Occupational Therapy Assistant Program
Level I Fieldwork – B Evaluation
Student: ____________________________________________
Date: _____/_____/______
Dates of Placement:
From: ________/________/________
To: ________/________/________
Fieldwork Setting:
Facility:_______________________________________________
_____________________________________________________________________________________
Address: _________________________________________________________________________
____________________________________________________________________________________
City: ______________________________________________________________________________
Fieldwork Educator Name: _______________________________________________________
Level I Fieldwork: (check one)
☐ Level I Fieldwork A: Integration and Practice Applications – OCTH 1019
Midterm Date_____________________
Final
Date_____________________ Score ___________________
☐Level I Fieldwork B: Integration and Practice Applications – OCTH 1029
Midterm Date_____________________
Final
Date_____________________ Score ___________________
A student must earn 34 points for a passing grade at Final
☐Level I Fieldwork C: Integration and Practice Applications – OCTH 1039
Midterm Date______________________
Final
Date_____________________ Score ___________________
Last update: 12_2009
1
_____________________________________
Fieldwork Educator Signature
_______________________________________
OTA Student Signature
Fieldwork Educator Summary:
Midterm
Final
Last update: 12_2009
2
OTA Student Summary:
Midterm
Final
Last update: 12_2009
3
Please complete objective evaluation at Final and use as a guideline for narrative comments on progress at midterm.
The OTA student must complete self-assessment and discuss with supervisor at both mid term and final.
Please return signed copies of all documents to Karen Kowalski, Academic Fieldwork Coordinator.
Score the Rutgers Level I Evaluation using the criteria below and include comments to support rating:
4 = Exceeds Standards: Performance is skilled and self-initiated. This rating is rarely
given and would represent the top 5% for Level I students.
3 = Meets Standards: Performance is consistent and meets the standards for this Level
fieldwork. This rating is given infrequently at midterm and is considered a strong
final rating.
2 = Needs Improvement: Performance is progressing but l needs improvement.
This is a realistic rating of performance at midterm, and some ratings of 2
may be reasonable at final.
1 = Unsatisfactory: Performance is below standards for a Level I student and
requires significant development. This rating is given when there is a concern
about performance at midterm or when the student is unable to meet requirements
by the final evaluation.
Last update: 12_2009
4
PASSING SCORE AT FINAL
Last update: 12_2009
34 points
5
I.
Becoming an OTA Professional
The OTA Student:
1. Attends all fieldwork sessions, is prompt, adheres to polices of fieldwork site, and participates in learning activities.
4321
2. Uses sound judgment in regard to safety of health and others.
4321
3. Participates in the supervisory process by giving, receiving, and responding to questions and feedback and seeking guidance
as necessary.
4321
4. Effectively interacts with client and /or family or identified caregiver in a professional and therapeutic manner.
4321
5. Explains the role of occupation in the promotion of health and prevention of disease and disability.
4321
6. Identify interventions consistent with models of occupational performance.
Last update: 12_2009
4321
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II.
Occupational Beings Across the Lifespan
The OTA Student:
7. Evaluates the client’s occupational performance in activities of daily living (ADLs, and/or instrumental activities of daily living
(IADLs).
4321
III.
Adaptation
The OTA Student:
8. Provides therapeutic use of occupation, exercises, and activities with clients appropriate to their needs and goals.
4321
9. Discusses and implements ideas for appropriate grading of activities and interventions.
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10. Provides training using OT techniques in an ADL or an IADL for a client or caregiver.
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IV.
OT Practice
The OTA Student:
11. Articulates the role of the occupational therapy assistant and occupational therapist in the screening and evaluation process.
4321
12. Documents occupational therapy intervention according to the facility requirements.
4321
Last update: 12_2009
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