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.     

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.     

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.     

A self-directed fieldwork program to provide alternative occupational health placements for undergraduate occupational therapy students

Second-year students of undergraduate occupational therapy at the University of Newcastle, NSW, undertake a fieldwork placement in occupational health. However, sufficient placements are not always available. A new fieldwork program attempts to meet this need. Three groups of students conducted risk assessments throughout the academic year, with generally positive results. Students enjoyed the self-directed nature of the placement and the opportunity to learn generic and occupational health related skills. Although there were some limitations to the program, we believe that fieldwork placements met the learning needs of second-year students and offered them an excellent opportunity to gain practical experience related to occupational health practice in prevention.     

Novice occupational therapists' perceptions of readiness to undertake fieldwork supervision

Aim: This study investigated new graduate occupational therapists’ perceived readiness for the fieldwork supervisor role at a metropolitan Melbourne Hospital. Methods: Data from four in‐depth individual interviews and a focus group conducted with seven Grade 1 occupational therapists were analysed thematically. An iterative process was used to develop themes from the categories of data. Results: The new graduate occupational therapists’ perceived readiness for supervising students was strongly influenced by a sense of still learning themselves. High expectations were expressed of the supervisory role. Active support and supervision from the workplace and the university are seen as neccessary. Conclusions: A deeper understanding of the supervisory role and associated skills required for new graduate therapists is needed. Support from senior colleagues and workshops conducted by the university to up‐skill the therapists are recommended.     

Clarifying ambiguity in problem fieldwork placements: Picking up and dealing with problem signals

Grounded theory methodology was used to explore the experience of fieldwork supervisors dealing with 'problem' students. Seventeen supervisors were interviewed and further data were derived from informal observation and relevant literature. What the participants in this study found difficult was ambiguity or uncertainty about the student's performance and other issues related to the fieldwork placement. The ambiguity was managed by a clarification process that occurred in three phases: the pinpointing phase during the placement, the deciding phase at the end of the placement and the closing phase after the completion of the placement. Ambiguity was evoked in the supervisors when they first picked up signals of potential problems. Discussion focuses on strategies aimed at picking up signals early enough to facilitate the clarifying process and thereby preventing the supervisor's self-doubt and personal sense of failure.     

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.     

Perceptions of fieldwork education in Malta: Challenges and opportunities

Academic upgrading of the occupational therapy programme in Malta has necessitated exploration of current fieldwork practices through a qualitative study. Data were collected through one-to-one interviews with 18 recently qualified occupational therapists. The findings showed the multi-faceted and complex nature of the fieldwork process, confirming the strong influence and relationships between the fieldwork context, the fieldwork supervisor and the different values and attitudes each learner brings to the fieldwork situation. The various practices as voiced by the participants affected the quality of their fieldwork experiences in different ways. Awareness of these key influences will pave the way forward for fieldwork education planners to provide meaningful experiences.     

Occupational therapy students' perspectives regarding international cross-cultural experiences

Background: The purpose of this study was to investigate the perspectives of occupational therapy students who have engaged in international, cross‐cultural learning and service experiences. Methods: This study utilized a qualitative, phenomenological design. Nine semi‐structured interviews were conducted with students who engaged in international learning opportunities. The interviews were coded and analyzed using a constant comparative analysis approach. Results: Three central themes emerged from the data anlysis. Connectedness is the process of forming relationships with others while engaging in cross‐cultural experiences. Students formed relationships with faculty, other students, and people within the community. Cultural awareness is the recognition and understanding of a different culture and responding to those differences. Students attempted to understand the new culture in comparison to their own lived experiences. Complexity portrays cross‐cultural opportunities as dynamic, multi‐faceted and intricate. This was demonstrated as the students raised additional questions about the conflict between their own culture and the new culture they entered. Students also identified limited orientation, support and structure with such experiences and the conflicting roles between volunteer, student, and team member. Conclusions: The ability to connect with others when building relationships in diverse cultural contexts held meaning for the students; however, the students also expressed conflict in trying to make sense of the new culture as it often challenged personal beliefs and constructs. The complexity and challenges of engaging in these opportunities needs to be recognized and further explored to assess how curricula and faculty best supports culturally responsive care.     

Cross-cultural awareness and occupational therapy education

Occupational therapy educators across the USA are designing curricula to enhance future therapists' cultural competence, in order to meet the increasing demands of serving clients from a variety of cultural backgrounds. Curricula based on an experiential learning approach to increase multicultural awareness and sensitivity have been advocated in the literature. This study describes the use of a cultural interview experience with first-year occupational therapy students and the impact of the experience on increasing students' cultural awareness, sensitivity and attitude towards another ethnic group. As part of their course assignment, students were required to interview someone who either originated from another country, or had spent at least 10 years in a foreign country. Most students interviewed international students on campus; the ethnic background of the interviewees was very diverse, and included European, South American, African, Middle Eastern and Asian backgrounds. Forty-two students provided written feedback after their interview. Content analysis showed that more than 70% of the students said the interview had a positive effect on their awareness of another cultural group; and about 45% said the interview had a positive effect on their sensitivity and attitude towards another culture. Some ethnocentric views still existed among some students. It is concluded that experiential learning in the form of interviewing an individual of another ethnic background can have a positive impact on awareness of and, to a certain extent, on sensitivity and attitude toward another cultural group. Copyright © 1999 Whurr Publishers Ltd.     

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.