Gretchen Reeks, MA, LOTR, C/NDT

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

Revised: 08.16.2016

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.”

* 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.

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):

American Occupational Therapy Association (AOTA):

Canadian Association of Occupational Therapy (CAOT):

FIELDWORK WIKI:

Louisiana Occupational Therapy Association (LOTA):

Louisiana State Board of Medical Examiners: (LSBME):

LSU HEALTH-Shreveport:

Master of Occupational Therapy Program:

LSU Office of Legal Affairs (Affiliation Agreements for Fieldwork):

National Board for Certification in Occupational Therapy (NBCOT):

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:

Florida Gulf Coast University:

San Jose State University:

University of North Dakota:

Washington University School of Medicine in St. Louis:

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 RequiredFieldwork Documentation 7

2.2 Medical Insurance 7

2.3 Cardiopulmonary Resuscitation 7

2.4Health Information 7

2.5 Immunizations 7

2.6 Drug Screen 7

2.7 Criminal Background Check 8

2.8 Criminal Background Re-Check 8

2.9 Fieldwork Policy Forms 8

2.10 Incident Reports 8

2.11 Worker’s Compensation 9

2.12 Blood Pressure/Pulse and Universal Precautions 9

2.13 Americans with Disabilities Act 9

2.14 Cost of Fieldwork 9

2.15Professional Appearance 9

2.16 Social Networking 9

2.17 Computer Use 10

2.18Electronic Communication 10

2.19 Fieldwork Cancellation 10

2.20Change in Medical Status 10

2.21 Accident Reports 10

2.22 Vacation Days 10

2.23 ACOTEAttendance Requirements 10

2.24 Attendance DuringFieldwork Experiences 10

2.25 Ethical Standards 11

2.26 LSU Health–S E-Mail 11

2.27 Electronic Devices 11

2.28 Inclement Weather 11

2.29 The Family Educational Rights & Privacy Act 11

SECTION 3. FW I

3.1 Purpose of FW I 12

3.2 Master of Occupational Therapy Student Evaluation of Fieldwork I Site 12

3.3 Fieldwork I Evaluation of the Master of Occupational Therapy Student 12

SECTION 4. FW II

4.1 Purpose of Fieldwork II 13

4.2 Fieldwork II Participants Rules & Responsibilities 13

4.3 Master of Occupational Therapy Student Fieldwork II Site Selection Process 16

4.4 Master of Occupational Therapy Student Fieldwork II Site Selection Request Form 17

4.5 Fieldwork Syllabus 17

4.6 Independent Study 21

SECTION 5.BECOMING A PROFESSIONAL

5.1 Graduation 22

5.2 National Board of Certification in Occupational Therapy 22

5.3 Temporary Licensure 23

5.4 Alumni 23

5.5 Transcript Request 23

SECTION 6. PHILOSOPHY OF FIELDWORK EDUCATION

6.1 Accreditation Council of Occupational Therapy Education 24

6.2 Student Responsibilities Agreement 24

6.3 Student Fieldwork Professional Behaviors 25

6.4 Academic Fieldwork Site Selection 25

APPENDICES

Appendix 1 ACOTE Fieldwork Education Standards 26

Appendix 2 ACOTE Fieldwork Standards 27

Appendix 3MOTS Request for FW Experience 28

Appendix 4 Fieldwork I Sample Letter 29

Appendix 5 Fieldwork Commitment Form 32

Appendix 6 Fieldwork I MOT Student Objectives 33

Appendix 7 Fieldwork I MOTS Evaluation of Site 34

Appendix 8 Fieldwork I FE Evaluation of MOTS 36

Appendix 9 Fieldwork II Sample Letter 39

Appendix 10 Fieldwork II MOTS Objectives 43

Appendix 11 Fieldwork II First Rotation Three Week Check-In 44

Appendix 12 Fieldwork II GOTOMTG.COM Midterm (Both Rotations) 45

Appendix 13 Fieldwork II Second Rotation Three Week Check-In 46

Appendix 14 Weekly Collaboration Form 47

Appendix 15 Fieldwork II AOTA Fieldwork Performance Evaluation 48

Appendix 16 Fieldwork II Expanded Rubric 56

Appendix 17 Fieldwork II Student Evaluation of the Fieldwork Experience 59

Appendix 18 Fieldwork Experience Assessment Tool 67

Appendix 19Learning Contract Guidelines 72

Appendix 20 Independent Study Objectives Form 75

Appendix 21 Independent Study Contract 76

SECTION 1. MASTER OF OCCUPATIONAL THERAPY STUDENT (MOTS) FORMS

1.1 MOTS Verification of Occupational Therapy Program Policies

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 to the AFWC to callmy emergency contacts at her own discretion.

______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 wanting 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 Contacts

1. Name: ______

Relationship: ______Phone: ______

1. 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 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

Cell phone: 318.453.4448

Fax: 318.813.3001

Louisiana State University Health – Shreveport

School of Allied Health Professions

Program in Occupational Therapy

1450 Claiborne Avenue

Shreveport, LA 71103

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 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 available from LSUHealth-S, the American Heart Association, the Red Cross, and most local hospitals.

2.4 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.

2.5 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.

2.6Drug screen

LSU Health Shreveport requires all incoming students to complete a Drug Test and authorize release of test results as a condition of initial and continued admission to the university. This step is part of the pre-registration task list of duties for admission to the University. Students incur no cost through the university’s vendor.

