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FIELDWORK MANUAL
Lenoir-Rhyne University
School of Occupational Therapy
Revised July, 2011
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INDEX
General Guidelines: Level I and Level II Fieldwork
Overview………………………….……….……………………....……………….…………………………4
Fieldwork Sites and Supervisors......................................................................................................4
Student Responsibilities for Fieldwork Site Requirements Compliance.……….…….……………….5
Criminal Background Checks……………………………..……………………….……………….………5
Malpractice Insurance………………………………………..………….…………………………….……5
Liability Insurance……………….…………………………….………….……………….………..……….5
Typhon….........................................................................................................................................5
Disclosure of Information……………....………………………..……….…………………………..........6
Travel and Transportation Issues..............................................................................................…...6
Housing during Fieldwork………………………………..……………………….…..…………………….6
Conflict of Interest…………………………………..………………….………………..…………………..6
Contacting Fieldwork Sites after Placement…………………..………………….…..…………………..7
Dress Code…………………………………………………………..…….…………………..…………….7
Communication with Academic Fieldwork Coordinator……….....…………………………..………….8
Counseling Students…....................................................................................................................8
Completion of Fieldwork………………………………….…….……………….………………..…………9
Withdrawals……………………………………………………..…….……………………………..……….9
Non-discrimination……………………………………………….…….…………………………..………..9
Confidentiality………...…………………………………….…………..………………………..….……….9
Fieldwork Advisory Council…........................................................................................................10
Level I Fieldwork
Level I Fieldwork Overview………………………….……………………………………………………12
COE Guidelines……………………………………………………………………………………………12
Level I Fieldwork Goals, Objectives, and Competencies……………………………………………..12
Level I Fieldwork Placement Process……………………………..……………………………………13
Level I Fieldwork Placement Appeals Process………………………...……………………..……….13
New Fieldwork Site Request Process…………………………………………...……..……………….14
Level I Fieldwork Grades……………………………………………………………..…………………..14
Attendance Policy……………………………………………………………..…………..………………14
Cancellation or Changes by FW site……………………………………...………………..…………...14
Forms………………………………………...…………………………...………………….…………….15
Level II Fieldwork
Level II Fieldwork Overview………………………………………………..……………………..……..17
Progression and Graduation Requirements………………………………..……………….…………17
COE Guidelines…………………………………………………………………..………….……………17
Level II Fieldwork Goals, Objectives, and Competencies……………………..……..….…………..21
Level II Fieldwork Placement Process………………………………………..…………..……………22
Fieldwork Assignment Process………………………………………………..………....….………….23
Level II Fieldwork Lottery Appeals Process……….………………………..…………....……………23
New Fieldwork Site Request Process…………….………………………..…………………………..24
Attendance Policy…………………………………….……………………….………………………….24
Cancellation or Changes by FW site……………….………………………….……………………….24
Forms……………………………………………….……………………….…………………………….25
Grading of Level II Fieldwork Experience………………………………………………………………25
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General Guidelines
Level I and Level II Fieldwork
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Overview
Fieldwork is an integral part of the curriculum and is required of all therapists for certification. Fieldwork
provides students with the opportunity to use clinical reasoning skills to begin to identify, frame, and solve
clinical problems under the supervision of experienced, clinic-based fieldwork educators (FE), as well as
to begin to take on professional roles and responsibilities under appropriate supervision. Fieldwork
education is designed to provide occupational therapy students with opportunities to integrate
academically acquired education with practice. It is during the fieldwork experience that the student can
learn, practice and refine skills of observation, evaluation, treatment planning, implementation and
communication. In the fieldwork setting the student begins to define his or her future roles as a practicing
occupational therapist and can develop the necessary self-confidence and affective characteristics
essential to meeting the demands for this challenging field. Fieldwork provides many opportunities for
feedback which promotes professional behaviors and attitudes and clinical expertise.
Fieldwork is an integral part of the education of an occupational therapist and must occur in an
environment that provides those experiences which reinforce previous learning and which challenge and
motivate the student to develop professionally and adapt to clinic situations. The Academic Fieldwork
Coordinator is responsible for the planning and implementation of integrated and sustained fieldwork
experiences. The experiences occur under the supervision of and with the support of occupational
therapist or other professionals. To ensure that the fieldwork activities support and enhance the goals of
the program there is continual collaboration by clinical educators, academic faculty, and the Fieldwork
Coordinator. In keeping with Lenoir-Rhyne University’s occupational therapy program’s mission and
curriculum design, fieldwork experiences are designed to encourage values and behaviors that exemplify
professional leadership, integrity and social consciousness to support the program’s goals to develop
ethical practitioners to meet the immediate and future needs of the community.
The occupational therapy program requires both Level I and Level II fieldwork experiences.
Level I fieldwork is an integral part of the didactic portion of the educational program. Students are
exposed to diverse settings to increase their understanding of occupational therapy and/or the health care
arena. Level II fieldwork is the culminating educational experience for the Lenoir-Rhyne University
occupational therapy student.
Occupational therapy fieldwork sites expect students to come prepared with the necessary skills to work
with clients; excessive absences, regardless of the reason, will contribute to lack of preparation for
fieldwork experiences. Students should budget their study time accordingly so that they do not need to
“skip” classes and/or fieldwork to study for a test in another class. Excessive absences and/or lateness
will be dealt with through the Academic Fieldwork Coordinator (AFWC) and/or the Program Director (PD).
The student must realize that absences may prohibit him/her from progressing in program.
