Master of Occupational Therapy
FIELDWORK EXPERIENCE MANUAL
Gretchen Reeks, MA, LOTR, C/NDT
Academic Fieldwork Coordinator (AFWC)
Assistant Professor
Office: (318) 813-2953
Fax: (318) 813-3001
Louisiana State University HEALTH – Shreveport
School of Allied Health Professions
Program in Occupational Therapy
1450 Claiborne Avenue
Shreveport, LA 71103
* The material contained herein is subject to change from time to time. The Occupational Therapy Program reserves the right to alter or amend the terms, conditions and requirements as necessary.
** LSU HEALTH-S MOT students are responsible for understanding information in this manual.
AOTA’s Centennial Vision
We envision that occupational therapy is a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society’s occupational needs.
LSU HEALTH-S OT Program Mission Statement
The Program in OT at LSU HEALTH-S subscribes to a three-fold mission. First, to educate students to become reflective and empathetic practitioners who provide excellent quality care while maintaining high ethical standards. These practitioners will be able to collaborate with clients, family members and other healthcare providers. Second, to foster scholarly development through a spirit of inquiry that will result in intellectual growth and lifelong learning. Scholarly development will promote research in order to enrich and validate the knowledge base of occupational therapy. Third, to provide service through varied delivery models, to people in Louisiana, the nation and the world, to enhance occupational performance.
Resources
Accreditation Council for OT Education (ACOTE): www.aota.org/Educate/Accredit.aspx
American Occupational Therapy Association (AOTA): www.aota.org
Canadian Association of Occupational Therapy (CAOT): www.caot.ca
FIELDWORK WIKI: http://motfieldwork.pbworks.com/FrontPage
Louisiana Occupational Therapy Association (LOTA): www.lota.org
Louisiana State Board of Medical Examiners: (LSBME): www.lsbme.la.gov
LSU HEALTH-Shreveport: www.sh.lsuhsc.edu
Master of Occupational Therapy Program: http://www.medcom.lsuhscshreveport.edu/ah/page.php?id=13
LSU Office of Legal Affairs (Affiliation Agreements for Fieldwork):
http://www.lsuhscshreveport.edu/ImmigrationContracts/ImmigrationAffiliationSAHP.aspx
National Board for Certification in Occupational Therapy (NBCOT): http://www.nbcot.org/index.html
Acknowledgements
The LSUHSC-Shreveport program in Occupational Therapy would like to recognize the following universities for their contributions to this Fieldwork Experience Manual:
Colorado State University: http://www.ot.chhs.colostate.edu/ot/index.aspx
Florida Gulf Coast University: http://www.fgcu.edu/CHPSW/RS/OTMS/index.asp
San Jose State University: http://www.sjsu.edu/occupationaltherapy/Programs/entry-level_ms/
University of North Dakota: http://www.med.und.edu/occupational-therapy/
Washington University School of Medicine in St. Louis: http://www.ot.wustl.edu/
TABLE OF CONTENTS
SECTION 1. STUDENT FORMS
1.1 Master of Occupational Therapy Student Verification of OT Program Policies 5
1.2 Master of Occupational Therapy Student Acknowledgement of Ethical Practice 5
1.3 Master of Occupational Therapy Student Verification of Understanding 5
1.4 Master of Occupational Therapy Student Waiver 5
1.5 Master of Occupational Therapy Student Contact Information 6
1.6 Academic Fieldwork Coordinator Contact Information 6
SECTION 2. FIELDWORK
2.1 Required Fieldwork Documentation 7
2.2 Medical Insurance 7
2.3 Professional Liability Insurance 7
2.4 Cardiopulmonary Resuscitation 7
2.5 Health Information 7
2.6 Immunizations 7
2.7 Drug Screen 8
2.8 Criminal Background Check 8
2.9 Criminal Background Re-Check 8
2.10 Fieldwork Policy Forms 9
2.11 Incident Reports 9
2.12 Worker’s Compensation 9
2.13 Blood Pressure/Pulse and Universal Precautions 9
2.14 Americans with Disabilities Act 9
2.15 Cost of Fieldwork 10
2.16 Professional Appearance 10
2.17 Social Networking 10
2.18 Computer Use 10
2.19 Electronic Communication 10
2.20 Fieldwork Cancellation 10
2.21 Pregnancy 11
2.22 Accident Reports 11
2.23 Vacation Days 11
2.24 ACOTE Attendance Requirements 11
2.25 Attendance During Fieldwork Experiences 11
2.26 Ethical Standards 12
2.27 LSU Health–S E-Mail 12
2.28 Electronic Devices 12
2.29 Inclement Weather 12
2.30 The Family Educational Rights & Privacy Act 12
SECTION 3. FW I
3.1 Purpose of FW I 13
3.2 Master of Occupational Therapy Student Evaluation of Fieldwork I Site 13
3.3 Fieldwork I Evaluation of the Master of Occupational Therapy Student 13
SECTION 4. FW II
4.1 Purpose of Fieldwork II 14
4.2 Fieldwork II Participants Rules & Responsibilities 15
4.3 Master of Occupational Therapy Student Fieldwork II Site Selection Process 17
4.4 Master of Occupational Therapy Student Fieldwork II Site Selection Request Form 18
