A cooperative inquiry study to identify strategies for group supervision in occupational therapy fieldwork placements

The purpose of this study was to identify effective strategies for supervising small groups of second-year students in an occupational therapy fieldwork programme based on a collaborative group model. Contemporary models for fieldwork education over the past decade have involved more placements for students working in peer groups, to address the shortage of fieldwork placements and to create opportunities for students to work in a team environment. Discussion about these fieldwork options has focused on the perceived value of the programmes rather than on the processes used for supervising students in groups. The research methodology chosen for this study was cooperative inquiry because of its congruence with the qualitative nature of group supervision and the collaborative model on which the fieldwork programme was based. Thirteen of a total of 18 occupational therapy supervisors volunteered to participate in the study. Data about supervision skills that would enhance student learning were generated through a series of experiential action cycles in the fieldwork setting, interspersed with regular peer reflection meetings. The results highlighted a range of supervision strategies such as student orientation, the facilitation of peer discussion and reflection on practice, and encouragement by the supervisor for students to use resources in the fieldwork environment and to take responsibility for their own learning. The depth of data gained from the study may have been limited owing to time constraints and other commitments of research participants. A social culture of mutual learning and support was established through the cooperative inquiry process, with potential for building ongoing relationships and participant awareness of educational innovations. Copyright © 1999 Whurr Publishers Ltd.     

A Descriptive Study on Level II Fieldwork Supervision in Hospital Settings

ABSTRACT

The objective of this study was to examine the factors influencing fieldwork educators’ ability and willingness to supervise Level II occupational therapy students in hospital-based settings. Qualitative focus groups were used to explore the perceptions of occupational therapists in four urban hospitals in Nebraska. The study presents the issues facing fieldwork supervisors and their suggestions on how to improve the fieldwork process. Both personal and professional factors influenced occupational therapists’ willingness to accept students, while facility constraints were the primary reason occupational therapists would not accept Level II students. Fieldwork educators believe that their facilities need structured fieldwork programs and that students need more formalized fieldwork preparation at their academic institutions. Themes highlight the need for continued collaborative endeavors between academic fieldwork coordinators and fieldwork educators.     

The Collaborative Model of Fieldwork Education: Implementation of the model in a regional hospital rehabilitation setting

Aim:   This paper describes the implementation of a Collaborative Model of Fieldwork Education in a regional hospital occupational therapy department.
Methods:  The literature on models of fieldwork education for occupational therapy students is reviewed, and an approach to the implementation of the collaborative model with three students to one clinical educator is described after piloting of this model's recommendations, arising from the pilot placement, are proposed.
Conclusions:  The implementation of a Collaborative Model of Fieldwork Education requires careful planning, close links with the university fieldwork team and a willingness on the behalf of occupational therapist clinical educators to explore alternative approaches to the provision of fieldwork education.     

Effective fieldwork supervision: Occupationa therapy student perspectives

Qualitative research methodology was used to explore occupational therapy student perceptions of the characteristics of effective fieldwork supervisors and the limitations on effective fieldwork supervision. In addition, the study investigated differences in perceptions between students in each of the 4 years of the undergraduate course. Forty-eight students completed an open-ended questionnaire. The two major characteristics of effective fieldwork supervisors identified by the students were well-developed interpersonal skills and the use of collaborative and facilitatory teaching/learning strategies. The major environmental issue limiting the effectiveness of fieldwork supervisors was a lack of time for student supervision. Although students in all years of the occupational therapy course expressed similar viewpoints, variations were identified across the years, particularly with teaching/learning strategies used. Findings from the study need to be interpreted in light of its limitations, which include small student numbers.     

The influence of fieldwork on the preferred future practice areas of final year occupational therapy students

The student fieldwork experience has been recognised as an important influence on the areas of occupational therapy practice pursued by clinicians after graduation. The recruitment patterns of graduate occupational therapists is a key issue, especially in clinical areas such as rural practice and mental health. This study aimed to investigate the future practice preferences of 50 final year occupational therapy students from two occupational therapy schools in New South Wales, in relationship to their fieldwork experience, using a focus group and a survey. General physical dysfunction was the most popular area of future practice for this group. Results suggested that fieldwork influenced students through the programme content, the timing of placements, supervision, and students' personal responses to their experiences. The study also demonstrated that students use the fieldwork experience to guide their decision to enter an area of practice.     

