and upon completion of the internship. In addition, the student
evaluation of the facility will be completed during the final week of the internship. This data is
essential for future students seeking fieldwork sites. This form may be found in
Appendix J.
Absentee Policy for Level II Fieldwork:
Many fieldwork settings will allow 1-3 days of absence without having to make the time up. Students
need to become familiar with each facility’s policy.
*NOTE: Up to 3 days can be taken for illness/family emergency. You are not entitled to 3 days off
during fieldwork.
Completion of Level II Fieldwork:
Two level II fieldwork placements must be completed by each occupational therapy student prior to
graduating. Each placement is completed for 12 weeks full time or 480 hours (if done on a part-time
basis). Any part-time level II fieldwork must be at least 20 hours/week and the student must be
available at least 3 week days/week.
Successful completion of each level II fieldwork placement includes:
 Completion 12 weeks of full time fieldwork OR 480 hours of part-time fieldwork as
documented by the Fieldwork Educator and Academic Fieldwork Coordinator
 Passing the AOTA Level II Fieldwork Performance Evaluation (FWPE) for the
Occupational Therapist
 Passing of the seminar assignments attached to the level II fieldwork (A or B) as
outlined in the course syllabi
Failing Level II Fieldwork
Failing a level II experience is a serious concern. Level II Fieldwork is the opportunity to put
academic learning into practice. This application of knowledge and clinical reasoning are paramount
to being a successful occupational therapist. If a student feels that some unusual or extreme
circumstance related to the failure of the fieldwork experience occurred, an appeal may be made in
writing to the OT Academic Review Committee within the OT Department. Generally, the
Academic Fieldwork Coordinator will be part of this appeals process.
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If this appeals committee recommends a make-up affiliation, then a one-time only make-up
affiliation will be scheduled by the Academic Fieldwork Coordinator. Remediation may be
required before the student is allowed to retake a failed Fieldwork II or to advance to further
scheduled fieldwork.
Any further appeals must follow the student academic appeals procedure of the SSU Graduate school
located at the following link:
http://catalog.salemstate.edu/content.php?catoid=20&navoid=2331#Academic_Appeal_Procedure
Note *****Any student that has been convicted of a prior felony may be considered ineligible by
NBCOT to sit for the examination and may also be unable to attain an occupational therapy license
from the State Licensure Board.
6. Documentation
 Massachusetts Criminal Offender Record Information (CORI): A CORI is performed on
every student in the occupational therapy program prior to attending a fieldwork placement.
Students may not be allowed to attend fieldwork experiences if they have felony conviction(s)
or open cases.
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Liability Insurance: Every student taking OCT courses must purchase Liability Insurance
every fall from the Bursar’s Office and provide a copy of their receipt to the Occupational
Therapy Department Administrative Assistant. The Liability Insurance must be purchased
every year a student is registered in the OCT courses until they have graduated. Without the
Liability Insurance, a student will not be able to acquire or attend any fieldwork placements.
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Immunization Records: All students taking OCT courses must provide the SSU Counseling
and Health Services with updated immunization records (including MMR, Hepatitis B,
Chicken Pox & TB). To obtain forms, go to SSU counseling and health services website and
click on Forms link. Immunization records, including Flu shots, MUST be updated yearly.
Without immunization records completed and updated yearly, a student will not be able to
acquire or attend any fieldwork placements.
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Valid CPR Card: All students taking OCT courses must maintain a valid CPR card until the
complete all their OCT coursework, including their level II fieldwork placements. It is the
student’s responsibility to provide the Occupational Therapy Department Administrative
Assistant with current copies of the CPR card. Without a current and valid CPR card a student
may not be able to acquire or attend a fieldwork placement.
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HIPAA Certificate: All students participating in fieldwork must acquire a HIPAA
certificate. They may use the following link: https://www.citiprogramorg, to create an
account and take the “CITI Health Information Privacy and Security (HIPS) for Students and
Instructors – Basic Course”. This course has five modules. Each module must be passed with
at least an 80%. Upon completion, print the certificate and provide it to the Occupational
Therapy Department Administrative Assistant. Without a current and valid HIPAA card a
student may not be able to acquire or attend a fieldwork placement.
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AOTA Membership: All students taking OCT courses must provide a valid AOTA
membership card to the Occupational Therapy Department Administrative Assistant each fall.
Without a current and valid AOTA card a student will not be able to acquire or attend a
fieldwork placement.
