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: A Blueprint for Group Supervision of Students

ABSTRACT. Historically, occupational therapists have used a traditional one-to-one approach to supervision on fieldwork. Due to the impact of managed care on health-care delivery systems, a dramatic increase in the number of students needing fieldwork placement, and the advantages of group learning, the collaborative supervision model has evolved as a strong alternative to an apprenticeship supervision approach. This article builds on the available research to address barriers to model use, applying theoretical foundations of collaborative supervision to practical considerations for academic fieldwork coordinators and fieldwork educators as they prepare for participation in group supervision of occupational therapy and occupational therapy assistant students on level II fieldwork.     

The Perspectives of Fieldwork Educators Regarding Level II Fieldwork Students

ABSTRACT

Ten occupational therapists employed in pediatric and adult rehabilitation settings participated in focus groups to discuss their perceptions of the benefits and drawbacks in working with occupational therapy students. Participants identified professional values, opportunities for continued professional development, recruitment of future employees, and pride in learning experiences available as incentives for working with students. Fieldwork educators who had supervised students lacking foundational communication, problem-solving, and clinical skills were cautious about accepting future Level II students. Time constraints and lack of preparation for the educator role were perceived as barriers to working with students. Fieldwork educators expected the academic institution to provide efficient support, including training for the educator role, information regarding the expectations of the academic program, and ongoing communication over the fieldwork experience. Strategies for strengthening the ties between academic programs and fieldwork sites were explored.     

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.     

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.     

Informing fieldwork design: Key elements to quality in fieldwork education for undergraduate occupational therapy students

Aim:  In this current climate of escalating student fees, students as paying consumers expect a quality fieldwork experience. However, the ability of universities to deliver quality fieldwork programs is compromised by the increasing pressure experienced by fieldwork educators to meet productivity targets in the face of diminishing resources. This paper details how one university, Monash University, sought input from stakeholders to design a fieldwork program.
Methods:  This qualitative study utilised focus groups to inform the researchers of stakeholders' perceptions of what constitutes quality fieldwork education. A total of five focus groups were held, involving 47 occupational therapists practising in Victoria.
Results:  The major findings include the need to provide ongoing professional development for fieldwork educators, the need to develop tangible strategies in recognition of their contribution towards fieldwork education, and the imperative for closer collaboration between universities and fieldwork educators.
Conclusions:  Based on literature and in response to the focus group discussions, Monash University has implemented a number of measures to ensure the successful implementation of quality fieldwork education. These include providing ongoing professional development for fieldwork educators to enhance their role, addressing fieldwork educators' concerns about project placements and supporting students with fieldwork relocation. Most importantly, this study demonstrates the need for educational institutions to take the lead in dialogue with the profession to enhance a collaborative response to constant changes in health-care directions. The importance of ongoing research to inform quality fieldwork education is critical to moving the profession forward.     

Differentiating Fieldwork Settings: Matching Student Characteristics to Demands

Abstract

Academic fieldwork coordinators (AFWCs) face the challenge of matching students to Level II fieldwork (FW) sites. This study surveyed 301 fieldwork educators (FWEs) from 30 states to explore how important it was for students to possess 25 characteristics or abilities to enable success at the educators’ individual work sites. The top three characteristics and abilities overall were as follows: (1) time management, (2) ability to communicate with supervisor when help is needed, and (3) overall professional behavior. Using Mann–Whitney U-tests for ordinal data, statistically significant differences (p?≤?.01) were found between settings with acute care having the highest expectations of students. Overall results support the value of FW coordinators matching students’ abilities to demands of settings prior to Level II FW placements. Top ranking items may also guide schools on admissions criteria and skill development throughout curriculum.     

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.     

Fieldwork education: The future of occupational therapy depends on it

Fieldwork continues to be the cornerstone of preparation for entry-level occupational therapy clinicians. During the past five years the Canadian healthcare system has experienced decreases in federal funding, organizational changes such as the movement to programme management, and increased focus on community-based needs. Two fieldwork projects were tested at a large health sciences facility, to meet the challenge of providing effective fieldwork experiences that build on current educational methodologies while still responding to changing realities in healthcare practice. The academic programme with which the health sciences facility is affiliated has developed a strong focus on self-directed learning, using problem-based and small group learning formats. The development, implementation and evaluation of the two fieldwork projects is described. Discussion focuses on the processes needed to facilitate innovative, flexible fieldwork models.     