Collaborative Learning Applied to Fieldwork Education

SUMMARY

Occupational therapists of the 21st century must be educated to provide intervention within health, education, community, and policy-making areas. Therapists need to solve complex problems, often in collaboration with numerous stakeholders. This article proposes that preparing occupational therapists for current practice requires a fundamental change in our educational beliefs and that a collaborative approach among students and fieldwork educators is most congruent with the interactive environments of current practice. The philosophical principles of collaborative learning are reviewed and practical considerations to apply the principles to Level II fieldwork programs are described.     

An application of the model of human occupation to fieldwork supervision and fieldwork issues in NSW

Occupational therapists in New South Wales (NSW), both clinicians and academics, find themselves in the position of adapting to the continually increasing demands for sufficient fieldwork opportunities for students. There are now four occupational therapy undergraduate programmes in NSW presenting further challenges for the supply of fieldwork placements. In response to this situation, the NSW Fieldwork Issues Group was formed to address issues arising for all involved. This paper is a result of initial attempts by members of the group to identify and explore the major issues confronting fieldwork supervisors, in order to develop some strategies for managing the changes taking place in NSW. In an effort to clarify the issues involved, a variety of models were considered and the 'model of human occupation' was applied. This paper presents, briefly, the reasons for choosing this model and details its potential application to issues facing fieldwork supervisors in NSW and the implications for fieldwork supervision within the occupational therapy profession as a whole.     

The Reindeer of Hope: An Occupational Therapy Program in a Homeless Shelter

SUMMARY

This article describes a successfully designed and implemented program created for mentally ill homeless men by Level II occupational therapy students from Eastern Kentucky University. Outcomes for the clients, the staff and the students were extremely positive and have contributed to the appreciation and acceptance of occupational therapy as a discipline that can contribute to the health of this underserved population. This model demonstrates the effectiveness of University sponsored fieldwork in introducing occupational therapy to the community, creating awareness of what occupational therapy has to offer and developing a climate to bring needed services to clients and provide community-based employment for occupational therapists.     

Growing from dilemmas: developing a professional identity through collaborative reflections on relational dilemmas

Health educators nurture future generations of professionals by helping them to navigate the complex transition from students to therapists. The purpose of this study was to illustrate how a pedagogical method of collaborative reflection (involving reflective writing, sharing, and discussion) on relational dilemmas with role partners can develop occupational therapists’ professional identity. The course, in which this method was applied, implemented the supervision and peer learning frameworks as related to student’s fieldwork experiences, and is based on the perception of growing from conflicts and exploration. The study is based on analyzing qualitative data of 392 dilemma cases and 196 texts of personal reflection on classroom work of undergraduate students in occupational therapy. A thematic analysis of the case studies revealed six overarching relational dilemmas that novice therapists are often called upon to deal with when working with patients, patients’ families and colleagues from other health professions. Analyzing the personal texts of reflection highlighted the effectiveness of collaborative reflection in bridging the gap between theory and practice, and in helping students develop their professional identity. The method can be adapted to curricula for students and therapists in other health professions, in undergraduate courses, and in group supervision programs.     

