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An excellent resource is available from the Occupational Therapy Outreach

Development Team, School of Medical Rehabilitation, University of Manitoba. They

have developed a “tip sheet” for each of the fieldwork placement models listed

below. See:

http://www.umanitoba.ca/faculties/medicine/units/medrehab/ot/ot_fieldwork.html

1:1 Apprenticeship Format

Most frequently used format in occupational therapy fieldwork

Apprenticeship model

1 student : 1 fieldwork educator (FWEd)

Supervision is individual

On the basis of the apprenticeship model, the student is paired with one FWEd

throughout the placement who plans, directs, and evaluates all of the student’s

work and learning.

Supervision is individual and the student is frequently mentored by the FWEd.

1:2 Multiple FW Educator Supervision Format

1 student: 2 FWEds.

Part-time staff, co-supervision for training

Same site or different sites.

Requires good communication and planning

This model usually refers to one student paired with two FWEds.

Co-supervision is done when there is part-time staff or when a therapist is being

trained to become a FWEd.

The two FWEds may work in the same site or two different sites.

When using this format, it is imperative that there be good communication and

planning among all three parties involved.

1:2 Variations: i.e. Multiple Sites

One student divided between two fieldwork sites

May be used when:

» FWEds work part-time

» Specialty area (like hand therapy)

» There is not enough work at a site to justify a full-time fieldwork

assignment

» “Test the waters” to develop a new FW site

Communication is critical between the two sites so that the student clearly

knows expectations and the two FWEds do not contradict or criticize each

other or each give the student full-time caseloads or assignments.

2:1 Student Supervision Model

2 students : 1 FWEd

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Students usually are at the same level

Power of peer supervision

This format is often used in placements where the FWEd is not always present.

Usually, but not necessarily, the two students are at the same level (e.g.,

occupational therapist, occupational therapy assistant, first year, second year)

This format introduces the power of peer supervision so that the students get

feedback from each other as well as from the FWEd.

Group

2–6 students : 1 FWEd

Supervisory sessions occur in group format

Same level or different levels; at the same site or different sites

The FWEd full-time or part-time, employed by the site or college

Students learn from each other, work as team

The FWEd challenged in beginning to facilitate the formation of group process and

establish ground rules. Supervisory sessions are provided in a group format.

Students become proficient in learning from each other and working together as a

team.

Peer

Junior student : senior student

Important to provide instruction to both groups of students

Examples include:

» Occupational therapy student supervising an occupational therapy

assistant student

» Level II student supervising a Level I student

» Level II student in his or her final week(s) orienting the new Level II

student

It is important to provide instruction to both groups of students about what you

expect—be very specific!

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Learning Activity Supervision Module: Feedback Checklist

Learning Activity: Feedback Checklist and Grid

Directions: 1. View the video on feedback.2. Using the structure of the Feedback Grid Handout, apply the strategies from the Feedback Checklistbelow.3. Participants pair-up and role play effective feedback strategies for Aubrey (OT student) and Jeanette(FWEd) from the video. First each person plans their part for either Jeanette or Aubrey according to the Feedback Checklist,

then role play both parts. (allow 5 minutes) Partner A will be Jeanette and Partner B will play Aubrey, for the first half (5 minutes) of the activity

(use Feedback Grid format to guide). Switch roles for the second half (5 minutes) of the activity (use Feedback Grid format to guide).

Tips for Effective Feedback: Feedback is best when sought by student Identify the source (s) of the feedback; source must be credible, & well-intentioned Modify feedback based on the student’s level of experience or education Focus on the behavior rather than the student himself/herself, be accurate, factual, clear and non-

judgmental Keep feedback relevant, descriptive (not evaluative), and timely Relate feedback to learning goals Preface feedback with “I” statements Avoid inflammatory language Be aware of self-esteem Avoid assumptions Give feedback privately Summarize briefly- give limited amount at any given time

Allow time to respond to feedback

On reverse side is Feedback Grid

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Learning Activity Supervision Module: Feedback Checklist

Feedback Checklist

1. Is well-timed and expected

2. Is based on first-hand or observed data

3. Is appropriate in amount

4. Is focused on changeable behaviors

5. Is phrased in descriptive, nonjudgmental language

6. Deals with specific performance, not generalities

7. Labels subjective data as such

8. Avoids assumptions.

FEEDBACK GRID

Continue… Comment on aspects of performance that were effective. Be specific, and describe impact. Highlight things you would like to see be done in the future.

Start, or do more… Identify behavior the student knows how to do, could do, or could do more often.

Consider… Highlight a point of growth for the learner, a “doable” challenge for future interactions.

