Sunday, February 12, 2012

Fieldwork Advice

Lately I've had a few conversations with co-workers and friends about students: OT, PT, ST, etc. There a lot of students where I work and they have always seemed very prepared and ready to take on the demands of being a student. However, I've known some people who have had a lot of problems with students. I'll give you a couple examples of the kinds of students we get nervous about as well as a GREAT link written by students and others for tips for OT fieldwork. A lot of it would also apply to other areas of work as well.

I personally have never had a student for the whole 12 or 8 weeks because of the nature of my past employment and most likely won't in my current position since I will often be floating from position to position. I have had experience supervising students however in both OT and COTA roles, mostly for shorter periods of time.

I think having a student is great but I wouldn't be able to do it all year long. It's a lot of extra work for the therapist, mostly in the beginning, because of the prep work and maintaining your caseload while helping the student become comfortable with everything. As time goes on and the student becomes more independent and confident with clients it's great! For me it's a great learning experience and keeps me on my toes sometimes making me a better therapist. There are good clinical educators and not so good. I hope you only end up with the good. :) There are also good students and not so good students. Your fieldwork will help shape you into the therapist you will become, so take it seriously and have fun!

Some problems that are more common are students that aren't professional: dress, talk, and actions.
Dress:  I've seen students and other co-workers who have worn clothes that are either way too tight or low where skin shows that is super unecessary. Be sensitive to the cultures you work with. Some may be very offended. If you wear scrubs, wear something underneath. When you're bending over to help them with socks, shoes, or whatever, the client can often see everything. If you don't wear scrubs, watch how low your shirts are. Also, make sure they cover your back is covered when you bend over from behind. Your clients do NOT need to see your back tattoos, butt, or what kind of underwear you're wearing.
Talk: Be compassionate. Try to make conversation if client's want to talk, but make sure it's appropriate. Often religion, politics and sometimes death are stay away topics. If it comes up, don't be one sided. A friend of mine just told me that they had a student tell a client that they didn't like a certain denomination of Christianity because they weren't 'real' or 'authentic'. Turned out that the client practiced that denomination. I can't imagine how angry I would be with that student. I've worked with others who talked often of their fear of death in front of client's that were trying to defeat it. Also, talk at their level. If they are kids, don't talk to them like they are infants and know some of them have real hard problems in life and reasons for their behaviors. If they are elderly, don't assume that they are hard of hearing and remember that they have led an important life worth learning about. Don't assume anything.
Action: I often bring water into my sessions, and offer it to my clients as well. However this is not appropriate in all settings. Always let client's know what you are going to do before you do it. We would never want to be treated in that way in our own personal appointments. Be kind. If someone is asking for directions and you don't have time, find someone to help them. Smile. You are representing that company for the time you are there, make your representation positive.

Here is the link with some great advice. It was last updated in 2003, but is from AOTA and was put together by ASD (Assembly of Student Delegates) Steering Commitee. I'll put a bit of their information here. It talks about finding housing, how to get by without much money, what will prepare you the most, advice from others, skills to brush up on, time and stress management, tips, sample code of ethics for students, and common fears about fieldwork. It's definitely worth checking out! Here is the sample code of eithics and common fears::::I'll add my comments in a different color.