Incoming students complete the “Student Candidate Agreement and Authorization for Alcohol and Drug Test” form and return the form to the Office of Admissions and Records. Once received, a test packet will be mailed to the student. Remember to bring a photo.

Within several days the Alcohol and Drug Test results are reported to the Human Resources Department and then to the Office of Admissions and Record. Should there be questions about the test results, the incoming student will be contacted by the Human Resources Officer.

2.7 Criminal Background Check

LSU Health Shreveport requires all incoming students to complete a criminal background check through our vendor. This step is part of the pre-registration task list. Incoming students assume responsibility for the cost of this service (approximately $100).

An e-mail request is sent to incoming students outlining the procedure for initiating the request to conduct the background check. Incoming students should anticipate an email from “Application Station” which will arrive shortly after the Office of Admissions and Records receives your signed attached documents. Once received, incoming students should promptly open the “Application Station” email which will direct them through the steps and complete of the process. The turnaround time to complete the background check can be up to 10 days.

Criminal background check results are posted to the vendors secure website in a tamper-proof environment where the incoming student, as well as the Director of Admissions and Records, can review the results. Confidentiality regarding this process is protected by the Office of Student Affairs. Results of the check are forwarded to the LSU Health Shreveport's Department of Human Resources and become part of the student’s permanent academic record. Incoming students are encouraged to secure their user name and PIN number created to initiate the check since most likely they will need access to a copy at a later time during their time as a student with LSU Health Shreveport and beyond.

Should any questionable, illegal or negative indicators appear on the check, the Director of Admissions and Records will confer with the Program Director and Associate Dean for Academic Affairs regarding the most appropriate course of action to take. Many considerations are weighed including the effect of state and national licensure. Incoming students who fail to report a potentially negative incident prior to the background check may be denied admission to the program and admission to the University.

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.

2.8Criminal Background Re-Check

This is the original background check requested during the pre-registration time period.

You are responsible for your User ID and PIN number.

1. Contact the SAHP Office of Admissions and Records for a criminal background re-check
2. You may also go to the Office of Admissions and Records with your photo ID and receive a copy of the report.Or you may contact the Certiphi Request Line: 1.800.260.1680 to request a hard copy.
3. No results, User ID’s or PINS are retained in the Office of Student Affairs.
4. Students have unlimited, 24-hour online access to their check up to one year from the time the report was completed at:

Students may not participate in any FW or community activity until these are completed. A copy must be given to the AFWC one month prior to FW start date. Keep the original in your FW Portfolio.

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.

2.9FW Policy Forms

Read, sign and turn in to the AFWC: MOTS Verification of OT Program Policies; MOTS Acknowledgment of Ethical Practice; MOTS Verification of Understanding; MOTS Waiver and MOTS contact/emergency contact information. This is due week 3 of the first fall semester.

If these forms are not completed the student will not be able to participate in any course related activities that involve patient/ client contact in or out of the classroom.

2.10 Incident Reports

An on-site incident must comply with sites written policies and the student must immediately notify the AFWC. Your personal medical insurance is the primary policy for any injury you incur.

2.11Worker’s Compensation

Students do not qualify for worker’s compensation. An on-site incident must comply with sites written policies and the student must immediately notify the AFWC. Your personal medical insurance is the primary policy for any injury you incur.

2.12Blood Pressure/Pulse and Universal Precautions

Prior to any FW experience, students are instructed by LSU HEALTH-S in blood pressure/pulse and universal precautions.

2.13 Americans with Disabilities Act (ADA)

The School of Allied Health Professions seeks to comply with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act by providing reasonable accommodations to students with documented disabilities. Students must register with the Office of Student Affairs to request disability-related accommodations, and are responsible for providing documentation of a disability. Costs associated with documentation of a disability are the responsibility of the student.

For further information contact Melissa Greaves: 318.813.2908

Students with identified disabilities are strongly encouraged to initiate a discussion with the AFWC during the second semester of the program to discuss their needs for accommodations within the FW settings. This should allow sufficient time for the student to become well informed of his/her rights and to determine if and what information s/he wishes to disclose to the FE. If a student would like to request ADA accommodations for FW, the appropriate documents must be submitted to the AWFC from the Office of Student Affairs. Students may not ask for accommodations once the FW placement has begun. The FW courses will not provide accommodations without prior knowledge. Students who choose not to disclose such information may be in jeopardy of failing.

2.14 Cost of Fieldwork

Students financially assume the costs that accompany all FW experiences. The cost includes full tuition per FW course and all other site-specific fees. Additional expenses may consist of: housing, meals, transportation, travel, parking, materials for projects, scrubs, uniforms, etc.

The LSU HEALTH web page has the specific tuition/fee schedule for each semester:

2.15 Professional Appearance

Students are required to dress as designated by the assigned fieldwork facility. In the absence of a facility dress code, the OT Program dress code is in effect at all times that the student is in the fieldwork facility. In all instances the student must wear a name badge. Full-length pants must meet malleoli. Axilla must be covered. Undergarments must be worn and may not be visible. No facial piercings or jewelry. Tattoos covered at all times. Excellent personal hygiene is expected including hair, facial hair and nails: no longer than ¼ inch; no artificial nails. Hair must be pulled back and out of face and eyes. Chewing gum or tobacco is strictly prohibited.