2014 Fieldwork Educator Appreciation Workshop

1. 2014 Fieldwork Educator Appreciation Workshop Scoring the Fieldwork Performance Evaluation Supporting the Struggling/Failing Student

2. Welcome & Introductions • OTA Program Faculty • Community Educators

3. Session Objectives • Upon completion of the session, participants willbe able to: • Summarize the purposes of the AOTA Fieldwork Performance Evaluation (FWPE) for the OTA student. • Demonstrate an understanding of the FWPE scoring system by accurately scoring sections of the tool based on case studies. • Write one site-specific fieldwork objective that meets the RUMBA test. • Identify a minimum of 3 strategies that could be incorporated into the fieldwork experience to support a struggling/failing student. • Locate additional fieldwork resources on the ACC OTA program website.

4. Part 1 Scoring the Fieldwork Performance Evaluation

5. Discussion • Community experiences with the FWPE • Faculty experiences with the FWPE

6. AOTA Fieldwork Performance Evaluation (FWPE) for the Occupational Therapy Assistant Student • Document Highlights • Purposes • Design of the FWPE • Scoring System • *Fundamentals of Practice (Ethics and Safety Items) • Midterm and Final Scores • Individualizing the FWPE

7. Primary Purposesof the FWPEs • Measures entry-levelcompetence • Designed to differentiate the competent student from the incompetent student • Not designed to differentiate levels above entry-level competence

8. Purposes (continued) • Provides student with accurate assessment of his or her competence for entry-level practice over time • Growth occurs over time • Midterm and final scores reflect this change • Midterm scores: Satisfactory–unsatisfactory • Final scores: Pass–no pass

9. Purposes (continued) • Provides feedback to student • Provides opportunity for student self-assessment

10. Design of the FWPEs • The “doing” of the occupational therapy process is evaluated, not the individual tasks in isolation • NOT all items are equal in level of difficulty (i.e., simple to complex) • Evaluation is supplemented with development of site-specific objectives

11. Scoring System of FWPE • Each item must be scored • *Ethics and safety items must be passed • Each item rating recorded on Performance Rating Summary Sheet • All items summed up at midterm and final • Score compared to scales provided

12. Rating Scale Review RATING SCALE FOR STUDENT PERFORMANCE 4 — Exceeds Standards: Performance is highly skilled and self-initiated. This rating is rarelygivenand would represent the top 5% of all the students you have supervised. 3 — Meets Standards: Performance is consistent with entry-level practice. This rating is infrequently given at midterm and is a strong rating at final. 2 — Needs improvement: Performance is progressing but still needs improvement for entry-level practice. This is a realistic rating of performance at midterm, and some ratings of 2 may be reasonable at the final. 1 — Unsatisfactory: Performance is below standards and requires development for entry-level practice. This rating is given when there is a concern about performance.

13. Midterm and Final Scoresof the FWPE for the OTA Overall Midterm Score Satisfactory: 54 & above Unsatisfactory: 53 & below Overall Final Score Pass: 70 & above No Pass: 69 & below

14. Individualizing the FWPE • Designed for additionalobjectives to be written to add clarification • Site-specific objectives • NOT supervisor-specific • If an item is very clear and meets the RUMBA test, then there is no need to write another objective: R = Is the objective relevant to the practice setting, and is it an essential entry-level skill for the practice setting? U = Is the objective understandable to the student? M = Is the objective measurable? Can the performance be measured? B = Is the objective behavioral? Can the objective be seen? A = Is the objective achievable within the desired time frame?

15. Objectives: An Example From FWPE for the OT Student • 16. Establishes accurate and appropriate plan • School—Provides behavioral-based, measurable OT goals during IEP process • Acute Care—Overall intervention plan is achievable within client’s length of stay

16. Activity • Take a moment to reflect on your practice setting. • Select one item from the FWPE. • Write one site-specific objective that reflects the unique nature of your practice setting. • Evaluate the objective to determine whether it meets the RUMBA test.

