FIELDWORK EDUCATION MANUAL (for facilities) Occupational Therapy Assistant Program Kent State University East Liverpool Campus

Transcription

1 FIELDWORK EDUCATION MANUAL (for facilities) Occupational Therapy Assistant Program Kent State University East Liverpool Campus 2014

2 TABLE OF CONTENTS SECTION Accreditation Information...2 Mission Statements...3 Program Philosophy...4 Program Curriculum Design...5 Program Goals and Student Learning Outcomes...5 OCAT Program Sequence of Courses...11 OCAT Program Terminology...12 SECTION The Fieldwork Experience...15 Fieldwork Experience Schedule...17 Fieldwork Educator Qualifications...18 Fieldwork Responsibilities...19 Fieldwork Experience Student Supervision...21 Fieldwork Experience Evaluation...25 Remediation / FW Evaluation...27 Students with Disabilities...27 SECTION Contract Agreement Process...31 Student Placement Process...32 Fieldwork Experience Site Request Form...33 Student Assignment of Fieldwork Sites...34 SECTION Student Fieldwork Requirements...37 Student Responsibilities...38 SECTION Fieldwork Policies and Procedures...43 Progression Standards...44 Behavior Policy...46 Attendance / Hours / Weather...47 Pregnancy / Parking / Dress Code...48 Social Network / Smoke and Tobacco Free...49 Requirements for Clinical Sites / Safety...50 FERPA / Resources / Remediation Policy & Plan...51

3 SECTION Level I Fieldwork Assignments...57 Directed Log / Feedback Form...59 Orientation Report...61 Patient / Client Interview (Psyche)...63 Patient Interview Form (Physical Dysfunction)...65 Treatment Plan...67 Inter-professional Healthcare Delivery Activity...68 ADL Activity Checklist...69 Self-Assessment...71 Student Evaluation of Fieldwork Experience...73 Level I Fieldwork Objectives...75 Fieldwork Performance Evaluation Directions...76 Fieldwork Performance Evaluation...77 SECTION Level II Fieldwork Assignments...81 Directed Log / Feedback Form...83 Orientation Report...84 Inter-professional Healthcare Delivery Activity...85 Student In-service Assessment...86 Student In-service Evaluation...87 Group Protocol Format (Psychosocial)...88 ADL Activity Checklist (Physical Dysfunction)...89 Level II Fieldwork Objectives...90 SECTION Code of Ethics

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5 KENT STATE UNIVERSITY EAST LIVERPOOL CAMPUS OCCUPATIONAL THERAPY ASSISTANT PROGRAM The Occupation Therapy Assistant Technology Program is fully accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association (AOTA), 4720 Montgomery Lane, Suite 200, Bethesda, MD , Phone: (301) 652-AOTA; Web: Graduates of accredited programs will be able to sit for the national certification examination for Occupational Therapy Assistants administered by the National Board for Certification of Occupational Therapists (NBCOT). After successful completion of the exam, the individual will be a Certified Occupational Therapy Assistant (COTA). Most states require licensure in order to practice; however, state licensures are usually based on the results of the NBCOT Certification Examination. 2

6 Institution Mission The mission of Kent State University is to prepare students for responsible citizenship and productive careers, broaden intellectual perspectives and foster ethical and humanitarian values. Our faculty and staff are engaged in teaching, research, creative expression, service, and partnerships that address the needs of a complex and changing world. Kent State s eight-campus network, anchored by the largest residential campus in the region, serves as a key resource for economic, social, cultural and technological advancement. Kent State is a supportive and inclusive learning community devoted to teaching excellence and academic freedom. By discovering and sharing knowledge in a broad array of graduate and undergraduate programs, Kent State University meets the dynamic needs of a global society. East Liverpool Campus Mission Kent State University East Liverpool, an open admission campus, provides high quality credit and non-credit courses and educational programs, career preparation, stimulation of critical thinking, and enhancement of creative and educational activity. Located in the Appalachian region, this campus also serves as a cultural center, thereby enhancing the quality of life. Educational opportunities and programs provide insight into local cultures, and increase understanding and appreciation of the rich and diverse cultural heritage of the region. Although regionally unique, Kent State East Liverpool shares the eight-campus network mission: to advance knowledge and creative activity, and to further the fulfillment of key societal goals. Occupational Therapy Assistant Technology Mission The Occupational Therapy Assistant Technology Program at Kent State University shares the 8 campus network mission to advance quality student education and clinical competency to fulfill key societal goals for a diverse cultural region. Through the pursuit of excellence in personal and professional development, students will demonstrate the ability to utilize critical thinking, and clinical reasoning to complete therapeutic interventions based on knowledge acquired from theory, technical skills and research. This knowledge and newly acquired skills will lead to an Applied Science Associate Degree in Occupational Therapy Assistant Technology, and eligibility to become certified and licensed to practice, under the supervision of a Registered Occupational Therapist. 3