Fieldwork Sites and Supervisors
Level I and II fieldwork experiences are an integral part of the occupational therapy curriculum at LenoirRhyne University. The faculty, clinicians, and students are mutually involved in the process. The School
of Occupational Therapy evaluates and selects fieldwork sites according to specific criteria that meet the
needs of the curriculum and to assure that the facility is able to provide adequate supervision and
experiences to enable the student to successfully meet the requirements of the AOTA Fieldwork
Performance Evaluation for the Occupational Therapy Student. The scope of fieldwork sites range from
traditional settings in pediatrics, geriatrics, physical disabilities and mental health, to emerging practice
settings in community health. All sites utilized for student fieldwork placement meet the requirements and
learning objectives of the curriculum. A contractual agreement is completed with all facilities. The
Academic Fieldwork Coordinator and fieldwork supervisors collaborate on objectives, practice activities
and the advising of students. In order for a fieldwork site to be established and retained, it must provide a
quality educational experience for the students and meet Commission on Education requirements for
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Level I or II fieldwork sites. In addition, the School of Occupational Therapy and students must
conscientiously cooperate and fulfill the duties/requirements of the contract.
Student Responsibilities for Fieldwork Site Requirements Compliance
Students are ultimately responsible for keeping the following records current and accessible for use
during fieldwork rotations. Some FW sites require additional certifications or immunizations along with the
below requirements, and it is the responsibility of the student to insure compliance with all fieldwork site
health requirements. Information regarding site requirements may be obtained from the fieldwork office
and should be confirmed with the site during the student’s initial contact with the fieldwork educator.
Copies of these site requirements are NOT kept in the OT Fieldwork Office for privacy reasons but are
requested for review prior to each FW experience.
CPR certification (adult, child and infant)
Immunizations (as required for University entry)
Hepatitis B vaccination series
Yearly TB test results
Proof of health insurance
Criminal background checks
Proof of liability insurance
OSHA/HIPAA/Bloodborne pathogen training (completed in LAMP class)
Criminal Background Checks
A criminal background check will be required prior to fieldwork I or II experiences. Students need to go to
www.certifiedbackground.com. Click on “applicants” and then “order now”. In the package code box, enter
EN52R. Select a method of payment. CertifiedBackground.com accepts Visa, MasterCard, and Money
order. This background check will cover NC statewide review, national database review, OIG review, and
a residency history. If your particular FW site requires additional types of review, please contact the
AFWC who can assist you in the background check process.
Malpractice Insurance
While Lenoir-Rhyne University holds malpractice insurance for its students, it is required that students
obtain personal malpractice insurance prior to their first FW I experience. Evidence of this malpractice
must be given to the administrative assistant. Students are responsible for supplying a copy of this to the
administrative assistant. To obtain malpractice insurance go to www.hpso.com or other organization that
provides malpractice insurance for occupational therapists.
Liability Insurance
Lenoir-Rhyne University maintains liability for students who are on their fieldwork experiences. However,
the student prior to any FW experience must purchase additional malpractice insurance (see above). For
information regarding malpractice go to www.hpso.co and utilize the sign-in information from the OT
bulletin board at the receptionist’s desk.
Typhon
Typhon functions as a complete electronic student tracking system, including comprehensive logging of
each student’s clinical competencies and skills achieved during their Level I and Level II fieldwork
experiences. Prior to the initiation of the first Level I experience, students will purchase Typhon and
complete a training program.
Program directors, faculty members, clinical supervisors, and students can have instant online access to
enter data and view tallies and charts of cumulative clinical experiences. Custom searches also provide
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program administrators with further case details based on filters and subsets. Students can quickly and
easily enter all patient encounter information from one page, including demographics, clinical information,
competencies (observed, assisted, achieved), medications, and clinical notes. Administrators can
customize various areas including course lists, clinical locations, medication & competency details,
expiration dates, time logs and optional data fields; students can set defaults for commonly used fields.
There are a variety of pre-built reports, including cumulative tallies, individual case logs, and time log
totals. Reports can be run by date, course, semester, clinical site or clinical supervisor.
Information from the Typhon program allows faculty and program directors to follow the progress of each
student. Faculty can track whether or not students are satisfactorily progressing in their clinical
experiences, thereby meeting the objectives of the course. They can also compare what students are
being taught and how that compares to actual performance in the clinical arena. As a result, the program
will be able to assess what areas need to be changed so that students continue to meet nationally
established clinical competencies.
An added benefit of the system is that students can automatically generate beautiful reports to include in
their online portfolio (included) that can be used when seeking employment after graduation.
Because the application is hosted at Typhon Group's offices, users can login from anywhere and receive
the latest upgrades and features automatically, without installing any software. The web application
works with any web browser without any additional software (including the iPhone), and LRU retains
control and ownership of your data.
Disclosure of Information
The University cannot discuss a student’s past academic or fieldwork performance with fieldwork
educators without a written release of information from the student. It is, therefore, your responsibility to
let the fieldwork educator know if you need any accommodations due to a disability. Faculty cannot
discuss progress of student unless a FERPA form (in registrar’s office) has been signed.
Travel and Transportation Issues
Students are expected to have a reliable means of transportation to and from classes and fieldwork
experiences. Level I experiences occur within an hour’s drive of the University, while Level II fieldwork
can occur anywhere in the United States. It is, therefore, imperative that you budget for related
transportation expenses.
Housing during Fieldwork
During the student’s Level II Fieldwork, s/he may be placed in a site that is not within commuting distance
of his/her residence. Very few sites provide free housing. Fieldwork sites can sometimes give the student
information on possible temporary housing. It is the sole responsibility of the student to arrange for their
housing prior to the commencement of their FW experience.
Conflict of Interest
Students who receive tuition or other assistance from a Fieldwork II facility in return for subsequent
employment will be scheduled at other facilities (This does not interfere with a student’s eligibility to
receive a stipend). This will ensure consistent student role expectations and objective student evaluation.
Additionally, students will not be scheduled to participate in a Fieldwork II experience under the
direct supervision of a family member or close friend.
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A student will not be assigned to a fieldwork site where he/she has been hospitalized and
received OT treatment for reasons of confidentiality.
Contacting Fieldwork Sites after Placement
A. Role of the Student - Student must adhere to policies of the Fieldwork Manual
1. Write a letter or email the fieldwork educator confirming the fieldwork placement. This
letter/email should be written at least one month in advance of the starting date. A copy of
this letter/email should be submitted to the fieldwork office at least three weeks prior to the
fieldwork experience for our files. In the letter, the student should request additional
information related to the assignment, directions, housing (if applicable), and dress code. A
telephone call should be made to the fieldwork educator at least two weeks before the
starting date to make final confirmation of fieldwork placement.
a.
