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BPCC OTA Program Level II Fieldwork Site Specific Objectives Checklist for use
with: AOTA Fieldwork Performance Evaluation for the Occupational Therapy Assistant
Student
Site: Date:
Contact Person:
Email:
Phone #:
FUNDAMENTALS OF PRACTICE
Ethics ( FWPE item #1 Adheres consistently to AOTACode of Ethics & Ethics Standards (AOTA
2010, draft) & site’s policies & procedures; including, when relevant, those related to human
subject research) as stated below :
- Demonstrates concern for well-being & safety of recipients of services ( beneficence )
- Intentionally refrains from actions that cause harm ( nonmaleficence )
- Respects right of individual to self rule ( autonomy, confidentiality )
- Provides services in fair & equitable manner ( social justice )
- Complies with institutional rules, local, state, federal, international laws & AOTA documents applicable to profession of occupational therapy ( procedural justice )
- Provides comprehensive, accurate, & objective information when representing profession ( veracity )
- Treats colleagues & other professionals with respect, fairness, discretion, & integrity ( fidelity ) ___Other:________________________________________________________________
Safety (FWPE item #2 Adheres consistently to safety regulations. Anticipates potentially
hazardous situations & takes steps to prevent accidents) for all clients & staff members
throughout all fieldwork related activities aeb:
___record review ___medication side effects ___post-surgical ___infection control ___fall prevention ___swallowing ___food allergies ___ambulation status ___behavioral system/privilege level (e.g., locked area/unit, on grounds)
___OSHA/BBP
___I.V./lines ___ER codes/protocols ___restraint reduction ___HIPAA ___w/c locks/bedrails/call button ___Vital signs (BP, O2) ___Trach/Ventilator monitoring ___Fire/Evacuation/Lockdown ___CPR certification ___1:1 for personal safety/suicide precautions ___Communication re: change in status ___sharps count ___other: _________________ ___environment set up (no clutter, spills, unsafe items, etc.,)
___Other:______________________________________________________________________
Judgment in Safety (FWPE item #3 Uses sound judgment in regards to safety of self &
others during all fieldwork-related activities) aeb:
___proper body mechanics for lifting ___effective use of self-disclosure (boundaries) ___ability to limit set ___follows ambulation/functional mobility protocols ___gait belt ___contact guard ___proper transfer techniques ___proper wheelchair positioning (e.g., footrests, cushions, trays/poseys, etc.) ___effective group leadership (planning, protocols, time use) ___monitors correct Splinting use by client __Static __Dynamic ___proper positioning in chair/bed ___checks MD orders ___confirms parent agreement has been obtained for services per IDEA
___Other:______________________________________________________________________
BASIC TENETS
Occupational Therapy Philosophy ( FWPE item #4 Clearly communicates values & beliefs of
occupational therapy, highlighting use of occupation) aeb:
Confidently explains profession’s values & beliefs, using examples appropriate to setting to : ___client ___families/significant others ___OT ___PT ___SLP ___Teacher ___Aides ___MDs ___Nursing ___LISCW ___Psychologist ___RT ___CRC ___AT ___MT ___ 3 rd^ party payers ___regulatory bodies ___general public (e.g., via promotional materials/activities such as brochures, flyers/press releases, in-services)
___Other :______________________________________________________________________
OT/OTA Roles (FWPE item #5 Communicates role of OT/OTA) as collaborative team according
to state laws/practice acts ___verbally &/or ___via written material provided to : ___client ___families/significant others ___OT ___PT ___SLP ___Teacher ___Aides ___MDs ___Nursing ___LiSCW ___Psychologist ___RT ___CRC ___AT ___MT ___ 3 rd^ party payers ___regulatory bodies ___general public (e.g., via promotional materials/activities such as brochures, flyers/press releases, in-services)
___Other:______________________________________________________________________
Evidence-based practice (FWPE #6 Makes informed practice decisions using published research
& relevant informational resources ) using evidence from sources such as:
___summarized evidence from Critically Appraised Topics/Papers (CATs/CAPs) ___articles from peer reviewed journals (e.g., AJOT, OTJR, etc.,) ___discussion/sharing of material learned via other sources (textbooks, OT Practice, coursework, conference workshops, website searches, conferences, etc.,) in supervision ___materials found using EBP approach (e.g., PICO question: Person, Intervention, Condition, Outcome) to search for relevant evidence
___Other:______________________________________________________________________
EVALUATION & SCREENING
Gathers data (FWPE item #7 Under supervision of & in cooperation with OT/OTA, gathers
relevant information re: clients’ occupations of self care, productivity, leisure, & factors that
support/hinder occupational performance) according to state law & to assessed level of
competency via:
___record review ___interview ___observation in context ___describing observed performance as per setting’s policies & procedures/scope of practice ___gathering data using site sanctioned methods within expected time frame of:___________ ___completing expected number of screenings: ____per day ____per week ____per month ___completing expected number of evaluations: ____per day ____per week ____per month
___Other:______________________________________________________________________
____Theories/Frames of reference such as PEO Sensory Integrative Biomechanical NDT Behavioral Functional Group Model Acquistional MOHO Psychodynamic Occupational adaptation Cognitive Behavioral Ecology of Human Performance DBT Rehabilitation Sensory Processing Clinical Reasoning Developmental Cognitive/Cognitive Disability Motor Learning Other(s): Other(s): Other(s):
___clients interests/roles ___clients beliefs & values ___current context & resources ___future context & resources ___intervention plan goals ___client status/current performance ___Other:_________________________________________________________________
Implements (FWPE item # 14: Implements occupation-based interventions effectively in collaboration with clients, families, significant others, & service providers) ___maintains open attitude re: clients’ occupational performance needs/interests ___seeks & responds to feedback from clients, families, significant others, service providers ___respectfully engages in discussion with client/family/caregivers, occupational therapist, others ___provides written documentation of collaborative plan (e.g., home program) ___communication with others (documentation, at meetings, in letters or documents to other providers) incorporates examples of occupation-based interventions used and clients response.