7 Program Philosophy Our department has the following beliefs about occupational therapy. Humans are intrinsically motivated to master their environment through the successful performance in daily activities or occupations (purposeful and meaningful engagement in life activities). Mastery of occupations is usually achieved in the course of normal development with adaptive skills being learned sequentially. The program believes that occupational development occurs through sequential acquisition of skills. The student initially develops competency in psychosocial skills and theories which are utilized throughout the curriculum and are therefore presented early in the program. The next step in occupational development is acquiring skills in physical dysfunction. Competency in pediatric populations requires the combination of the previously acquired knowledge with specialty skills and therefore this is presented later in the program. Mental or physical illness or disability at any stage may interrupt the ability to successfully participate in occupations, tasks or activities and adapt to the environment. Occupational therapy encourages and facilitates occupations and occupational roles through the restoration or enhancement of function, adaptation of the environment and/or teaching compensatory techniques. The individual s acceptable capacity to interact with the environment within the limitation of a disability will result in improved quality of life through the collaboration of the OT practitioner, client and others. Occupational therapy also promotes health and wellness to foster normal development, the ability to participate in occupations and the occupational role to those who are at risk of developing an illness, injury, etc. (AOTA, Definition of Occupational Therapy for the AOTA Model Practice Act). The program at Kent State University believes that learning is a dynamic developmental process involving one s cognitive, affective and psychomotor skills. Bloom s Taxonomy or learning domains illustrates this process defining how students expand their knowledge and develop intellectual skills, grow emotionally and acquire technical skills related to occupational therapy service delivery. Students are admitted into the program with varied values, beliefs and attitudes, differing degrees of interaction skills and limited understanding of the profession. It is the program s responsibility to foster problem solving, critical thinking, and clinical reasoning skills to facilitate development in knowledge, skills and attitudes pertaining to the profession. 4

8 CURRICULUM DESIGN Program Goals and Student Learning Outcomes In keeping with the Program Philosophy, the curriculum design is based on the developmental model utilizing Bloom s Taxonomy when determining program goals and student learning outcomes. Themes/threads were designed to guide student learning outcomes within the three learning domains. Each domain increases in complexity. Themes/Threads of the curriculum: 1. Academic Foundational Content 2. Personal Development 3. Basic Tenets of Occupational Therapy and Theoretical Perspectives 4. Occupational Therapy Practice 5. Professional Development 6. Research (evidence based-practice) Levels of the curriculum: 1. Affective growth of feelings and emotional areas (attitude) 2. Cognitive mental skills (knowledge) 3. Psychomotor manual or physical skills (skills) Academic (Pre-requisite) Foundational Content: Academic foundational content provides students with basic knowledge of the human body and development, concepts of occupation related to socioeconomic changes, cultural issues, diversity factors and life style choices in society. It prepares students for participation in classroom activities and the provision of OT services in various clinical settings. Affective 1. Participate in class discussions, presentations and other activities to fully understand the concepts being presented. 2. Being able to question concepts, and new ideas to enhance knowledge. Cognitive 1. Recall, comprehend function & structure of the human body, human development throughout the life span. 2. Recall, comprehend concepts of occupation and human behavior, including the role of socioeconomic changes, cultural issues, diversity factors, prevailing health and welfare issues and lifestyle choices in society. 3. Recall, comprehend basic effects of physiological, psychological, & sociological aspects of life on human beings. Psychomotor 1. Utilize academic foundational concepts when providing OT services in various clinical settings. 2. Communicate effectively with peers & diverse populations when providing OT services. 5

9 Personal Development Personal development provides the basis for the development and utilization of intra & interpersonal skills required for interaction with clients and peers. Affective 1. Develop intra & interpersonal skills, and intrinsic motivation to succeed in the OT program. 2. Develop self-confidence to be successful in the OTA program. Cognitive 1. Understand the need for self-assessment as a method of determining areas requiring positive change for ongoing personal growth & development. 2. Integrate insight, intuition, empathy & inquisitiveness when providing OT services. 3. Synthesize knowledge to develop the ability to interact with diverse populations. Psychomotor 1. Utilize intra & interpersonal skills when interacting with peers and clients during the OT process. Tenets of Occupational Therapy Theory & Techniques Tenets of occupational therapy theory and techniques provides students with basic OT philosophies, theories, concepts, and models required to develop critical thinking and problem solving skills when delivering OT services. Affective 1. Participate in class discussion, presentations and other activities to fully understand the concepts being presented. 2. Being able to question concepts, models and new ideas to enhance knowledge. Cognitive 1. Understand the philosophy & theories of the profession. 2. Understand the meaning of occupation in relation to the residual disabling effects of physical and mental illness. 3. Analyze tasks in relationship to areas of occupation, performance skills & patterns, activity demands, contexts and client factors using critical thinking and clinical reasoning. 4. Integrate tasks & theories into interventions to improve client skills in relationship with occupation & the environment. 5. Synthesize knowledge to support client engagement in occupation to support participation in contexts. OT Practice and Framework: Domain and Process Psychomotor 1. Utilize various OT theories & techniques when providing OT services to improve client ability to participate in occupations, resume the occupational role & interact with the environment. 2. Use clinical reasoning, problem solving & critical thinking skills when providing OT services to diverse populations. Occupational Therapy Practice Occupational therapy practice provides the basis for providing OT services from screening clients to provision of interventions based on client condition or disability. Affective 6

