Occupational Therapy Level II Fieldwork: Effectiveness in Preparing Students for Entry-Level Practice

Abstract

Occupational therapy (OT) is a rehabilitation profession in which licensed therapists facilitate functional independence, to the greatest extent possible, of an individual with disabilities. Education for OT is at the Master’s level consisting of a two-year academic program followed by clinical Fieldwork II, a required 12-week internship under the mentorship of a licensed therapist with at least one year’s experience. In light of the fact that clinical fieldwork sites differ in size and resources, and clinical instructors may have only one year’s experience and no formal training in instruction, there is great variability in students’ clinical fieldwork experiences. The purpose of this study was to determine novice rehab OT’s perceptions of four key factors in clinical education: First, skill areas in which they felt most prepared; second, areas perceived as obstacles in adjustment to entry-level practice; third, essential elements of an ideal clinical learning environment; and fourth, the need for credentialing clinical instructors. Participants were 1-3 years post rehab fieldwork with first job in rehab. An online survey (N=45) and audiotaped interviews (N=9) were utilized to collect data on the perceptions of new OT’s on Fieldwork II experiences. Interviewees represented a convenience sample independent of survey participants. Most participants reported feeling prepared to perform basic clinical skills, communicate on interdisciplinary teams and seek mentorship in the workplace. Less proficiency was perceived in the areas of patient/family communication, and coping with reality shock (adjustment to real life practice). Over half of the participants felt that there should be some kind of mandatory credentialing for clinical instructors. There was consensus among OT’s regarding the ideal Fieldwork II setting which included well-trained instructors, availability for onsite learning and a well-equipped clinical site.