St. Ambrose University

School of Occupational Therapy

MOT 566 Fieldwork Level 1C

Field Experience with Older Adults

Summer 2003

 

Fieldwork Coordinators: Shelli Engelbrecht, MBAH, OTR/L

Hayes 217, (563) 333-6353, EngelbrechtShelli@sau.edu

Laura Anderson, OTR/L

Hayes 217, (563) 333-6278, AndersonLauraL@sau.edu

 

COURSE DESCRIPTION: This course will include both field experience and classroom activities. Students will be placed in settings that serve the elderly. They will have the opportunity to observe and interact with individuals and with groups. In the classroom, students will have the opportunity to discuss and synthesize their experiences. Through the clinical and classroom experiences, students should learn to appreciate the role of Occupation in Health and wellness, and develop positive Professional and Ethical integrity.

 

GRADING: A student must achieve a "P" on every major content item to pass the course. Final grades will be either satisfactory (P) or unsatisfactory (F).

 

OBJECTIVES: The basic objective for this fieldwork is for the student to gain as much hands-on experience as possible. (Fulfills the following standards: B1.1, B1.2, B1.3, B2.3, B2.4, B2.6, B2.7, B2.8, B2.9, B3.1, B3.2, B3.3, B3.4, B3.5, B4.1, B4.2, B4.3, B4.4, B4.5, B4.6, B4.7, B4.8, B4.10, B5.1, B5.2, B5.3, B5.4, B5.5, B5.6, B5.7, B5.8, B5.9, B5.10, B5.11, B5.12, B5.13, B5.14, B5.16, B5.17, B5.19, B5.20, B6.1, B6.4, B7.1, B7.2, B7.3, B7.4, B7.9, B7.14, B8.1, B9.1, B9.3, B9.4, B9.6, B9.8, B9.9, B9.10, (B10.0)) The following breakdown is given for specific objectives and learning activities (assignments) to clarify what is expected of the student and demonstrate the rationale for assignments.

Upon completion of a semester of field experience with older adult clients, with supervision, the student will:

1. Demonstrate professional communication skills by:

1.1 Writing objective client reports

Learning activities include written evaluations of clients, SOAP notes,

treatment plans, and self and facility evaluation.

1.2 Communicating effectively with clients and their family/caregivers

Learning activities include client evaluations and interactions with

clients and family/caregivers

1.3 Communicating effectively with staff, peers, and faculty

Learning activities include participation in class discussions, attendance and participation in rounds, staffings, patient-related meetings, team meetings, or other professional conferences as available and feasible

2. Demonstrate skill in data gathering from:

2.1 Client records

Learning activities include reading client records to gather background

information for evaluation/summary/treatment plan, and discussing

assigned clients with appropriate personnel

2.2 Selecting and utilizing evaluation methods/tools appropriate to the client

Learning activities include observing assigned clients and discussing

these observations with supervisor, selecting and administering

appropriate evaluation tools/methods per assigned client learned in

previous occupational therapy courses, or assigned agency

3. Demonstrate skill in treatment planning by:

3.1 Explaining rationale for treatment techniques

Learning activities include observing and discussing treatment

techniques with supervisor and written evaluation reports for

treatment program

3.2 Data analysis

Learning activities include interpreting data collected on individuals

according to frame of reference/treatment approach and assessing

strengths and areas of deficit performance and including this in

written reports. Analyze and integrate information gathered for

evaluation, treatment plan, and progress notes

3.3 Planning goals, recommending methods of treatment

Learning activities include using evaluation findings and the AOTA

Uniform Terminology to choose goals and methods for achieving each

Short-term goal, including long and short term goals, and choosing goals and methods for achieving goals for a client - and discussing with supervisor and/or academic fieldwork supervisor

3.4 Identifying the rationale for selected treatment techniques

Learning activities include presenting the rationale for recommended

program for client(s) in class discussions

4. Demonstrate skill in treatment implementation by:

4.1 Participating in the assigned facility's client program

Learning activities include attending fieldwork experience, evaluating

assigned client(s), observing and meeting with supervisor, sharing in

activities with a client and client group, planning and implementing

individual treatment sessions, encouraging client participation in

activity; and observe staff role models

4.2 Following/adhering to safety considerations

Learning activities include identifying and discussing physical factors

at agency with academic or on-site supervisor, and demonstrating safe

transfers with clients if feasible

5. Demonstrate Professional Identity by:

5.1 Being punctual for daily fieldwork experiences and scheduled class

meetings

5.2 Respecting clients and maintaining client's confidentiality

Learning activities include identifying agency's confidentiality rules

and policies and discussing them with fieldwork supervisor, maintaining agency and client confidentiality, identifying department, college, and AOTA ethics statements related to client confidentiality

5.3 Assuming responsibility for self

Learning activities include demonstrating appropriate

personal/professional appearance during client visits, discussing

schedule with agency supervisor and using time at fieldwork

effectively, adapting to agency pace, completing self-eval report,

discussing with supervisor ways to change own behavior to meet

course, personal, and/or site objectives, demonstrate initiative for

additional learning experiences, and submitting all written assignments on or before due date

