Department of Occupational Science and Occupational Therapy C r e a t i n g L e a d e r s i n O T Introduction to Fieldwork October 13 – October 23, 2009

Department of Occupational Science and Occupational Therapy

C r e a t i n g L e a d e r s i n O T

Introduction to FieldworkIntroduction to FieldworkOctober 13 – October 23, October 13 – October 23,

20092009

Pre- Placement MeetingPre- Placement MeetingOctober 1, 2009October 1, 2009

Iris Greenspoon, Fieldwork CoordinatorIris Greenspoon, Fieldwork Coordinator


Fieldwork Contact Information

Fieldwork Coordinator [Intro, FW1 and FW4] Iris Greenspoon [email protected]

Fieldwork Coordinator [FW2, FW3 and FW4] Donna Barker [email protected]

International Fieldwork Coordinator Lynn Cockburn [email protected]

Administrative Assistant – Student Affairs Nella Rupp [email protected]


Agenda for Meeting

Overview of the MSc.OT Program at the University of Toronto

Overview of the MSc.OT Fieldwork Program

Information specifically related to Introduction to Fieldwork Placement

Opportunities to get involved with the University of Toronto : Status-only appointments


Structure, Flow & Content Curriculum Structure, Flow & Content Curriculum OutlineOutline

Term 1: Foundation

Occupational Science, Research, OT Practice (including Intro to FW), Assessment, Neuromotor/Neurocognitive, Mentorship

Term 2: Enabling the Occupational Human

Research Methods, OT Practice 2, MSK Structure and Function, Psychosocial perspectives, Neuromotor/Neurocognitive, Mentorship, Skills and Technology course

Term 3: Skill Enhancement

Research, OT Practice 3, FW1, Mentorship


Year 2

Term 4: Enabling the Occupational Human in context I

Mentorship, Research Project, Enabling Occupation with Children, Adults, Older Adults, FW2

Term 5: Enabling the Occupational Human in context II

Mentorship, Research Project, Enabling Occupation with Children, Adults, Older Adults

Term 6: Advanced Application and Skill Enhancement

Mentorship, Research project, ,FW3, FW4


Enabling Occupation II

“Enabling Occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation”

New press release by CAOT in July 2007 that we have incorporated into our curriculum


Enabling Occupation II

New models and terminology Canadian Model of Client-Centred

Enablement (CMCE) Canadian Practice Process Framework

(CPPF)


Fieldwork Placements – Schedule2009 -2010

Intro to Fieldwork : Oct 13 – 23, 2009

Fieldwork II: November 2 - December 18, 2009

Fieldwork III: April 19 - June 4, 2010

Fieldwork I: May 3 - June 11, 2010

Fieldwork IV: June 28 - August 20, 2010


Fieldwork Placements

Refer to Fieldwork Resource Manual for Philosophy of fieldwork and professional standards Health policies Contracts and insurance Requirements and selection process Pre-placement communication Objectives Evaluation Process www.ot.utoronto.ca


In case of flu (H1N1)

University of Toronto’s pandemic and emergency website – www.preparedness.utoronto.ca

Students must contact us and their preceptor directly and inform him/her of their illness

Students must follow your facility guidelines regarding return to placement an appointment with the occupational health nurse

may be required seven days and 24 hours symptom free (U of T)


Objectives for Introduction to Fieldwork

Generally: Identify client issues Observe OT interventions Practice generic assessment skills


Objectives for Introduction to Fieldwork

Specifically: Begin to develop observational skills Utilize appropriate communication skills with

clients and supervising therapist(s) Begin to develop rapport with clients and

understand the stages of a professional therapeutic relationship

Apply a variety of interviewing techniques Demonstrate professional behaviour


Objectives for Introduction to Fieldwork (cont’d)

Have exposure to different types of documentation

Gain an understanding of the role of OT within the setting

Begin to understand the role of other health care professionals


Course Assignments Based on ‘Intro to Fieldwork’ Placement

Students should not be spending fieldwork hours working on these assignments.

Preceptors do not need to take time answering questions about these assignments. They are intended to be done independently by the student on non-fieldwork time.



Each student will write and submit a discussion paper based on her or his observations and experiences of their introductory fieldwork placement in relation to concepts and processes presented in OCT1131H. The contents of the paper will include:

Background: (5%)

- Describe the practice context, populations served, and the disciplines of service providers

- Describe the mechanisms that promote the accountability of service providers in your placement.