Arrange living accommodations if these are not provided by the facility (Level II).
b.
Obey all policies and procedures of the facility unless exempted, including
prompt notification of unplanned or planned absences.
c.
Fulfill all duties and assignments made by the fieldwork educator within the time
specified.
d.
Notify the fieldwork facility and academic educational program of current address
and telephone number.
e.
Complete and submit all required forms and evaluations to the fieldwork educator
and the AFWC in a timely manner.
f.
Fax evaluation of student’s performance to AFWC on last day of directed clinical
experience in order to expedite processing of grades.
2. Write a letter of appreciation to the fieldwork educator with a copy to the AFWC
acknowledging the educational opportunities provided by the facility, within three weeks
following completion of the experience. A copy of this letter should be submitted to the
fieldwork office no more than four weeks after the fieldwork experience.
3. All students are required to maintain ongoing communication with the AFWC and Fieldwork
Assistant at Lenoir-Rhyne University via Lenoir-Rhyne University’s LAMP, completing all
fieldwork assignments and postings as designated on LAMP.
4. If problems occur that might interfere with successful completion of the fieldwork experience,
student should contact the AFWC immediately for directions or intervention on student’s
behalf.
Dress Code
Students are expected to present a professional appearance at all fieldwork facilities. Because dress
codes at facilities vary widely, this information should be researched prior to attendance at the site. At the
very least, students should wear their professional LR OT scrubs or professional clothing and their
nametag on the first day of any fieldwork experience even if no dress code policy was specified by your
supervisor. All staff and students shall come to work dressed in a manner that will provide a good
example for the consumer with whom they are involved. Good personal hygiene is an important part of
the good example.
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Student and Staff are expected to comply with the following:
1.
It will be the responsibility of the immediate supervisor to see that the staff are
appropriately dressed and groomed and to counsel the staff when needed.
2.
It is the responsibility of the supervisor to determine when exceptions to the policy should
be made; i.e., camping, swimming, and other recreational activities.
3.
Shoes will be worn at all times unless engaging in an activity in which shoes are not
normally worn.
4.
Clothing will be clean, neat, and in good repair.
5.
The following are not appropriate dress:
o
o
o
o
o
o
o
o
See-through clothes, tops with spaghetti straps
Short shorts
Midriff or halter tops, or short tops that expose student’s skin when bending.
Women’s cleavage should not be visible.
Hats or caps, unless outdoors
Flip-flop rubber sandals, open toed shoes.
Excessive jewelry or long nails that could interfere with treatment
Noticeable perfumes that could cause others displeasure due to allergies,
headaches, etc.
Communication with Academic Fieldwork Coordinator
The AFWC will be available to assist potential fieldwork facilities with their development of fieldwork
programs, and to discuss fieldwork issues with individual fieldwork supervisors.
A system of ongoing communication between the AFWC and the clinical fieldwork supervisors is critical to
the success of fieldwork experience. If feasible, the AFWC will make arrangements for an onsite visit
during Level II experiences. If this is not possible, the AFWC will contact the student’s clinical fieldwork
supervisor by telephone at least once during each Level II Fieldwork experience.
During Level I and Level II Fieldwork, the student should address minor difficulties with his/her fieldwork
educator in supervision meetings. If the student is having difficulties with the fieldwork educator that
cannot be resolved, it is imperative that the AFWC be contacted as soon as possible to avoid putting the
student’s grade or experience in jeopardy. All difficulties with Level I and Level II experiences should be
addressed to the Academic Fieldwork Coordinator. He or she will involve the necessary faculty members
and fieldwork supervisors in assisting to remediate the problems that have been identified.
Counseling students with difficulties during fieldwork experiences
A. Fieldwork educators and/or students should identify problems early to allow time for the
student, fieldwork educator, and/or AFWC to collaboratively discuss student performance and
devise goals to foster the successful completion of fieldwork.
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B. Through telephone consultation or on-site consultation with the supervisor and the student,
the AFWC may assist in identifying and clarifying issues related to fieldwork placement. The
AFWC may also assist with the development of a plan to resolve fieldwork issues.
C. Students who need academic and/or personal counseling during Level I or Level II fieldwork
are still eligible for the services offered at Lenoir-Rhyne University; however, geographic
location for the fieldwork site may prohibit access to these services. If the student is in a
placement not within driving distance to Lenoir-Rhyne University, he or she is encouraged to
seek counseling services in the local community.
Completion of Fieldwork
1. Students must complete all Level I fieldwork experiences during the appropriate clinical
education semester unless otherwise approved by the AFWC.
2. Students must complete both Level II fieldwork experiences:
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within 24 months of completion of academic coursework, and
o
prior to graduation from Lenoir-Rhyne University.
2. AOTA requires successful completion of both fieldwork experiences. NBCOT requires
graduates to have fulfilled ALL of the requirements at THEIR educational institution. Students
should realize that employers not only require certification, but also graduation from an accredited
school.
3. Students are not allowed to withdraw from fieldwork experiences without the approval of the
PD and/or AFWC. Difficulties during fieldwork should be brought to the attention of the AFWC as
soon as possible to avoid jeopardizing the student’s grade. It is in the student’s best interest to a
have a written copy of student’s performance on a weekly basis during their FWII experiences.
Withdrawals
Leaving a fieldwork site without notifying and receiving a written or direct telephone response from the
clinical fieldwork educator and the School of Occupational Therapy is viewed as a serious infraction of
professional ethics and is considered abandonment of one’s professional responsibilities to the patients
and facility. The student will receive a failing grade in the fieldwork and will not have the option to petition
to re-enter the program.
Non-discrimination in fieldwork placements
The student has the right to be treated fairly and not be discriminated against in the selection of fieldwork
facilities or by any representative of the academic or fieldwork facility. See the Lenoir-Rhyne University
Policy on Non-Discrimination.