17. Additional Resources for Developing Site-Specific Objectives • Available to all practitioners through AOTA’s website: http://www.aota.org/Education-Careers/Fieldwork/SiteObj.aspx

18. Summary • Evaluations designed to measure entry-level competence, NOT level of performance above competency • OT practice examined as a generalist • Evaluations reflect the occupational therapy process • Performance develops over time

19. Case Examples & Discussion Scoring the Fieldwork Performance Evaluation Screening/Evaluation: Sandra, OTA Student Intervention: David, OTA Student

20. Session Break

21. Part 2 Supporting the Struggling/Failing Student

22. Why Do Students Struggle With/Fail the Fieldwork Experience? • Community Insight • OTA Program Analysis

23. Why Do Students Struggle With/Fail the Fieldwork Experience? • Community Insight • In your experience, why do students struggle/fail fieldwork?

24. Why Do Students Struggle With/Fail the Fieldwork Experience? • OTA Program Analysis • Review of data over the past 5 years indicates the following reasons for failed fieldwork experiences: • Interpersonal Issues/Professional Behavior Issues • Personal Life Issues • Clinical Performance Issues/Clinical Reasoning • Academic Issues

25. Why Do Students Struggle With/Fail the Fieldwork Experience? “Academic Reasons • Student struggles with content of practice area of placement • Poor learning strategies • Practice is limited Personal Reasons • Stress, depression, physical illness, learning disability • Having second thoughts about their career choice • Unprofessional behavior or unsafe with clients • Difficulty working with other people • Poor insight (student may blame you or others for failing) • Motivation or commitment to the learning process is lacking Poor Teaching • Fieldwork educator unclear about objectives or teaching strategies • No orientation or needs assessment provided • No feedback/assistance provided when problems identified (or feedback and assistance provided too late)” http://www.philau.edu/ot/download/OTlearning%20objectivesfailingastudent.pdf

26. Why Do Students Struggle With/Fail the Fieldwork Experience? • Early-Warning Signs • Rigidity in thinking • Uncomfortable with the ambiguity present in clinical reasoning • Lack of insight • Difficulty interpreting/incorporating feedback; unable to learn from errors • Externalizing issues • Uncomfortable with physically handling clients • Low self-esteem (dependence on external validation) • Early Warning Signs (cont.) • Difficulty using supervision • Inconsistent work behaviors • Personal life issues • Passive attitude, difficulty engaging • Inconsistent work performance • Feeling overwhelmed/stressed • Unable to think on their feet • Poor time management skills Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 201). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

27. Strategies to Support the Struggling/Failing Student • Community Insight • Based on your past experience, what strategies can you share to support the struggling/failing student?

28. Additional Strategies:Utilize Resources • Contact the school and begin to develop a collaborative plan as soon as possible.

29. Additional Strategies:Identify the Specific Problem • Objectively evaluate the student’s performance and/or behavior. • Document concretely and objectively. • Analyze to determine the type of issue with which the student is struggling: • Interpersonal Issues/Professional Behavior Issues • Personal Life Issues • Clinical Performance Issues/Clinical Reasoning • Academic Issues • Other • Identifying the fundamental issue is a critical component in selecting an appropriate follow-up course of action.

30. Additional Strategies:Implement a Systematic Process for Remediation • Specifically identify the problem • Give careful thought as to the importance of the problematic behavior in the “big picture” of clinical success • Meet with the student ; discuss and document: • Your expectations • Any self-identified problems (student insight) • Exactly what you need to see from the student(clear, concrete expectations) as well as a timeline • Suggestions and/or resources to support improvement • Student strategies for how the FWE can better support his/her learning needs • Meet with the student for a follow-up; document progress (or lack thereof); modify plan as appropriate Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 208). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

31. Additional Strategies:Implement a Systematic Process for Remediation Maintain contact with the school throughout the process, the earlier the better • Identify the steps you have taken and the results • Request feedback/support as needed from the school • In the event that the student is not making progress, the school can be a valuable support for the FWE in considering any remaining options Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 208). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

32. Additional Strategies:Consider a Learning Contract • Developed primarily by the student as a means to facilitate self-directed learning • Used by some educators as a remedial tool; can also be used for students who are successful in the learning environment Costa, D. M. (2007). Clinical supervision in occupational therapy: A guide for fieldwork and practice (pp. 133-136). Bethesda, MD: AOTA Press.

