LEVEL I
TABLE OF CONTENTS
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Page
Number |
Section or Topic |
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PROGRAM
INFORMATION |
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1. |
LATI OTA Program Mission & Philosophy |
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2. |
LATI OTA Program Philosophy continued |
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3. |
LATI OTA Program Objectives |
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4. |
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LEVEL I FIELDWORK INFORMATION & POLICIES & PROCEDURES |
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5. |
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6. |
Guide
to Fieldwork Titles & COE guidelines for Level One |
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7. |
COE Guidelines for Level I |
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8. |
LATI Fieldwork Policies & Procedures (confidentiality & insurance) |
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9. |
LATI Fieldwork Policies & Procedures (immunization, travel, housing, personal business, attendance, assignments, grading, & grade appeals) |
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10. |
LATI Fieldwork Policies & Procedures (dress & student grievance) |
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11. |
LATI Fieldwork Policies & Procedures (supervisor grievance) |
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12. |
Guide to LATI Forms |
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13. |
Appendix
A |
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Supervisor
Evaluation of Student (3pages) |
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Student
Evaluation of the Fieldwork Experience (2 pages) |
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Supervisor
Grievance Form (1 page) |
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Accommodation Request Form (1 page) |
The mission of the Lake Area Technical Institute
Occupational Therapy Assistant Program is to provide an entry-level education
in occupational therapy, which meets, established
standards and prepares students to be competent, well rounded, and adaptable
practitioners. The program seeks to instill
each student with a drive for continuing growth and a realistic level of
confidence in order to be successful in their profession.
The program will provide a broad-based
education and includes:
·
development of interpersonal skills for therapeutic relationships
·
critical and ethical decision making
·
practice skills needed for rural settings
·
an understanding of diversity
·
opportunities for professional advocacy.
PHILOSOPHICAL
THEMES
OCCUPATIONAL
THERAPY ASSISTANTS (OTA) PRACTICE INDEPENDENTLY BUT WITHIN ESTABLISHED ROLE
PARAMETERS
We believe that OTA’s receive
educational experiences that allow them to practice in an independent manner
and to make appropriate treatment decisions based on sound clinical
reasoning. The term “partnership” best describes
the relationship between an OTA and their supervising Occupational Therapist
(OT). It is a relationship in which
collaboration is professionally emphasized and legally required. The establishment of service competency with
a supervising OT can allow an OTA to continue to expand their professional
knowledge.
THE
CONCEPT OF OCCUPATIONS IS THE HEART OF OCCUPATIONAL THERAPY (OT) PRACTICE
We believe that “occupations” are
the center of our practice philosophy, as the title of our profession
signifies. Occupations are the
activities and tasks that facilitate intrinsic motivation for each unique
individual. They are activities or tasks
that an
individual likes to perform, wants to perform, or has to perform in their
life. Occupation as a modality for
treatment is as diverse and as complex as each individual we treat. The unique
ability of the occupational therapy practitioner, particularly the OTA, is to
analyze and modify activities to be meaningful and satisfying to the
participants. By articulating the meaning
of occupations, the purpose for interventions is clear to the individual
receiving the occupational therapy service.
INDIVIDUALS HAVE A RIGHT TO
FULL PARTICIPATION IN THE TREATMENT PROCESS
We believe that OT
recognizes the importance of each service recipient’s participation in the team
process. Within the context of a
treatment team, an OTA should foster the need for a humanistic approach to an
individual’s situation or condition.
This includes encouraging all recipients of OT services and caregivers
be actively engaged in decisions regarding their physical, mental, social, and
spiritual well being.
IN SCHOOL, IN THE CLINIC,
AND IN THE COMMUNITY WE MUST FOSTER AN ENVIRONMENT THAT PROMOTES CREATIVITY
1.
DIVERSITY IS IMPORTANT TO
UNDERSTAND AND ACCEPT
The result of this life-long
growth process for the OTA includes an expectation, a commitment and a
confidence to participate in opportunities to advocate for OT.
DISABILITIES IMPACT THE
INDIVIDUAL’S WHOLE LIFE AND THEREFORE THE WHOLE LIFE NEEDS TO BE
THERAPEUTICALLY ADDRESSED
We believe that holistic
treatment is at the opposite end of the spectrum from reductionistic treatment.
