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Student-evaluation-fieldwork-experience-2016 07-STUDENT EVALUATION OF FIELDWORK EXPERIENCE

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AOTA SEFWE Task Force, 2016
1
STUDENT EVALUATION OF THE FIELDWORK EXPERIENCE (SEFWE)
Purpose:
This evaluation serves as a tool for fieldwork sites, academic programs, and students. The main objectives of
this evaluation are to:
• Enable the Level II fieldwork student who is completing a placement at the site to evaluate and provide
feedback to the fieldwork educator[s] and fieldwork setting
• Enable academic programs, fieldwork sites, and fieldwork educators to benefit from student feedback in
order to develop and refine their Level II fieldwork programs
• Provide objective information to students who are selecting sites for future Level II fieldwork
This form is designed to offer each program the opportunity to gather meaningful and useful information.
Programs may adapt this form to suit their needs.
Instructions to the Student:
Complete the SEFWE before your final meeting with your fieldwork educator(s).
Make a copy of the form for yourself. This form gets submitted to your fieldwork educator during or after you
review your final fieldwork performance evaluation (FWPE). The SEFWE is signed by you and the fieldwork
educator(s).
Instructions to the Fieldwork Educator(s):
Review the SEFWE with the student after the final Fieldwork Performance Evaluation (FWPE) has been
reviewed and signed.
The SEFWE is signed by both the fieldwork educator(s) and the student.
Return both the FWPE and SEFWE promptly upon completion of the fieldwork to the academic fieldwork
coordinator.
AOTA SEFWE Task Force, 2016
2
STUDENT EVALUATION OF THE FIELDWORK EXPERIENCE
Fieldwork Site:
Address:
Type of Fieldwork:
Placement Dates: from _________________________ to _______________________
Order of Placement: [ ] First [ ] Second [ ] Third [ ] Fourth
Student work schedule:
Hours required: per week
Weekends required Evenings required
Flex/Alternate Schedules Describe:
Identify Access to Public Transportation:
Please write your e-mail address here if you don’t mind future students contacting you to ask you about your
experience at this site: ______________________________________
We have mutually shared and clarified this Student Evaluation of the Fieldwork
Experience report on .
(date)
___________________________________
____________________________________
Student's Signature
FW Educator's Signature
___________________________________
_________________________________________
Student’s Name (Please Print)
FW Educator’s Name and credentials (Please Print)
FW Educator’s years of experience ____________
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AOTA SEFWE Task Force, 2016
3
ORIENTATION—WEEK 1
Indicate the adequacy of the orientation by checking “Yes” (Y) or “Needs Improvement” (I).
TOPIC
Adequate
Comment
Y
I
Site-specific fieldwork objectives
Student supervision process
Requirements/assignments for students
Student schedule (daily/weekly/monthly)
Agency/Department policies and procedures
Documentation procedures
Safety and Emergency Procedures
CLIENT PROFILE
Check age groups worked with List most commonly seen occupational performance
issues in this setting
Age
Occupational Performance Issues
0–5 years old
6–12 years old
13–21 years old
22–65 years old
65+ years old
Describe the typical population:
AOTA SEFWE Task Force, 2016
4
OCCUPATIONAL THERAPY PROCESS
I. EVALUATION
List assessment tools used
Observed
Performed
II. INTERVENTION
List major therapeutic interventions frequently used and indicate whether each was provided as individual, group,
or co-treatment, or as a consultation. List other professionals involved.