10 1. Participate in class discussions, presentations & other activities to fully understand the concepts being presented. 2. Being able to question concepts, and new ideas to enhance knowledge. Cognitive 1. Understand the use of occupation-based interventions to enhance client roles and health and wellness. 2. Assist in the application, analysis & documentation of the OT process from screening to discharging clients utilizing critical thinking, problem solving, and clinical reasoning with the completion of client interventions. 3. Integrate the use of purposeful activity & occupation-based interventions to support client participation. 4. Provide OT services to diverse populations based on particular contexts. Psychomotor 1. Utilize clinical reasoning, critical thinking, & problem solving skills when determining appropriate interventions to support client participation in occupations & the occupational role. 2. Adapt the environment to support client participation in occupations & the occupational role. Professional Development Professional development provides the basis for ethical and professional behaviors, life-long learning, and ability to advocate and promote the profession. Affective 1. Recognizes professional behaviors to be a part of the foundation of the profession. 2. Accepts responsibility for developing values, beliefs & attitudes that are congruent with those of the profession. Cognitive 1. Understand AOTA s Code of Ethics, Core Values & Attitudes, & Standards of Practice as the basis for professional behavior. 2. Analyze professional needs to seek strategies to enhance knowledge base, & increase education and training & explore various aspects of the profession. 3. Integrate professional behaviors to become an advocate for the profession while increasing skills. 4. Synthesize & integrate professional behaviors & habits to facilitate life-long learning skills. Psychomotor 1. Advocate for the profession. 2. Become a life-long learner. 3. Participate in professional organizations. Research Research provides the basis for exploration of literature and application of current trends and knowledge with client interventions. Affective 1. Develop intrinsic motivation to explore professional literature to increase knowledge in the profession. 7

11 Cognitive 1. Understand professional literature & how it relates to OT occupation-based practice and recognize the importance of research in the development of the profession. 2. Analyze current relevant literature that relates to practice settings, diagnoses, contexts, & client based interventions. 3. Integrate use of personal and professional development, occupation-based practice, and theory to develop mechanisms for understanding of data analysis, case studies, records, research, and general investigation. 4. Synthesize professional literature to develop evidence-based practice skills with client interventions under the supervision of an OT. Psychomotor 1. Integrate research findings throughout delivery of the OT process. 8

12 Academic Foundational Content Personal Development Tenets of Occupational Therapy Theory & Techniques Occupational Therapy Practice Affective Cognitive Psychomotor Recall, comprehend function & structure of the human body, & human development throughout the life span. Recall, comprehend concepts of occupation and human behavior, including the role of socioeconomic changes, cultural issues, diversity factors, prevailing health and welfare issues & lifestyle choices in society. Recall, comprehend basic effects of physiological, psychological, & sociological aspects of life on human beings. Participate in class discussions, presentations and other activities to fully understand the concepts being presented. Being able to question concepts, and new ideas to enhance knowledge. Develop intra & interpersonal skills, intrinsic motivation to succeed in the OT program. Develop selfconfidence to be successful in the OT program. Participate in class discussions, presentations and other activities to fully understand the concepts being presented. Being able to question concepts, models and new ideas to enhance knowledge. Participate in class discussions, presentations and other activities to fully understand the concepts being presented. Understanding the need for selfassessment as a method of determining areas requiring positive change for ongoing personal growth & development. Integrate insight, intuition, empathy & inquisitiveness when providing OT services. Synthesize knowledge to develop the ability to interact with diverse populations. Understand the philosophy & theories of the profession. Understand the meaning of occupation in relation to the residual disabling effects of physical and mental illness. Analyze tasks in relationship to areas of occupation, performance skills & patterns, activity demands, contexts and client factors using critical thinking and clinical reasoning. Integrate tasks & theories into interventions to improve client skills in relationship with occupation & the environment. Synthesize knowledge to support client engagement in occupation to support participation in contexts. OT Practice and Framework: Domain and Process Understand the use of occupation-based interventions to enhance client roles and health and wellness. Assist in the application, analysis & documentation of the OT process from screening to discharging clients utilizing critical thinking, problem Utilize academic foundational concepts when providing OT services in various clinical settings with diverse populations. Communicate effectively with peers & diverse populations when providing OT services. Utilize intra- & interpersonal skills when interacting with peers and clients during the OT process. Utilize various OT theories & techniques when providing interventions to improve client occupations, resume the occupational role & interact with the environment. Use clinical reasoning, problem solving and critical thinking skills when providing OT services to diverse populations. Utilize clinical reasoning, critical thinking & problem solving skills when determining appropriate interventions to support client participation in 9