The whole life of the individual, including their context must be part of the
therapeutic process. From a holistic standpoint, any change in one system of an
individual will result in changes in other systems as well. Changes can be the
result of such things as aging, injury, disease, and poor lifestyle choices.
The individual’s whole life must be evaluated with treatment planned and
interventions carried out to address changes.
THERE IS A REASON FOR
EVERYTHING THAT OT DOES
We believe that OT sometimes
looks simple but the clinical reasoning behind the decisions that OT
practitioners make is very complex. OT
addresses not only the biopsychosocial components of the individual but the
spiritual and environmental factors as well. Education in OT emphasizes the
uniqueness of OT and treatment methods, which are particular, reasoned, and
specific.
OT CAN BE FUN – FOR
LEARNING, FOR PRACTICE AND FOR THE INDIVIDUALS WHO RECEIVE OT SERVICES
We also believe that
students who are happy and enjoy the learning experience are going to have
better attitudes, be healthier, and carry that into school or practice. They
are less likely to burn out from the stress of school and/or clinical
requirements.
1.
Explain the role and value of occupational therapy in
various settings.
2.
Define the scope and practice of the Occupational
Therapy Assistant within various practice settings.
3.
Adhere to school, program, and fieldwork policies and
procedures.
4.
Manage time wisely in classroom and fieldwork
settings.
5.
Display respect for self and others.
6.
Modify behavior in response to constructive feedback.
7.
Communicate personal and professional needs to
supervisor.
8.
Demonstrate effective problem solving skills.
9.
Maintain treatment area, equipment, supplies, and
department records.
10.
Collect pertinent information from written data
sources (e.g. charts, records), interviews, and observations as part of the OT
process.
11.
Correctly administer assigned assessments under the
direction of an OT.
12.
Collaborate with an OT in planning an intervention
program.
13.
Select appropriate activities to meet established
goals.
14.
Implement treatment programs as per the treatment plan
and adjust intervention techniques according to needs of the client.
15.
Communicate with client and/or caregiver regarding the
intervention plan and strategies.
16.
Utilize principles of group process when working with
groups.
17.
Communicate changes in client status, treatment,
and/or progress with supervisor.
18.
Report factual information in written and verbal form
to supervisor and team members.
19.
Establish and maintain a therapeutic relationship with
recipients of OT services.
20.
Attend to safety needs in all educational
environments.
21.
Display professional behavior in classroom and
fieldwork settings.
22.
Orient client and/or caregivers to nature and purpose
of the occupational therapy program.
23.
Maintain confidentiality.
24.
Maintain accurate written records.
25.
Provide quality services in a variety of practice
settings, within the scope of practice, adhering to applicable rules and
regulations, and within the professional Code of Ethics.
26.
Participate in identifying research investigation
topics and analyze articles relevant to topic.
27.
Participate in continuing education opportunities to
promote continued professional growth, sustain learning, network with other
occupational therapy practitioners, and develop professional behaviors.