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Personal Data Form: All students taking OCT courses must complete a Personal Data Form
every fall and to provide it to the Occupational Therapy Department Administrative Assistant.
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Authorization for Disclosure of Health Care Information: Every semester a student has
fieldwork, the Authorization for Disclosure form will need to be signed so immunization and
data records can be released to fieldwork settings.
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OSHA Training: Any student who has taken OSHA training with your employer, please
provide us with a copy of the training certificate for your files.
7. Fieldwork Site Requirements
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It is the responsibility of the student to adhere to policies of each facility they attend.
Including, but not limited to dress code, wearing of jewelry, exposure of tattoos, wearing of
fake nails or keeping nails trimmed, etc.
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Some fieldwork settings will require their own Criminal Offender Record Information (CORI)
check prior to starting at the facility. Facilities have the right to refuse students based on the
CORI results.
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Some fieldwork settings require finger printing and drug testing
**Students are responsible to pay for any additional background checks, drug testing,
and/or finger printing required by fieldwork facilities.
8. General Fieldwork Policies and Procedures (Level I & Level II)
Process for Requesting Sites
Level I
Students will meet with the fieldwork coordinator when beginning the professional aspect of the
program after completion of all prerequisite course requirements. A plan for level I and level II will
be established for each student. This is subject to change per discussion with the AFC.
Level II
The process for requesting fieldwork sites will be similar to requesting Level I sites. It will be
mandatory to choose two fieldwork placements outside of your current realm of practice to ensure a
holistic student experience and to assist you in preparing for the national certification examination.
Obtaining Reservations
Level I
The AFC will notify each student verbally or through email of his/her level I placement. The AFC
will try to accommodate each student’s request. It is the student’s responsibility to contact the Level I
fieldwork educator to confirm the starting date and time. If students have specific sites that you
would like the AFC to contact, please send an e-mail with requests. Please include the following
information:
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Name of the facility
Address
Telephone number
Contact person (if you know who it is)
Type of facility (phys-dysfunction, hand clinic, school, etc.)
Level II
The Academic Fieldwork Coordinator will contact students by telephone or by email when a level II
placement is secured. Include the same information as stated above when requesting a facility to
contact for a Level II placement.
Level II reservations for internships beginning in the summer and spring semesters will be
coordinated through the AFC. Students will meet approximately 1-2 times per semester with the
Academic Fieldwork Coordinator to review options and obtain the placement that will best fulfills
his/her needs.
Fieldwork Cancellations
There are times when a facility may cancel an internship. This may be due to a variety of reasons.
The reason that most often occurs is related to staffing changes at the facility. It is important to
maintain an open attitude when it comes to fieldwork. Securing fieldwork placements is not an exact
science. At times it may become a frustrating process. The AFC will work closely with the student
to determine an alternative arrangement that will be most accommodating. It will be important to
maintain this open attitude and be prepared ahead of time to "expect the unexpected" in regards to
fieldwork.
The student is expected to honor his or her commitment to the internship where he/she has been
scheduled. At times, extraordinary circumstances do occur which may lead to a cancellation by the
student. If this occurs the following steps must be taken.

Contact the AFC to explain the situation. There may be an alternative solution to the problem
that may avoid an unnecessary cancellation.

If the circumstances warrant cancellation, a formal letter must be written to the OT
undergraduate committee stating the reasons for the cancellation and any steps that were taken
to avoid the cancellation. A decision to cancel will then be made by the committee if the
cancellation is warranted. You will receive written notice within two weeks of your
submission to the committee.

If permission to cancel is granted, the student will write an additional letter to the facility
explaining the reasons for cancellation and express regret for not fulfilling the commitment.
Before the letter is sent to the facility it must be reviewed by the AFC.

Options for an alternative placement and time will be discussed once the letter has been
mailed to the facility.

If the petition to cancel the fieldwork placement is denied, the student will be expected to
report to the scheduled facility at the stated beginning date and time. Failure to do so will
only delay the ability to meet certification examination deadlines. It is imperative that
Page 16
Revised 2014
students work closely with the AFC regarding any issues or concerns regarding fieldwork
placements.
Health Insurance/Health Forms
Massachusetts State Law requires that all students enrolled in at least 75 percent of a full-time course
load at an institution of higher learning in Massachusetts must participate in a student health
insurance program or in a health insurance plan with comparable coverage. Please see the following
link for additional information: https://www.salemstate.edu/4928.php
Students have the right, under the Family Educational Rights and Privacy Act to have access to their
educational records and to prevent disclosure of their contents to third parties without formal
authorization. Records may be requested in writing through the Registrar’s Office.