Client/family confidentiality and coworker privacy
Students are allowed to discuss client cases with fieldwork educators and academic faculty; however,
cases should not be discussed in public places or with persons who have no need to know the
information. Protecting the dignity and privacy of the client/family is a critical part of the development of
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professional behavior and is also required by HIPAA regulations. Students must also get written
permission to use photos/videos or case information about clients with whom they work.
Students should also note that their supervisors, co-workers, and other students in the facility also have a
right to confidentiality and privacy. Use discretion when speaking of them out of their presence, or
disclosing information of a personal nature.
Fieldwork Advisory Council
The HOS/OT Division has developed an Advisory Committee comprised of Lenoir-Rhyne University
faculty members and 3-5 fieldwork educators in order to facilitate coordination and communication
between the University and the fieldwork sites. The council will provide the opportunity to discuss
concerns, issues, and ideas about fieldwork education and the HOS/OT curriculum.
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Level I Fieldwork
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Level I Fieldwork Overview
Level I fieldworks are completed during each semester the student is taking the basic clinical coursework
in physical disabilities, geriatrics, pediatrics, and mental health. Each Level I experience is one week in
length. All students will participate in a minimum of 160 hours of Level I Fieldwork during their
occupational therapy education. The purpose of this experience is threefold:
1. To increase exposure to patients with deficits in occupational performance.
2. To help the student apply knowledge and skills in working with clients of various diagnostic categories
being discussed in class.
3. To provide students with clinical models using a variety of frames of reference in the delivery of
occupational therapy services.
Students will usually, but not always, encounter an occupational therapist or occupational therapy
assistant as their supervisor in each Level I fieldwork experience. Students may be given additional
guidance and assignments by faculty and/or facility fieldwork educators to attain the most benefit from
each clinical setting. The “OT Practice Framework: Domain and Process (2nd edition)” can assist the
student in gaining patient and clinical observation skills in each of the four practice areas of FW I
experience. The areas include mental health, physical rehabilitation, geriatrics, and pediatrics. Students
should be aware that Level I Fieldwork cannot be used as a substitute for Level II Fieldwork. Level I
fieldwork is graded on a pass/fail basis.
Commission on Education Guidelines for Level I Fieldwork
The AOTA Standards describe the goal of Level I Fieldwork "to introduce students to the
fieldwork experience, and develop a basic comfort level with an understanding of the needs of
clients." Level I Fieldwork is not intended to develop independent performance, but to "include
experiences designed to enrich didactic coursework through directed observation and
participation in selected aspects of the occupational therapy process."
Services may be provided to a variety of populations through a variety of settings. Experiences
may include those directly related to occupational therapy, as well as other situations to enhance
an understanding of the developmental stages, tasks, and roles of individuals throughout the life
span. Day care centers, schools, neighborhood centers, hospice, homeless shelters, community
mental health centers, and therapeutic activity or work centers are among the many possible
sites. Level I Fieldwork may also include services management and administrative experiences in
occupational therapy settings, community agencies, or environmental analysis experiences.
Populations may include disabled or well populations; age-specific or diagnosis-specific clients.
Qualified personnel for supervision of Level I Fieldwork may include, but are not limited to,
academic or fieldwork educators, occupational therapy practitioners initially certified nationally,
psychologists, physician assistants, teachers, social workers, nurses, physical therapists, social
workers, etc. The supervisors must be knowledgeable about occupational therapy and cognizant
of the goals and objectives of the Level I Fieldwork experience.
Level I Fieldwork Goals, Objectives, and Competencies
It is the mission of the School of Occupational Therapy to develop skilled and caring clinicians who
respond adaptively to situations, meticulously investigate their work and knowledge base, and provide
ethical and unbiased services. In addition to mastery of the Lenoir-Rhyne University School of
Occupational Therapy educational mission and goals, and attaining competencies as specified on the
Level I Student Performance Evaluation, general goals and objectives for Level I Fieldwork include:
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1. Demonstrate professional behaviors and work skills:
a. Student adheres to facility dress code
b. Student demonstrates use of time management strategies in preparation, maintaining
schedule, and completing assignments on time.
c. Student takes initiative for learning and assumes responsibility for learning
d. Student accepts and responds appropriately to feedback and supervision.
2. Demonstrate effective communication within the clinical setting:
a. Student establishes rapport with co-workers, clients/families, and
interdisciplinary team members
b. Student demonstrates effective therapeutic use of self, including appropriate
limit setting
c. Student demonstrates the ability to produce documentation with correct professional
terminology and clearly written notes/reports
d. Student demonstrates ability to collaborate/consult with client/family
regarding treatment plan and/or goals
3. Demonstrate the ability to perform introductory client interaction and assessment skills:
a. Student is exposed to the client interview process
b. Student is exposed to the administration of screening and/or assessment tools
c. Student presents one client case study consisting of interview/observation and
assessment data, treatment objectives, treatment plan, treatment documentation, and
discharge summary as specified by instructor and/or Fieldwork I fieldwork educator.
4. Observe and describe the characteristics of various occupational dysfunctions and various
theoretical frames of reference and/or treatment techniques for working with these clients:
a. Student completes Level I Fieldwork assignments as provided by AFWC and/or
fieldwork educator
b. Student demonstrates the ability to communicate with clients/families regarding the
perspective and value of Occupational Therapy
c. Student becomes familiar with appropriate selection and application of a variety of
therapy evaluations and therapeutic activities commonly used with clients of varying
occupational dysfunctions, learning needs, and age groups
Level I Fieldwork Placement Process
Fieldwork I assignments are made by the Academic Fieldwork Coordinator (AFWC). Students will be
placed in locations within an hour’s drive of the local Hickory area. Students are unable to request specific
fieldwork locations. However, if students wish to be placed outside of the Hickory area or have issues with
the lottery process, they need to follow the new fieldwork site requests or appeals processes. Students
are required to inform the AFWC of any disability accommodations needed during a fieldwork experience
to allow for appropriate fieldwork placement. Fieldwork I communication between students and the AFWC
will take place through LR’s LAMP course management system.