Disability law and health care education

Health care education programs, regardless of the discipline, will face similar challenges and issues related to students with disabilities. These are likely to include issues related to admission, retention, and academic adjustments, auxiliary aids, and services. A review of the literature reveals limited information beyond medical and nursing education programs, although students with disabilities are enrolled in education programs in other health care disciplines. Recent research indicates that students with disabilities are enrolling in health care education programs with increasing frequency. Educators and administrators will benefit from a better understanding of disability law and how it impacts education programs. Further, this knowledge should allow health care educators to be more proactive in regard to students with disabilities and to maintain a greater degree of autonomy over their respective programs. This report reviews pertinent legislation and case law as it applies to students with disabilities in health care education.     

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.     

Confidentiality dilemmas in clinical education

Through an analysis of three cases, this article illustrates many of the subtleties of ethical discernment involved during clinical fieldwork rotations when allied health students decide to withhold information about their disabilities. By law in the United States, educators are bound to uphold students' confidentiality in this regard. However, this analysis examines many of the complexities that clinical coordinators, preceptors, and students must grasp when faced with conflicting ethical duties.     

Fieldwork Supervision: Roles,Tasks and Responsibilities

Fieldwork constitutes approximately thirty-five per cent of occupational therapy undergraduate programme of study. It is of concern to occupational therapy educators that the fieldwork portion of the curriculum be planned and implemented to provide educationally sound learning experiences. Whatever the level of training and experience of fieldwork supervisors, implementation of a fieldwork training programme which will provide the necessary levels of learning, is dependent on the supervisor's understanding and use of methods of supervision. These include a knowledge of learning theories, skill in directing, supervising and guiding students in the performance of desired action. This paper will focus on effective and ineffective supervisors and how an understanding of student learning styles can increase the supervisor's ability to provide quality learning experience.     

Physicians' Perceptions of the Changing Health Care System: Comparisons by Gender and Specialties

This study was designed to investigate physicians' perceptions of changes in the United States health care system impacting academic medicine, quality of care, patient referrals, cost, ethical and sociopolitical aspects of medicine. A survey was mailed in 1998 to 1,272 physicians (graduates of Jefferson Medical College between 1987 and 1992); 835 physicians (66%) responded. Results showed that a substantial majority (92%) believed that learning to work in a managed care environment should become an essential component of medical education. Physicians perceived that current changes impair physicians' autonomy (94%), and restrain physicians' freedom to provide optimal care (84%). A sizable majority (76%) endorsed patients' freedom to seek specialist care, and 55% believed that capitation reduces physicians' motivation for long-term monitoring of patients. The majority endorsed universal health coverage (80%), and agreed to support rather than resist the changes (62%). Only 18% hold a positive view of the changes in the future. The majority believed that medical education should prepare physicians to provide end-of-life care (92%), and that organized medicine should take a stand on social issues that can influence the well-being of society (79%). Only 34% endorsed the legalization of physician-assisted suicide. No gender differences were observed, but a few differences were found between generalists and specialists. Results can help in understanding physicians' perceptions of current changes in the United States health care system, and in providing guidelines for the development of educational programs to prepare physicians to face new challenges.     

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.     

Reliability and validity of the occupational therapy attribute scale

The Occupational Therapy Attribute Scale (OTAS) was developed as a systematic, valid, and reliable tool for use as a formative and summative assessment of occupational therapy (OT) student professional behavior during level II fieldwork. The purpose of this study was to investigate the validity and reliability of the OTAS as a summative assessment for level II fieldwork. Items were created by OT clinical educators during focus groups. Internal consistency (reliability) was tested using Cronbach's alpha. The resulting Fieldwork Evaluation coefficients ranged from 0.98 to 0.99; OTAS coefficients ranged from 0.91 to 0.96. A principal components exploratory factor analysis with varimax rotation yielded three factors: judgment/clinical reasoning, professional communication, and organization and time management. External construct validity was tested using Pearson correlation; the results indicated a strong (r = 0.74) degree of consistency between the Fieldwork Evaluation, the gold standard, and the OTAS. The sensitivity of the OTAS was 0.94, suggesting the OTAS is able to identify OT students who would be hired. The authors conclude that the OTAS is a reliable and valid measure of professional behavior of OT students on level II fieldwork.     

