1/9/2015 - aota/media/corporate/files/... · 179 – 29.9% • fieldwork educator (clinical site)...
TRANSCRIPT
1/9/2015
1
Level I Survey – 2014
Commission on Education Andrea R. Bilics, PhD, OTR/L, FAOTA
Chairperson
Respondents
• Academic Fieldwork Coordinator
179 – 29.9%
• Fieldwork Educator (Clinical Site)
420 - 70.1%
• Other (please specify)
12
answered question 599
AFWC respondents
• OTA Level 68
• OT - Masters Level 76
• OT- Doctoral Level 6
Item 1
Level I should be observational only AFWC FW educator
1. Strongly agree 8 26
2. Agree 11 53
3. Neutral 14 42
4. Disagree 74 220
5. Strongly disagree 65 77
172 418
Item 2
Level I should include experiential
learning activities AFWC FW educator
1. Strongly agree 78 168
2. Agree 73 210
3. Neutral 12 24
4. Disagree 5 10
5. Strongly disagree 2 6
170 418
Item 3
Level I is to introduce students to
occupational therapy practice AFWC FW educator
1. Strongly agree 63 167
2. Agree 74 175
3. Neutral 18 25
4. Disagree 12 40
5. Strongly disagree 2 9
169 416
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Item 4
Level I should ONLY occur when
supervision is provided by an OT
practitioner
AFWC FW educator
1. Strongly agree 26 187
2. Agree 18 116
3. Neutral 18 52
4. Disagree 72 55
5. Strongly disagree 39 9
173 419
Item 5
Level I can occur in settings where
no OT practitioner is available when
it is consistent with the curriculum
design
AFWC FW educator
1. Strongly agree 66 22
2. Agree 55 72
3. Neutral 13 58
4. Disagree 22 136
5. Strongly disagree 18 131
174 419
Item 6
Level I should prepare students for
the Level II experience AFWC FW educator
1. Strongly agree 56 190
2. Agree 76 167
3. Neutral 25 51
4. Disagree 13 10
5. Strongly disagree 3 2
173 420
Item 7
There should be a uniform Level I
Competency Scale that can be
utilized across all practice settings
AFWC FW educator
1. Strongly agree 41 119
2. Agree 59 199
3. Neutral 36 80
4. Disagree 26 20
5. Strongly disagree 15 1
177 419
Level I Competencies
List of suggested items
Level I Competency Suggested competency AFWC
n=179
FW Educator
n=420
Time management 149 350
Organization 149 375
Engagement in the fieldwork experience 162 414
Self-directed learning 139 368
Reasoning/problem solving 148 378
Written communication 138 345
Initiative 158 398
Observation skills
158 408
Ratings above are combined for strongly agree and agree
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Level I Competency
Suggested competency AFWC
n=179
FW Educator
n=420
Participation in the supervisory process 121 306
Verbal communication and interpersonal skills
with patients/clients/staff/caregivers 161 399
Professional and personal boundaries 162 406
Use of professional terminology 152 343
Ratings above are combined for strongly agree and agree
And the survey says…..
• There are strong opinions that Level I
should go beyond observation only
• AFWCs support supervision for Level I by
non-OT professionals
• Level I should lay the foundation for the
Level II fieldwork experience
• There is support for a uniform Level I
evaluation tool
Conclusion
• COE has agreed to explore the
development of a uniform Level I
evaluation tool
• If interested in participating in a task group
to develop this tool please e-mail your
intent and qualifications to Andrea Bilics @
Special thanks
• To all who responded to this survey, 599 is
an impressive response rate!
• To the Philadelphia Fieldwork Consortium
for use of the items on the Level I
Fieldwork Student Evaluation [2nd ed.]