Focused Content: (20%)

- Analyze the use (or potential use) of the Canadian Practice Process Framework (CPPF) in your the placement, using the steps of the CPPF to focus analysis and discussions

- Discuss one way in which your analysis may have changed if you had used the OPPM to structure your observations.

- Analyze the use (or potential use) of research evidence to guide occupational therapy service delivery at the placement

Conclusion: (5%)

- Summarize your findings related to the use of the CPPF and research utilization (RU) in your placement

- Suggest two recommendations to enhance the use of the CPPF and RU based on your findings



CRITIQUE OF COPM AND POST-PLACEMENT REFLECTION

(Due: OCT. 29, 2009) (25%)

PART A: CRITIQUE OF COPM

Students are expected to consider the use of the COPM in relation to the assigned Introduction to Fieldwork placement setting. As details of the particular placement may not be known, students are expected to briefly describe the setting and generate specific details (as needed) in order to meaningfully consider the clinical utility of the COPM (ex. age of clients, diagnoses, practice area, setting, role of OT, etc.).

After a description of the practice setting outlined above, the strengths and limitations of the COPM should be clearly discussed in this short paper. In particular, when discussing clinical utility, students are expected to anticipate how the use of the COPM may fit with the particular setting (ex. What advantages are there to using the COPM? What challenges would there be in using the COPM? What are the psychometric properties of the COPM and how do they relate to our confidence using the COPM?). Use of references beyond assigned readings is expected. Refer to Appendix E in text for additional resources re: critiquing a measure.


POST-PLACEMENT REFLECTION

PART B:

students should complete a post-placement reflection on the actual use of the COPM, students should reflect on differences and similarities between their pre-fieldwork expectations and post-placement understanding

If the COPM was used regularly, what were some of the advantages and challenges? How may challenges to the use of COPM be realistically addressed?

If the COPM was not used, how were OPIs identified? Were any standardized tools used? Why or why not? Describe outcome measures used. What are the advantages and limitations of alternate forms of OPI identification?

generalizing learning about assessments in class to actual clinical experiences with clients


Expectations of Students While on Placement

Professional Behaviour Follow CAOT and COTO Codes of Ethics Privacy and Confidentiality OT Student Code of Conduct Attendance

Dress Code Comply with dress code of facility University Guidelines Name tags


Placement Evaluation

Students will be evaluated using a modified Competency Based Fieldwork Evaluation for OT’s (CBFE - OT) A final score only. No mid-term evaluation Evaluated on the following areas only:

Practice Knowledge Facilitating Change Professional Interactions Communication Overall Rating of Student’s Performance


Stages of Professional Competency Development

Entry-Level Student

Knowledge Application

Consolidation

Transition

Entry-Level Clinician

Stage 1

Stage 2

Stage 3

Source: Competency Based Fieldwork Evaluation for Occupational TherapistsBossers, Miller, Polatajko, Hartley, 2002


1. Knowledge Application - educating

Emphasis on development of interaction skills with clients, family, & other health care personnel

Students endeavour to apply their current academic knowledge base to actual practice

Supervision should be consistent/readily available Students require opportunities to observe & practise professional

behaviours & skills that may include assessment & intervention techniques communication with family members / other health care personnel clinical/professional reasoning specific to client centred occupational

therapy practice


2. Transition - coaching

Emphasis on practice & experience in clinical problem-solving, assessment, & intervention

Students should begin to share & assume responsibility for all components of client centred practice, such as referral analysis & assessment planning & implementation of intervention programs discharge planning & follow-up

Students should be encouraged to try & develop their own ideas/insights & should be able to engage in discussion of several solutions to occupational performance problems & viable courses of action


3. Consolidation - mentoring

Emphasis on final preparation of student to assume the role of competent, entry-level occupational therapist

Students should be encouraged to assume as much independence as possible in professional reasoning & in linking academic theory with practice

Students may require some guidance but should take responsibility for of client centred practice components: referral analysis & assessment planning & Implementation of intervention programs discharge planning & follow-up


Stage 1 Stage 2 Stage 3

Student Performance

Knowledge Application

Transition - Reflection on Action

Consolidation – Reflection in Action

Educator Supervision Style

Direct Teaching Evaluation Feedback

Coaching Consulting Mentoring

Scoring Scores 1-3

1 = low S1

2 = rudimentary S1

3 = mastery of S1 / transition to S2

Scores 3-6

3 = transition to S2

4 = rudimentary S2

5 = intermediate S2

6 = mastery of S2 / transition to S3

Scores 6-8

6 = transition to S3

7 = rudimentary S3

8 = mastery of S3 / ready to enter clinical practice

Stages of Competency Stages of Competency DevelopmentDevelopmentSource: Competency Based Fieldwork Evaluation for

Occupational TherapistsBossers, Miller, Polatajko, Hartley, 2002


Competencies of the CBFE

Practice Knowledge Discipline- specific theory and technical knowledge.