13 Professional Development Research Evidence Based Practice Being able to question concepts, and new ideas to enhance knowledge. Recognizes professional behaviors to be part of the foundation of the profession. Accepts responsibility for developing values, beliefs & attitudes that are congruent with those of the profession. Develop intrinsic motivation to explore professional literature to increase knowledge in the profession. solving, and clinical reasoning with the completion of client interventions. Integrate the use of purposeful activity and occupation-based interventions to support client participation. Provide OT services to diverse populations based on particular contexts. Understand AOTA s Code of Ethics, Core Values & Attitudes, & Standards of Practice as the basis for professional behavior. Analyze professional needs to seek strategies to enhance knowledge base, & increase education and training & explore various aspects of the profession. Integrate professional behaviors to become an advocate for the profession while increasing skills. Synthesize & integrate professional behaviors and habits to facilitate lifelong learning skills. Understand professional literature & how it relates to OT occupation-based practice and recognize the importance of research in the development of the profession. Analyze current relevant literature that relates to practice settings, diagnoses, contexts, & client based interventions. Integrate use of personal and professional development, occupationbased practice, and theory to develop mechanisms for understanding of data analysis, case studies, records, research, and general investigation. Synthesize professional literature to develop evidence-based practice skills with client interventions under the supervision of an OT. occupations & the occupational role. Adapt the environment to support client participation. Advocate for the profession. Become a life-long learner. Participate in professional organizations. Utilize evidence-based practice skills when determining interventions to improve client outcomes. 10

14 OCAT PROGRAM SEQUENCE OF COURSES Course Number Course Title Credit Hour FIRST YEAR Summer Semester BSCI Anatomy & Physiology I 3 3 Fall Semester BSCI Anatomy & Physiology II 3 Kent Core Composition 3 PSYC General Psychology 3 EXPR Destination Kent: First Year Experience 1 OCAT Foundations in Occupational Therapy 2 OCAT Occupational Therapy Practice Skills 1 PTAT Therapeutic Communications in PT/OT 1 SOC Introduction to Sociology 3 17 Spring Semester PSYC 21211/40111 Psychology of Adjustment or Abnormal Psychology 3 NURS Human Growth and Development 3 PTAT Analysis of Movement 4 OCAT OT Practice Skills II 3 OCAT Therapeutic Techniques I - Psychosocial 4 OCAT Therapeutic Techniques Fieldwork 1A 1 18 SECOND YEAR Summer Semester OCAT Therapeutic Techniques II - Physical Dysfunction 4 OCAT Therapeutic Techniques Fieldwork 1B 1 OCAT OT Practice Skills III 3 8 Fall Semester Kent Core Mathematics & Critical Reasoning 3 OCAT Professional Issues 2 OCAT Therapeutic Techniques III - Developmental 3 OCAT Therapeutic Techniques IV - Physical Dysfunction 3 Kent Core Humanities/Fine Arts 3 14 Spring Semester OCAT Clinical Applications I 4 OCAT Clinical Applications II 4 OCAT General Elective 1 9 TOTAL REQUIREMENTS: 69 Hours 11

15 OCAT PROGRAM TERMINOLOGY Below are the definitions of common terms used by the OCAT Faculty and throughout this handbook. Academic Fieldwork Coordinator - Faculty member, who is responsible for the administration, managing and coordination of the Level I and Level II fieldwork experiences for the students. Fieldwork Experience - The portion of the OCAT curriculum where the student develops clinical skills by applying didactic information in a practice setting. Level I fieldwork is related to the Therapeutic Techniques I Psychosocial and Therapeutic Techniques II Physical Dysfunction courses. Level II fieldwork encompasses the application of knowledge in a work setting. Students complete 2 Level II experience at the end of the program. Fieldwork Educator - The licensed occupational therapist or occupational therapy assistant who is responsible for direct supervision and instruction of the student during a fieldwork experience whether it is a Level I or Level II experience. Competency - The minimum level of knowledge, skills and behaviors necessary to progress in the OCAT Program and to participate in a fieldwork experience. Instructor - The faculty member, presenter or clinical instructor directly responsible for instruction and supervision of content area within the OCAT Program. Lab Practical - A type of examination that requires the student to role-play a clinical situation. Occupational Therapist (OT) - The legal title of a person who is educated and licensed to practice occupational therapy. Occupational Therapy Assistant (OTA) - The legal title of a person who is educated and licensed to practice occupational therapy. OCAT Class - Any scheduled OCAT curriculum activity, including lectures, labs, fieldwork experience or special trips, is referred to as Class throughout this handbook. Occupational Therapy Assistant Technology (OCAT) This is the KSU name of the Associate of Applied Science degree earned in the OTA Program. These initials also identify the KSU department and core courses in the program. OCAT Faculty - The persons employed by Kent State University to instruct courses in the OCAT curriculum. Program Director - The faculty member who is responsible for oversight and administration of the OCAT Program. 12