5.4 Giving and receiving feedback

Learning activities include asking questions and contributing to class

discussions during fieldwork site visits, completing and discussing with

supervisor performance evals, asking for feedback on professional

behavior and performance and accuracy of written assignments

throughout the semester, receiving feedback from academic and

clinical fieldwork supervisors in an open, positive manner, and providing accurate, constructive feedback on fieldwork experience

5.5 Appreciating the various types of clients served, without regard to

race, religion, or age

Learning activities include asking questions and contributing to class

meetings and supervisor site visits, receiving feedback from fieldwork

and academic supervisor throughout the semester, assisting in

treatment planning, and participating in the assigned facilities client

program

5.6 Integrating educational experiences and related content to the

numerous variations of human behavior and conditions

Learning activities include completing and discussing with supervisor

progress notes, asking questions and contributing to class meetings and supervisor site visits, client interview, receiving feedback from clinical

and academic fieldwork supervisors throughout the semester, and

assisting in treatment planning and implementation

 

REQUIRED TEXTS:

St. Ambrose University OT Department Student Fieldwork Manual for Levels 1 & 2

Pedretti, L.W. & Early, M. (2001). Occupational therapy: practice skills for physical dysfunction. St. Louis, MO: Mosby.

OPTIONAL TEXTS:

Borcherding, S. (2000). Documentation for writing SOAP notes. Thorofare, NJ: Slack.

Kettenbach, G. (1995). Writing SOAP notes (2nd ed.). Philadelphia, PA: F.A. Davis Company.

 

 

GENERAL EXPECTATIONS

ATTENDANCE POLICY: Students are expected to complete a minimum of 30 hours each week in fieldwork. Ideally, students will complete a full-time week simulating hours of their supervisor. When a student is unable to attend a fieldwork experience (because of illness or serious inclement weather, for example), this time must be made-up. The student must call their fieldwork supervisor prior to the absence and schedule a make-up time. The course instructor must also be notified of any absences. Failure to do so may automatically result in failure of the course.

 

ASSIGNMENTS: Written assignments should be mailed* or left in Shelli’s hanging folder in Lori/Joyce’s office. Assignments are due 2 weeks after the last day of fieldwork (unless otherwise noted). This is a Pass/Fail course and you must pass this course in order to progress through the program. All assignments and FW expectations must be completed to receive a passing grade. Three late assignments will result in referral to the retention committee for possible failure of the class. Excessive re-submits could also result in failure and the need to retake the class, at the discretion of the instructor. (*If you mail your assignments in, please keep a copy of everything and mail the originals. The envelope must be postmarked by the due date.)

- Assignments for Fieldwork IC should be typed whenever feasible. If handwriting the assignments, please do so legibly. The IC assignments should all be turned in together (unless otherwise noted). Each assignment must be separate and labeled. Once you have received your graded assignments back, please save them (along with all your other fieldwork assignments) and bring them with you to school next fall, as we will be discussing them during FW Seminar.

 

ACCOMODATIONS: Students with disabilities who believe that they may need accommodations in this class (for class or clinicals) are encouraged to contact the course instructor as well as the Office of Services for Students with disabilities at 333-6161 as soon as possible to ensure that accommodations are implemented in a timely fashion.

 

TB and CPR: Students are responsible for making sure their TB and CPR are up to date and on file with Joyce and Lori prior to their fieldwork experience.

 

Code of Ethics: Students are expected to follow the AOTA Code of Ethics at all times.

 

ASSIGNMENTS:

Documentation assignments:

One progress note in SOAP format.

Write one progress note in SOAP format after participating in a treatment session with a client. In the ‘P’ section of the note, include two treatment ideas that you would use in the next session with the client.

2) One treatment plan write-up.

After participating in one-30 minute session with a client, complete a full-patient write-up (see attached sheet). This assignment is designed to focus on your observation and evaluation skills given a short amount of contact with a client. Much can be learned during a treatment session using pointed observation, interview, screenings, assessment and treatment.

Facility format documentation.

Complete three notes (any combination of initial, progress, and d/c) in the facility’s format, to your supervisor’s satisfaction. Expect your supervisor to give you detailed feedback. You may be required to re-write the notes more than once. You do not need to return a copy of this documentation to me. Your supervisor must sign-off that these notes were completed (see attached sheet). The sign-off sheet must be returned to me.

 

Cafeteria assignment:

Assignments are divided into four sections based on the threads of the MOT program: Health, Occupation, Professionalism, and Ethical Integrity. Complete assignments as instructed for each section. (See attached sheet).

 

Journal:

Keep a journal to reflect on your experiences at this facility. (See attached sheet).

 

Performance Evaluation on yourself: Complete attached sheet and share it with your supervisor at the end of your Fieldwork. For credit, you must complete each section with both a numerical score and comments on areas of strength and areas for improvement. You are responsible for returning this form to me.

