McGill University

FIELDWORK SITE PROFILE

Fieldwork Site Profile i

CONTENTS

Appendix B: Fieldwork Site Profile Template .................................................................. 1

Fieldwork Site Profile ....................................................................................................... 2

Fieldwork Site Profile ....................................................................................................... 3

Fieldwork Site Profile ....................................................................................................... 9

Milieu : ____________________________________

UFCC- ACOTUP Canadian Guidelines on Clinical Training in Occupational Therapy – v2003 1

APPENDIX B: FIELDWORK SITE PROFILE TEMPLATE

Association of Canadian Occupational Therapy University Programs (ACOTUP)

The University Coordinator of Clinical Education needs information on the clinical

training environments, like internship prospects and resources in relation to the training

of students. The main objective of this approach is to describe the learning environment

in which the student will evolve. The information provided in the fieldwork site profile will

assist the University Clinical Coordinator and the student in making an informed training

choice. Thus, they should achieve a balanced profile for the student while complying

with their learning needs. In addition, the University Clinical Education Coordinator will

also use this information to renew the partnership with the institution.

The information provided in the clinical profile also supports the promotion of

clinical training excellence among partners and contributes to meeting the requirements

of the Canadian Association of Occupational Therapists for accreditation of university

programs.

Milieu : ____________________________________

UFCC- ACOTUP Canadian Guidelines on Clinical Training in Occupational Therapy – v2003 2

FIELDWORK SITE PROFILE

Learning Opportunities and Resources

Please fill in and return to your affiliated university occupational therapy program.

Site and Contact Information

Name of site:

Program/sector:

Contact person:

Title of contact person:

Address:

Phone* ( ) Fax*: ( )

Email*:

Web site:

Supporting material about the site and occupational therapy services attached. (e.g. pamphlet, brochure, fact sheet)

*of contact person

If you have any questions or comments, please contact your university representative:

A member of the University Fieldwork Coordinators Committee (UFCC), a sub-committee of the Association of Canadian Occupational Therapy University Programs (ACOTUP)

Indicate the name and address of the coordinator (Suggested font: Arial 11)

Milieu : ____________________________________

UFCC- ACOTUP Canadian Guidelines on Clinical Training in Occupational Therapy – v2003 3

FIELDWORK SITE PROFILE

Learning Opportunities and Resources

Copy and complete for individual location or program as appropriate.

Name of program/site: __________________________________________________

(If different from page 1)

Contact information if different from page one: Location of occupational therapy services in the building:

Characteristics of occupational Therapy Services:

1. Occupational therapy services are organized on: O.T. department basis Program

basis

No O.T. on site Other: ___________________________

2. System(s) / services in which you practice:

Public sector Private practice

Rehabilitation centre

Long-term care centre

Insurance

Outpatient clinic

Home

Community

Hospital

Day hospital

School

Other :

3. Occupational therapy roles: Direct care Indirect care Consultation

Research Administration Other:

_________________________________________

4. Client lifespan : Children Adolescents Adults Older adults

Description :

Milieu : ____________________________________

UFCC- ACOTUP Canadian Guidelines on Clinical Training in Occupational Therapy – v2003 4

Characteristics of occupational therapy services (continued):

5. Client conditions: Mental health Physical health Combined Other

6. Areas of practice and/or occupational therapy focus (e.g. occupational performance issues):

7. Hours of operations: _________________________________________________________

8. Total number of occupational therapists working at/for your site:

Full-time: ________ Part-time: ________

9. Support Staff? Yes No If yes, how many: ________

Please list the most frequently encountered issues:

Please describe the main fields of practice, interventions and programs:

Milieu : ____________________________________

UFCC- ACOTUP Canadian Guidelines on Clinical Training in Occupational Therapy – v2003 5

Learning opportunities and resources for students:

1. Access to a library (either on or off-site): Yes No

2. Internet access: Yes No

3. Other learning opportunities and resources for students (please list):

4. In addition to the University’s expected learning objectives for each placement, please state

the general learning expectations and the educational philosophy of your site to assist

students in preparing for fieldwork at your site.

