1/9/2015 - AOTA/media/Corporate/Files/... · 179 – 29.9% • Fieldwork Educator (Clinical Site) 420 - 70.1% • Other (please specify) 12 answered question 599 AFWC respondents

1/9/2015

1

Level I Survey – 2014

Commission on Education Andrea R. Bilics, PhD, OTR/L, FAOTA

Chairperson

Respondents

• Academic Fieldwork Coordinator

179 – 29.9%

• Fieldwork Educator (Clinical Site)

420 - 70.1%

• Other (please specify)

12

answered question 599

AFWC respondents

• OTA Level 68

• OT - Masters Level 76

• OT- Doctoral Level 6

Item 1

Level I should be observational only AFWC FW educator

1. Strongly agree 8 26

2. Agree 11 53

3. Neutral 14 42

4. Disagree 74 220

5. Strongly disagree 65 77

172 418

Item 2

Level I should include experiential

learning activities AFWC FW educator


2. Agree 73 210

3. Neutral 12 24

4. Disagree 5 10


170 418

Item 3

Level I is to introduce students to

occupational therapy practice AFWC FW educator


2. Agree 74 175

3. Neutral 18 25

4. Disagree 12 40


169 416

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Item 4

Level I should ONLY occur when

supervision is provided by an OT

practitioner

AFWC FW educator


2. Agree 18 116

3. Neutral 18 52

4. Disagree 72 55


173 419

Item 5

Level I can occur in settings where

no OT practitioner is available when

it is consistent with the curriculum

design

AFWC FW educator


2. Agree 55 72

3. Neutral 13 58

4. Disagree 22 136


174 419

Item 6

Level I should prepare students for

the Level II experience AFWC FW educator


2. Agree 76 167

3. Neutral 25 51

4. Disagree 13 10


173 420

Item 7

There should be a uniform Level I

Competency Scale that can be

utilized across all practice settings

AFWC FW educator


2. Agree 59 199

3. Neutral 36 80

4. Disagree 26 20


177 419

Level I Competencies

List of suggested items

Level I Competency Suggested competency AFWC

n=179

FW Educator

n=420

Time management 149 350

Organization 149 375

Engagement in the fieldwork experience 162 414

Self-directed learning 139 368

Reasoning/problem solving 148 378

Written communication 138 345

Initiative 158 398

Observation skills

158 408

Ratings above are combined for strongly agree and agree

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Level I Competency

Suggested competency AFWC

n=179

FW Educator

n=420

Participation in the supervisory process 121 306

Verbal communication and interpersonal skills

with patients/clients/staff/caregivers 161 399

Professional and personal boundaries 162 406

Use of professional terminology 152 343

Ratings above are combined for strongly agree and agree

And the survey says…..

• There are strong opinions that Level I

should go beyond observation only

• AFWCs support supervision for Level I by

non-OT professionals

• Level I should lay the foundation for the

Level II fieldwork experience

• There is support for a uniform Level I

evaluation tool

Conclusion

• COE has agreed to explore the

development of a uniform Level I

evaluation tool

• If interested in participating in a task group

to develop this tool please e-mail your

intent and qualifications to Andrea Bilics @

[email protected]

Special thanks

• To all who responded to this survey, 599 is

an impressive response rate!

• To the Philadelphia Fieldwork Consortium

for use of the items on the Level I

Fieldwork Student Evaluation [2nd ed.]

1/9/2015

1

COE Fieldwork Capacity & Retention

Survey Ad Hoc Committee:

Preliminary Results of a National Survey

on Fieldwork Capacity

AOTA Academic Leadership/Academic Fieldwork Coordinator Meeting

Fri, Oct. 24, 2014

New Orleans, LA

COE Task Group: Fieldwork Capacity &

Retention Survey Ad Hoc Committee

Tamra Trenary, COE Fieldwork Educator Representative, Mayo Clinic

Study Investigators:

Michael Roberts, Tufts University

Mary Evenson, MGH Institute of Health Professions

Jennifer Kaldenberg, Boston University

Rebecca Ozelie, Rush University

Mary Alicia Barnes, Tufts University

Acknowledgements: Matt Mekkes, former COE OTA Educator

Representative, Grand Rapids Community College

Introduction & Background

• Fieldwork as ACOTE & graduation requirements

for OT/OTA programs

• Increasing enrollments OTD/OT/OTA

• Changes in healthcare & public school funding-fiscal

challenges

• Anecdotal reports via list serve & colloquia re:

difficulty securing fieldwork placements

Enrollment data

OT student enrollment total 2014

Master’s 17,342

Doctorate 508

OTA student enrollment total 2014

9,175

Total # students

needing placements

27,025

Minimum # Level II

placements needed

54,050

Ten-year trends in enrollment & licenses

2005 2014 10-year percent change

Total OT Enrollment 10,239 17,850 74%

Number of OT licenses 101678 139154 37%

Total OTA Enrollment 4,480 9,175 105%

Number of OTA licenses 32234 52209 62%


OT licenses per OT enrollee 9.93 7.80 -21%

OTA licenses per OTA enrollee 7.1951 5.690354 -21%

Enrollment & Program Increases: 2005-2014 2005 2014 10-year percent change

Master's: 8,440 17,342 105%

Doctoral: 201 508 153%

Total OT Enrollment 10,239 17,850 74%

Total OTA Enrollment 4,480 9,175 105%

TOTAL ENROLLMENT 14,719 27,025 84%


Number of OT Programs (MS & Doct) 150 151 1%

Number of OTA Programs 134 175 31%

TOTAL PROGRAMS 284 326 15%

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Purpose of Survey - Objectives

Gain information on:

• Capacity of training facilities to work with students

• FW Educator perceptions of benefits & challenges

associated with fieldwork

• Factors effecting collaborative relationship between

academia & practice to inform development of

supports to address needs of all stakeholders (FW

Sites, FW Educators, Students, Academic Programs)

Methods

Descriptive, non-experimental exploratory survey

• Pilot survey (UMC & Tufts IRB approval)

• Designed using the framework of the Queensland Occupational

Therapy Fieldwork Collaborative Survey 2006-OT Student Fieldwork

Placements (with permission) (Broadbridge, et al, as referenced in

Thomas, et al., 2007)

• Included guiding questions for student research project (Davis et

al., University of Mississippi)

• Distributed to south-central U.S. Spring 2013

• n=80 respondents

Methods

National Survey

• Review of pilot survey response informed revisions to survey

• Revised survey of 49 items (Tufts IRB approval)

• National distribution Fall 2013

• Snow-balling method via Qualtrics online survey software (Survey open for 3 weeks)

• Academic Fieldwork Coordinators (AFC) at 48 programs across 42 states in continental U.S asked to email survey to all FW contacts who could also forward to other practitioners

Participant Demographics

• 1,101 respondents opened online survey; 817 completed survey (74% response rate)

• 85% Occupational Therapists

• 5% Occupational Therapy Assistants

• 10% identified as ‘other’

• 59% Student Program Coordinator (map – next slide)

• 88% had experience as FW Educator

• 12% reported no experience

• 96% reported setting currently takes fieldwork students

• 54% reported practice in teaching institutions

Participant

Demographics

Site Fieldwork Coordinators

responding to survey, n=455.

41 states and D.C. included.

Practice Settings 41%

31% 28% 27%

17% 15%

10% 9% 6% 6%

4% 4% 3% 2%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

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3

Preliminary Results

for the following Survey Items

Level I – preferred timeframe

& format

Acquisition of Applied Skills

Level II – preferred timeframe Valued supports

Model of OT & OTA Level II

Supervision Provision

Most helpful items (resources,

remediation)

Fieldwork Educator Training

AOTA FWECP

Perceived Benefits

# of OT & OTA students/yr. Perceived Challenges

Preferred Timeframes:

Level I Fieldwork

What are the preferred timeframes to take Level I students for

fieldwork placements?

• Mid-semester (40%)

• Other [no preference, anytime, not sure] (37%),

• End of semester (29%)

• Start of classes (12%).

Preferred Format:

Level I Fieldwork

What are the preferred formats to take Level I students for


• Week-long (53%)

• Weekly (41%)

• Other [2-week, no preference, blocks of 3-4 hours,

flexible] (18%)

Preferred Timeframes:

Level II Fieldwork

What are the preferred timeframes to take Level II students for


• Fall (58%)

• Winter (54%)

• Spring (53%)

• Summer (29%)

Models of OT Level II Student

Supervision Provision & Preferred

Model Provide% Prefer %

1 supvr:1 student 78 68

2 supvrs:1 student 37 15

OT – primary; other

secondary

19 9

1 supvr:2 students 8 2

2supvrs:2 students 3 1

Models of OTA Level II Student

Supervision Provision

Model %

1 OTR/L: 1 OTA 54

1 COTA/L: 1 OTA 33

1 OTR/L: 2 OTA 4

1 COTA/L: 2 OTA 4

1 OTR/L: OTA group 2

1/9/2015

4

Fieldwork Educator Certificate

Program Completion

How many staff at your site have completed the AOTA

Fieldwork Educator Certificate Course?