Clinical Reasoning Analytical and conceptual thinking, judgment, decision making, and problem solving.

Facilitating Change within a practice Process

Assessment, intervention planning, intervention delivery, and discharge planning

Professional Interactions and Responsibility

Relationship with clients and colleagues, legal and ethical standards


Competencies of CBFE (cont’d)

Communication Verbal, non-verbal, and written communication

Professional Development Commitment to profession, self-directed learning, and accountability

Performance Management Time and resource management, leadership


5. COMMUNICATION

Fosters open communication Listens actively Speaks clearly and appropriately Provides explanations and/or education

that is at an appropriate level for the client Writes clearly and appropriately Modifies language for the listener Uses non-verbal communication appropriately

and effectively

STAGES SCORE

1

2

3

1 - Low Stage 1 competencies2 - Rudimentary Stage 1 competencies3 - Mastery of Stage 1 competencies/ Transition to Stage 2

3 - Transition to Stage 24 - Rudimentary Stage 2 competencies5 - Intermediate Stage 2 competencies6 - Mastery of Stage 2 competencies/ Transition to Stage 3

6 - Transition to Stage 37 - Rudimentary Stage 3 competencies8 - Mastery of Stage 3 competencies/ ready to enter clinical practice

The Competency Rating Scale

Mid-term

Final

Exceptional

Entry Level Student

Entry Level Clinician

P l e a se c i rc l e t h e l e v e l o f p e r fo rm a n c e .

Unacceptable Developing

U 1 2 3 4 5 6 7 8 E

U 1 2 3 4 5 6 7 8 E


The Learning Objective Rating Scale

Mid-term

Final

Doesn’t Meet Objectives

Meets AllObjectivesVery Well

P l e a se p la c e a v e r t i c a l b a r i n t e rs e c t in g t h e fi n e l in e i n th e sh a d e d a re a

Student’s Learning Objective(s) - Communication

Objective(s) Resource(s) Required to Meet the Objective(s)

Evidence Validation

Learnin

g Objectiv

es Not R

equired F

or Intro

to F

ieldwork


Scoring of CBFE-OT

Please circle whole numbers only

Comments are important

If 2 supervisors, please come to consensus on marks


Student Evaluations

Students have been instructed to bring their CBFE-OT manuals to clinic.

Students are required to complete and review the modified Student Report on Fieldwork Placement with their preceptor(s)

Students will also be bringing the Work/Education Placement Agreement (WSIB form), the modified CBFE evaluation, their Health Form, Maskfit info, and CPR certificate on their first day.

Please contact me if you have any concerns regarding the student’s performance.


Completion of placement

Students require the following information to be returned to U of T upon completion of placement

Completed CBFE - OT (including signatures) Student Report on Fieldwork Placement Completed WSIB form (Section A.2. and Section

E- need to be completed by the Fieldwork Site)

Students will not receive a grade for fieldwork until hard copy of CBFE - OT including all necessary signatures on the form is returned to U of T.


Confidentiality

You must obtain the student’s permission to keep a copy of the student evaluation at your facility.

If permission obtained, keep in secure area.


Opportunities to get Involved

Status-Only Appointment Guidelines are on the web (http://www.rehab.utoronto.ca/Guidelines/index.htm) and will provide you with:

• Status-only appointment documentation and process• Information on the 5 status-only appointment ranks• The criteria for initial appointment, reappointment and promotion• Your privileges, responsibilities and expectations


Your status-only appointment brings you:

Privileges The right to apply for grants that require that

you hold a University appointment U of T library privileges and e-mail Reduced fee for TTC Metropass Free or reduced rates on various U of T

Continuing Education opportunities An opportunity for personal and professional

growth


Your status-only appointment brings you:

Responsibilities Stimulate, challenge and develop the clinical

capacity of students

Contribute to the development of the discipline by contributing to the body of knowledge or by advancing the quality, efficiency and effectiveness of practice

Acknowledge your affiliation with the department on all publications and scholarly works


Questions?

Documents

Department of Occupational Science and Occupational Therapy C r e a t i n g L e a d e r s i n O T Introduction to Fieldwork October 13 – October 23, 2009