Activity analysis: (FWPE item #15 Grades activities to motivate/challenge client & facilitate progress) by: ___adapting sequence of activity & objects used ___changing length/frequency/timing of sessions ___ increase and/or decrease sensory input ___ increase and/or decrease cognitive demand ___ increase and/or decrease visual/verbal cues ___ increase and/or decrease physical requirements ___ increase and/or decrease amount of physical assistance provided ___ increase and/or decrease social demand (1:1 vs. group, family vs. peer(s), rules/norms) ___ increase and/or decrease amount of emotional/behavioral support provided ___promoting increased safety (awareness, environmental modifications for fall prevention, removing potential sources of self injury, etc., ) ___reviewing/revising expectations with client(s) relative to desired occupations, role(s) & context ___Other:______________________________________________________________________
Therapeutic Use of Self: (FWPE item #16: Effectively interacts w/clients to facilitate accomplishment of established goals) ___communicates to address concerns in 1st^ person manner (e.g., “I statements”) ___provides clear and concise instructions ___provides timely and specific feedback ___remains calm when conveying point of view ___compromises as needed to facilitate therapeutic alliance ___demonstrates ongoing awareness of impact of own behavior on others ___displays positive regard for others; genuine in client interaction ___utilizes own strengths and personality to establish rapport & motivate clients ___provides encouraging and empathetic responses to maximize client’s participation & occupational performance ___sets limits to allow for positive performance in therapeutic process ___Other:_________________________________________________________________
Monitors client status to modify intervention plan as needed in collaboration with occupational therapist based on (FWPE item #17): ___fatigue ___O2 sat/respiration rate ____BP/heart rate ___frustration tolerance ___anxiety ___acuity ___concerns re: safety (please specify):____________________ ___cultural sensitivity ___cognitive status ___pain ___client distress/discomfort ___inability to perform task ___refusal to engage ___Other:_________________________________________________________________
COMMUNICATION
Verbal & Nonverbal ( FWPE item #18 Clearly & effectively communicates verbally & nonverbally with clients, families, significant others, colleagues, service providers, & the public) ___uses language appropriate to the level of understanding of person with whom communicating ___utilizes examples to illustrate meaning/intent ___uses active listening strategies (restates/paraphrases) to ensure that both parties have shared understanding of information/plan ___uses multiple modes of communication (verbal, written, nonverbal) ___makes eye contact when appropriate ___attends to physical boundaries/body space ___demonstrates professional presentation/demeanor in facial expression, posture, grooming affect, & attire ___utilizes setting’s services for translators or translation of written materials when indicated/available ___Other:_________________________________________________________________
Written (FWPE item #19 Produces clear & accurate documentation according to site requirements. All written communication is legible, using proper spelling, punctuation, & grammar) ___completes computerized &/or hand-written documentation per setting protocols/formats ___uses approved institutional terminology/abbreviations ___completes all documentation within expected time periods ___writes in a manner conducive to being read by recipients of services & other disciplines, free of jargon while retaining language consistent with OTPF-Revised ___uses technology when available to check work (grammar, spelling) ___uses strategies such as proof reading, reading aloud, checking against template, asking colleague/peer to proof if feasible ___Other:_________________________________________________________________
PROFESSIONAL BEHAVIORS
Self-Responsibility ( FWPE item #20 Takes responsibility for attaining professional competence by seeking out learning opportunities & interactions with supervisor(s) & others) ___shares information about learning style with supervisor ___asks for help incorporating learning style in ways consistent with setting if needed ___comes to supervision with list of questions/concerns & possible options for how to address ___takes initiative to meet with other members of team to understand their role/perspective ___reviews testing materials/manuals on own prior to observing or administering ___seeks out, reviews & shares reading materials/articles on frames of reference/EBP, client conditions, public law/policy ___judges when choosing to attend in-services or other continuing education opportunities based on workload management & caseload focus ___asks for specific feedback ___consistently checks ins to clarify expectations ___utilizes structured methods in setting to support learning (e.g., student manual, readings, in- services, self-assessment, tracking own caseload/workload ___assertive regarding need to meet for supervision ___openly discusses concerns & identifies possible avenues for changes or improvements ___able to discuss &/or negotiate needs for adjustments to supervisory relationship, expectations, caseload, environment to improve quality of experience ___Other:_________________________________________________________________
Feedback ( FWPE item #21 Responds constructively to feedback) : ___engages in mutual feedback exchange (e.g., listens, clarifies, acknowledges the feedback &/or redirection, provides examples, asks "How can I improve?"; discusses ways make active changes, identifies what would be helpful, discusses options) ___demonstrates commitment to learning by identifying specific goals/actions to improve behavior/performance based on feedback in collaboration with supervisor ___processes feedback & seeks support from supervisor within context of supervisory