The Occupational Therapy Department faculty may discuss a student’s academic and fieldwork
performance with potential employers and others, only if the student has given formal, written
permission to do so. Such disclosure occurs only in the best interest of the student and is used to
benefit his or her educational experience.
Students with special needs (physical, mental and or learning disabilities) who may need
accommodations related to completing academic or fieldwork requirements are responsible for
discussing such needs with their academic advisor. Students needing assistance should contact the
Disability Services Office at (978) 542-6217. Please refer to the Undergraduate Student Handbook
for additional information.
Financial Aid during Level II Fieldwork
Fieldwork is comprised of six credits for each level II experience. Please contact the Financial Aid
Department with additional questions in regards to credits and financial aid. The Financial Aid office
may be reached at (978) 542-6112.
9. *****Felony Statement *****
Students meeting all academic and fieldwork requirements may be eligible to sit for the NBCOT
Certification Examination and be allowed to obtain a state license to practice as a registered
occupational therapist. Any student who has been convicted of a prior felony may be considered
ineligible by NBCOT to sit for the examination and may also be unable to attain an occupational
therapy license from the State Licensure Board.
10. NBCOT Certification
Upon completion of Level II fieldwork (960 hours) and all academic course work requirements and
graduation; students may be eligible to sit for the National Certification Examination through
NBCOT. This examination is completed at a testing center such as Sylvan Learning Center and is
available on demand. Please refer to the NBCOT website for additional specifics pertaining to the
examination and location of testing sites. www.nbcot.org
Revised 2014
Page 17
The National Board for Certification in Occupational Therapy, Inc. (NBCOT) administers the
National Certification Examination for Occupational Therapy upon demand at assigned test centers.
Sylvan Learning Center is listed as one of these test centers. These centers are located throughout
Massachusetts. Course work and fieldwork requirements must be met before a student is eligible to
sit for the examination. In addition, outstanding financial obligations to SSU must be cleared through
the billing office prior to taking the examination.
Students may find all necessary information and the test application at the NBCOT website at
www.nbcot.org or send correspondence to:
National Board for Certification of Occupational Therapists
2/100 S Summit Ave,
Gaithersburg, MD 20877
(301) 990-7979
Fax (301) 869-8492
Revised 2014
Page 18
11. Appendix (see following pages)
The following documents listed below received permission to print status by the American
Occupational Therapy Association - September 2007
Appendix A: The Purpose and Value of Occupational Therapy Fieldwork Education
Appendix B: ACOTE Standards of Accreditation
Appendix C: SSU Professional Behaviors Assessment and Action Plan
Appendix D: HIPPA Guidelines for Fieldwork
Appendix F: The American Occupational Therapy Association Code of Ethics
Appendix G: Level II Fieldwork Data Form (AOTA)
Appendix H: Student Personal Data Sheet (AOTA)
Appendix I: Level II Fieldwork Performance Evaluation (FWPE) for the Occupational Therapist
(AOTA)
Appendix J: Level II Student Evaluation of Fieldwork Experience (AOTA)
Appendix K: SSU Health Form
Appendix L: Self-Assessment Tool for Fieldwork Educator Competency
Appendix M: Fieldwork Experience Assessment Tool (FEAT)
Appendix N: COE Level I and Level II Fieldwork Guidelines
Revised 2014
Page 19
APPENDIX A
Revised 2014
Page 20
APPENDIX B
Revised 2014
Page 21
APPENDIX C
Revised 2014
Page 22
Salem State University
Schools of Human Services
Professional Behaviors Assessment
Student name:____________________________ Faculty name: _____________________
Course number: ____________________ Student ID code: _________________________
Semester:
( ) Midterm
( ) End of Semester
Indicate the student’s level of performance using the scale below.
1= Well Below Standards:
2= Below Standards:
3= Meets Standards:
4= Exceeds Standards:
5= Far Exceeds Standards:
Performance is weak in most required tasks and activities.
Work is frequently unacceptable
Opportunity for improvement exist however student has not demonstrated
adequate response to feedback. Work is occasionally unacceptable
Carries out required tasks and activities. This rating represents good, solid
performance and should be used more than all the others.
Frequently carries out tasks and activities that surpass requirements.
At times, performance is exceptional.
