Introduction

Fieldwork allows students to apply the skills, attitudes and behaviours developed through the academic units in the 'real world'. Curtin University's Occupational Therapy fieldwork program is designed to develop OT students' skills, behaviours, attitudes and practice competencies by continually advancing the expected learning outcomes from the first through to the final year of the course.

All the School of OT's Occupational Therapy programs are approved by the World Federation of Occupational Therapy (WFOT). WFOT's Revised Minimum Standards for the Education of Occupational Therapists 2002 will be applied to the allocation and approval of clinical placements. Graduates of WFOT approved programs will demonstrate knowledge, skills and attitudes in the following competencies ¹.

• The person-occupation-environment and its relationship to health;
• Therapeutic and professional relationships;
• Occupational therapy processes;
• Professional reasoning and behaviour;
• The context of professional practice.

According to WFOT, fieldwork placements must be in locations offering differing levels of health care (e.g. acute care, rehabilitation, disability, community or wellness) and must always include²:

• People of different age groups;
• People who have acute and chronic health needs;
• Interventions that focus on the person, the occupation, and the environment.

WFOT Guidelines state that OT students complete a minimum of 1000 hours of approved clinical fieldwork. WFOT requires at least some placements to be up to eight weeks in length and that fieldwork is spread through all years of the program. Curtin's fieldwork program provides students with more than 1200 hours of fieldwork experiences from first through to the final year of the program. The School of Occupational Therapy has developed a comprehensive database that tracks student hours and experiences throughout the course enabling the fieldwork team to validate that each student has completed the required fieldwork hours.

Students will also need to meet the standards set out in the following professional association and Curtin University documents:

1. Occupational Therapy Association Australia "Code of Ethics";
2. Occupational Therapy Association Australia (WA) "Standards of Conduct and Practice";
3. Faculty of Health Sciences "Education Fieldwork Policy";
4. Curtin University "Student Charter";
5. Curtin University's "Guiding Ethical Principles";
6. School of Occupational Therapy "Fieldwork Manual".

¹ World Federation of Occupational Therapy, Revised Minimum Standards for the Education of Occupational Therapists, Council of World Federation of Occupational Therapists, Western Australia, 2002, p13.

² World Federation of Occupational Therapy, Revised Minimum Standards for the Education of Occupational Therapists, Council of World Federation of Occupational Therapists, Western Australia, 2002, p14.

WFOT Fieldwork Hours

WFOT Guidelines state that OT students complete a minimum of 1000 hours of approved clinical fieldwork. The School of Occupational Therapy has developed a comprehensive database that tracks student hours and experiences throughout the course.

Canvassing for Fieldwork Placements

• Canvassing for fieldwork offers commences in July each - for example we will commence seeking fieldwork placements for 2009 in July 2008. Canvassing will continue via emails, phone calls and personal visits until adequate placements have been located for all students.
• please expect multiple contacts requesting fieldwork placements
• If OT's or OT sites have projects or caseloads that students could assist with, please contact the Fieldwork Team to discuss.

Supervisor Awards

In November 2004 the School of OT held its first Supervisor Awards Evening. This has become an annual event and the occasion seeks to recognise those therapists and organisations that provide fieldwork experiences "above and beyond" the expected standard. The Awards are presented at the same time as the Academic Awards to students. Students and the fieldwork team are responsible for award nomination. Students can use the form on the OT website to nominate supervisors.

Fieldwork in 2008

2008 will be the first year of the full implementation of the new fieldwork model.

Fourth year undergraduates will undertake four seven week full-time fieldwork placements. Some students will undertake four supervised placements in Perth while others will do three supervised and OT Abroad or a self-directed project.

The Graduate Entry Master of Occupational Therapy (GEM) students will undertake three full-time placements - six, nine and eight weeks in length. Second year GEM students can participate in the OT Abroad program in the final block of the year.

Figure 1 demonstrates the variable schedule of fieldwork placements for students in the 4th year undergraduate program in 2008.

Figure 1 : Fieldwork Hours - undergraduate and GEM students in 2008

The following benefits for students have been identified for the new fieldwork program relative to the previous model:

• increased number of fieldwork hours and experiences for each student;
• for fourth year undergraduates, all fieldwork placements are seven weeks full-time;
• no tutorials during the placement - thus allowing students to focus on their practical skills;
• increased mean length of fieldwork placements (increased from 5.32 to 7.4 weeks). Thus student's opportunity to observe and practice the full spectrum of the OT process and evaluate outcomes of interventions is enhanced;
• for undergraduates:
  • all full-time placements occur after the applied occupational therapy units have been completed. In the previous model, third years completed a six-week placement and had NOT completed various units (e.g. applied Neuroscience, mental health, vocational rehab) but may have been required to undertake a fieldwork placement with patients in these areas;
  • the final year of the new program becomes a pseudo-internship year with the primary focus on the professional practice of occupational therapy practice enhancing the work-readiness of new graduates in preparation for entering the workforce;
• the new model spreads all the fieldwork placements throughout the academic year reducing the quantity of placements required at the same time.

The following benefits for organisations and supervisors have been identified for the new fieldwork program:

• The new program offers fieldwork throughout the year from January to December allowing for sites to utilise students for 48 weeks per year if required. The previous program only offered fieldwork in the later half of the year, thus when OT sites request students they are not always available for fieldwork;
• The new model allows OT sites to host student's throughout the year e.g. students could facilitate group programs (e.g. for children) six times per year or three times per year (depending on need) with dates at regular intervals:
  • e.g. pairs of students could be allocated to a site for an entire year providing services to clients above and beyond the services the employed OT's could offer. Each pair of students then orientates the next pair of students reducing the administrative load on the fieldwork sit;
  • e.g. the neuro ward at a large facility could host students all year to provide one-on-one self-care retraining to patients;
• The fieldwork program is more flexible than previously - students will be able to participate in blocks of fieldwork that start every eight weeks;
• Greater flexibility in setting up multi-disciplinary fieldwork placements.