 

Performance Evaluation completed by facility: Your fieldwork supervisor will need to complete this and review it with you briefly at the end of your Fieldwork. You are responsible for providing this form to your FW supervisor on your first visit to the facility and returning it to me.

 

Evaluation of the Fieldwork Experience: You are responsible for filling out this form completely. Please complete it in ink; it will stay in the files for future reference.

 

 

TREATMENT PLAN WRITE-UP

*This assignment is due at the end of your second week of FW. Please mail in the assignment in the envelope provided. This assignment must be typed.

This assignment is designed to help you start ‘thinking on your feet’ and using the short amount of evaluation time that you may have with a client to it’s potential.

Participate in one 30-minute session with a client (this can be a session of evaluation or treatment). During the session, use the activities, interviews, screenings, or assessments being used as well as observation to gather information in as many areas as you can (client’s strengths and weaknesses, occupational deficits, etc.). Use this information to develop a treatment plan that you would use when working with this client. Use the following format when reporting your findings:

Client’s current status:

Based on the session, comment on client’s status in each of the following areas:

ADL’s

Cognition—orientation, memory, safety, judgment

ROM/Strength/Coordination

Sensation

Vision/Hearing

Visual-Perception

Mobility/Balance

Pain

Sleep

Nutrition

Client’s occupational summary:

What are the occupations of this client?

Which occupations have been impacted by illness/disease/injury?

Clinical reasoning:

Summarize your client’s strengths and weaknesses, what are the person’s functional limitations?

Treatment plan:

What will your interventions be with this client? How will the client respond? What is your recommendation for frequency/duration of intervention?

Goals:

Indicate a minimum of 3 long-term goals and 3 short-term goals for this client with time frames for each. What will the client be able to accomplish as a result of these goals?

 

FACILITY DOCUMENTATION VERIFICATION

 

STUDENT: _____________________________________________________________

 

FACILITY: ______________________________________________________________

 

SUPERVISOR: __________________________________________________________

 

The student must complete three notes (any combination of initial, progress and d/c) in the facility’s format to the supervisor’s satisfaction.

 

 

Please indicate what type of notes were completed:

Note #1: Initial Progress D/C

 

Note #2: Initial Progress D/C

 

Note #3: Initial Progress D/C

 

 

 

Comments on student’s documentation skills:

 

 

 

 

 

 

 

 

 

 

Supervisor’s Signature: ________________________________ Date: ___________

 

Student’s Signature: ___________________________________ Date: ___________

 

 

CAFETERIA ASSIGNMENT

Complete assignments as indicated in each section. This assignment should be typed using the following format (using HOPE headings and paragraph format):

(Assignments with this symbol ® are required.)

HEALTH:

® List all of the diagnoses observed and worked with at this facility. Include discussion on those you found most interesting, those that were easiest/most difficult to work with. Were any of these diagnoses new to you? If so, how did you obtain more information about the diagnosis?

Choose one:

*Describe the resources that are available to promote health for clients (i.e. support groups, health fairs, free clinics, services available, etc.)?

or

*Provide education to a patient or family member regarding a diagnosis or treatment provided in occupational therapy. What information did you provide and why? What resources did you use?

OCCUPATION:

® Describe the current practice at this facility. What treatments or interventions did you see a lot of?

Choose one:

*How is occupation incorporated into treatment at this facility (list specific examples)?

or

*What are ways you could foresee incorporating occupation at this facility (list specific examples)? What would be the biggest barrier to implementing this?

 

PROFESSIONAL IDENTITY:

Choose two:

*How does OT fit at this facility?

*How is professionalism demonstrated at this facility?

*Briefly describe what changes you would make to enhance the role of OT at this facility.

 

ETHICAL INTEGRITY:

Choose one:

*Describe an ethical situation that came up during your FW. Include who was involved, how it was resolved, how would you have handled the situation? What resources were used?

or

*Interview a therapist about an ethical situation that he/she was involved in. Describe the situation, who was involved, the resolution and the person’s reactions to the situation.

 

JOURNAL

 

Keep a journal to reflect on your experiences at this facility. Ideally, you will journal several times per week, but twice weekly is the minimum. Items to reflect on in your journal should include (but are not limited to):

 

· Clients that caught your interest (include diagnosis, problem areas, interventions used, etc.). What might you have done differently if treating this person?

· Types of documentation used at this facility. How thorough and effective do you feel they are? What are the strengths/weaknesses of these types of documentation?

· Examples and description of evidence-based practice used at this facility.

· Describe the facility and how OT fits.

· Identify the disciplines that OT collaborates with and describe how they interact with one another to promote the health of the client.

· Describe the OTR/COTA relationship at this facility. Is the ratio appropriate? Do you feel the supervision is adequate?

· Most challenging situations

· Most rewarding situations

 

This can be hand-written or typed. To adequately meet the requirements of this assignment, you must discuss all of the areas listed above at least once in the journal. This journal should be a minimum of 3 pages.