Thinking Outside the Box – Expanding Fieldwork

Awareness of occupational therapy as a profession has improved (haven’t we been asking for this for a long time?), and applications to OT and OTA programs have tripled in the past 5 years. What does that mean? It means the burden on clinicians is greater for providing clinical educational experiences for OT and OTA students but also providing observation experiences for those who are exploring OT.  Whether you are involved in educating fieldwork students or not, you are probably aware of the increase over the past years in requests for fieldwork as well as requests for high school students’ observations or shadowing.

As a trainer for the AOTA’s Fieldwork Education Certificate Program, I promote other ways of providing fieldwork than just the most popular 1:1 apprentice:preceptor model. Just as we as clinicians try a new technique when the old one isn’t as effective with our patients, we can do likewise in educational situations. Among Etown’s 300+ fieldwork sites, a group/collaborative or multiple student model is more prevalent in mental health settings than physical rehabilitation. Of note is that Mayo Clinic’s OTs and PTs ONLY take 3 level II students at once instead of just 1. They offer their expertise on how others can implement it. If you are interested in learning more about it, check out the Journal of Allied Health¹. Mayo has provided a model from which we are welcome to create opportunities.

Alternatives to the 1:1 model include 1:2+ (supervisor:students), 2:1 (supervisors:student), remote supervision, multiple site models and any other model you may create as long as the student is

• Meeting the level II requirements of the Accreditation Council of Occupational Therapy Education (section C of the ACOTE standards).  These include, but are not limited to: a minimum of 8 hours per WEEK of supervision; fieldwork educator is “adequately prepared” as a fieldwork educator; and the student meets “entry level” at the end of 12 weeks as your site’s OT job description describes it
• Your site’s expectations are met (including what the third-party payers require, e.g. Medicare’s line of sight supervision).

We can also think outside the box and have more than 1 supervisor in the case of 2 part-time OTs supervising 1 student. A student can also provide services at a remote location if supervision is provided appropriately.  As long as the “primary” fieldwork educator is an OT who is adequately prepared and has been employed as an OT for at least a year following initial NBCOT certification, the sky’s the limit. A secondary supervisor does not have to be an OT but could be a service provider who understands the role of OT sufficiently to guide the student.

One fieldwork site, where Elizabethtown College OT students participate in level I and II fieldwork, uses a model that emphasizes theory, reflection and creativity in treatment planning. One supervisor oversees several dyads of students who work in various units providing NON-reimbursed OT services. This gives a value-added service to the residents of the program, a learning experience for the students, and multiplies the lone OT’s effectiveness several-fold. This facility will be presenting on their model at AOTA annual conference in April in Nashville.

I am hopeful that we can begin to branch out into new models to demonstrate that OTs and OTAs are, indeed, flexible and creative problem-solvers. The future of our profession depends on educating today’s students. I am optimistic that you will embrace this opportunity and partner with your friendly neighborhood OT or OTA fieldwork coordinator to find new solutions to a growing challenge.

If you would like more information about this or any other opportunity listed here, please contact Elizabethtown College’s OT Academic Fieldwork Coordinator about how we can explore the possibilities. Chris is available at achenbachc@etown.edu or at 717-361-1146.

¹Rindflesch,A. B.,  Dunfee, H. J., Cieslak, K. C., Eischen, S. L., Trenary, T., Calley, D. Q., & Heinle, D. K. (2009). Collaborative Model of Clinical Education in Physical and Occupational Therapy at the Mayo Clinic. Journal of Allied Health, 38(3), 132–142