安徽省高校医学生突发公共卫生事件应急管理能力现状及影响因素研究

  目的   调查安徽省医学生突发公共卫生事件应急管理能力现状及其影响因素，为进一步协同提高全社会的突发公共卫生事件应急管理水平提供依据。
  方法   采用线上问卷调研的方法，对安徽省4所本科医学类院校的1 287名在校医学生进行问卷调研；采用多元线性回归分析影响医学生突发公共卫生事件应急管理能力现状的相关因素。
  结果   本次调研共收集有效答卷1 190份，有效回收率92.46%。医学生突发公共卫生事件应急管理能力的平均得分为（54.51 ± 10.79）分。多元线性回归分析结果显示:相比新事物新知识接受能力差的医学生，接受能力很好的同学应急管理能力得分提高19.456分，较好的提高15.807分，接受能力一般的提高12.016分（P < 0.01）；相比理论课学习后偶尔复习的医学生，经常复习的同学应急管理能力得分提高8.322分，有时复习的提高3.801分（P < 0.01）；相比没系统学习过卫生急救医学相关课程的医学生，系统学习过的同学应急管理能力得分提高4.165分（P < 0.01）；相比女性医学生，男性学生应急管理能力得分提高3.408分（P < 0.01）；相比来自城市的医学生，农村同学应急管理能力得分降低2.872分（P < 0.01）；相比学习成绩差的医学生，学习成绩很好的同学应急管理能力得分提高11.074分，较好的提高8.781分，一般的提高5.619分（P < 0.01）；相比未参加过临床见习的医学生，参加过临床见习的同学应急管理能力得分提高1.680分（P < 0.05）。
  结论   安徽省医学生的突发公共卫生事件应急管理能力处于中等水平，有待进一步提高。应通过提升学生对于新事物的接受能力，督促学生按时课后复习，严抓学生专业课学习成绩等措施，提高医学生突发公共卫生事件应急管理能力。
     

A descriptive analysis of patient education courses in undergraduate and graduate health education programs

Patient education is a necessary component of quality health care, yet little attention has been given to the preparation of health educators to work in that setting. This study seeks to determine the status of and content in patient education courses offered in professional preparation programs. Results show that 9% of respondents offered a patient education course in their academic unit, whereas 18% indicated that such a course was offered in another unit on campus. It appears there is not agreement between university faculty members and practicing patient educators on what should be taught in such a course. In addition, no significant relationship is found between (a) programs with accreditation or approval and offering a patient education course and (b) programs that prepared students for the Certified Health Education Specialist examination and offering a patient education course. Recommendations are offered for improving the preparation of health educators for the medical care setting.     

Developing a strategic plan for school health services in Massachusetts

School health service programs underwent rapid changes to meet the health needs of today's students. These needs stem largely from: a) increased number of students with special health care needs attending school, b) increased stress and time pressure on families, c) rapid restructuring of the health care system serving children, and d) recognition that schools provide opportunities to identify students with health risks. This paper describes seven components of a statewide Massachusetts plan to develop school health services by: a) setting standards, b) reviewing and revising statutes and regulations, c) promoting credentialing of school health personnel, d) providing continuing education on subjects pertinent to school health, e) exploring reimbursement systems and new funding sources, including funds from the tobacco settlement, f) exploring new models of care, and g) implementing data systems. The plan focuses on developing school nurse-managed school health services within a public health model.     

What motivates managers to coordinate the learning experience of interprofessional student teams in service delivery settings?

This article addresses the realities of providing interdisciplinary student team placements (i.e., experiential team learning for students) in healthcare settings. Three site coordinators from different clinical settings in Alberta (a geriatric assessment unit, a geriatric dementia care unit, and a primary healthcare centre), who facilitated Student Team Placements from the University of Alberta (UofA) in 2004, comment on their experiences and incentives for participating in interdisciplinary teamwork with students. The coordinators suggest that students provide input into the sites’ continuous quality improvement cycle, contribute to host organizations, and confer benefits for the student preceptors, the staff and the patients who participate. The site coordinators also recognize and accept the responsibility common to all service providers, to model a unique site culture that promotes learning/teaching of team skills for health science students. The experience of others in the literature supports our findings that two systems – the system to educate health professionals and the system that influences the health of the community – can interact so that each realizes a mutual benefit.