Stop, or do less. . . Point out actions that were not helpful or could be harmful. Be specific, and indicate potential impact.

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Brookfield’s Critical Incident Questions: Reflective Questions for Supervision

• At what moment during this past week’s supervision did you feel the most engaged?

• When during the past week’s supervision did you feel the most

distanced? • What action did the FWEd take during this past week that you found

the most helpful? • Which of the FWEd’s actions during the past week left you feeling

confused or puzzled? • What did you learn through supervision this past week that surprised

you the most? Reflective Questions for Student Performance • “What can you do now that you couldn’t do this time last week?”

• “What do you know now that you didn’t know this time last week?”

• “What could you teach someone to know or do that you couldn’t teach

them last week?”

(Brookfield, 2006; used with permission)

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Types of Power

Proxy Power – refers to the kind of power one has because of their

relationship to people in “high” positions. “Students may do as I want

because I have friends (or relatives) in high places.”

Resource Power- this refers to the type of power that exists because the

supervisor controls resources that the students value or need. “Students may

do as I want because of the position I hold over them”.

Position Power- This type of power exists in the supervisory relationship

because of the position that the supervisor holds in the organization. “I have

power over students because of the position I hold in the organization”.

Reward Power- This refers to the type of power that exists because the

supervisor has the ability to provide rewards to supervisees. “Students may

do as I want because I can reward those who comply.”

Sanctions (coercive) Power- This type of power is the opposite of reward

power; the supervisor has the ability to punish those who don’t comply.

“Students may do as I want because I can punish those who don’t.”

Expert Power- This type of power exists because the supervisor views

him/herself as the expert, the source of absolute knowledge. “Students may

do as I want because they respect my professional knowledge & clinical

expertise.”

Favor Power – This type of power refers to the supervisor’s ability to collect

favors from others and then can call on them when he or she needs

compliance, a kind of “you owe me” mentality. “Students may do as I want

because I build a bank of favors and call on them when I need compliance.”

Personal Power – This type of power refers to that which exists because

people like the supervisor and therefore will do what he or she wants

because they want to emulate them. “Students may do as I want because

they like me and want to model their behavior after mine.”

Status Power – refers to that kind of power that exists because the

supervisor has status in the department of facility – he or she could have the

most seniority, be the oldest, have the most initials after their name, etc.

“Students may do as I want because I have status within the group – I may

be the oldest, the longest-serving, the only one with a post-graduate degree,

research grant, etc.”

Charisma Power – Refers to the kind of power that the supervisor has

because they are impressed by his or her personality, ability to influence,

charm, enthusiasm, vision, wisdom,, etc. “Students may do as I want

because they are influenced by my vision, enthusiasm, charm, or

personality.”

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Power Management Cont’d

Reflections

1. Which of these power sources do you use most frequently?

2. Which are you the least comfortable with?

3. How do these affect my role as supervisor?

4. If asked, do you think a work colleague would agree with your analysis?

5. If asked, do you think a family member would agree with your analysis?

6. What are your surprises about this knowledge?

7. Next time I have a student in the clinic, I will…

Games

1. What student games can you identify in the workplace?

2. What is the motivation for any game in clinical education?

3. What clinical educator games can you identify?

4. Can you recognize any personal favorites?

Rose & Best, 2005, p. 204

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The Difficult Learning Situation: Assessment Framework

KNOWLEDGE AND SKILL PROFESSIONAL BEHAVIOUR / ATTITUDE

PERSONAL / HEALTH

LEARNER

• Poor knowledge base• Difficulty applying and/or

integrating knowledge topractice

• Poor problem solving skillsor clinical reasoning

• Time inefficiency• Problems with case/clinical

presentations• Poor communication

and/or relationship skills• Poor manual skills• Work poorly organized

• Concern re professionalresponsibility with patientcare

• Attendanceproblems/lateness

• ‘Boundary’ concerns withpatients peers or staff

• Defensive with feedbackand/or lacks self awareness

• Disrespect towards patients,peers or staff

• Dishonesty• Poor work habits or lacks

effort – assignments notcompleted

• Mental health problems –depression, anxiety, stress,other psychiatric conditions

• Substance abuse• Physical health problems or

limitations• Personal issues –family

health problems, child orelder care, partner issues,sexual orientation issues etc.