1/9/2015
1
COE Fieldwork Capacity & Retention
Survey Ad Hoc Committee:
Preliminary Results of a National Survey
on Fieldwork Capacity
AOTA Academic Leadership/Academic Fieldwork Coordinator Meeting
Fri, Oct. 24, 2014
New Orleans, LA
COE Task Group: Fieldwork Capacity &
Retention Survey Ad Hoc Committee
Tamra Trenary, COE Fieldwork Educator Representative, Mayo Clinic
Study Investigators:
Michael Roberts, Tufts University
Mary Evenson, MGH Institute of Health Professions
Jennifer Kaldenberg, Boston University
Rebecca Ozelie, Rush University
Mary Alicia Barnes, Tufts University
Acknowledgements: Matt Mekkes, former COE OTA Educator
Representative, Grand Rapids Community College
Introduction & Background
• Fieldwork as ACOTE & graduation requirements
for OT/OTA programs
• Increasing enrollments OTD/OT/OTA
• Changes in healthcare & public school funding-fiscal
challenges
• Anecdotal reports via list serve & colloquia re:
difficulty securing fieldwork placements
Enrollment data
OT student enrollment total 2014
Master’s 17,342
Doctorate 508
OTA student enrollment total 2014
9,175
Total # students
needing placements
27,025
Minimum # Level II
placements needed
54,050
Ten-year trends in enrollment & licenses
2005 2014 10-year percent change
Total OT Enrollment 10,239 17,850 74%
Number of OT licenses 101678 139154 37%
Total OTA Enrollment 4,480 9,175 105%
Number of OTA licenses 32234 52209 62%
2005 2014 10-year percent change
OT licenses per OT enrollee 9.93 7.80 -21%
OTA licenses per OTA enrollee 7.1951 5.690354 -21%
Enrollment & Program Increases: 2005-2014 2005 2014 10-year percent change
Master's: 8,440 17,342 105%
Doctoral: 201 508 153%
Total OT Enrollment 10,239 17,850 74%
Total OTA Enrollment 4,480 9,175 105%
TOTAL ENROLLMENT 14,719 27,025 84%
2005 2014 10-year percent change
Number of OT Programs (MS & Doct) 150 151 1%
Number of OTA Programs 134 175 31%
TOTAL PROGRAMS 284 326 15%
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Purpose of Survey - Objectives
Gain information on:
• Capacity of training facilities to work with students
• FW Educator perceptions of benefits & challenges
associated with fieldwork
• Factors effecting collaborative relationship between
academia & practice to inform development of
supports to address needs of all stakeholders (FW
Sites, FW Educators, Students, Academic Programs)
Methods
Descriptive, non-experimental exploratory survey
• Pilot survey (UMC & Tufts IRB approval)
• Designed using the framework of the Queensland Occupational
Therapy Fieldwork Collaborative Survey 2006-OT Student Fieldwork
Placements (with permission) (Broadbridge, et al, as referenced in
Thomas, et al., 2007)
• Included guiding questions for student research project (Davis et
al., University of Mississippi)
• Distributed to south-central U.S. Spring 2013
• n=80 respondents
Methods
National Survey
• Review of pilot survey response informed revisions to survey
• Revised survey of 49 items (Tufts IRB approval)
• National distribution Fall 2013
• Snow-balling method via Qualtrics online survey software (Survey open for 3 weeks)
• Academic Fieldwork Coordinators (AFC) at 48 programs across 42 states in continental U.S asked to email survey to all FW contacts who could also forward to other practitioners
Participant Demographics
• 1,101 respondents opened online survey; 817 completed survey (74% response rate)
• 85% Occupational Therapists
• 5% Occupational Therapy Assistants
• 10% identified as ‘other’
• 59% Student Program Coordinator (map – next slide)
• 88% had experience as FW Educator
• 12% reported no experience
• 96% reported setting currently takes fieldwork students
• 54% reported practice in teaching institutions
Participant
Demographics
Site Fieldwork Coordinators
responding to survey, n=455.
41 states and D.C. included.
Practice Settings 41%
31% 28% 27%
17% 15%
10% 9% 6% 6%
4% 4% 3% 2%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
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3
Preliminary Results
for the following Survey Items
Level I – preferred timeframe
& format
Acquisition of Applied Skills
Level II – preferred timeframe Valued supports
Model of OT & OTA Level II
Supervision Provision
Most helpful items (resources,
remediation)
Fieldwork Educator Training
AOTA FWECP
Perceived Benefits
# of OT & OTA students/yr. Perceived Challenges
Preferred Timeframes:
Level I Fieldwork
What are the preferred timeframes to take Level I students for
fieldwork placements?
• Mid-semester (40%)
• Other [no preference, anytime, not sure] (37%),
• End of semester (29%)
• Start of classes (12%).
Preferred Format:
Level I Fieldwork
What are the preferred formats to take Level I students for
fieldwork placements?