International fieldwork placements and occupational therapy: lived experiences of the major stakeholders

Introduction: Occupational therapy students obtain a great deal of their professional preparation and experience through fieldwork placements. Although many occupational therapy students have taken part in international fieldwork placements, there is little research on this topic. As fieldwork placements are an integral part of the education of occupational therapy students, literature on the subject of international fieldwork placements is necessary. Accordingly, the aim of this study was to examine the personal and professional experiences of occupational therapy students, supervisors, and on‐site staff who have taken part in an international fieldwork placement. Methods: Qualitative interviews for this phenomenological study were administered with 14 participants who had taken part in an international fieldwork placement in Trinidad and Tobago. Data were analysed using thematic analysis. Findings: Three themes emerged: collaborative learning, cultural negotiations and thinking on my own. Discussion: Considering fieldwork is a critical component in the occupational therapy curriculum, it is reassuring to uncover that international placements can be of benefit to all stakeholders while achieving its primary goal of preparing students to become competent therapists. All participants developed a greater cultural awareness and appreciation, which is necessary as occupational therapists are increasingly working in diverse settings with diverse client groups. This information can also be used to enhance international fieldwork education as students continue to travel abroad to complete their mandatory fieldwork hours.     

Group Co-Leadership by Occupational Therapy Students in Community Centers: Learning Transitional Roles

SUMMARY

The experience of contact with community populations and settings at the beginning of fieldwork is essential in expanding the dimensions of non-traditional skills and roles for occupational therapy students. This article describes an initial fieldwork experience which builds on an occupational therapy group process course to enable students to supplement a community-based program with activities designed to meet a need of their group at the appropriate level of group interaction. Pairs of students select a receptive community site prior to the beginning of fieldwork to open dialog with the center's coordinator regarding performance areas, components, or contexts needed by the group. Working to assess the current programmatic offerings and desires of the participants for new activities and planning activities in collaboration with local staff, the students propose to conduct a series of five sessions addressing a theme desired or needed by the group. Upon immersion in the site's program, students are able to provide an in-depth assessment of the community group's psychosocial skill needs using the Group Level of Function Profile (Donohue, 2000).     

Emotional Intelligence,Self-Efficacy,and Occupational Therapy Students’ Fieldwork Performance

ABSTRACT

This study explored the relationship of emotional intelligence level and self-efficacy to fieldwork performance for occupational therapy students. Occupational therapy students (n = 199) from 36 occupational therapy programs in the United States completed the two surveys, the Mayer-Salovey-Caruso Emotional Intelligence Test and the Student Confidence Questionnaire, during their professional Level 2 fieldwork placements. The surveys were compared to the Fieldwork Performance Evaluation for the Occupational Therapy Student completed by the fieldwork educators. Results showed that degree of emotional intelligence, having a choice in the fieldwork setting, and having professional experience in a related setting were positively correlated to Fieldwork Performance scores. Students’ self-efficacy was not related to Fieldwork Performance scores. This suggests fostering students’ emotional intelligence and capacity for accurate skill appraisal supports fieldwork success.     

Differences and similarities in therapeutic mode use between occupational therapists and occupational therapy students in Norway

Background: The Intentional Relationship Model (IRM) is a new model of the therapeutic relationship in occupational therapy practice. Two previous studies have focused on therapist communication style, or ‘mode’ use, but to date no group comparisons have been reported.

Aim: To explore differences between occupational therapists and occupational therapy students with regard to their therapeutic mode use.

Methods: The study had a cross-sectional design, and convenience samples consisting of occupational therapists (n?=?109) and of second-year occupational therapy students (n?=?96) were recruited. The Self-Assessment of Modes Questionnaire was the main data collection tool. Group differences were analysed with independent t-tests.

Results: The occupational therapists responded more within the collaborative and empathizing modes than the students did. The students responded more within the advocating and instructing modes than the occupational therapists did.

Conclusion and significance: There may be systematic differences between occupational therapists and students concerning their therapeutic mode use. Some modes, such as the collaborating and empathizing modes, may be viewed as requiring more experience, whereas other modes, such as the advocating mode may be related to more recent rehabilitation ideologies. These factors may contribute to explaining several of the group differences observed.     