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18 Purpose Fieldwork Experience Supervised fieldwork experiences in occupational therapy are an integral part of both the educational process and professional preparation. It is intended to complement academic preparation by offering additional opportunities for growth, for learning to apply knowledge, for developing and testing clinical skills and for validating and consolidating those functions that comprise professional competence. The goal of the educational process is to produce competent occupational therapy practitioners. Upon completion of Level II fieldwork education the student is expected to function at or above the minimum entry-level competence. Therefore, fieldwork experiences should be developed to offer opportunities for development of the necessary skills and abilities identified in the role delineation report. Levels of fieldwork Level I Level I fieldwork rotations are held concurrently with OCAT Therapeutic Techniques- Psychosocial (OCAT Fieldwork 1a), and OCAT Therapeutic Techniques-Physical Dysfunction I (OCAT Fieldwork 1b). A modified fieldwork schedule will be utilized for the OCAT Therapeutic Techniques Developmental Disabilities. No part of Level I fieldwork may be substituted for Level II fieldwork. Level II (C.1.13) Level II fieldwork experiences (OCAT Clinical Applications & OCAT 20292) are required to be a minimum of 16 weeks. There are two (2) Level II experiences, each lasting eight (8) consecutive weeks/forty hours per week, complying with the work schedule of the assigned facility. These fieldwork rotations are scheduled after the coursework has been successfully completed. After each Level II rotation has been completed, a pass/fail grade will be given for the course. The student may complete Level II fieldwork in a minimum of one setting if it is reflective of more than one practice area, or in a maximum of three different settings. Level II fieldwork may be completed on a part-time basis as long as it is at least 50% or 20 hours of the full-time equivalent. Note: Fieldwork experiences must be successfully completed within 18 months of the didactic coursework. 15

19 There are 2 Level II fieldwork experiences, each lasting 8 consecutive weeks, for a total of 16 weeks of full time attendance. Students will be placed in two distinct placement areas, which consist of: Inpatient Acute, Inpatient Rehabilitation, Psychosocial, Pediatrics (Schools, Outpatient, or hospital), Outpatient, Skilled Nursing Facility, and Community-based Practice. Students are to comply with the work schedule of the assigned facility. These fieldwork rotations are scheduled after the coursework has been successfully completed. After both Level II rotations have been completed, a pass/fail grade will be given. Level II fieldwork may be completed on a part-time basis as long as it is at least 50% or 20 hours of the full-time equivalent. The student may complete Level II fieldwork in a minimum of one setting if it is reflective of more than one practice area, or in a maximum of three different settings. For every Level I affiliation, we supply you with the syllabus for the associated academic course (i.e., Psyche or Phys Dys). Your copy of the syllabus provides you with an outline of the topics week by week, so that you are aware of where the student is in the course of study. This will also help the student enhance his/her to apply academic knowledge with clinical skills. During each Level I fieldwork experience, the student is required to perform a self-assessment and meet with the AFWC one on one to discuss the assessment. This assessment requires the student to self-evaluate how they are performing at the Level I affiliation. It also requires the student to assess strengths and weaknesses and acquire goals for improvement in those areas. The AFWC performs on-site mid-term visits for ALL affiliations. The fieldwork educator is to call the AFWC early on in the affiliation if they are having trouble with a student, so that a remediation plan can be established. A remediation plan provides a more structured form of learning objectives based on the students current performance and will list consequences for termination. You may reach the AFWC Nina Sullivan at (330) Please leave a message on voice mail. 16

20 Kent State University Occupational Therapy Assistant Technology Program Fieldwork Experiences Level I & II The following placements must be completed to fulfill the requirements of the program: Semester Course Number Course Title Fieldwork Population and Setting Fieldwork Days Fieldwork Schedule Supervision Spring 1 st Summer 1 st Fall 2 nd Year Spring 2 nd Spring 2 nd Year Year Year Year OCAT OCAT OCAT OCAT OCAT Therapeutic Techniques: Fieldwork 1a Psychosocial Children-Geri Psychosocial Settings: Hospital, SNF, school, outpatient clinic, day center, community site, Alzheimer s center, correctional facility, residential farm, workshop TU/FRI or TH /FRI 2 full days/wk for 5 weeks (10 visits) Facility Supervision (can be non-ot staff) Therapeutic Techniques II: Fieldwork 1b Physical Dysfunction Children-Geri Physical Dys Settings: Acute hospital, SNF, rehab center, school system, outpatient clinic, community site, adult senior center, workshop, hand center TU /FRI 2 full days/wk for 5 weeks (10 visits) Facility Supervision (can be non-ot staff) Therapeutic Techniques III: Developmental Disabilities Children Pediatric Settings: Community daycare, public school, residential home, specialty school, outpatient center, preschool Various days of week Students rotate through 6-7 pediatric sites in small groups; one visit per site Facility Supervision (can be non-ot staff) Clinical Applications I Children-Geri Inpatient Acute, Inpatient Rehab, Psychosocial, Pediatrics (Schools, Outpatient, or hospital), Outpatient, Skilled Nursing Facility, or Community-based Practice Monday-Friday (Possible weekends) FT 5 days per week for 8 weeks following facility hours Facility Supervision OT Staff Clinical Applications II Children-Geri Inpatient Acute, Inpatient Rehab Psychosocial, Pediatrics (Schools, Outpatient, or hospital), Outpatient, Skilled Nursing Facility, or Community-based Practice Monday-Friday (Possible weekends) FT 5 days per week for 8 weeks following facility hours Facility Supervision OT Staff 17