• Week-long (53%)
• Weekly (41%)
• Other [2-week, no preference, blocks of 3-4 hours,
flexible] (18%)
Preferred Timeframes:
Level II Fieldwork
What are the preferred timeframes to take Level II students for
fieldwork placements?
• Fall (58%)
• Winter (54%)
• Spring (53%)
• Summer (29%)
Models of OT Level II Student
Supervision Provision & Preferred
Model Provide% Prefer %
1 supvr:1 student 78 68
2 supvrs:1 student 37 15
OT – primary; other
secondary
19 9
1 supvr:2 students 8 2
2supvrs:2 students 3 1
Models of OTA Level II Student
Supervision Provision
Model %
1 OTR/L: 1 OTA 54
1 COTA/L: 1 OTA 33
1 OTR/L: 2 OTA 4
1 COTA/L: 2 OTA 4
1 OTR/L: OTA group 2
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Fieldwork Educator Certificate
Program Completion
How many staff at your site have completed the AOTA
Fieldwork Educator Certificate Course?
OTs OTAs
0 55%
92%
1 24%
6%
2+ 21%
2%
Opinion about AOTA FWECP
response %
Not attended – would consider online 34
Not attended – would like to attend 28
Attended – beneficial 24
Not attended – do not plan to attend 12
Attended – not beneficial 1
Are you currently aware of the resources available through the
AOTA website for fieldwork education?
No – 61% Yes – 39%
Results: # of LII OTS/year per site
LII_OTS/yr_Zero
LII_OTS/yr_One
LII_OTS/yr_Two
LII_OTS/yr_Three
LII_OTS/yr_4-6
LII_OTS/yr_7-9
LII_OTS/yr_10-15
LII_OTS/yr16plus
25%
9%
20% 14%
17%
5% 6%
4%
Results: # of LII OTAS/year per
site
LII_OTAS/yr_Zero
LII_OTAS/yr_One
LII_OTAS/yr_Two
LII_OTAS/yr_Three
LII_OTAS/yr_4-6
LII_OTAS/yr_7-9
LII_OTAS/yr_10-15
LII_OTAS/yr16plus29%
20%
8% 7%
1%
33%
Results:
Acquisition of Applied Practice Skills
Please indicate what percentage of applied practice skills (e.g.
transfers, evaluation, documentation, vital signs, group
leadership, etc.) you believe should be learned in each
setting (percentages should total 100%):
• On average, respondents indicated 55% of applied
practice skills (e.g. transfers, evaluation,
documentation, vital signs, group leadership, etc.)
should be taught in academic program, with 45%
expected to be learned during fieldwork
Most Valued Supports from
Academic Programs
Rated 1 to 4 with 1: Not Beneficial to 4: Highly Beneficial
Support for program: Highly Beneficial Total Responses Mean
Readiness/high-quality educational
preparation of student 709 783 3.89
Availability of AFC by phone or email 606 779 3.72
Face-to-face meeting with Student and
Fieldwork Educator if needed 472 795 3.43
Free conferences on issues related to
fieldwork education 449 778 3.46
Student completion of fieldwork training
seminar before placement 416 721 3.45
Lecture/continuing ed. for staff on site 363 749 3.21
Course vouchers 357 726 3.22
Regular check-in by faculty and/or AFC 356 794 3.25
Library access 262 749 2.86
Fieldwork inservices on site by AFC 227 743 2.95
Research assistance 218 706 2.79
Lecture/continuing ed. for staff on academic
program's campus 195 755 2.69
Other: 31 37 3.78
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Most helpful items to provide an
effective fieldwork experience
Answer Response %
Self-Assessment Tools for Students 514 63%
Sample Site Specific Student Objectives 438 54%
Sample Weekly Schedules 415 51%
Information on Management of Unprofessional Behavior in Students 412 51%
Fieldwork Educator Self-Assessments 398 49%
Remediation Plans Before Student Fieldwork Failure 395 49%
Articles on Supervising Students 359 44%
Sample Student Weekly Supervisory Meeting Forms 356 44%
Sample Orientation List 351 43%
Information on scoring the AOTA fieldwork Student Evaluation 348 43%
Newsletters with Fieldwork Education tips 317 39%
ACOTE Program Accreditation Requirements 178 22%
Info on How the School Determines Students’ Grades 152 19%
Other: 39 5%
Perceived Benefits
Rated 1 to 4 with 1: Not Beneficial to 4: Highly Beneficial
Question Highly beneficial Total Responses Mean
Opportunity to update practice/keep
current/apply new ideas, research, or
theories 574 810 3.65
Personal satisfaction/reward 536 809 3.61
Give back to university/profession 480 811 3.51
Opportunity to develop clinical reasoning 467 811 3.49
Opportunity to develop supervision skills 444 812 3.42
Ability to assess for future employment
potential 349 805 3.17
PDUs for NBCOT Certification 333 805 3.13
CEUs for State Licensure 329 808 3.1
Opportunity to develop organization / time
management skills 300 811 3.05
Connection to university 218 807 2.9
Meets organizational goals/objectives 190 806 2.85
Build capacity to increase workforce 187 805 2.74
Workload benefit (e.g. eases staff load) 160 811 2.48
Criteria for promotion 68 804 2.2
Perceived challenges with having
fieldwork students (all)
Rated 1 to 4 with 1: Not Challenging to 4: Highly Challenging