Level I Fieldwork Placement Appeals Process
The appeal process is designed to meet the occasional need of students for whom the placement
process would prove disruptive to their family responsibilities and would result in the student’s probable
discontinuation of their schooling. Petitions for appeals are not to be made lightly. Students should
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consider the gravity of their appeal and submit an appeal only if they feel they could not continue in the
program and complete their training if the appeal were denied. Appeals for special consideration in
placement are based on demonstrated need for one of the following reasons: dependent care, extreme
personal issues, and students with disabilities who have identified themselves to LR University Disability
Services. Appeals cannot be made for financial or marital status reasons. Appeals found to be made on
false claims will be overturned and denied, and students may be removed from the program for this highly
unethical behavior. Students who falsify appeal claims will be placed in any remaining site at the
conclusion of the lottery process. Students will be informed of the dates of the Appeal process. Appeal
decisions are made subject to the availability of fieldwork sites. All decisions of the faculty will be final.
New Fieldwork Site Request Process
All prospective and contracted fieldwork sites are considered a resource of the School of Occupational
Therapy not the individual student. Therefore students shall not contact fieldwork sites, currently or
prospectively contracted with the university, with the intent to establish personal fieldwork
placement without prior consent of the AFWC. Students wishing to obtain a fieldwork site in a specific
location must first meet with the AFWC to determine if a contract already exists with the facility. If no
contract exists, students may contact fieldwork sites and complete a New Fieldwork Site Request Form
(to be obtained from the AFWC). While the ability to place the student is not guaranteed, if a fieldwork
contract is obtained with a requested site, the student must go to that site for their fieldwork rotation.
Level I Fieldwork Grades
Level I fieldwork is graded on a pass/fail basis. The facility fieldwork educator will complete the formal FW
Level I Evaluation form and determine the student’s grade. The AFWC has final approval of all student
fieldwork grades. Grade appeals are to be completed according the student handbook guidelines.
Attendance Policy
1. Level I Fieldwork students must notify their fieldwork educator least 30 minutes prior
to reporting time. Students missing more than 3 successive days on are required to
have a doctor’s excuse to be able to return to fieldwork. No absences are allowed,
and all missed days need to be replaced for full execution of the fieldwork
2. Students are expected to make up any hours that are missed to receive credit for the
fieldwork experience. If arrangements cannot be made for making up fieldwork hours,
the fieldwork educator or AFWC may require additional fieldwork at another site or
require an additional assignment from the student for successful completion of that
course for which the fieldwork was required.
Cancellation or Changes by the Fieldwork Site
Students must understand that many of the fieldworks are arranged well in advance of student
placement. Occasionally, facilities will cancel contracts without much notice to the University. In the event
this occurs, the fieldwork coordinator will do his or her best to find another suitable and timely placement.
While attempts will be made to accommodate student preferences, this may not be possible with short
notice in arranging alternative placements. The Occupational Therapy Program cannot assume
responsibility for delays in completion of the program or eligibility for certification, if the student fails to
accept or complete a scheduled fieldwork assignment, or if the fieldwork site cancels a scheduled
placement.
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Forms used by Level I Fieldwork Students
Fieldwork forms can be obtained from the AFWC or department administrative assistant. Forms will be
provided for use during each FW experience during the fieldwork orientation process prior to the initiation
of each FW experience.
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Level II Fieldwork
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Level II Fieldwork Education Overview
All occupational therapy majors must complete the equivalent of two 12-week (480 hour), full-time clinical
rotations for a required total of 24 weeks of Level II Fieldwork experience. In special circumstances,
fieldwork may be completed on a part-time basis per ACOTE guidelines. Fieldwork II experiences are
more structured than Fieldwork I experiences. Specific assignments and duties may be given by the
fieldwork educator and/or the AFWC.
Level II fieldwork educators need to be currently licensed or credentialed occupational therapists who
have a minimum of 1 year of practice experience subsequent to initial certification, and are adequately
prepared to serve as fieldwork educators. In addition to the program educational goals, and Level II
Fieldwork goals, the AOTA Fieldwork Performance Evaluation for Occupational Therapy Students
(completed by fieldwork educator) is also used as a guideline for establishing goals, objectives, and
competencies for Fieldwork II experiences. Level II fieldwork is graded on a pass/fail basis.
Progression through Level II Fieldwork and Relationship to Graduation Requirements
Students must complete each Fieldwork II experience with a passing grade before progressing to the next
fieldwork II experience. Twenty-four weeks of Fieldwork Level II are mandated for accreditation. The
student must pass both Fieldwork II rotations to graduate from Lenoir-Rhyne University. It should be
noted that most employers require graduation from an accredited school, including Level II fieldwork, and
in most cases completion of the NBCOT certification examination prior to permanently hiring a newly
graduated occupational therapist. Many states will issue a provisional license to practice as long as the
student has applied to take the NBCOT exam.
Commission on Education Guidelines for Level II Fieldwork
The ACOTE/AOTA Standards (1998) describe Level II Fieldwork as...a crucial part of professional
preparation...The goal of Level II Fieldwork is to develop competent, entry-level, generalist occupational
therapists and occupational therapy assistants. The fieldwork experience is to provide students with the
opportunity to integrate academic knowledge with the application of skills in a practice setting. (AOTA,
1999a & b; AOTA, 1996)
1. The fieldwork agency should have currently participated in a review process as
established by the appropriate body, such as Joint Commission on Accreditation of Health
Care Organizations, the Commission on Accreditation of Rehabilitation Facilities or a state
regulatory board. In lieu of this review body there should be a review by the
university/program which is using the center as a fieldwork site.
2. The fieldwork agency should have a stated philosophy regarding service delivery.
A philosophy of the fieldwork agency is a statement of the foundation or principles underlying its
operation. This statement should serve as a guide for the delivery of service for individuals and
groups, the degree of emphasis on research, and the commitment to education.