• Financial pressures• Transportation problems

TEACHER

• Lacks knowledge ofobjectives and realisticexpectations for stage oflearner

• Expectations/objectives notestablished by teacher

• Lacks feedback skills• Fails to provide feedback

at appropriate intervals• Lacks knowledge and/ or

experience with evaluationprocess

• Problematic reaction tolearner:

-Avoidance-Rescue-Anger or rejection

• Teacher not approachable ordefensive

• Teacher inflexible andunwilling to accommodateto learner needs

• Teacher not available asrequired

Teacher health or personal problems affecting expectations, reactions or availability to student

SYSTEM

• Expectations/objectives notestablished by program

• Expectations unrealistic• Inadequate teaching and

learning resourcesavailable

• Poor communication orlack of agreement betweendifferent teachers involved

• Excessive workloaddemands

• Scheduling problems-inflexibility or inadequatenotice

• Program inflexible andunwilling to accommodateto learner needs

• ‘Culture’ of abuse,intimidation and/ordiscrimination presentwithin program

Resources not available to meet learner’s health or personal issues

© 2001 13

The Difficult Learning Situation Assessment Process

PART A

Describe the problem:

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________

*REFER TO THE ASSESSMENT FORM

PART B

Does this problem need to be addressed with the student? YES � NO � Is this problem owned by others, eg. preceptor, system? YES � NO � Is it a problem that requires change? YES � NO �

Frame the problem for the student: � type/class______________________________________________________________________ � severity _______________________________________________________________________ � impact __________________________________________________________________

Determine how, and when this will be communicated to the student (consider written and verbal). ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

If this problem is also owned by others, determine how and what will be done to address this. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Bonny Jung

© Program for Faculty Development (June, 2001)

McMaster University, Faculty of Health Sciences, Hamilton, ON

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The Difficult Learning Situation

Assessment Form Assessing the problem:

METHODS CLASS

Direct Observation Case Discussion Record Review

Knowledge & Skill

Professional Behaviour/Attitude

Personal/Health

Bonny Jung

© Program for Faculty Development (June, 2001)

McMaster University, Faculty of Health Sciences, Hamilton, ON

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Directions: Using the handout titled “The Difficult Learning Situation: Assessment Process” by McMaster University, assess the case scenario assigned to your group.

1. Part A: Describe the problem2. Part B: Discuss and answer questions3. Part B: Frame the problem for the student4. Part B: Determine how and when this will be communicated to the student5. Part B: Determine how and what will be done to address the issues (Note: Disregard “if owned by others”)

Case A: Alex Student with a Disability

Alex is in the third week of his Level II occupational therapy assistant fieldwork when he breaks his ankle playing socceer. Alex returns to the clinic with a cast and crutches. He approaches the fieldwork educator and states that he wants to request accommodations under the Americans With Disabilities Act (ADA) for an aide to assist him with transferring patients, lifting heavy equipment, and carrying items.

Case B: Betty Safety Issues

Betty has struggled with safety awareness and judgment during the first 4 weeks of her acute surgical Level II fieldwork. She forgets to lock the brakes when doing a wheelchair transfer and she cannot recall precautions for a client who had a spinal fusion. Now at in her sixth week, it seems like Betty is doing better, but she fails to check with the nursing staff prior to seeing a client with bilateral knee replacement and secondary diabetes. The client had deteriorated during the day and was not to participate in standing activities longer than 2 minutes. Betty is transferring the client from bed to do a sink-side standing toothbrush activity when her occupational therapy supervisor walks in.

Case C: Casey To Fail or Not to Fail

Casey is completing her first Level II fieldwork and is unsuccessful in meeting expectations. During the final evaluation session, the student claims that she cannot be failed because she has a learning disability and is protected by ADA. The supervisor is unaware that Casey has a disability. Casey states that she did not make a request for accommodation because she never had problems keeping up in the classroom. She has problems at the facility because of the many distractions, which make it hard for her to concentrate on doing the evaluations and documentation. The supervisor asks why Casey did not report these difficulties earlier when they had met numerous times to discuss her incomplete evaluations and documentation. Casey states, “I thought it was your role and responsibility to teach me what I needed to know.”

Case D: Daryl Professional Behavior

Daryl had an exceptional first Level II fieldwork placement in an outpatient general rehabilitation placement and

he began his second fieldwork in psychology confident that with his psychology Bachelor’s degree, this placement

was going to be a piece-of-cake. At the midpoint the supervisor is disappointed with the student’s performance

because she has concerns about the student’s professional boundaries. When Daryl is asked to educate nursing

students about the role of occupational therapy in psychology, Daryl turns the educational meeting into a social

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gathering after work. The supervisor has trouble finding Daryl on days when he is scheduled in another unit, paging

and unable to find him for 2–3 hours more than once. When she does locate Daryl, he says he was surfing the Web

for intervention ideas, but he has nothing concrete to show her. He is always asking for feedback and seems

needier than previous students. The supervisor is tired at the six week point of keeping track of him, it takes so

much time to deal with his with constant questioning , pushing the limits, and neediness.