Challenge Highly challenging Total Responses Mean
Workload pressures / time 333 804 3.24
Physical space / availability of room / desk / computer 223 803 2.76
Concern about student capabilities 149 802 2.71
Cost of staff time 138 802 2.64
Potential difficulties with clients / consumers 48 804 2.2
Issues with 3rd party payor if students deliver services 64 803 2.15
Concern about supervisory skill readiness 46 802 2.06
Insurance indemnity issues 34 801 2.01
Lack of support from academic program 37 802 1.85
Lack of support from employer 36 801 1.73
Limitations
• Results are nearly one-year old
• Did not include items about:
• Cancellation rate
• Limiting number of contracts/school affiliations
• Turning-away schools with requests for placements
• Small response from individuals/sites that do not take fieldwork students
• Very little data about entry-level OTD placements
• Varied geography of respondents
Discussion: Instructional Methods &
Placement Settings & Students/Year
Format, Timeframes and Models:
• Level I – varied models & timeframes being used
• Level II – Fall, Winter, Spring preferred (~50+%) Vs. Summer 29%
• Supervision – 1:1 model most utilized & preferred Majority of fieldwork sites are in traditional settings Students/year: ~60% of sites report taking 1-3 OT or OTA students
Discussion: Learner
Characteristics & Competencies
• Valued Support from Academic Program:
• Readiness/high-quality educational preparation of
student
• Perceived Challenge:
• Concern about student capabilities
• Identified Needs:
• Management of unprofessional behavior
• Remediation plans before student failure
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Implications
• Academic curricula calendars: Summer is the least preferred time for Level II Fieldwork Vs. Fall/Winter/Spring
• OT versus OTA supervising OTA students
• Curriculum design and academic gate-keeping: Student performance issues are an identified need and concern about student capabilities is a challenge
• Further research may be needed into why collaborative model fieldwork is underutilized
• Valued supports require increased time from AFC role
Recommendations:
Training and Support
• Academic Programs/Consortia can support fieldwork
sites by providing:
• Education about AOTA Fieldwork Resources
• Self-assessment tools for students & FW Educators
• Sample site-specific objectives & weekly objectives
• Continuing Education (onsite)/Free conferences on
issues related to fieldwork education
• Readily available support/intervention, especially for
student performance challenges
Recommendations to
Increase Fieldwork Capacity
• Develop fieldwork in community-based, emerging practice areas – home health, day programs, private practice
• Promote awareness of AOTA FWECP & website resources
• Train more OTs, and especially OTAs, as Fieldwork Educators
• Capitalize on benefits of being a Fieldwork Educator
• Encourage and support use of collaborative supervision, 1 supervisor: 2 students
• Consider re-examining 3rd Level II in ELM programs that offer/require that option
Recommendations related to
Research Agenda
Research Agenda Relevance to Fieldwork
Pedagogy Developing a progression of practices to prepare students
for fieldwork – promoting “readiness”
Instructional
Methods
Examining framework for instruction, supervision models,
sequence of content, time
Learner
Characteristics &
Competencies
Supporting diverse students; creating performance-based
tools
Socialization to the
Profession
Identifying “best practices” for initial socialization to
profession; promoting professional behaviors & self-
directed learning
Faculty Development
and Resources
Endorsing & evaluating Fieldwork Educator Training;
studying & addressing challenges related to time & space
(Harvison et al., 2014)
Future work
• Further analysis of complete data set, including
metrics
• Coding of qualitative responses - i.e., challenges
identified by sites, preferred model of supervision
Conclusions
• Valuable information regarding needs & strategies to
strengthen collaborative relationship with fieldwork
facilities
• Evidence/justification for increased time needed for
AFC role to advocate to Academic Program
Administration
1/9/2015
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Acknowledgements
• Robin Davis, UMC, & her research students
• Deb Hanson & Camille Sauerwald
• Chuck Wilmarth & Neil Harvison
References
• AOTA Enrollment data:http://www.aota.org/-/media/Corporate/Files/EducationCareers/Accredit/2013-2014-Annual-Data-Report.pdf
• Harvison, N., Burke, J., Bilics, A.R., Gupta, J., Hanson, D., & Hooper, B. (2014, April). AOTA research agenda for OT education. Presentation at the Annual meeting of the American Occupational Therapy Association, Baltimore, MD.