3. There should be regular professional conferences to evaluate patient/client programming
regarding intervention needs.
In situations where there is little possibility for professional conference due to the nature of the
fieldwork placement, the occupational therapist may independently establish intervention plans
and goals when providing consultation, evaluation and treatment services.
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4. There should be occupational therapy representation in planning programs and
formulating policies which would affect occupational therapy services or involvement.
Occupational therapy representation may be through participation in program-related
conferences, quality review processes, or in groups in which planning and policy-making may be
carried out.
5. The administrators and staff of the fieldwork placement should understand the philosophy
and principles of the occupational therapy fieldwork education program and should accept
the responsibility for making it an integral part of their function.
Since the occupational therapy fieldwork education experience exists within the philosophy and
policies of the fieldwork agency, it is essential that the administration and staff accept and support
the program.
6. The fieldwork agency recognizes that the primary objective of the fieldwork experience is
to benefit the student's education.
The educational value of the student fieldwork experience should be of primary importance, and
the placement should not be used to extend services offered by the fieldwork agency.
7. Opportunities for continuing education and professional development of the occupational
therapy staff and students should be supported.
A. Attendance at workshops, institutes, conferences, courses and professional meetings
should be encouraged.
B. Financial support should be given for professional development whenever feasible with
the budget of the fieldwork agency.
C. Inservice education programs should be developed and made available.
D. Fieldwork students should be encouraged to participate in continuing education and be
provided time to do so, when content is relevant to the fieldwork experience.
8. Occupational therapy staff members should participate actively in occupational therapy
associations and in occupational therapy educational programs, whenever possible.
Occupational therapists and occupational therapy assistants as role models should be actively
involved with national and state occupational therapy associations.
Occupational therapists and occupational therapy assistants should be involved with the
occupational therapy educational programs from which they accept students on an ongoing basis.
Such involvement may include education council meetings, on-site visits, correspondence,
telephone calls, etc.
9. The fieldwork placement shall meet all existing local, state, and/or federal safety and
health requirements and should provide adequate and efficient working conditions.
Space for client-related consultation, preparation, writing, in-service education and research
activities by occupational therapists, practitioners and students should be provided.
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10. There must be adequate financial resources to support the fieldwork placement with
adequate staff, equipment, and supplies.
11. Client records should be available to the staff and students for intervention planning and
practice, educational and research purposes.
12. The occupational therapy philosophy regarding practice and education programs should
be stated in writing. The written objectives of the program should reflect the specific
contribution occupational therapy makes to the overall agency and program.
The philosophy of the occupational therapy services should be written and should include the
following: purpose; responsibility to society, profession, staff, and service recipients; degree of
commitment to service recipients, education and research; and attitude toward future growth. The
objectives should be based on the concepts, beliefs, and values established in the philosophy.
13. The occupational therapist and occupational therapy practitioner should comply with state
regulations governing referrals from qualified physicians and from others seeking service
in the medical, educational and broader human services community. Occupational therapy
staff should collaborate with duly licensed physicians in those instances where medical
management is active, indicated or required.
14. Fieldwork educators responsible for educating Level II Fieldwork occupational therapy
students shall meet state regulations governing practice and have as a minimum 1 year of
practice experience, subsequent to initial certification by NBCOT as an occupational
therapist.
15. Fieldwork educators responsible for educating Level II Fieldwork occupational therapy
assistant students shall meet state regulations governing practice and have as a minimum
1 year of practice experience, subsequent to initial certification by NBCOT as an
occupational therapist or an occupational therapy assistant.
16. The fieldwork agency's communication system ensures accountability in service provision
and documentation.
A. There should be regular procedures for communication among all fieldwork educators
and students.
B. Adequate records and reports should be maintained in accordance with AOTA standards
and legal requirements.
C. Records should be maintained to provide sufficient data for quality improvement. Records
may include administrative, service and other data. Administrative reports would include
such information as numbers of persons serviced, attendance records, schedules and
budgets. Service records should include such information as referral data, client
assessments, intervention plan progress notes and discharge summaries.
17. The fieldwork educator and student should have access to current professional
information, publications, texts, and Internet resources related to occupational therapy
and pertinent topics related to populations and systems being served.
18. The fieldwork experience shall meet requirements in accordance with the Standards for an
Accredited Educational Program for the Occupational Therapist and/or the Standards for
an Accredited Educational Program for the Occupational Therapy Assistant."
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19. The educational program and the fieldwork placement should work collaboratively to
develop objectives in which the aims are compatible with those of the educational
program. The objectives should be reviewed at least annually. These objectives should be
clearly defined for the student and continually evaluated to determine the effectiveness of
the educational experience.
The fieldwork experience should be an extension of the educational program into the clinical or
community setting. The objectives should reflect both the curriculum design of the educational
program and the model of service delivery of the fieldwork setting.
20. Adequate staff to provide occupational therapy services and educational services should
be maintained with supervisory and administrative responsibilities clearly defined.
A. The ratio of fieldwork educators considered adequate to carry out a fieldwork experience
is dependent upon the complexity of the services and the ability to ensure proper
supervision and frequent assessment in achieving fieldwork objectives.
B. Administrative and staff responsibilities should be clearly defined.
21. The fieldwork educator should carry out an organized procedure of orientation to the
agency, services, and the fieldwork experience.
22. The fieldwork placements should provide the student with experience with various groups
across the life span, persons with various psychosocial and physical performance
challenges, and various service delivery models reflective of current practice in the
profession.
Within the required total of 16 weeks for the occupational therapy assistant student and 24 weeks
for the occupational therapy student, there should be exposure to a variety of traditional and
emerging settings and a variety of client ages and conditions.
23. The fieldwork educator shall provide ongoing supervision of the student.
A. The student should be supervised in all aspects of his/her fieldwork experience by
adequate supervisory staff who should have full knowledge of and responsibility for all
aspects of the program being carried out by the student under her or his guidance and
protection.