Table 1 compares the fieldwork experiences of the undergraduate and GEM programs.

Table 1: Fieldwork Hours - undergraduate and GEM students in 2008

Support to Supervisors and Students from School of OT

The School of OT at Curtin is committed to providing optimal support to students and clinical supervisors before and during fieldwork placement. In 2008, each supervisor and student will be supported through one of the following models:

• Direct supervision;
• Enhanced Fieldwork Model;
• Externally Supervised pracs.

1. Direct Supervision

The student is supervised directly by an occupational therapist/s (OT supervisor) who works on-site for the majority of the working week.

A School of OT staff member will be allocated as the Academic Supervisor. The Academic Supervisor and/or the Fieldwork Unit Coordinator will make contact with the OT supervisor on in Week 1, 3 and the final week to ensure the student is progressing adequately.

Any issues and performance problems of the student and supervisor are directed to the Academic Supervisor and/or the Fieldwork Unit Coordinator for resolution. See the section below detailing the two tiers of supports offered for students who are under-performing or failing practicums.

2. Enhanced Fieldwork Support

In 2008, some larger sites able to host two or more students per fieldwork block will be remunerated to select an on-site Clinical Education Coordinator (CEC). The CEC will maintain close contact with students and OT supervisors throughout the placement and report progress of students to the School of OT.

Any issues and performance problems of the student and supervisor are directed to the CEC. Significant performance issues will require the Fieldwork Unit Coordinator to assist with mediation and problem-solving. See the section below detailing the two tiers of supports offered for students who are under-performing or failing practicums.

3. Externally Supervised Fieldwork Placements

The School of OT places some students into fieldwork placements in some organisations where no occupational therapist is currently employed. Examples include primary schools, nursing homes, and workplaces requiring safety assessments. In all cases, the School of OT employs an experienced occupational therapist to supervise the students. The OT supervises the students via regular face-to-face meeting/s, phone and email contact.

A School of OT staff member will be allocated as the Academic Supervisor. The Academic Supervisor and/or the Fieldwork Unit Coordinator will make contact with the OT supervisor on a regular basis to ensure the student is progressing adequately.

Any issues and performance problems of the student and supervisor are directed to the OT Supervisor. Significant performance issues will require the Fieldwork Unit Coordinator to assist with mediation and problem-solving. See the section below detailing the two tiers of supports offered for students who are under-performing or failing practicums.

STUDENT PERFORMANCE ISSUES

The OT supervisor is required to highlight any concerns at the earliest possible time directly and objectively to the student, Academic Supervisor and/or on-site Clinical Education Coordinator.

During all fieldwork placements, two tiers of support are available for OT supervisors.

1. Passing Student - Support -when students are progressing adequately during the placement and are considered as passing the fieldwork placement. Contact with the OT supervisor will generally include:
   • phone or email contact with the OT supervisor prior to the midway evaluation and the final evaluation;
   • if the student is progressing adequately, no further action is taken - unless guidance or advice is requested by the OT supervisor or student.
2. Failing or At Risk Student - Support - is implemented when a student is identified as under-performing, at risk of failing or failing the fieldwork placement.

The process when student performance issues are identified is as follows:

1. As soon as performance issues or problems are identified, ddiscuss the performance issues with the student. Give specific examples to explain the problem areas and actions to improve performance.
2. If performance does not improve, contact Academic Supervisor (or Clinical Education Coordinator).
3. The OT supervisor MUST advise the student in writing that concerns exist. If student is failing, OT supervisors must inform the student that they are failing the fieldwork placement. Concerns can be documented using:
   • the midway evaluation forms;
   • Concerns Exist Form (in the Forms Package); or
   • Letter or email.
   The documentation should clearly state the student's areas of strength and areas for improvement giving demonstrated examples:
• of where, when and why the student underperformed;
• actions and behaviours they need to demonstrate in order to improve their performance.
4. If the performance issues are significant - then the Academic Supervisor (or Clinical Education Coordinator) will meet with the student and OT supervisor to discuss the problem areas.
• Ideally this meeting should occur within 24 hours of the Academic Supervisor being notified of the performance issues.
• If early in the placement then the mid-way evaluation should be brought forward and completed with the Academic Supervisor (or Clinical Education Coordinator) present.
5. On completion of this initial meeting, it is recommended that the following be utilised (although not mandatory):
   • The student could rewrite their Learning Objectives with an emphasis on specific areas of performance requiring improvement
   • The student, OT supervisor and/or the Academic Supervisor (or Clinical Education Coordinator) could write an Action Plan to address the concerns identified. An example development plan is included below:

Area for Development	Action Plan	Measurement of Performance
1. Demonstrate effective time management skills on a daily, weekly and monthly basis	1. Purchase a diary 2. Schedule appointments with clients and colleagues using diary 3. 8:30am Monday morning meeting with supervisor to discuss time management for the week ahead 4. Demonstrate flexibility in scheduling your time with clients during core clinical hours	1. Appointments and treatment sessions are scheduled in diary without double bookings or missed appointments. 2. Appointments and treatment sessions are not missed due to incorrect scheduling.

6. Regular reviews of the student's progress in relation to the documented areas of concerns and actions should occur.
   • It is recommended that a formal review of the students progress occur every week.
7. Students, who fail to demonstrate adequate improvement after being given a fail grade at the midway evaluation, could have their final evaluation brought forward. If a fail grade is given at this final evaluation, the practicum will finish earlier than the planned date and the student will be deemed to have failed the fieldwork placement.