Milieu : ____________________________________

UFCC- ACOTUP Canadian Guidelines on Clinical Training in Occupational Therapy – v2003 6

Administrative resources:

1. Orientation session offered upon student’s arrival:

Yes No, it will be available on (specify date): __________________

2. Space and resources available to students (phone, desk, computer or other):

3. Policies and procedures information available:

Yes, location? _____________________________________________

No, will be available on (specify date): __________________________________

4. Health and safety policy in place:

Yes No, will be available on (specify date):

__________________________________

5. Emergency procedures information available:

Yes, location? _____________________________________________

No, will be available on (specify date): __________________________________

6. Contingency plan available (for absent fieldwork educator during placement):

No, it will be available on (specify date): ____________________________________

Yes. Please outline its major characteristics:

Milieu : ____________________________________

UFCC- ACOTUP Canadian Guidelines on Clinical Training in Occupational Therapy – v2003 7

Administrative resources (continued):

7. Continuing education plan in place for occupational therapists on site:

No, it will be available on (specify date): ____________________________________

Yes. Please outline its major characteristics:

Amenities available to students:

1. Cafeteria: Yes No

2. Kitchen: Microwave oven Refrigerator Other: _______________________

3. Locker: Yes No

4. Bicycle rack: Yes No

5. Parking : Yes, cost: ______________________ No

6. Public transport available: Yes No

7. Other (please list):

(e.g. accommodation for students)

Milieu : ____________________________________

UFCC- ACOTUP Canadian Guidelines on Clinical Training in Occupational Therapy – v2003 8

Site Requirements for Students:

1. Immunization: Yes No If yes, specify in the box below.

2. Criminal record check: Yes No If yes, specify in the box below.

3. Dress code: Yes No If yes, specify in the box below.

4. A car is required during placement hours : Yes Non

If yes, describe the site “gas reimbursement” policy for OT students, in the box below..

Please specify additional information and/or requirements:

Message to Students:

Please add anything else you would like students to know or prepare for prior to starting a placement at your site.

Pre-placement information package sent to student (e.g. reading list or material, schedule): ☐ yes ☐ no

Signatures:

Profile completed by: __________________________________________ Date: ____________

(Name and title)

My organization wishes to offer placements to occupational therapy students from:

my affiliated University Canadian universities International O.T. programs

For fieldwork education purposes, I hereby authorize my affiliated university occupational therapy program to forward the information included in the FS-PRO to students and fieldwork coordinators from other occupational therapy programs.

I shall ensure that students will be supervised by qualified occupational therapists who have a minimum of one year of professional experience, and hold credentials with their provincial regulatory body.

Signature : ____________________________________________ Date : ___________

Milieu : ____________________________________

UFCC- ACOTUP Fieldwork Site Profile: Learning Opportunities and Resources – v2003 9

FIELDWORK SITE PROFILE

Learning Opportunities and Resources

Comment Form for Partnership Renewal.

Name of program/institution: ______________________________________________ The content of this page will not be passed on to the student.

Every five years, the University Clinical Coordinator will provide feedback to the

institutional representative on the clinical training program. Supervisors are asked to review

these comments and their own experience in the clinical training program and to complete

this form. The information thus obtained will be used as the basis for an analysis of the clinical

training that will be carried out by the University Clinical Coordinator and the Institutional

Representative. This periodic exchange will help to improve the quality of the clinical training

and an ongoing partnership in this field.

Aspects to improve

(At the time of the renewal and/or updating of the clinical profile form)

1. Suggest improvements or make comments about the University's clinical education

program:

Milieu : ____________________________________

UFCC- ACOTUP Fieldwork Site Profile: Learning Opportunities and Resources – v2003 10

1. What aspect of your clinical training program needs to be expanded and / or enhanced to optimize the overall clinical experience?

3. What objectives will you pursue and what action plan will you put in place to improve the

identified elements?

Forms completed by: ____________________________________ Date: ___________ Signature: _____________________________________________ Date: ___________