21 Fieldwork Educator s Qualifications (C.1.9 & C.1.14) The OCAT Program is responsible for ensuring that all fieldwork educators are qualified to supervise Level I & II fieldwork students. Fieldwork educators must meet the following criteria: 1. Currently licensed as an occupational therapist or occupational therapy assistant. 2. Have a minimum of 1 year of practice experience subsequent to the initial certification. 3. Adequately prepared to serve as a fieldwork educator. Fieldwork educators must provide documentation that they are currently licensed in the State of Ohio, West Virginia or Pennsylvania in order to receive students. Qualified personnel, other than OT practitioners, must provide documentation that they are licensed in their respective profession. Educators must also provide evidence of their ongoing certification whether they are OT practitioners or other qualified personnel. 18

22 Fieldwork Educator s Responsibilities FIELDWORK RESPONSIBILITIES 1. Notify the AFWC of probable availability or commitment to fieldwork experience dates and of changes in terms of the affiliation (such as; immunizations required, etc.). 2. Maintain current contracts with KSU OCAT Program, and update Facility Data Forms annually. A copy of the fieldwork educator s credentials should be included. 3. Contact the AFWC immediately, at the first indication of a problem or concern regarding a student during the fieldwork experience. Provide the AFWC with written documentation of critical incidents or anecdotal records. Updates must be provided on a regular basis until the problems have been resolved. 4. Provide the following information to the student on the first day: a. Departmental information i. Facility policies and procedures ii. Safety regulations iii. Handling of body substances and hazardous materials iv. Security and evacuation procedures v. Access to emergency services vi. Equipment safety procedures b. Orientation to the facility 5. Other guidelines to follow with the student include: a. Appropriate supervision as required by state law, AOTA guidelines and Medicare regulations, if appropriate. b. Appropriate and varied fieldwork experience to the student. c. Instruction in Occupational Therapy techniques and skills and intervention rational. d. Frequent feedback regarding performance e. Completed AOTA Fieldwork Performance Evaluation at mid-term and final. f. Formal meetings at mid-term and final to review and assess progress and goals of the fieldwork experience. 6. Evaluate AFWC performance when requested. 19

23 Academic Fieldwork Coordinator (AFWC) Responsibilities 1. Establish and maintain contractual agreements between KSU and the fieldwork education facilities. 2. Notify the facilities in writing of fieldwork experience dates at least 4-6 months prior to their occurrence. 3. Assign students to a facility for each fieldwork experience. The primary criterion for the placement will always be the educational experience. 4. Send specific student and fieldwork assignment, location, phone number and contact person about 4 weeks prior to the start date of an experience, to the facility. 5. Provide the student with fieldwork assignment, location, phone number and contact person about 4 weeks prior to the beginning date of an experience. 6. Contact the by phone and complete a site visit at least once during each Level I & II fieldwork experience. 7. Consult and mediate with the student, and regarding any clinic related problems. 8. Assist fieldwork experience facilities in developing quality educational programs for students. 20

24 FIELDWORK EXPERIENCE STUDENT SUPERVISION Medicare Regulations Over the past few years the Centers for Medicare and Medicaid Services (CMS) have changed the payment systems to facilities. These changes with CMS have also brought about changes to the payment rules and regulations regarding payment for services provided by students. Students are allowed to treat patients, but a facility needs to know how and when student treatment may be billed. The OCAT Program needs to notify fieldwork facilities of the changes by Medicare regarding when they are involved in provision of treatment. The fieldwork facility needs to understand whether or not Medicare payment rules will allow them to bill for student delivery of services. The facility also must understand the type and level of supervision that is required for services provided by a student to be paid. The following chart sets out for each Medicare setting whether Medicare payment rules specifically allow or restrict coverage of services provided by students and what type and level of supervision Medicare requires to raise the services provided by students to the level of covered "skilled" occupational therapy. Practitioners should take care to ensure an appropriate level of supervision, whether or not a specific CMS rule regarding students has been issued. Therapy Students Medicare Part A Therapy students are not required to be in line-of-sight of the professional supervising therapist/assistant (Federal Register, August 8, 2011). Within individual facilities, supervising therapists/assistants must make the determination as to whether or not a student is ready to treat patients without line-of-sight supervision. Additionally all state and professional practice guidelines for student supervision must be followed. Time may be coded on the MDS when the therapist provides skilled services and direction to a student who is participating in the provision of therapy. All time that the student spends with patients should be documented. Medicare Part B The following criteria must be met in order for services provided by a student to be billed by the long-term care facility: The qualified professional is present and in the room for the entire session. The student participates in the delivery of services when the qualified practitioner is directing the service, making the skilled judgment, and is responsible for the assessment and treatment. The practitioner is not engaged in treating another patient or doing other tasks at the same time. The qualified professional is the person responsible for the services and, as such, signs all documentation. (A student may, of course, also sign but it is not necessary because the Part B payment is for the clinician s service, not for the student s services.) Physical therapy assistants and occupational therapy assistants are not precluded from serving as clinical instructors for therapy assistant students while providing services within their scope of work and performed under the direction and supervision of a qualified physical or occupational therapist. 21

