Date Presented 04/04/19
This study will share findings about OT student experiences using what they know about evidence and occupation-based practice during Level II fieldwork. Information about barriers to and supports for students to be successful applying what they know will be presented. Implications for OT practice and education will also be discussed.
Primary Author and Speaker: Leslie Jackson
Additional Authors and Speakers: Kaylen Bye, Daniel Drumm, Mireya Elizondo, Jasmine Murphy
PURPOSE: This study explored OT student perceptions about their experiences using and applying what they know about evidence and occupation-based practice while on Level II fieldwork (FW). The hallmark of OT is its focus on “occupation” and how practitioners support clients to engage in those everyday activities. In addition, OT practitioners and students are expected to utilize evidence-based practices (EBP) to help inform decisions about patient care. Level II FW provides in-depth experiential opportunities for students to practice and apply what they learned in the didactic portion of OT education and to refine their skills. Since students are expected to apply what they have learned about evidence and occupation on FW, this study looked at whether students are doing so and the factors that support and interfere with applying what they know.
DESIGN: A non-experimental descriptive survey design was used to identify the characteristics and experiences of Level II OT students. An online survey consisting of 18 multiple choice and open-ended questions was developed to elicit demographic information and student perspectives on their fieldwork experiences, including preparation, comfort levels with their knowledge, and (any) barriers to and supports for using and applying evidence and occupation-based practices (OBP). The survey was open 7 weeks.
METHOD: Inclusion criteria: OT students who were currently enrolled in a Master of Occupational Therapy program or entry level Doctor of Occupational Therapy (OTD) program, AND had completed at least one level II fieldwork rotation; OR were a 2017 graduate from an MOT or OTD program. Convenience and snowball sampling was used to identify as many potential participants as possible.
Participants were recruited by personal contact from research group members. Emails were sent to the state Academic Fieldwork Coordinator Consortium and AOTA Academic Fieldwork Coordinator Listserv asking academic fieldwork coordinators to share the information with their students; and information was posted on research members Facebook and LinkedIn pages and on Facebook instant messenger.
RESULTS: Descriptive statistics (i.e., percentages, frequencies) were used to analyze the quantitative data and themes were identified from the open-ended questions. 71 respondents participated in the survey; nine (12.3%) were disqualified because they did not meet the inclusion criteria. Over 90% of participants were female and MOT students; 85% graduated in 2017. Most respondents were somewhat or very comfortable with their knowledge about EBP and OBP prior to starting fieldwork, however were not always confident in applying what they knew. Respondents also identified a lack of time and high productivity expectations as other barriers. Of those respondents needing support on fieldwork, 35% needed to see the fieldwork educator (FWE) using EBP and OBP, and 27% needed encouragement to use what they knew. Open-ended themes supported the quantitative findings: student confidence in their own abilities; need to see what EBP/OBP looked like; and need for guidance and support from the FWE.
CONCLUSIONS: Results demonstrate that Level II fieldwork students are using evidence to guide their clinical decisions on FW but lack confidence and need support and models to do so appropriately. Students clearly need to see what OBP “looks like” with real-world clients. Student confidence increases significantly with experience and ongoing modeling from their FWE and other therapists onsite. FWEs also need support and training in practical ways to engage in EBP/OBP in the field. With the approaching OTD mandate, OT education programs must find ways to integrate more hands-on opportunities into the curriculum to increase student confidence and comfort.
References
Andonian, L. (2017). Occupational therapy students’ self-efficacy, experience of supervision, and perception of meaningfulness of level II fieldwork. The Open Journal of Occupational Therapy, 5(2). doi.org/10.15453/2168-6408.1220
DeCleene Huber, K., Nichols, A., Bowman, K., Hershberger, J., Marquis, J., Murphy, T., Pierce, C. & Sanders, C. (2015). The correlation between confidence and knowledge of evidence-based practice among occupational therapy students. The Open Journal of Occupational Therapy, 3(1). doi.org/10.15453/2168-6408.1142
Edwards, M., Gentry, A., Showalter, M. & Thomas, H. (2015). Occupation-based practice as experienced by occupational therapy students during Level II fieldwork. Education special interest section quarterly, 25(2), 1-4
Evenson, M. (2011). Preparing for fieldwork: Students’ perceptions of their readiness to provide evidence-based practice. MGH Institute of Health Professions, IOS Press, 44(2013), 297-306