OCCUPATIONAL THERAPY
ASSISTANT
CURRICULUM OUTLINE
Revised:
01/02
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First Year - Fall Semester |
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Course Number |
Course Title |
Clock Hours |
Credits |
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General Education Requirements: |
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CSC 100 |
Introduction to Computers |
28 |
1 |
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ENGL 101 |
Composition |
48 |
3 |
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PSYC 101 |
General Psychology |
48 |
3 |
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SPCM 101 |
Fundamentals of Speech |
48 |
3 |
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Related Courses: |
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MA 115 |
Medical Terminology |
42 |
1.5 |
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ANAT 142 |
Anatomy |
48 |
3 |
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Occupational Therapy Requirements: |
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OTA 100 |
Introduction to
Occupational Therapy |
56 |
2 |
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OTA 105 |
Crafts and Activity
Analysis |
84 |
3 |
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Total Credits |
402 |
19.5 |
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First Year - Spring Semester |
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Course Number |
Course Title |
Clock Hours |
Credits |
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Related Courses: |
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PHGY 210 |
Human Physiology |
64 |
4 |
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PSYC 251 |
Abnormal Psychology |
48 |
3 |
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AED 100 |
Automated External
Defibrillator |
14 |
.5 |
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Occupational Therapy Requirements: |
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OTA 111 |
Kinesiology/Neurology for
Occupational Therapy Assistant |
140 |
5 |
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OTA 120 |
Human Development 0-21 |
56 |
2 |
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OTA 125 |
Human Development 0-21 Lab |
84 |
3 |
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OTA 131 |
Activities of Daily Living |
84 |
3 |
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OTA 215 |
Assistive Technology and Occupational
Therapy |
56 |
2 |
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Total Credits |
546 |
22.5 |
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First Year - Summer Session |
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Course Number |
Course Title |
Clock Hours |
Credits |
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Occupational Therapy Requirements: |
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OTA 135 |
Group Dynamics |
56 |
2 |
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OTA 140 |
Ethics and Issues in
Occupational Therapy |
56 |
2 |
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OTA 150 |
Fieldwork I-A |
40 |
.5 |
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OTA 155 |
Fieldwork I-B |
40 |
.5 |
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OTA 200 |
Adult Human Development |
28 |
1 |
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OTA 205 |
Adult Human Development Lab |
84 |
3 |
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Total Credits |
304 |
9 |
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Second Year -
Fall Semester |
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Course Number |
Course Title |
Clock Hours |
Credits |
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General Education Requirements: |
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MATH 100 |
Applied General Math |
48 |
3 |
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SOC 100 |
Introduction to Sociology |
48 |
3 |
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Occupational Therapy Requirements: |
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OTA 145 |
Occupational Therapy in
Mental Health |
84 |
3 |
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OTA 210 |
Pathophysiology |
84 |
3 |
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OTA 220 |
Physical Disabilities |
56 |
2 |
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OTA 225 |
Physical Disabilities Lab |
84 |
3 |
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Total Credits |
404 |
17 |
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Second Year - Spring Semester |
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Course Number |
Course Title |
Clock Hours |
Credits |
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Occupational Therapy Requirements: |
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OTA 231 |
Special Topics in
Occupational Therapy |
28 |
1 |
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OTA 236 |
Fieldwork II-A |
330 |
5.5 |
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OTA 241 |
Fieldwork II-B |
330 |
5.5 |
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Total Credits |
688 |
12 |
Credit
Breakdown:
80 credits
required for graduation
General
Education Courses = 16
• Related Courses =
12 •
Occupational Therapy Courses = 52
Lake
Area Technical Institute
OTA Program
Fieldwork Program
Overview
New
Site Information
Fieldwork
Agreements:
Fieldwork
Requests;
Placements:
Level I placements are one week in length and are
scheduled for late spring and mid summer. The first placement is termed
Level II placements are two months in length and are
scheduled for midwinter (January) through late spring (May). The
are termed Level IIA and Level II B. Request for placements are
typically sent out to fieldwork site in late summer or early fall. After
placements have been secured, the fieldwork coordinator sends out an student information packet to the site. This packet
contains forms that provide proof of professional liability, childhood
immunization, a negative TB test and CPR certification within the past 12
months, as well as a student signed confidentiality form. The information
packet also includes proof medical insurance and a hepatitis B immunizations or
a student signed waiver.
Dataforms:
Student
Objectives:
GUIDE TO FIELDWORK TITLES
Academic Fieldwork Coordinator: This is
the representative from Lake Area Technical Institute’s Occupational Therapy
Assistant Program who organizes fieldwork contracts and addresses issues
relevant to LATI fieldwork experiences.
Any questions regarding fieldwork should be directed to:
Randy Breske, COTA/L
Fieldwork Coordinator
Occupational Therapy
Assistant Program
Lake Area Technical
Institute
Phone: 800-657-4344, ext.
372
Email: bresker@lati.tec.sd.us
Primary
Fieldwork Educator: The individual who serves as the contact person between the facility
and the LATI OTA program. This
individual coordinates the placement of and must have at least one-year
experience.
Clinical
Supervisor: The
individual who serves as the direct supervisor of the student. This person can be an OT, OTA, or other
qualified professional.
Definition and Purpose
The AOTA Standards describe the goal of
Level I Fieldwork "to introduce students to the fieldwork experience, and
develop a basic comfort level with an understanding of the needs of
clients." Level I Fieldwork is not intended to develop independent
performance, but to "include experiences designed to enrich didactic
coursework through directed observation and participation in selected aspects of
the occupational therapy process."