OTs OTAs

0 55%

92%

1 24%

6%

2+ 21%

2%

Opinion about AOTA FWECP

response %

Not attended – would consider online 34

Not attended – would like to attend 28

Attended – beneficial 24

Not attended – do not plan to attend 12

Attended – not beneficial 1

Are you currently aware of the resources available through the

AOTA website for fieldwork education?

No – 61% Yes – 39%

Results: # of LII OTS/year per site

LII_OTS/yr_Zero

LII_OTS/yr_One

LII_OTS/yr_Two

LII_OTS/yr_Three

LII_OTS/yr_4-6

LII_OTS/yr_7-9

LII_OTS/yr_10-15

LII_OTS/yr16plus

25%

9%

20% 14%

17%

5% 6%

4%

Results: # of LII OTAS/year per

site

LII_OTAS/yr_Zero

LII_OTAS/yr_One

LII_OTAS/yr_Two

LII_OTAS/yr_Three

LII_OTAS/yr_4-6

LII_OTAS/yr_7-9

LII_OTAS/yr_10-15

LII_OTAS/yr16plus29%

20%

8% 7%

1%

33%

Results:

Acquisition of Applied Practice Skills

Please indicate what percentage of applied practice skills (e.g.

transfers, evaluation, documentation, vital signs, group

leadership, etc.) you believe should be learned in each

setting (percentages should total 100%):

• On average, respondents indicated 55% of applied

practice skills (e.g. transfers, evaluation,

documentation, vital signs, group leadership, etc.)

should be taught in academic program, with 45%

expected to be learned during fieldwork

Most Valued Supports from

Academic Programs

Rated 1 to 4 with 1: Not Beneficial to 4: Highly Beneficial

Support for program: Highly Beneficial Total Responses Mean

Readiness/high-quality educational

preparation of student 709 783 3.89

Availability of AFC by phone or email 606 779 3.72

Face-to-face meeting with Student and

Fieldwork Educator if needed 472 795 3.43

Free conferences on issues related to

fieldwork education 449 778 3.46

Student completion of fieldwork training

seminar before placement 416 721 3.45

Lecture/continuing ed. for staff on site 363 749 3.21

Course vouchers 357 726 3.22

Regular check-in by faculty and/or AFC 356 794 3.25

Library access 262 749 2.86

Fieldwork inservices on site by AFC 227 743 2.95

Research assistance 218 706 2.79

Lecture/continuing ed. for staff on academic

program's campus 195 755 2.69

Other: 31 37 3.78

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Most helpful items to provide an

effective fieldwork experience

Answer Response %

Self-Assessment Tools for Students 514 63%

Sample Site Specific Student Objectives 438 54%

Sample Weekly Schedules 415 51%

Information on Management of Unprofessional Behavior in Students 412 51%

Fieldwork Educator Self-Assessments 398 49%

Remediation Plans Before Student Fieldwork Failure 395 49%

Articles on Supervising Students 359 44%

Sample Student Weekly Supervisory Meeting Forms 356 44%

Sample Orientation List 351 43%

Information on scoring the AOTA fieldwork Student Evaluation 348 43%

Newsletters with Fieldwork Education tips 317 39%

ACOTE Program Accreditation Requirements 178 22%

Info on How the School Determines Students’ Grades 152 19%

Other: 39 5%

Perceived Benefits

Rated 1 to 4 with 1: Not Beneficial to 4: Highly Beneficial

Question Highly beneficial Total Responses Mean

Opportunity to update practice/keep

current/apply new ideas, research, or

theories 574 810 3.65

Personal satisfaction/reward 536 809 3.61

Give back to university/profession 480 811 3.51

Opportunity to develop clinical reasoning 467 811 3.49

Opportunity to develop supervision skills 444 812 3.42

Ability to assess for future employment

potential 349 805 3.17

PDUs for NBCOT Certification 333 805 3.13

CEUs for State Licensure 329 808 3.1

Opportunity to develop organization / time

management skills 300 811 3.05

Connection to university 218 807 2.9

Meets organizational goals/objectives 190 806 2.85

Build capacity to increase workforce 187 805 2.74

Workload benefit (e.g. eases staff load) 160 811 2.48

Criteria for promotion 68 804 2.2

Perceived challenges with having

fieldwork students (all)