25 Modes of Therapy A resident may receive therapy via different modes during the same day or even treatment session. When developing the plan of care, the therapist and assistant must determine which mode(s) of therapy and the amount of time the resident receives for each mode and code the MDS appropriately. The therapist and assistant should document the reason a specific mode of therapy was chosen as well as anticipated goals for that mode of therapy. For any therapy that does not meet one of the therapy mode definitions below, those minutes may not be counted on the MDS. (Please also see the section on group therapy for limited exceptions related to group size.) The therapy mode definitions must always be followed and apply regardless of when the therapy is provided in relationship to all assessment windows (i.e., applies whether or not the resident is in a look back period for an MDS assessment). Individual Therapy The treatment of one resident at a time. The resident is receiving the therapist s or the assistant s full attention. Treatment of a resident individually at intermittent times during the day is individual treatment, and the minutes of individual treatment are added for the daily count. For example, the speech-language pathologist treats the resident individually during breakfast for 8 minutes and again at lunch for 13 minutes. The total of individual time for this day would be 21 minutes. When a therapy student is involved with the treatment of a resident, the minutes may be coded as individual therapy when only one resident is being treated by the therapy student and supervising therapist/assistant (Medicare A and Medicare B). The supervising therapist/assistant shall not be engaged in any other activity or treatment when the resident is receiving therapy under Medicare B. However, for those residents whose stay is covered under Medicare A, the supervising therapist/assistant shall not be treating or supervising other individuals and he/she is able to immediately intervene/assist the student as needed. Example: A speech therapy graduate student treats Mr. A for 30 minutes. Mr. A. s therapy is covered under the Medicare Part A benefit. The supervising speech-language pathologist is not treating any patients at this time but is not in the room with the student or Mr. A. Mr. A. s therapy may be coded as 30 minutes of individual therapy on the MDS. Concurrent Therapy Medicare Part A-The treatment of 2 residents, who are not performing the same or similar activities, at the same time, regardless of payer source, both of whom must be in line-of-sight of the treating therapist or assistant. NOTE: The minutes being coded on the MDS are unadjusted minutes, meaning, the minutes are coded in the MDS as the full time spent in therapy; however, the software grouper will allocate the minutes appropriately. In the case of concurrent therapy, the minutes will be divided by 2. When a therapy student is involved with the treatment, and one of the following occurs, the minutes may be coded as concurrent therapy: The therapy student is treating one resident and the supervising therapist/assistant is treating another resident, and both residents are in line of sight of the therapist/assistant or student providing their therapy.; or 22

26 The therapy student is treating 2 residents, regardless of payer source, both of whom are in line-of-sight of the therapy student, and the therapist is not treating any residents and not supervising other individuals; or The therapy student is not treating any residents and the supervising therapist/assistant is treating 2 residents at the same time, regardless of payer source, both of whom are in line-ofsight. Medicare Part B-The treatment of two or more residents who may or may not be performing the same or similar activity, regardless of payer source, at the same time is documented as group treatment Group Therapy Medicare Part A-The treatment of 4 residents, regardless of payer source, who are performing the same or similar activities, and are supervised by a therapist or assistant who is not supervising any other individuals. NOTE: The minutes being coded on the MDS are unadjusted minutes, meaning, the minutes are coded in the MDS as the full time spent in therapy; however, the software grouper will allocate the minutes appropriately. In the case of group therapy, the minutes will be divided by 4. When a therapy student is involved with group therapy treatment, and one of the following occurs, the minutes may be coded as group therapy: The therapy student is providing the group treatment and the supervising therapist/assistant is not treating any residents and is not supervising other individuals (students or residents); or The supervising therapist/assistant is providing the group treatment and the therapy student is not providing treatment to any resident. In this case, the student is simply assisting the supervising therapist. Medicare Part B-The treatment of 2 or more individuals simultaneously, regardless of payer source, who may or may not be performing the same activity. When a therapy student is involved with group therapy treatment, and one of the following occurs, the minutes may be coded as group therapy: The therapy student is providing group treatment and the supervising therapist/assistant is not engaged in any other activity or treatment; or The supervising therapist/assistant is providing group treatment and the therapy student is not providing treatment to any resident. [October 2011 CMS s RAI Version 3.0 Manual CH 3: MDS Items O] 23

27 Occupational Therapy Assistants OTAs are allowed to be supervisors while providing services within their scope of work and performed under the direction and supervision of a licensed OT. State Law All OCAT Program students and fieldwork educators must follow the state licensure laws governing supervision in an occupational therapy setting in the state practice act where the fieldwork experience is taking place. See these websites for the latest information OH: WV: PA: Other States When a fieldwork experience is completed in another state, it is the student s responsibility to research, understand and adhere to the laws governing that state. Amount of Supervision To protect clients and consumers, initial supervision of Level II fieldwork students is to be direct, meaning that the must be present and available to respond to the needs of the students and is responsible for co-signing all paperwork related to OT practice. As the students progress, less direct supervision is required depending on the facility, skills of the students, and the severity of the client s condition. Effectiveness of Supervision To determine the effectiveness of student supervision, the student must complete the Student Evaluation of Fieldwork form and return it to the Fieldwork Coordinator to determine the quality of the fieldwork site. If the site receives 2-3 unfavorable student evaluations, the Fieldwork Coordinator must contact the site to discuss problems or situations presented by the students. If the problems cannot be resolved, use of this site will be discontinued. To enhance the quality of student supervision, the OCAT Program will provide fieldwork sites educational materials on increasing supervisory skills and other continuing education opportunities related to fieldwork education. The OCAT and PTST Programs at the Kent State University provide a luncheon/seminar for supervisors to address fieldwork and student issues. 24