Services may be provided to a variety of
populations through a variety of settings. Experiences may include those
directly related to occupational therapy, as well as other situations to
enhance an understanding of the developmental stages, tasks, and roles of
individuals throughout the life span. Day care centers, schools, neighborhood
centers, hospice, homeless shelters, community mental health centers, and
therapeutic activity or work centers are among the many possible sites. Level I
Fieldwork may also include services management and administrative experiences
in occupational therapy settings, community agencies, or environmental analysis
experiences. Populations may include disabled or well populations; age-specific
or diagnosis-specific clients.
Qualified personnel for supervision of Level I
Fieldwork may include, but are not limited to, academic or fieldwork educators,
occupational therapy practitioners initially certified nationally,
psychologists, physician assistants, teachers, social workers, nurses, physical
therapists, social workers, etc. The supervisors must be knowledgeable about
occupational therapy and cognizant of the goals and objectives of the Level I
Fieldwork experience.
Objectives of Level I Fieldwork may vary
significantly from one academic institution to another. These variations occur
as a result of differences in individual academic institutional missions,
programmatic philosophical base, curriculum design and resources, etc. As a
result, the individual academic institutions should provide information
regarding the specific didactic relationship and should provide objectives for
the experience. Fieldwork educators should determine if the resources of their
facilities are adequate to meet the objectives of the educational institution,
and then apply the objectives to the fieldwork setting.
COE Guidelines Level I continued
Fieldwork objectives should reflect role
delineation between professional and technical level students as specified by The
Guide to OT Practice, AJOT, Vol.53, No.3.
In the event a facility provides Level I Fieldwork experiences to both levels
of students, separate objectives and learning experiences should be utilized, as
developed by the academic program faculty. Students should be evaluated using
these objectives.
In instances where students will have a
prolonged/consecutive fieldwork experience in the same facility, the objectives
should also reflect a sequential orientation and move from concrete to
conceptual or from simple to more complex learning activities. In the event
that the student will rotate through a variety of settings it is recommended
that a master list of objectives be developed that demonstrate a developmental
learning continuum and indicate which objectives/learning experiences have been
provided in previous experiences.
Schedule design of Level I Fieldwork will depend
on the type of setting and the curriculum of the academic institution. Options
include, but are not limited to, full days for one-half a term, full days in
alternating weeks for one term, half days for one term, or one week.
Academic Institution
AOTA Commission on Education (COE)
and Fieldwork Issues Committee (FWIC)
Amended and Approved by FWIC 11/99 and COE 12/99
Last Updated
LEVEL I FIELDWORK EXPERIENCE
POLICIES AND PROCEDURES
The
LATI OTA program faculty, clinical faculty, and student shall respect the right
for confidentiality of clients/patients and fellow professionals. Information, which promotes effective
client/patient care or student education, may be shared with appropriate
individuals. Personal information and/or
prejudicial remarks that could diminish the quality of client/patient care or
student education are in violation of this confidentiality policy and may
violate state and federal privacy law.
The
LATI OTA Academic Fieldwork Coordinator:
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May |
May
Not |
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Communicate
the level of supervision the student needs at the fieldwork facility. |
Communicate
clinical or academic performance level at other fieldwork sites. |
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Communicate
types of fieldwork settings that the student has previously experience. |
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Communicate
the type of clinical experience that student needs at the facility. |
The
Primary Fieldwork Educator/Clinical Supervisor:
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May |
May
Not |
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Communicate
to the LATI Academic Fieldwork Coordinator the student’s strengths,
weaknesses and performance level. |
Communicate
the student’s ability to co-workers, peers, patients, family, friends, or
others that are not directly involved in the student’s education
process. |
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Communicate
to their own supervisor/manager the performance abilities of the student, as
appropriate. |
The
Students:
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May |
May
Not |
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Have
access to the written evaluation of the site through the Academic Fieldwork
Coordinator. |
Communicate
to others (outside the OTA Program) any confidential information observed at the
fieldwork site. This may include: ü Patient information ü Facility information ü Professional conduct of
employees/contractors of facility/business |
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Communicate
to the LATI Academic Fieldwork Coordinator the strengths and weaknesses of their
fieldwork experience. |
Communicate
any prejudicial remarks about previous fieldwork facilities. |
INSURANCE POLICY
Health Insurance:
Each OTA student enrolled in the OTA program is required to have health insurance or sign a waiver indicating that they will be responsible for any cost incurred from an illness or injury during the course of the academic or clinical periods of the program. The students must be able to show proof of their insurance upon request from the academic or clinical facility.