4.5 Fieldwork Syllabus 18
4.6 Independent Study 23
SECTION 5. GRADUATION
5.1 Graduation 24
5.2 National Board of Certification in Occupational Therapy 24
5.3 Temporary Licensure 24
5.4 Alumni 24
5.5 Transcript Request 25
SECTION 6. PHILOSOPHY OF FIELDWORK EDUCATION
6.1 Accreditation Council of Occupational Therapy Education 25
6.2 Student Responsibilities Agreement 25
6.3 Student Fieldwork Professional Behaviors 27
6.4 Academic Fieldwork Site Selection 27
APPENDICES
Appendix 1 ACOTE Fieldwork Standards 28
Appendix 2 MOTS Request for FW Experience 31
Appendix 3 Fieldwork I Sample Letter 32
Appendix 4 Fieldwork Commitment Form 35
Appendix 5 Fieldwork I MOT Student Objectives 36
Appendix 6 Fieldwork I MOTS Evaluation of Site 37
Appendix 7 Fieldwork I FE Evaluation of MOTS 38
Appendix 8 Fieldwork II Sample Letter 41
Appendix 9 Fieldwork II MOTS Objectives 45
Appendix 10 Fieldwork II First Rotation Three Week Check-In 46
Appendix 11 Fieldwork II GOTOMTG.COM Midterm (Both Rotations) 47
Appendix 12 Fieldwork II Second Rotation Three Week Check-In 48
Appendix 13 Weekly Collaboration Form 49
Appendix 14 Fieldwork II AOTA Fieldwork Performance Evaluation 50
Appendix 15 Fieldwork II Expanded Rubric 58
Appendix 16 Fieldwork II Student Evaluation of the Fieldwork Experience 62
Appendix 17 Fieldwork Experience Assessment Tool 70
Appendix 17 Learning Contract Guidelines 75
Appendix 18 Independent Study Objectives Form 78
Appendix 19 Independent Study Contract 79
SECTION 1. MASTER OF OCCUPATIONAL THERAPY STUDENT (MOTS) FORMS
1.1 MOTS Verification of Occupational Therapy Program Policies
REVISED 10/2/13
By my signature below, I attest that I have received a copy of the Occupational Therapy (OT) program policies and guidelines. I understand that I must have knowledge and familiarity of said policies and agree to abide by the regulations as stated while I am on or off campus. I understand that this policy supersedes any policy that an externship site might give to me. I understand I am bound by the policies and procedures provided in the fieldwork (FW) syllabus, current school catalog, OT program student policy, SAHP student policy, and LSU Health institution policies. I also understand this is a dynamic document and is subject to review and revision as indicated by the changing needs of the OT program.
1.2 MOTS Acknowledgement of Ethical Practice
By my signature below, I attest that I have read and understand the American Occupational Therapy Association (AOTA) Code of Ethics. I also agree to transmit the values and beliefs that enable ethical practice, and to develop professionalism and competence in occupational therapy as identified by the Accreditation Council for Occupational Therapy Education (ACOTE). I am aware that it is my duty to read and comprehend the terms of these documents.
1.3 MOTS Verification of Understanding
By my signature below, I attest that I have read and understand the policies in this manual and agree to take responsibility for my actions as outlined in the Fieldwork Manual. All MOT students are expected to read and abide by the policies contained in this manual. The person listed for emergencies will be contacted upon discretion of the Academic Fieldwork Coordinator (AFWC) and Program Director (PD). A successful FW experience is dependent on the application of course work, intentional learning and initiated communication with the FW educator (FE) and AFWC.
Upon completion of reading this manual and acceptance of these policies, please sign and date this page. The signed copy is placed in the AFWC’s mailbox and retained in your student file. This manual is a guide for fieldwork. The AFWC is available to clarify any information.
1.4 MOTS Waiver By my signature below, I agree to the checked applicable statement (s)
______I grant permission for the AFWC to give out my name, address, email, and phone number to FW educators needing to contact me.
______I grant permission for the AFWC to give out my address, email, and phone number to my classmates.
______I grant permission for the AFWC to give out my name, address, email, and phone number to potential job recruiters needing to contact me.
Signature: ______Date: ______
Printed Name: ______
1.5 MOTS Contact Information
MOTS Contact Information
Printed Name: ______
Cell Phone (include area code) ______
LSU email: ______other email: ______
Emergency Contact
Name: ______
Relationship: ______Phone: ______
Name: ______
Relationship: ______Phone: ______
1.6 AFWC Contact Information
FW students should seek to develop open lines of communication with their immediate FE and concerns should be addressed directly to this person. If students have concerns in which the FE(s) are unable to adequately address, or which go beyond the scope of the FW site, the student should contact the LSU AFWC.