The fieldwork educator should have full knowledge of the student's assigned workload
and responsibilities and how they are being handled and should be available to the
setting and to the needs of the student.
B. Ongoing supervision should be provided daily and/or weekly as an essential part of the
fieldwork program. It should be flexible in accordance with the interests, needs and
abilities of the student. Supervision should begin with more direct supervision and
gradually decrease to less direct supervision as the student demonstrates competence
with respect to the setting and client's condition and needs.
C. The ratio of fieldwork educators to students shall be such as to ensure proper supervision
and frequent assessment in achieving fieldwork objectives.
D. In a setting where there is no occupational therapy practitioner on site, ACOTE/AOTA
Standards requires a minimum of 6 hours of supervision per week by an occupational
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therapy practitioner. This should include direct observation of client/student interaction,
role modeling, meetings with the student, review of student paperwork, consultation and
communication regarding the learning experience. The fieldwork educator may work with
students in groups, but should be aware of the individual student needs and respond
accordingly. In addition, a designated on-site professional person should be available for
communication throughout the experience. A documented plan for provision of
occupational therapy services in accordance with state regulations and in coordination
with the educational program should be in place. This fieldwork shall not exceed 12
weeks for the occupational therapy student or 8 weeks for the occupational therapy
assistant student.
24. Level II fieldwork shall be required and designed to promote clinical reasoning and
reflective practice, to transmit the values and beliefs that enable the application of ethics
related to the profession, to communicate and model professionalism as a developmental
process and a career responsibility, and to develop and expand a repertoire of
occupational therapy assessments and interventions related to human occupation and
performance.
Level II fieldwork experience should include in-depth experience in delivering occupational
therapy services to clients, focusing on the application of purposeful and meaningful occupation.
25. The student shall have the opportunity to develop increased knowledge, attitudes, and
skills in administration, research and professional relationships.
Suggested ways to implement this guideline, for example, are actual supervision of support staff,
volunteers, or Level I Fieldwork students in certain tasks or work assignments; involvement in
research projects; and attendance at administrative meetings.
26. The student shall be evaluated and be kept informed on an ongoing basis of her/his
performance status.
A. The AOTA Fieldwork Evaluation (FWE) should be used as a rating tool. The student
should be formally evaluated using this form when the fieldwork experience is completed.
Performance should be reviewed by the fieldwork educator and the student at both
midterm and end of the fieldwork experience. Other structured forms of feedback that
promote educator/student communication on the student's progress may also be used on
an ongoing basis.
B. The fieldwork experience should be evaluated by the student, using the AOTA Student
Evaluation for Fieldwork Experience (SEFWE) form, and should be reviewed by the
fieldwork educator and the student ant the conclusion of the fieldwork experience. Other
structured forms of feedback that promote educator/student communication on the
learning experience may also be used on an ongoing basis.
C. If the student's performance is not satisfactory at mid-term or at any point in the fieldwork
experience, both the student and academic institution must be notified immediately and
documentation concerning the student's progress and outcomes of interventions should
be maintained.
Level II Fieldwork Goals, Objectives, and Competencies
Fieldwork II is intended to provide students with an in-depth experience in the delivery of
occupational therapy services to clients and to assist students in fully integrating academic
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knowledge with clinical practice. It is the mission of the School of Occupational Therapy to
develop skilled and caring clinicians who respond adaptively to situations, meticulously
investigate their work and knowledge base, and provide ethical and unbiased services. During
fieldwork experiences, students gradually assume responsibility for the delivery of occupational
therapy services, and develop competence as entry-level principle-centered practitioners. In
addition to mastery of the Lenoir-Rhyne University School of Occupational Therapy educational
mission and goals, and attaining competencies as specified on the AOTA Fieldwork Performance
Evaluation for the OT student form, general goals and objectives for Level II Fieldwork include:
1. Demonstrate collaboration with the client, family, COTA, and other interdisciplinary
team members
2. Communicate client status, concerns, current progress, future needs, and discharge
plans in written and verbal form in a professional and coherent manner
3. Behave in a manner congruent with values, standards, and ethics of the profession
4. Understand and demonstrate adherence to facility policies and procedures
5. Demonstrate a sense of personal responsibility by: accepting feedback, assuming
responsibility for own learning, and taking opportunities to teach others
6. Synthesize through the analysis of tasks, activities, and occupational roles of clients
in order to effectively implement treatment plans
7. Analyze the environment and make appropriate adaptations for clients/families
8. Determine sequence, frequency and duration of occupational therapy services
9. Evaluate the effectiveness of services through re-evaluation of clients and
participation in the quality improvement process
10. Apply occupational therapy theory and frames of reference in the choice of treatment
activities for clients
11. Develop achievable client goals, objectives and treatment activities based on:
assessment, realistic expectations, collaboration with others, and the client/family
needs
12. Demonstrate commitment to lifelong learning through independent research efforts
and willingness to present to occupational therapy peers
13. Use current research findings and other resources as a basis for assessment and
intervention decisions
14. Maintain work area, equipment and supplies according to facility policies and safety
standards
Level II Fieldwork Placement Process
The Lenoir-Rhyne Fieldwork Office utilizes a software system to assist in planning, tracking,
and maintaining all fieldwork education experiences. Student fieldwork assignments are chosen
based on: (a) the quality of educational experience available at the site; (b) the educational needs
of the occupational therapy students; and (c) availability of sites. Fieldwork sites are at a
premium and are a valuable resource of the School of Occupational Therapy. The School has
established fieldwork policies (i.e. Appeals, Assignment Process) designed to serve the largest
good in the fairest possible manner. Students are reminded that they have been informed, since
admission, that they are responsible for completing a minimum of six (6) months of Level II
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fieldwork. Students have been informed that they are responsible for the financial burden of this
part of their training, that this training may take place anywhere in the United States and that the
student is responsible for planning and preparing for this expensive part of their education.
Students will not be placed in fieldwork outside of the assignment process, new fieldwork
site, or assignment appeal processes. Students may not contact any fieldwork site
(scheduled or potential) without AFWC approval.