Professional Liability Insurance:
All students attending a fieldwork placement must have professional liability insurance. The student must be able to show proof of this insurance upon request from the academic or clinical facility.
8.
IMMUNIZATIONS POLICY
Students are required to provide documentation of immunizations that are required by LATI or the fieldwork site Immunization documentation includes but is not limited the following:
TRAVEL POLICY
OTA students are responsible for making his/her own travel arrangements.
HOUSING POLICY
OTA students are responsible for securing their own housing arrangements for living accommodations during fieldwork experience.
OTA
students should avoid making appointments for personal business during the time
they are scheduled for fieldwork.
During
a Level I Fieldwork experience the student is expected to attend the entire
week and be punctual. The students have
been told that they are a guest in the facility and they should be respectful
and appreciative of the staff’s time.
An absence due to medical emergency or family emergency must be reported
to the LATI OTA Academic Fieldwork Coordinator and the Primary Fieldwork
Educator at the earliest opportunity.
The Academic Fieldwork Coordinator will make arrangements to make up for
the lost time.
For
the Level I Fieldwork experience the student is expected to complete specific
assignments. The Academic Fieldwork Coordinator will grade these
assignments. The Primary Fieldwork
Educator may also assign facility specific/practice specific homework to the student.
Upon
completion of the Fieldwork I –A or Fieldwork I – B course, the Primary
Fieldwork Educator will evaluate the student and the student will hand in
assignments. The Academic Fieldwork Coordinator
will then assign a Pass/Fail grade to the student based on the evaluation and
the assignments. The student must
achieve at least 30 points on the Fieldwork Level I Evaluation Form, 80% on the
assignments and submit the site evaluation signed by their supervisor.
Any student who wishes to appeal a Level I Fieldwork grade must notify the Academic Fieldwork Coordinator within 14 days of notification of the failing grade. The student, Academic Fieldwork Coordinator, Primary Fieldwork Educator and OTA Program Director will meet to determine the outcome of the appeal process. If the student is unsatisfied with the appeal outcome, the student may then appeal the grade to LATI’s Assistant Director of Student Needs.
The
OTA programs requires that students dress in a professional manner, however
facility policy can override LATI dress policy at the Primary Fieldwork
Educators or Clinical Supervisors discretion.
If questions arise that cannot be readily answered, students are advised
to follow LATI dress code policy.
Any
student who disregards the dress code of the facility jeopardizes the future
relationship between Lake Area Technical Institute’s Occupational Therapy
Assistant Program and the facility. For
this reason, dress code is taken very seriously and any violation of the
facility’s dress code could result in suspension from the site if correction is
not made after an appropriate verbal warning.
Guidelines
are as follows:
1. Students will wear a nametag denoting OTA students daily.
2. Professional dress should include
conservative and tasteful attire.
3. Clothes must be clean and in good condition
(free of fading, tears, holes, wrinkles, etc).
4. Footwear should be practical and safe in
conjunction with setting and situation.
5. Avoid sweat suits, workout clothes, denim
jeans, ECT.
6 Special care
should be taken to ensure good personal hygiene. Body perfumes and odors should be minimized,
including the smell of smoke.
7. Hair must be
neat and pinned back if excessively long.
Beards and mustaches should be neatly trimmed.
8. Make-up and nail polish should be
conservative and not distracting. Nails
should be trimmed
Purpose To establish a method for expressing
grievances during fieldwork experiences.
Policy: Students
participating in Level I and Level II Fieldworks shall follow steps of specific
criteria to address any grievances should they occur.
Procedure:
1. The student shall follow the grievance
procedures outlined in the facility policy and procedures manual for specific
grievances regarding personnel and/or facility issues.