Carries out tasks and activities in consistently outstanding fashion.
Performance is the best that could be expected from any student.
1.Time management Skills
Consider ability to arrive on time, complete assignments on time:
Comments:
1
2. Organization
Consider ability to set priorities, be organized, follow through with responsibilities
Comments:
1 2 3 4 5
3. Engagement in the classroom experience
Consider student’s apparent level of interest, level of active participation while in class,
Investment in class activities or group work
Comments:
1 2 3 4
5
4. Self-Directed Learning
Consider ability to take responsibility for own learning, demonstrate motivation
Comments:
1 2 3 4
5
5. Reasoning/Problem Solving
Consider ability to use self-reflection, willingness to ask questions: ability to analyze, synthesize
And interpret information; understand the OT process
Comments:
1 2 3 4
5
Revised 2014
2 3 4 5
Page 23
6. Written Communication
Consider grammar, spelling, legibility, successful completion of written assignments and correct
Use of APA format
Comments:
1
2
3 4
5
7. Initiative
Consider initiative, ability to seek and acquire information from a variety of sources.
Comments:
1
2
3 4
5
8. Observation Skills
Consider ability to discuss performance areas and performance components and to verbalize
Perceptions regarding case studies or other in class activities
Comments:
1
2
3 4
5
9. Participation in the teacher/student Process
Consider ability to give, receive and respond to feedback; seek guidance when necessary; follow
Proper channels.
Comments:
1
2
3 4
5
1
2
3 4
5
1
2
3 4
5
1
2
3 4
5
10. Verbal communication and Interpersonal skills with students/teacher
Consider ability to interact appropriately with individuals such as eye contact, empathy, limit
Setting, respectfulness, use of authority, degree/quality of verbal interactions; use of body
Language and non-verbal communication
Comments:
11. Professional and Personal Boundaries
Consider ability to recognize/handle personal/professional frustrations,
balance personal/professional obligations; handle responsibilities: work with others cooperatively
considerately, effectively; responsive to social cues in the classroom
Comments:
12. Use of professional terminology
Consider ability to appropriately apply professional terminology ( such as Occupational Therapy
Framework, appropriate medical acronyms, abbreviations) in written and oral communications
Comments:
Final score:___________________________ ( ) Pass
( ) Fail
Student Signature _____________________________________
Faculty Signature _____________________________________
Requirements for passing
 No more than one item below a “2”, OR
 No more than two items below a “3”
 A Failing score requires completion of a Professional Behaviors Action Plan
 Until Professional Behaviors Action Plan is completed student will receive an Incomplete
Grade for course and will not be able to register for the next group of courses
Revised 2014
Page 24
Professional Behaviors Student Action Plan
Student Name:_________________________________
Student ID:______________
Probationary Semester_____________________________________________________
PB Meeting Held With Faculty:______________________________________________
Summarized Discussion/Current Professional Behavior Issues Targeted:
Comments
1) ⁯
Time Management
2) ⁯
Organization
3) ⁯
Engagement in Class
4) ⁯
Self-Directed Learning
5) ⁯
Reasoning/Problem Solving
6) ⁯
Written Communication
7) ⁯
Initiative
8) ⁯
Observation Skills
9) ⁯
Teacher/Student Process
10) ⁯
Verbal Communication
11) ⁯
Prof/Personal Boundaries
12) ⁯
Use Professional Language
Additional Comments:
Revised 2014
Page 25
Professional Behavior Action Plan:
Time Line:
Action Plan to take effect from date of signatures from both parties listed below:
Faculty Signature/Advisor:___________________________________________
Student Signature:__________________________________________________
Professional Behaviors Student Action Plan Follow Up Meeting
Revised 2014
Page 26
Student Name:_________________________________
Student ID:______________
Probationary Semester_____________________________________________________
PB Follow Up Meeting Held With Faculty:_____________________________________
Summarized Discussion/Current Professional Behavior Goal Attainment:
Recommendations:
⁯
Removal from Probation/Goals Attained
⁯
Extend Probationary Period
⁯
Revise Action Plan
⁯
Program Suspension
Additional Comments
Faculty Signature/Advisor:___________________________________________
Student Signature:__________________________________________________
Revised 2014
Page 27
APPENDIX D
Revised 2014
Page 28
Fact Sheet: HIPPA Privacy Rule Web Links
AOTA Reimbursement and Regulatory Policy Department
The HIPPA Privacy Rule establishes a federal requirement that most doctors, hospitals, and
other health care providers (such as occupational therapists) obtain a patient's written consent
before using or disclosing the patient's personal health information to carry out treatment,
payment, or health care operations (TPO). Health care providers must comply with the HIPPA
privacy rule by April 14, 2003.