Fieldwork Assignment Process
Site assignment is completed by the AFWC during the semester prior to the Level II fieldwork
experience. The AFWC first confirms all sites that have returned reservation forms indicating
slots available for LR OT students. Students wishing to request a specific geographic location or
a facility not currently under contract with LRU need to follow the assignment appeals or new
fieldwork site request processes outlined in the FW manual. Sites that are eligible to take
students must ensure that therapy is supervised by a certified and/or licensed occupational
therapist and that education of students is pragmatically or philosophically supported by the
administration of the facility. Students are reminded that the fieldwork policies regarding student
contact with fieldwork sites are in effect. Students are responsible for arranging their own
transportation, housing, and financing for their fieldwork experiences.
In order to take student preferences into consideration, all students will given a Fieldwork Type
Request Form prior to the first Level II experience. This form will indicate a student’s preference
for type of fieldwork placements (physical disabilities, pediatrics, mental health). Each student is
required to complete one physical disabilities rotation. During the semester prior to the fieldwork
experience, the AFWC will compile the final list of available fieldwork sites. Each student will
be given the opportunity to indicate their top three preferred facilities. Students are not
guaranteed any of their three preferred facilities, but their requests will be taken into
consideration. Final placement decisions are based on the fieldwork site that is determined by the
AFWC, in consultation with the OT faculty, to be the most beneficial educational opportunity for
the student and their learning needs.
After completion of the assignment process, students may exchange fieldwork assignments with
each other, if both students can give reasonable explanation as to why the switch would be
beneficial. This request is to be made in person by both students to the AFWC. The AFWC must
approve all changes. If the change is deemed educationally inappropriate for either student, the
AFWC may refuse the change. The LR School of Occupational Therapy reserves the right to
refuse requests for fieldwork placement changes after a given date prior to commencement of the
fieldwork experience.
Level II Fieldwork Assignment Appeals Process
The appeal process is designed to meet the occasional need of students for whom the assignment
process to any facility in the United States would prove disruptive to their family responsibilities
and would result in the student’s probable discontinuation of their schooling. Petitions for
appeals are not to be made lightly. Students should consider the gravity of their appeal and
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submit an appeal only if they feel they could not continue in the program and complete their
training if the appeal were denied. Appeals for special consideration in placement are based on
demonstrated need for one of the following reasons: dependent care, extreme personal issues,
and students with disabilities who have identified themselves to LR University Disability
Services. Appeals cannot be made for financial or marital status reasons. Appeals found to be
made on false claims will be overturned and denied, and students may be removed from the
program for this highly unethical behavior. Students who falsify appeal claims will be placed in
any remaining site at the conclusion of the assignment process. Students will be informed of the
dates of the appeal process. Appeal decisions are made subject to the availability of fieldwork
sites. All decisions of the faculty will be final.
New Fieldwork Site Request Process
All prospective and contracted fieldwork sites are considered a resource of the School of
Occupational Therapy not the individual student. Therefore students shall not contact
fieldwork sites, currently or prospectively contracted with the university, with the intent to
establish personal fieldwork placement without prior consent of the AFWC. Students
wishing to obtain a fieldwork site in a specific location must first meet with the AFWC to
determine if a contract already exists with the facility. If no contract exists, students may contact
fieldwork sites and complete a New Fieldwork Site Request Form (to be obtained from the
AFWC). While the ability to place the student is not guaranteed, if a fieldwork contract is
obtained with a requested site, the student must go to that site for their fieldwork rotation.
Attendance Policy
1.
Level II Fieldwork students are required to notify their fieldwork educator
least 30 minutes prior to reporting time. The student is allowed up to three
excused absences due to illness ONLY during Level II FW. If a student
misses more than 3 days, the student must schedule make-up time and inform
academic fieldwork coordinator. No time off is allowed for vacations, thesis
days, or schoolwork. All absences must be made up except for the 3 illnessrelated days. If a student is called for jury duty or has some other legal
obligations, they are to contact the AFWC and fieldwork educator for further
instructions.
2.
Students are expected to make up any hours that are missed to receive credit
for the fieldwork experience. If arrangements cannot be made for making up
fieldwork hours, the AFWC (in the case of Level II) may require additional
fieldwork at another site or require an additional assignment from the student
for successful completion of that course for which the fieldwork was required.
Cancellation or Changes by the Fieldwork Site
Students must understand that many of the fieldworks are arranged well in advance of student
placement. Occasionally, facilities will cancel contracts without much notice to the University.
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In the event this occurs, the fieldwork coordinator will do his or her best to find another suitable
and timely placement. While attempts will be made to accommodate student preferences, this
may not be possible with short notice in arranging alternative placements. The Occupational
Therapy Program cannot assume responsibility for delays in completion of the program or
eligibility for certification, if the student fails to accept or complete a scheduled fieldwork
assignment, or if the fieldwork site cancels a scheduled placement.
Forms used by Level II Fieldwork Students
Fieldwork forms can be obtained from the AFWC or department administrative assistant. Forms
will be provided for use during each FW experience during the fieldwork orientation process
prior to the initation of each FW experience.
Grading of Level II Fieldwork Experience
Level II Fieldwork is graded on a pass/fail basis using the AOTA Fieldwork Performance
Evaluation (FWPE). This FWPE is used for both midterm and final grading of the fieldwork
experience. Not receiving a passing score of 90 or above at midterm may result in termination of
the fieldwork experience. Students must obtain 122 points or above and a minimum score of 3
for questions 1,2, 3 (fundamentals of practice section) at the final evaluation to be able to pass
the fieldwork course. Students must also have completed all other assignments, such as
completion of Typhon entries and course paperwork, in order to be eligible to pass fieldwork.
Students must successfully complete and pass Level IIA Fieldwork (OCC 571) prior to initiating
600 level courses. Students may only repeat one Level II FW experience. Students withdrawing
from Level II fieldwork without the permission of the program director and the AFWC will be
placed on academic probation. Refer to the student handbook for further rules regarding
academic progression.