2. The student shall express the grievance to
the Occupational Therapy Assistant Program’s Fieldwork Coordinator and/or
Program Director from Lake Area Technical Institute at the beginning of the
next business day with written documentation to follow.
3. Grievances regarding fieldwork grades shall be handled in accordance with academic grievance procedures as outlined in the “Occupational Therapy Assistant Student Policies
11.
Purpose: To
establish a method for Primary Fieldwork Educators/Clinical Fieldwork Supervisors
to express grievances against an OTA student.
Policy: Primary
Fieldwork Educators/Clinical Fieldwork Supervisors of Level I and Level II
Fieldwork experiences shall be given a procedure to address grievances against
an OTA student.
Procedures:
a. Any existing policies the
facility may have regarding the grievance.
b. Any existing policies LATI
may have regarding the grievance.
c. The severity of the
grievance.
d. The recommendations of the
Primary Fieldwork Educator/Clinical Fieldwork Supervisor and the staff of the
OTA program at LATI.
12.
Guide to LATI Forms
Foreword: The
following descriptions give a synopsis of the various forms that LATI utilizes
to address fieldwork issues. Copies of these forms are to be made when the need
arises. If replacements are ever required please contact the Academic Fieldwork
Coordinator
Supervisor Evaluation of Supervisor
This form must be completed by the Fieldwork Educator/Supervisor/Clinical Supervisor or Facility Fieldwork Coordinator and sent to LATI each time a student has completed a Level I Fieldwork Experience at the facility. The student has been provided with this form and should present it to the facility personnel upon arrival to the Fieldwork setting. However, this form may be reproduced if necessary.
Student Evaluation of the Fieldwork Experience
Each student who is assigned to your facility will be required to complete this form and review it with the Fieldwork Educator or Facility Fieldwork Coordinator. This will need to be signed by a facility representative and returned to LATI by the student. Each student will be issued this form and take it with them to the site.
Supervisor Grievance Form
This form is to be filled out by the Fieldwork Educator or Facility Fieldwork Coordinator in the event of a grievance against a LATI OTA student. This form may be reproduced if needed. Please send completed form to The LATI OTA Fieldwork Coordinator.
LATI Accommodations Request Form
This form is utilized for students that request special accommodations for a documented disability.
LATI Placement Request Form
This form is sent out to fieldwork site to address possible placements for a specific calendar year. It lists various OT areas in which a facility may be able to accommodate a student placement.
LATI Student Information/Profile Packet
This packet is sent out to the site prior to the student attending a fieldwork experience. It gives the fieldwork site pertinent student information. It includes forms that address or provide proof of immunization, insurance, confidentiality, CPR and ECT
Appendix A Forms
STUDENT EVALUATION OF THE
FIELDWORK EXPERIENCE
LATI OTA Program
Level I Fieldwork
Supervisor Name:
_______________________________________Student Name:
_________________________________
Facility Name
___________________________________________________________________Date:
________________
**To the
Supervisor: Please rate
the student’s skills as you observed from 1.0-4.0 using the scale below. Please circle your response for each category. If more space is needed for comments, the
back of this page can be utilized. A
student’s overall grade will be determined by averaging the scores. A total of 32 is required to
pass.