28 Level I Fieldwork Experience FIELDWORK EXPERIENCE EVALUATION The student will receive a pass/fail grade at the end of each Level I fieldwork experience (OCAT and OCAT 20092) by the Fieldwork Coordinator using the following criteria: 1. Students are to complete each assignment as noted in the Fieldwork Manual and turned in to the Fieldwork Coordinator on the assigned due dates. 2. The fieldwork educator evaluates the student s performance utilizing the Level I Fieldwork Performance Evaluation form designed by KSU OCAT Program. Students must pass with a minimum final score of 56 points. 3. If a student does not complete the above components a failing grade may be assigned. *If a student does not complete any of the above components, a failing grade may be assigned. Level II Fieldwork Experiences The student will receive a pass/fail grade at the end of each Level II fieldwork experience (OCAT and OCAT 20292) by the Fieldwork Coordinator using the following criteria: 1. Student completes assignments as noted in the Fieldwork Manual. Assignments with designated due dates must be turned into the Fieldwork Coordinator during the fieldwork rotation to ensure timely correction and submission of a final grade. 2. The student will be evaluated by the fieldwork educator using the AOTA Fieldwork Performance Evaluation. The student must pass each evaluation with a 70 or higher (except a repeated experience must have a 75 or higher) to pass the Level II fieldwork experiences. A student may repeat a fieldwork experience one time. If the repeated experience is not passed the student will be dismissed from the Program. 3. A student who has fail failed a previous OCAT or related course and fails a Level II fieldwork experience will be dismissed from the program. Both failures indicate a failure to progress in the OCAT Program. The fieldwork educator provides written documentation, evaluation, and feedback regarding student performance to the Fieldwork Coordinator, by completing the AOTA Fieldwork Performance Evaluation at mid-term and final. It should include both the rating scale scores and written comments for each performance criteria, as well as summative comments and signatures. The rating scale is scored based on expectations of an entry-level COTA, who has professional skills, knowledge and behaviors. The fieldwork educator should send copies of supplemental documentation to the Fieldwork Coordinator including remediation plan, records, or incident 25

29 reports. The Fieldwork Coordinator must receive the information on a timely basis due to graduation requirements. The Fieldwork Coordinator will contact both the student and fieldwork educator to obtain verbal feedback related to the performance of the student and his/her progression toward meeting the learning objectives of the fieldwork experience. These conversations will occur in person during a scheduled site visit. The Fieldwork Coordinator will schedule a site visit with each student in both Level I and Level II fieldwork experiences around mid-terms. More site visits may be necessary if a student is having difficulties meeting the learning objectives. The final pass/fail grade for each fieldwork experience will be determined by the final grade on the AOTA Fieldwork Performance Evaluation and the Fieldwork Coordinator. Consideration will be given to the specific objectives for the fieldwork experience, completion of assignments, evaluations from the fieldwork educators and the student during site visits and any phone conversations. Students must pass each Level II fieldwork experience to complete OCAT Clinical Applications and successfully. Any student who is in jeopardy of not passing a fieldwork experience will be advised, by the fieldwork educator and Fieldwork Coordinator of the situation at the earliest possible opportunity. A remediation plan will be established in consultation with the fieldwork educator and Fieldwork Coordinator to assist the student in meeting the expectations of the fieldwork experience. A remediation plan may include, but not limited to independent study, tutoring, counseling, additional required clinical hours, or termination of the fieldwork experience. Instances where a student demonstrates extreme deficiencies in skills, knowledge or behaviors may result in the sudden and immediate removal from his/her facility. Students also have the right to discontinue their fieldwork experience at a facility. When doing so, the fieldwork coordinator and program director must be notified previous to the actual withdrawal. Reasons for withdrawal must be legitimate and approved by the fieldwork coordinator and program director. At that time, the student will be advised that this is considered a failure to progress. The student will not be eligible for graduation with his/her class and must wait to the beginning of the next rotation to resume with their level II fieldwork experience. Whenever a student is removed from a fieldwork experience or self withdraws, a process of counseling with the student, Fieldwork Coordinator, and/or Program Director, will be initiated to address all issues related to the failure or withdrawal from the fieldwork experience. A remediation plan will be developed for improvement of any areas where the student is having problems. This remediation may include, but not limited to written activities, completion of a lab practical and comprehensive examination. Upon successful completion of the terms of the remediation plan, the Fieldwork Coordinator will determine the student s next fieldwork assignment. **If three or more fieldwork assignments are submitted late and/or unsatisfactory, the student will receive a failing grade for the experience. 26