Sample Fieldwork "Code of Ethics" for Students
• Respect and adhere to the philosophy, policies, and procedures of the fieldwork center.
• Respect the opinions and decisions of the supervisor. Disagreements with stated policies, procedures, or directions should be discussed with the student’s immediate supervisor. If there are problems, also discuss this with your Fieldwork Director at your school.
• Respect, protect, and conserve the resources available to the student for learning and therapeutic purposes; prevent misuse, abuse, or destruction of materials, equipment, and resources. If you want to take copies with you when you leave, ask how you can use them in the future::(Will they care if you make copies and give them to future clients?)
• Maintain the clinic environment in a safe, organized manner and contribute to the maintenance of adequate supplies and equipment.
• Respect the rights and assure the integrity of clients/patients, which includes assuring confidentiality of treatment information regardless of the source as well as maintaining a goal-directed relationship.
• Complete all documentation related to the fieldwork experience in a timely manner and in accordance with fieldwork facility guidelines.
• Adhere to the contractual agreement for fieldwork education between their fieldwork center and academic program.
• Retain proof or current malpractice, professional liability, and health insurance. Your school usually helps to take care of the malpractice and liability insurance.
• Respect, cooperate, and collaborate with other members of the health team.
• Serve as an advocate for clients, their families, the fieldwork center, and occupational therapy.
• Contact the fieldwork coordinator when resolution of fieldwork problems with the supervisor is not successful or when concerns about continuance of the fieldwork arise.
• Abide by the uniform requirements of the fieldwork facility and assure a professional appearance that does not hinder the treatment environment.
• Commit to continual learning throughout the fieldwork program by using unscheduled time to observe therapies, engage in educational interaction with other team members, review resource materials, or engage in other professionally relevant educational opportunities. Take advantage of this, it's well worth it!!
• Be accountable for actions at all times during the fieldwork experience by recognizing that the facility is first and foremost a treatment environment and secondly an educational environment.
-Treatment has priority over education, and it is the student’s responsibility to assure this process while also maintaining his/her educational needs.
• Self-direct their learning as much as possible, carefully assess the need for supervision during difficult situations, and seek appropriate supervision before proceeding. Go home and research things you may have questions on, then seek further advice after. Go back to your books, search journals, and do a Google/Bing/Yahoo search!
• Seek information regarding principles, standards, and policies of fieldwork setting, fieldwork education, and the profession.
• Support quality assurance and research related to the fieldwork setting practices
• Do not act with improperly or engage in illegal conduct while on the fieldwork or act in a way that would question one’s integrity as a professional.
Crist, P. A., & Slach (1986). Fieldwork Philosophy. Contemporary Issues in Clinical Education, 7, 67-68.

Common Fears About Level IIs
• Don’t be afraid to express your thoughts and ideas. It might seem overwhelming at first, but you will feel comfortable and very competent by the end I usually did this after sessions with my supervisor, depending on the situation. They may have already attempted that with the client or maybe not at all. Sometimes it's more appropriate to bring ideas up after or prior to a session.
• Be enthusiastic—give ideas—everyone appreciates a new or different perspective - Same as above
• Relax and remain confident
• Groups and treatment sessions will fail—it’s okay, learn from it. We still sometimes feel this way at times, it's ok.
• Don’t be afraid to be wrong, try your ideas
• Keep a positive attitude, and speak up if there is a problem
• You won’t remember everything, that’s what books are for. Use them! Agree!!! :)
• Expect the worse and hope for the best - I'd say to expect anything, always be overly prepared.
• Don’t be afraid to contribute in team meetings
• Twelve (eight) weeks go by quickly, good experience or bad - Super true
• Go in with an open mind, you may see some pretty strange things - Yup!
• Your supervisor is there to help/teach, use his/her resources
• You will not be a perfect OT/OTA, not now, not even when you have 10 years experience :)
• Don’t be afraid to try new things. Don’t be afraid to ask questions. Don’t be afraid of your patients—treat them with love and respect. Learn from your patients, they have much to teach as well
• Keep a variety of resources, including your textbooks handy for reference. Use libraries and reference materials available at the site
• Clearly communicate your learning style with your supervisor in order to prevent yourself from becoming confused or overwhelmed during your fieldwork experience
• Relax and observe other professionals
• Be prepared to spend time on documentation techniques and language
• Learn to set limits with patients
• Ask for feedback if you feel you need it
• Keep a journal or patient log, writing down specific diagnoses and how you treated each patient (i.e. treatment plan, activities, what was good, what was bad, what you would have done differently, etc).

Alzoni, D., Link, S., & Trone, J. submitted as part of course requirement for OT 410: Administration, Management, and Supervision at Elizabethtown College, Elizabethtown, PA

So there you go! There is a ton of other advice out there, but here are at least a few good niblets of info to start with. Sorry it was so long, hopefully it was helpful!!!

1 comment:

Im'ma Make OT said...

Thanks for that. I am always am lookingfor advice to make me a better student and Ot in the future.