Case E: Elizabeth

Advanced Student

Elizabeth has a master’s degree as a social worker and several years of social work experience. She is doing Level

II OT fieldwork in a community-based transition program for adults with developmental disabilities that provides

supported employment, job coaching, independent living skills, and community transportation training. Elizabeth

readily catches on to the fieldwork expectations in the community setting and is seeing a full caseload by the

fourth week of the placement. She is independently completing job-site analysis and job coaching, has conducted

one inservice for potential employers, and is setting up a database of all employers in the community where clients

are placed. At the midterm Elizabeth expresses boredom because she has already met the expectations commonly

held for students at the end of their fieldwork.

Adapted from Costa, D. (2004). (Ed.). The Essential Guide to Occupational Therapy Fieldwork Education: Resources for Today’s Educators and Practitioners. Bethesda, MD: AOTA Press.

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Directions:

Think about the various supervision models and styles that were just presented. Consider your comfort level and experience with

each model. Complete the chart below to better understand where you are now and what you would like to develop.

Models Within my

comfort zone

Doesn’t fit with

my style, I’m not

interested

Challenging, might

want to develop

Goals for areas to

develop

Situational Leadership

Directing

Coaching

Supporting

Delegating

MBTI

Extraverted vs.

Introverted

Sensing vs. Intuitive

Thinking vs. Feeling

Judging vs. Perceiving

Developmental

Stagnation

Confusion

Integration

Supervision Formats

1:1

1:2

2:1

Multiple Sites

Group

Peer

Offsite/role emerging

Collaborative

Strategies for development:

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“Field instructors must be aware of their own preferences and recognize how these

preferences affect expectations of student performance. Field instructors may

prefer students with specific personality types because of the way these students

perform or may unwittingly evaluate students most like them as successful.”

(Moore, Dettlaff, & Dietz, 2004, pp. 346–347)

The Myers-Briggs is useful with fieldwork education because it enables us to

compare our basic personality style with that of our students. The better we

understand ourselves, the better we will be able to effectively interact with our

students and negotiate or navigate differences that affect the supervisory

relationship.

Extraverted:

Uses active approach

Is open, expressive, and energetic

Processes information and solves

problems

Introverted: Uses reflective approach

Allows time to process information internally

Helps students explore issues and cases in depth

Strategies and approaches:

Help students to explore issues and

cases in depth

Slow down and allow time for

reflection and processing

Talk less and listen more

Strategies and approaches:

Help students focus on action as well as reflection

Talk more and try to be more open and expressive

Sensing Focuses on present issues and

concerns Is good at details and facts Identifies practical, step-by-step

action plans

Intuitive Encourages students to use and trust

intuition and imagination Enjoys abstract thinking and theories

and identifying patterns and

meanings Skilled at helping students see big-

picture possibilities

Strategies and approaches Be open to varied approaches, rather

than just “tried-and-true” methods

Use intuition and imagination as well as facts

Step back to consider the big picture, patterns, and new possibilities

Strategies and approaches Be more attentive to facts, details,

and issues that need attention now

Integrate theories with practical applications

Thinking Is good at solving complex problems Intellectually challenging

Is logical Uses objective, analytical approach

Feeling Is empathetic, supportive, and

collaborative

Is good at facilitating growth and development of others

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Seeks harmony and avoids conflict

Strategies and approaches

Balance theory with concrete examples and practical approaches

Take feelings and values as well as logic and analysis into consideration

Moderate tendency to be overly

challenging and critical Remember to give positive feedback

Provide challenge as well as support

Strategies and approaches

Address conflicts and problems that arise in supervisory relationship and

help students to address these issues with clients

Be more objective; take analysis and

logic as well as feelings and values into consideration

Judging

Attends to details, schedules, and deadlines

Is structured and organized; dislikes

disruption in routine or last-minute changes

Perceiving

Is spontaneous; overlooks schedules and deadlines

Is open to new and innovative

approaches; encourages students to try new approaches

Tends to procrastinate and put off tasks and decisions

Strategies and approaches Be more flexible, spontaneous, and

open to innovation Focus on process, not just on goals

or deadlines Remember to give positive feedback

Strategies and approaches Be aware of tendency to

procrastinate and miss deadlines or details

Punctually conduct supervisory sessions and do so in structured

manner Help students to develop goals and

structured treatment plans

Moore, I. S., Dettlaf, A. J., & Dietz, T. J. (2004). Field notes. Using the Myers-

Briggs type indicator in field education supervision. Journal of Social Work

Education, 40, 337–349.

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