• Thomas, Y., Dickson, D., Broadbridge, J., Hopper, L., Hawkins, R., Edwards, A., & McBryde, C. (2007). Benefits and challenges of supervising occupational therapy fieldwork students: Supervisors’ perspectives. Australian Occupational Therapy Journal, 54, S2-S12.
1/9/2015
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What is EXPERENTIAL fieldwork ?
SANDRA PELHAM-FOSTER, OTR/L, OTD
SARAH FOIDEL OTR/L, OTD
PACIFIC UNIVERSITY
2014
Pacific University Oregon
1984 Bachelors of OT
Transitioned Bachelor of OT to MOT in 2000
Transitioned to Entry OTD 2012
POTD initiated in 2011, transition out 2015
As of 2014 – all 3 cohorts are OTD, with first graduating class 2015
Philosophy: Transformational education to ensure students will be well
equipped to enter practice with skills and knowledge to leaders in
healthcare and the promotion of occupational justice
Entry Level OTD Program
Enter with bachelors degree
First two years on campus
Third year is distance based
Clinical education: practicum community-based
Clinical education: labs associated with course work
Four level I field work
Two Level II Field work (24 weeks total)
Doctoral Experiential Internship in specialty focus (16 weeks)
Capstone Project Doctoral capstone project provides focus and determines experiential
internship.
Capstone planning begins second semester of first year
Capstone outcome is doctoral level project, publishable manuscript, presentation
The focus of capstone is in one or more of the following areas:
Clinical Practice
Research
Administration
Leadership
Program/Policy Development
Advocacy
Education
Theory Development
Experiential Internship
Experiential Internship is a site chosen to carry out doctoral
capstone project
Students seek out setting with faculty advisor and AFWC
Experiential planning begins second semester of second year- with
a capstone proposal due at the end of Summer
Final confirmation is done in spring of third you
Experiential Internship executed in final semester of third year
Completed after level II experiences and competency exam
Addressing ACOTE Standards
Addressing C.2.3
512 hours (80%) of 640 hours must be completed within the setting engaged in activities related to focus of the project.
Addressing C.2.5:
Objectives are developed for Capstone and Experiential
Addressing C.2.1:
Designed by faculty with individualized objectives and plan for supervision
Addressing C.2.4:
Student is mentored by someone with expertise in Capstone area (does not have to be an OT)
1/9/2015
2
What is everyone’s roles?
Student Faculty Advisor
AFWC Community
Advisor
Experiential
Example Projects- Graduating Class 2015
Student Interest Focus Area Experiential Site Project
Vision Education Commission for the Blind and
Skilled Nursing
Education Materials to increase
outcomes for low vision in physical rehab
End of Life Clinical Practice
Hospice 60% hospice practice; 40%
developing special role of OT- death as an occupation
International OT Program Development
Community Center/ Orphanage in
Poland
Development of life skills program for
children in Poland
LGBTQ Community Aging
Advocacy Assisted Living/ Retirement Living
Community
Programs that support LGBTQ
adults who are transitioning into ALF/LTC
Lessons from development… Students have amazing and Innovative ideas
Increased focus on emerging practice and psychosocial emphasis
Ideas are huge and need mentorship and management (time limited; entry-level experience)
Establishing roles within faculty
Protecting level II fieldwork settings while providing opportunity for experiential implementation
Contract tracking and development
Educating community advisors on scope
of their role
Work load for AFWC increases
Increased faculty advising load
Communication demand between AFWC,
Student, and faculty