Rated 1 to 4 with 1: Not Challenging to 4: Highly Challenging

Challenge Highly challenging Total Responses Mean

Workload pressures / time 333 804 3.24

Physical space / availability of room / desk / computer 223 803 2.76

Concern about student capabilities 149 802 2.71

Cost of staff time 138 802 2.64

Potential difficulties with clients / consumers 48 804 2.2

Issues with 3rd party payor if students deliver services 64 803 2.15

Concern about supervisory skill readiness 46 802 2.06

Insurance indemnity issues 34 801 2.01

Lack of support from academic program 37 802 1.85

Lack of support from employer 36 801 1.73

Limitations

• Results are nearly one-year old

• Did not include items about:

• Cancellation rate

• Limiting number of contracts/school affiliations

• Turning-away schools with requests for placements

• Small response from individuals/sites that do not take fieldwork students

• Very little data about entry-level OTD placements

• Varied geography of respondents

Discussion: Instructional Methods &

Placement Settings & Students/Year

Format, Timeframes and Models:

• Level I – varied models & timeframes being used

• Level II – Fall, Winter, Spring preferred (~50+%) Vs. Summer 29%

• Supervision – 1:1 model most utilized & preferred Majority of fieldwork sites are in traditional settings Students/year: ~60% of sites report taking 1-3 OT or OTA students

Discussion: Learner

Characteristics & Competencies

• Valued Support from Academic Program:

• Readiness/high-quality educational preparation of

student

• Perceived Challenge:

• Concern about student capabilities

• Identified Needs:

• Management of unprofessional behavior

• Remediation plans before student failure

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Implications

• Academic curricula calendars: Summer is the least preferred time for Level II Fieldwork Vs. Fall/Winter/Spring

• OT versus OTA supervising OTA students

• Curriculum design and academic gate-keeping: Student performance issues are an identified need and concern about student capabilities is a challenge

• Further research may be needed into why collaborative model fieldwork is underutilized

• Valued supports require increased time from AFC role

Recommendations:

Training and Support

• Academic Programs/Consortia can support fieldwork

sites by providing:

• Education about AOTA Fieldwork Resources

• Self-assessment tools for students & FW Educators

• Sample site-specific objectives & weekly objectives

• Continuing Education (onsite)/Free conferences on

issues related to fieldwork education

• Readily available support/intervention, especially for

student performance challenges

Recommendations to

Increase Fieldwork Capacity

• Develop fieldwork in community-based, emerging practice areas – home health, day programs, private practice

• Promote awareness of AOTA FWECP & website resources

• Train more OTs, and especially OTAs, as Fieldwork Educators

• Capitalize on benefits of being a Fieldwork Educator

• Encourage and support use of collaborative supervision, 1 supervisor: 2 students

• Consider re-examining 3rd Level II in ELM programs that offer/require that option

Recommendations related to

Research Agenda

Research Agenda Relevance to Fieldwork

Pedagogy Developing a progression of practices to prepare students

for fieldwork – promoting “readiness”

Instructional

Methods

Examining framework for instruction, supervision models,

sequence of content, time

Learner

Characteristics &

Competencies

Supporting diverse students; creating performance-based

tools

Socialization to the

Profession

Identifying “best practices” for initial socialization to

profession; promoting professional behaviors & self-

directed learning

Faculty Development

and Resources

Endorsing & evaluating Fieldwork Educator Training;

studying & addressing challenges related to time & space

(Harvison et al., 2014)

Future work

• Further analysis of complete data set, including

metrics

• Coding of qualitative responses - i.e., challenges

identified by sites, preferred model of supervision

Conclusions

• Valuable information regarding needs & strategies to

strengthen collaborative relationship with fieldwork

facilities

• Evidence/justification for increased time needed for

AFC role to advocate to Academic Program

Administration

1/9/2015

7

Acknowledgements

• Robin Davis, UMC, & her research students

• Deb Hanson & Camille Sauerwald

• Chuck Wilmarth & Neil Harvison

References

• AOTA Enrollment data:http://www.aota.org/-/media/Corporate/Files/EducationCareers/Accredit/2013-2014-Annual-Data-Report.pdf

• Harvison, N., Burke, J., Bilics, A.R., Gupta, J., Hanson, D., & Hooper, B. (2014, April). AOTA research agenda for OT education. Presentation at the Annual meeting of the American Occupational Therapy Association, Baltimore, MD.