For more information, see the following Web sites:
HIPAA Security Information Series: A set of 5 documents providing insight into the HIPAA
security rule
http://www.cms.hhs.gov/EducationMaterials/04_SecurityMaterials.asp#TopOfPage
Background and General Information
http://www.hhs.gov/ocr/hipaa/bkgrnd.html
The Final Privacy Rule
http://www.hhs.gov/ocr/hipaa/finalreg.html
U.S. Department of Health and Human Services: Administrative Simplification Privacy and
Security
http://www.cms.hhs.gov/HIPAAGenInfo/04_PrivacyStandards.asp#TopOfPage
HHS Office of Civil Rights: HIPAA FAQs
http://www.hhs.gov/hipaafaq/index.html
HHS Fact Sheet on Final Privacy Rule - Summary
http://www.hhs.gov/ocr/privacysummary.pdf
University of Miami, School of Medicine, Privacy / Data Protection webpage
http://privacy.med.miami.edu/index.htm
Revised 2014
Page 29
APPENDIX E
Revised 2014
Page 30
APPENDIX F
Revised 2014
Page 31
APPENDIX G
Revised 2014
Page 32
APPENDIX H
Revised 2014
Page 33
PERSONAL DATA SHEET
FOR STUDENT FIELDWORK EXPERIENCE
PERSONAL INFORMATION
Name _______________________________________________________________________________________
Permanent Home Address ______________________________________________________________________
____________________________________________________________________________________________
Phone number and dates that you will be available at that number
Phone Number _____________________________
Dates __________________________________________
Name, address, and phone number of person to be notified in case of accident or illness:
____________________________________________________________________________________________
____________________________________________________________________________________________
EDUCATION INFORMATION
1.
Expected degree (circle one)
OTA:
Associate
Baccalaureate
OT:
Baccalaureate
Masters
Masters
Doctorate
Doctorate
Certificate
Certificate
2.
Anticipated year of graduation ________________________
3.
Prior degrees obtained _______________________________
4.
Foreign languages read ______________________________ spoken ___________________________
5.
Do you hold a current CPR certification card? Yes _____ No _____
Date of expiration ________________________
HEALTH INFORMATION
1.
Are you currently covered under any health insurance? Yes _____ No _____
2.
If yes, name of company___________________________________________________________
Group # _____________________________ Subscriber # _______________________________
3.
Date of last Tine Test or chest x-ray: _____________________________
(If positive for TB, tine test is not given)
PREVIOUS WORK/VOLUNTEER EXPERIENCE
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Revised 2014
Page 34
PERSONAL PROFILE
1.
Strengths:
__________________________________________________________________________________________________
2.
Areas of growth:_________________________________________________________________
______________________________________________________________________________
3.
Special skills or interests:
4.
Describe your preferred learning style:
5.
Describe your preferred style of supervision:
6.
Will you need housing during your affiliation? Yes _____ No _____
7.
Will you have your own transportation during your affiliation? Yes _____ No _____
8.
(Optional) Do you require any reasonable accommodations (as defined by ADA) to complete
your
fieldwork? Yes _____ No _____. If yes, were there any reasonable accommodations
that you
successfully used in your academic coursework that you would like to continue during
fieldwork? If so,
list them. To promote your successful accommodation, it should be discussed
and documented before each
fieldwork experience.
FIELDWORK EXPERIENCE SCHEDULE
TYPE OF
FW SETTING
CENTER
Level I Exp.
Level II Exp.
ADDITIONAL COMMENTS
AOTA Commission on Education (COE) and Fieldwork Issues Committee (FWIC)
Amended and Approved by FWIC 11/99 and COE 12/99
fieldwork\miscell\persdatasheet.1299
35
LENGTH OF FW
EXPERIENCE
APPENDIX I
36
APPENDIX J
37
APPENDIX K
38
APPENDIX L
39
APPENDIX M
40
APPENDIX N
41

College of Health & Human Services Occupational Therapy Department Fieldwork Manual

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College of Health &amp; Human Services Occupational Therapy Department Fieldwork Manual

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College of Health & Human Services Occupational Therapy Department Fieldwork Manual