Professor Gretchen Reeks, MA, LOTR, C/NDT Email: Office phone: 318.813.2953
Emergency Contact: Cell phone: 318.453.4448 Home Phone: 318.797.4140 Fax: 318.813.3001
You may email or text me. Please be sure to indicate if an immediate email reply or telephone call is required. Also, indicate if the call should be made to your home, cell phone or to the fieldwork site. Be sure to include the phone numbers in your email. I will attempt to return all calls in a timely manner.
SECTION 2. FIELDWORK
2.1 Required FW Documentation
Students are required to provide proof of each of the following categories: medical insurance, professional liability insurance, CPR, health information, drug screen, and criminal background check. Students will not be permitted to begin FW if current proof of each is not on file. Failure to start FW on the designated date may result in the student being withdrawn from that placement, the loss of that specific placement opportunity, and delay in graduation. It is the student’s responsibility to provide one copy of each document to the OT Program Administrative Assistant, and keep one copy in their FW portfolio.
2.2 Medical Insurance
Students are required to carry their own medical insurance coverage, in the event of an injury while on fieldwork. The insurance must be applicable for coverage throughout all fieldwork experiences. The cost of emergency and medical care is the responsibility of the student or the student insurance provider.
2.3 Professional Liability Insurance
Malpractice insurance also referred to as professional liability insurance, with minimum limits of $1,000,000/$3,000,000. In order to meet the requirement of the FW site, please purchase from:
- Type in the address box: www.proliability.com (do not use search engine)
- Open Healthcare professional, open students, open get a quote and pay online: Visa or MasterCard.
- Type in the year of your graduation
- Choose the 3 year plan. You will need your AOTA number.
- If you have any questions M-F during the hours of 8:15-5:00, call 1-800-503-9230
- Purchase the liability insurance and give the AFWC a copy for the school file.
2.4 Cardiopulmonary Resuscitation Certification (CPR): Required for infant, child and adult.
Prior to any type of FW, students are required to provide proof of current CPR for Health Care Providers certification. CPR certification must be current though the completion of FW II. Training is also available from the American Heart Association, the Red Cross, and most local hospitals.
2.5 Health Information
All students have access to an electronic copy of their immunization records. Please request this information from Shauntee Gee () or Hazel Alexander (). You may also call the Occupational Health Department at 318.675.6281.
It is the student’s responsibility to meet site-specific immunization requirements. The AOTA data form has this information, and the student may also email the site fieldwork coordinator.
2.6 Immunizations and/or screening tests include:
1. Positive Rubella (German Measles) Titer Test or Immunization and Positive Rubeola (Measles) Titer Test or Immunization.
2. Positive Varicella (Chicken Pox, Herpes Zoster) Titer Test or Immunization or validation of having Chicken Pox.
3. Current Tetanus booster (within 10 years).
4. Mantoux TB screening test within 1 year of application and yearly thereafter. A positive Mantoux test result must be followed up with a chest x-ray and verification of inactive status.
5. Yearly evidence of TB mask fit/check.
6. Evidence of Hepatitis B Vaccine series completed or initiated, positive titer or a student signed waiver. Hepatitis B (HB) Vaccine is given as a series of 3 immunizations, with the final 2 given 1 and 6 months following the initial immunization. A student who does not wish to take or who is unable to take the immunization is required to sign a waiver for the Hepatitis B Vaccine series.
2.7 Drug screen
MOT students are required to complete the drug screen upon admission to LSU HEALTH-S. Please go to the FW WIKI page or LSU HEALTH web page http://myhsc.lsuhscshreveport.edu/HResources/HRForms.aspx and complete the form requesting a copy of your drug screen. Turn this form in to and the HR office will call or email you when the form ready.
2.8 Criminal Background Check
MOT students are required to complete a background check prior to admission to the LSU HEALTH-S OT program. All incoming students complete a criminal background check through our approved third-generation applicant screening company. Students have lifetime access to their criminal background check through the secure website of the applicant screening company. The cost of the check, which may range from $50 to $100 depending on the number of cities, parishes, counties or states you lived in, is the responsibility of the student.
Any student whose background check yields negative information will be required to meet and review the processes for prescreening through NBCOT and the LA OT Licensure Board to determine if the identified offense(s) will prevent the student from sitting for the NBCOT exam or from obtaining a license to practice.
LSU Health Shreveport requests that you use the Application Station - Student Edition to complete necessary screening services through Certiphi Screening, Inc. Please follow the instructions below:
1. Click the link below or paste it into your browser: http://www.applicationstation.com
2. Enter the Code: LSUHEALTH in the Application Station Code field.
3. If you have not already created an account for yourself, click the "SIGN UP NOW" button to do so. Otherwise, just clickthe "SIGN BACK IN" button to login using your Username and Password.
4. Follow the instructions on the Application Station web site.
5. If you have technical issues, please contact Application Station Support at: 888-291-1369 X2006.