Date of Paper/Work

5-2017

Type of Paper/Work

Doctoral Project

Degree Name

Doctor of Occupational Therapy

Department

Occupational Science/Occupational Therapy

First Advisor

Julie Bass

Abstract

Many health profession programs rely on clinical education to enhance didactic coursework and provide practical training. Occupational therapy and occupational therapy assistant education rely on fieldwork to bridge coursework and practice and is a core component and foundation of the educational program. The American Occupational Therapy Association (AOTA) defines fieldwork practicum as a hands-on experience that exposes students to various settings and client populations (1999). Fieldwork education has two stages, Level I Fieldwork and Level II Fieldwork. Level I Fieldwork is designed to supplement coursework through observation and participation in various components of the occupational therapy process (AOTA, 1999). The AOTA Commission of Education (COE) describes Level II Fieldwork as an experience that allows the student “to apply theoretical and scientific principles learned in the didactic portion of the academic program to address actual client needs and develop a professional identity as an occupational therapy practitioners within an interdisciplinary context” (2013, p. 1). Fieldwork is essential for both occupational therapy students and occupational therapy assistant students as it provides the foundation for the development of clinical reasoning and professionalism. However, in recent years placing students at fieldwork sites has become increasingly difficult for a number of reasons. The Bureau of Labor Statistics (BLS) reported that between the years of 2014-2024, the need for occupational therapy practitioners is expected to rise 27% while the need for occupational therapy assistants is expected to increase 40% (BLS, 2015). This workforce projection has led to growing interest in and numbers of both occupational therapy and occupational therapy assistant programs. The increase of students has resulted in sites being unable to meet fieldwork requests by programs (Rindflesch et al., 2009). In addition, practitioners’ hesitancy to take students due to time constraints, productivity demands, and reimbursement rates has contributed to a fieldwork dilemma (Casares, Bradley, Jaffe, & Lee, 2003). Fieldwork sites that do take students may not be able to accommodate all the requests due to changes in staff and site regulations (Casares et al., 2003; Thomas et al., 2007).

AOTA provides both occupational therapy and occupational therapy assistant supervision guidelines for Level I and Level II Fieldwork (2013). According to AOTA, any qualified practitioner who is aware and knowledgeable about occupational therapy may currently supervise Level I Fieldwork students (1999). Supervisors may include social workers, nurses, or any discipline that is familiar with the client population. Placing students at sites without an occupational therapist present may help the occupational therapy student understand where the profession can grow and the need for occupational therapists in emerging community-based sites. Many programs, however, choose to have only occupational therapists supervise their students for Level I and II Fieldwork placements. Although there may be a good reason for this decision, it may exacerbate the difficulties in finding fieldwork placements. As a result, occupational therapy educational programs have created innovative ways to address the limited number of fieldwork site placements. The alternative clinical models used by other allied health professions have provided solutions for some programs. Programs across the country have turned to community-based occupational therapists and collaborative education models to meet the need for new fieldwork sites. The use of community-based sites has relieved the stress placed on programs, but an examination of the effectiveness of collaborative education is needed. For the purpose of this project, the term, collaborative learning, will be used to describe the collaborative group model of clinical education.

Though recent literature has addressed the strengths and difficulties of collaborative learning, most of the evaluation approaches were qualitative. A systematic review of collaborative learning in speech-language pathology found that much of the current research is inadequate (Briffa & Porter, 2013). There also was a paucity of literature regarding the use of the collaborative learning in the occupational therapy profession. Further, there was a lack of research that included all stakeholders involved in the fieldwork placement.

St. Catherine University has created a novel way to address the fieldwork dilemma for the online occupational therapy assistant (OTA) program by placing groups of students with one fieldwork educator. The fieldwork site itself is a community-based site that does not typically have an occupational therapist on staff. The students meet for three consecutive days with the fieldwork educator to familiarize themselves with the site and types of clients. This doctoral project evaluated collaborative learning in the St. Catherine University OTA Level I Fieldwork program by obtaining the perceptions of fieldwork educators, students, and site administrators.

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