Types of Intervention
Individual
Group
Co-Tx
Consultation
Occupations: client-directed life activities that
match/support/address identified goals
Activities: meaningful to client, address performance
skills and patterns to facilitate occupational
engagement
Preparatory methods: modalities, devices and
techniques. These are provided to the client, no active
engagement
Preparatory tasks: actions that target specific client
factors or performance skills. Requires client
engagement
AOTA SEFWE Task Force, 2016
5
Education: provides knowledge & enhances
understanding about occupation, health and well-
being to client to develop helpful behaviors, habits,
routines
Training: develops concrete skills for specific goal
attainment. Targets client performance
Advocacy: promotes occupational justice and
empowers clients
Identify theory(ies) that guided intervention:
III. OUTCOMES
Identify the types of outcomes measured as a result of OT intervention provided:
Type of outcome
yes
no
Provide example
Occupational
Performance
Prevention
Health & Wellness
Quality of Life
Participation
Role competence
Well-being
Occupational Justice
**OTPF-III terminology
ASPECTS OF THE ENVIRONMENT
Yes No
The current Practice Framework was integrated into practice
Evidence-based practice was integrated into OT intervention
There were opportunities for OT/OTA collaboration
There were opportunities to collaborate with other professionals
There were opportunities to assist in the supervision of others—
AOTA SEFWE Task Force, 2016
6
specify:
There were opportunities to interact with other students
There were opportunities to expand knowledge of community resources
Student work area/supplies/equipment were adequate
Additional educational opportunities provided with comments (specify):
DOCUMENTATION AND CASE LOAD
Documentation Format:
Narrative SOAP Checklist Other:_______________________
Hand-written documentation Electronic
If electronic, name format & program:
Time frame & frequency of documentation:
Ending student caseload expectation: _____ # of clients per week or day
Ending student productivity expectation: _____ % per day (direct care)
SUPERVISION
What was the primary model of supervision used? (check one)
one fieldwork educator : one student
one fieldwork educator : group of students
two fieldwork educators : one student
one fieldwork educator : two students
distant supervision (primarily off-site)
three or more fieldwork educators : one student (count person as fieldwork educator if supervision occurred
at least weekly)
Frequency of meetings/types of meetings with fieldwork educator (value/frequency):
___________________________________________________________________________________________
___________________________________________________________________________________________
________________________________ __
General comments on supervision:
AOTA SEFWE Task Force, 2016
7
SUMMARY of FIELDWORK EXPERIENCE
1 = Strongly disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly agree
Circle one
Expectations of fieldwork experience were clearly defined
1
2
3
4
5
Expectations were challenging but not overwhelming
1
2
3
4
5
Experiences supported student’s professional development
1
2
3
4
5
What particular qualities or personal performance skills should a student have to function successfully on this
fieldwork placement?
___________________________________________________________________________________________
___________________________________________________________________________________________
What advice do you have for future students who wish to prepare for this placement?
Study the following evaluations:
___________________________________________________________________________________________
___________________________________________________________________________________________
Study the following intervention methods:
___________________________________________________________________________________________
___________________________________________________________________________________________
Read up on the following in advance:
___________________________________________________________________________________________
___________________________________________________________________________________________
Overall, what changes would you recommend in this Level II fieldwork experience?
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Please feel free to add any further comments, descriptions, or information concerning your fieldwork at this
center.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Would you recommend this fieldwork site to other students? Yes or No
Why or why not? __________________________________________________________________
____________________________________________________________________________________
AOTA SEFWE Task Force, 2016
8
INSTRUCTIONS
One form must be completed for each fieldwork educator who provided supervision. You can detach this page and
make more copies as needed.
Check the box that best describes your opinion of the fieldwork
educator’s efforts in each area
FIELDWORK EDUCATOR NAME:
___________________________________
FIELDWORK EDUCATOR YEARS OF EXPERIENCE: __________
1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly agree
1
2
3
4
5
Provided ongoing positive feedback in a timely manner
Provided ongoing constructive feedback in a timely manner
Reviewed written work in a timely manner
Made specific suggestions to student to improve performance
Provided clear performance expectations
Sequenced learning experiences to grade progression
Used a variety of instructional strategies
Taught knowledge and skills to facilitate learning and challenge student
Identified resources to promote student development
Presented clear explanations
Facilitated student’s clinical reasoning
Used a variety of supervisory approaches to facilitate student
performance
Elicited and responded to student feedback and concerns
Adjusted responsibilities to facilitate student’s growth
Supervision changed as fieldwork progressed
Provided a positive role model of professional behavior in practice
Modeled and encouraged occupation-based practice
Modeled and encouraged client-centered practice
Modeled and encouraged evidence-based practice
Modeled and encouraged interprofessional collaboration
Modeled and encouraged intra-professional collaboration
Comments:
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Completed 19 November 2019

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