• Thomas, Y., Dickson, D., Broadbridge, J., Hopper, L., Hawkins, R., Edwards, A., & McBryde, C. (2007). Benefits and challenges of supervising occupational therapy fieldwork students: Supervisors’ perspectives. Australian Occupational Therapy Journal, 54, S2-S12.

http://www.aota.org/-/media/Corporate/Files/EducationCareers/Accredit/2013-2014-Annual-Data-Report.pdf












1/9/2015

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What is EXPERENTIAL fieldwork ?

SANDRA PELHAM-FOSTER, OTR/L, OTD

SARAH FOIDEL OTR/L, OTD

PACIFIC UNIVERSITY

2014

Pacific University Oregon

1984 Bachelors of OT

Transitioned Bachelor of OT to MOT in 2000

Transitioned to Entry OTD 2012

POTD initiated in 2011, transition out 2015

As of 2014 – all 3 cohorts are OTD, with first graduating class 2015

Philosophy: Transformational education to ensure students will be well

equipped to enter practice with skills and knowledge to leaders in

healthcare and the promotion of occupational justice

Entry Level OTD Program

Enter with bachelors degree

First two years on campus

Third year is distance based

Clinical education: practicum community-based

Clinical education: labs associated with course work

Four level I field work

Two Level II Field work (24 weeks total)

Doctoral Experiential Internship in specialty focus (16 weeks)

Capstone Project Doctoral capstone project provides focus and determines experiential

internship.

Capstone planning begins second semester of first year

Capstone outcome is doctoral level project, publishable manuscript, presentation

The focus of capstone is in one or more of the following areas:

Clinical Practice

Research

Administration

Leadership

Program/Policy Development

Advocacy

Education

Theory Development

Experiential Internship

Experiential Internship is a site chosen to carry out doctoral

capstone project

Students seek out setting with faculty advisor and AFWC

Experiential planning begins second semester of second year- with

a capstone proposal due at the end of Summer

Final confirmation is done in spring of third you

Experiential Internship executed in final semester of third year

Completed after level II experiences and competency exam

Addressing ACOTE Standards

Addressing C.2.3

512 hours (80%) of 640 hours must be completed within the setting engaged in activities related to focus of the project.

Addressing C.2.5:

Objectives are developed for Capstone and Experiential

Addressing C.2.1:

Designed by faculty with individualized objectives and plan for supervision

Addressing C.2.4:

Student is mentored by someone with expertise in Capstone area (does not have to be an OT)

1/9/2015

2

What is everyone’s roles?

Student Faculty Advisor

AFWC Community

Advisor

Experiential

Example Projects- Graduating Class 2015

Student Interest Focus Area Experiential Site Project

Vision Education Commission for the Blind and

Skilled Nursing

Education Materials to increase

outcomes for low vision in physical rehab

End of Life Clinical Practice

Hospice 60% hospice practice; 40%

developing special role of OT- death as an occupation

International OT Program Development

Community Center/ Orphanage in

Poland

Development of life skills program for

children in Poland

LGBTQ Community Aging

Advocacy Assisted Living/ Retirement Living

Community

Programs that support LGBTQ

adults who are transitioning into ALF/LTC

Lessons from development… Students have amazing and Innovative ideas

Increased focus on emerging practice and psychosocial emphasis

Ideas are huge and need mentorship and management (time limited; entry-level experience)

Establishing roles within faculty

Protecting level II fieldwork settings while providing opportunity for experiential implementation

Contract tracking and development

Educating community advisors on scope

of their role

Work load for AFWC increases

Increased faculty advising load

Communication demand between AFWC,

Student, and faculty

Documents

1/9/2015 - AOTA/media/Corporate/Files/... · 179 – 29.9% • Fieldwork Educator (Clinical Site) 420 - 70.1% • Other (please specify) 12 answered question 599 AFWC respondents