|
Listening Skills |
|||||||
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1.0 No
listening skill present |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Excellent
listening skills |
|
|
Verbalization Skills |
|||||||
|
1.0 Limited
verbal skills |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Excellent
verbal skills |
|
|
Initiative |
|||||||
|
1.0 No
initiative |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Excellent
initiative |
|
|
Behavior |
|||||||
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1.0 Immature Behavior |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Professional
Behavior |
|
|
Dependability |
|||||||
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1.0 Unreliable |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Excellent
dependability |
|
|
Professional Dress |
|||||||
|
1.0 Inappropriate
dress |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Appropriate
dress |
|
|
Time Management |
|||||||
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1.0 Limited
time management skills |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Utilized
time effectively |
|
|
Assignments/Learning Experiences |
|||||||
|
1.0 Didn’t
participate |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 |
|
|
Supervisory relations |
|||||||
|
1.0 Limited
ability to interact with supervisor |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Excellent
Supervisory skills |
|
|
Professional awareness |
|||||||
|
1.0 No
professional awareness |
1.5 |
2.0 |
2.5 |
3.0 |
3.5 |
4.0 Excellent
professional awareness |
|
Supervisor Comments
Signatures indicate that both parties have read and discussed the information contained in the supervisor evaluation of student form
Clinical Supervisor Signature: ____________________________________ Date__________________
LATI OTA Student Signature: ______________________________________ Date________________
STUDENT EVALUATION
OF THE FIELDWORK EXPERIENCE
LEVEL IA AND IB
Student Name: ______________________________ Supervisor Name: ________________________
Facility Name: ______________________________ Placement Dates: ________________________
Type of Fieldwork (area): __________________________________________
|
Circle
the numerical value that you feel is appropriate for the following fieldwork
placement issues |
|||||
Organization of
the Fieldwork Educational Program
|
|||||
|
1.0 |
1.5 |
2.0 |
3.0 |
3.5 |
4.0 |
|
Unprepared, expectations
were not discussed |
|
|
|
|
Facility
was prepared, expectations were clear |
Assignments from
the site
|
|||||
|
1.0 |
1.5 |
2.0 |
3.0 |
3.5 |
4.0 |
|
Were
not explained, were overwhelming |
|
|
|
|
Were
explained, clear, appropriate amount and level difficulty |
Observations of
services or clients
|
|||||
|
1.0 |
1.5 |
2.0 |
3.0 |
3.5 |
4.0 |
|
Very little |
|
|
|
|
All
day every day |
Supervision
|
|||||
|
1.0 |
1.5 |
2.0 |
3.0 |
3.5 |
4.0 |
|
Supervisor
was rarely available for questions |
|
|
|
|
Supervisor
was available at all times |
Clinical
Supervisor
|
|||||
|
1.0 |
1.5 |
2.0 |
3.0 |
3.5 |
4.0 |
|
Friendly,
helpful Appeared knowledgeable of services |
|
|
|
|
Appeared
knowledgeable of services, offered very little explanation |
Professional
relationships
|
|||||
|
1.0 |
1.5 |
2.0 |
3.0 |
3.5 |
4.0 |
|
Student
felt like an outsider, uncomfortable in the setting |
|
|
|
|
Student
felt welcomed into the setting |
Comments:
Identify
the strengths of this placement.
Identify
suggestions for improvements to this fieldwork experience.
Identify
any suggestions to the OTA program for preparing a student for this Level I
placement.
Student signature:
_______________________________________________________ Date:_____________
Clinical Supervisor
signature______________________________________________ Date: ______________
or
Primary Fieldwork Educator
signature: ______________________________________Date: ______________
LAKE AREA TECHNICAL
INSTITUTE
OCCUPATIONAL
THERAPY ASSISTANT PROGRAM
STUDENT
SUPERVISOR GRIEVANCE OF AN OTA STUDENT
(FOR LEVEL I
AND LEVEL II FIELDWORK EXPERIENCES)
To
be completed by the Student Supervisor of the fieldwork facility. Please utilize the back of this page if
needed.
DATE
______________________________________________
NAME
OF FACILITY:
________________________________________________________________________________
STUDENT
SUPERVISOR: _____________________________________________________________________________
STUDENT:
__________________________________________________________________________________________
NATURE OF GRIEVANCE:
_______________________________________________________________________________________________________________________________
Facility
policy (if any) regarding grievance and action to be taken against the OTA
student:
If
no facility policy exists; administration's or the student's
supervisor recommended action to be taken against the OTA student:
SUPERIVISOR
SIGNATURE ______________________________________________ DATE _______________
STUDENT SIGNATURE __________________________________________________ DATE _______________
Lake Area Technical Institute
Occupational Therapy Assistant Program
FIELDWORK SPECIAL ACCOMMODATION REQUEST FORM
According to the guidelines of the Americans with Disability Act, it is the student’s choice and responsibility to reveal any information regarding a disability that may require special accommodation and thereby impact their educational experience.
Accommodations requested?
Summary of the accommodation agreed upon by the facility, LATI Fieldwork Coordinator, and student:
Signatures:
___________________________________________________________ _______________________
Student Date
___________________________________________________________ _______________________
Primary Fieldwork Educator Date
___________________________________________________________ _______________________
LATI Fieldwork Coordinator Date