Meeting the educational needs of fieldwork supervisors: A collaborative workshop developed by New South Wales occupational therapy fieldwork coordinators

This paper describes the collaborative preparation and implementation of a workshop for occupational therapy fieldwork supervisors which has been developed by the four occupational therapy programmes in New South Wales. The workshop was primarily designed to meet the education needs of new and inexperienced fieldwork supervisors who could subsequently be prepared to supervise students from any of the four occupational therapy programmes in the state. The workshop was also offered to more experienced fieldwork supervisors who were interested in adapting their fieldwork programmes to incorporate the needs of students from the four occupational therapy programmes. The process of constructing the workshop is outlined. Results from pre-workshop questionnaires ( n  = 237) and post-workshop evaluations ( n  = 257), during the first year of presentation of the workshop, suggested that the workshop was effective in meeting the objectives of preparing fieldwork supervisors to supervise students from a variety of educational programmes. In addition, the collaboration between the occupational therapy programmes during the workshops has enabled other state-wide fieldwork issues to be identified, and further projects have been undertaken to address fieldwork concerns.     

The Betty Project: Jump-Starting Clinical Observation Skills in an OTA Curriculum

SUMMARY

In the practice environment of many therapy practitioners today, fieldwork educators may have limited time for instructing students in applying basic theoretical concepts. Educators are therefore challenged to develop students who have the tools necessary to be successful in the clinical world.

Based on input from fieldwork educators, the “Betty Project” was developed to provide opportunities for occupational therapy assisting students to hone clinical observation and documentation skills while still in a classroom setting. This modified role-play project gives students an opportunity to treat, make clinical observations, and learn to process and prioritize data for effective documentation.

After implementation of this project, student performance in these areas on Level II fieldwork was markedly improved, as evidenced by scores on the FWE as well as fieldwork educator comments.     

Integrating the Centennial Vision Into an Evidence-Based Fieldwork-Learning Experience

ABSTRACT

Occupational Therapy's Centennial Vision includes the concept of evidence-based practice (EBP) as a core mechanism to move the profession forward. The literature reveals that although EBP has become an expected norm by occupational therapy consumers and payers, it is difficult to implement secondary to a variety of issues. The implementation and use of an EBP fieldwork experience within the physical disabilities context require problem-based and collaborative learning approaches. Fieldwork students complete 15 practitioner-facilitated EBP modules regarding performance approaches specific to the fieldwork site. The response of the participants suggests that EBP can have a positive impact on new knowledge acquisition and its application to new clinical skills. Future program goals include the development of more in-depth outcome measures to ascertain the effectiveness of a fieldwork clinical-learning module program.     

Predictors to Private Practice Occupational Therapy Fieldwork Opportunities in Canada: New Evidence suggests New Solutions

Abstract

The study examined predictors to increasing and enhancing fieldwork education opportunities provided by occupational therapists working in private practice. A cross-sectional design that used a self-administered questionnaire was provided to Canadian occupational therapists in private practice. Participants receiving funding from the workers’ compensation sector, those with between 11 and 20?years of work experience, and therapists working full-time hours were more likely to accept a student in fieldwork placement. Respondents who indicated that physical space and resources were not barriers to taking students on placement were more likely to accept students. Therapists more comfortable with the criteria and methods for appropriate and effective student teaching and supervision were also more likely to accept a student for fieldwork placement. The study findings can inform academic programs on how best to support preceptorship and guide university fieldwork coordinators’ strategies for outreach and education for private practitioners.     

Active Participation in Fieldwork Level I: Fieldwork Educator and Student Perceptions

ABSTRACT

Fieldwork experiences bridge the gap between a student's education and entry-level practice. Academic programs, faculty members, and fieldwork educators are challenged to prepare occupational therapy students for entry-level practice. The Accreditation Council for Occupational Therapy Education (ACOTE) standards advocate for both active participation and guided observation in Level I fieldwork experience (. Students report their most meaningful learning experiences, which include performance of clinical skills and participation in clinical reasoning. However, many students enrolled in the author's entry-level master's program and the other schools within a regional consortium report their Level I fieldwork experience is primarily observation. This article describes the results of a survey administered to fieldwork educators and occupational therapy students eliciting their perceptions of active participation in Level I fieldwork. Results indicate that perceptions of the groups are dissimilar. Recommendations and implications for increased active participation in Level I fieldwork are discussed.