33. Pros Cons Learning Contract • Provides learner with a sense of control over his/her own learning • Evaluative criteria established to determine whether learning occurred • Planning of experiences/activities becomes a collaborative effort between the student and educator • Allows student to develop ownership/commitment to learning needs • Control over learning may create anxiety/frustration for the student who is unfamiliar with self-directed/active learning • Time consuming to create • Success of the contract depends on the attitude of the educator and/or level of support from the site Costa, D. M. (2007). Clinical supervision in occupational therapy: A guide for fieldwork and practice (pp. 133-136). Bethesda, MD: AOTA Press.

34. Developing a Learning Contract • Assess prior experiences and learning: “Where have I been?” • Identify current knowledge/skills: “Where am I now?” • Develop goals and objectives: “Where do I want to go next?” • Create a study plan to meet goals and objectives: “How will I get there?” • Identify resources: “What will I need to help me?” • Establish evaluative criteria: “How will I know that I have reached my goals?” (Rose and Best (2005, p. 253) as cited in the text referenced below.) Costa, D. M. (2007). Clinical supervision in occupational therapy: A guide for fieldwork and practice (pp. 133-136). Bethesda, MD: AOTA Press.

35. Additional Strategies Based on Type of Issue • Academic/Clinical Performance Issues • Suggest remedial resources (texts, in-services, etc.) • Provide an opportunity for practice of skills • Notify the school; discuss remedial activities • Interpersonal Issues/Professional Behavior Issues • Provide direct feedback; role model appropriate/desired behaviors • Consider role play for practice • Outline clear expectations • Suggest remedial resources for skill development • Implement a plan of correction • Personal Life Issues • Maintain professional boundaries - direct the student to notify the school (students have access to free counseling/supportive resources) • Avoid becoming the student’s therapist, remember that the student must meet learning objectives • A note on program technical standards and accommodations…

36. Strategies for Prevention of Failure • Notify school immediately should any potential issues arise • Set clear expectations from day 1 • Provide routine feedback; request routine feedback from the student • Provide progressive structure to outline the experience • Structured plan for reduction of supervision/ensuring student competency

37. Importance of Feedback • Confirms areas of strength (affirming for those with low self-esteem/confidence) • Heightens student awareness of areas in need of attention • Identifies potential barriers to goal achievement/fieldwork success • Encourages alternative behaviors/actions • Motivating factor for change • Depending on delivery, can facilitate or hinder change • Demonstrates commitment of the educator • Clarifies whether there is a match between perceptions of performance and expectations between the student and educator Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 201). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

38. Case Examples & Discussion Strategies to Support the Struggling/Failing Student

39. Coping Strategies for the FWE • Seek support from the school and/or colleagues. • We are here to support you as well as the student! • Remember that failure is not the end of the world (for you or for the student). • Recognize that failing a student is a “higher form of caring, [involves] responsibility and accountability to the student, client, and the profession” (Turkett, 1987). Costa, D. M. (Ed.). (2004). The essential guide to occupational therapy fieldwork education: Resources for today's educators and practitioners (p. 201). Bethesda, MD: AOTA Press: The American Occupational Therapy Association, Inc.

40. Additional Fieldwork Resources Available on the ACC OTA Program Website at: http://www.austincc.edu/health/ota/fieldwork/educators/resources.php

41. Brainstorming Ideas for Upcoming Sessions

42. Session Wrap-Up Review of the Session Objectives

43. THANK YOU Not only for your attendance, but for your ongoing support. We could not fulfill our roles as educators without you!

44. References • Slides 6-10, 12-14, & 17 and Scoring Case Studies: AOTA’s InserviceIn A Box: Understanding the OT/OTA Fieldwork Performance Evaluations. Available at http://www.aota.org/en/Education-Careers/Fieldwork/Supervisor/Inservice.aspx