Occupational Therapy Fieldwork Tips and How to Set Yourself Up for Success

I searched high and low in the occupational therapy literature and posted blogs and resources from AOTA’s website to synthesize the most salient information to ensure your definite success in Level I and II Fieldworks.  

OK–so you are fully informed and mentally prepared for fieldwork. Let’s stay on the right path as you begin Day 1! Nicholas Rodriguez (2016), MOTR/L, claims that these 8 occupational therapy fieldwork tips will ensure even more victory on your first day of fieldwork.

1. Show up early.

Arrive 30 minutes early to give yourself a cushion, but wait until 15 minutes early to go in. This will not only show initiative but will also give you a time cushion just in case something goes wrong that morning. Showing up late on your first day is not the way to start your rotation.

2. Look professional.

First impressions are everything. While different facilities have different dress codes, it is still important to look professional. For example, if you are in a setting where scrubs are the dress code, iron or toss the scrubs in the dryer. Wrinkles might give the impression that you do not care to look professional or that you will not put in a quality effort.

3. Smile and say hello to everyone.

Be sure to say hello and be friendly to everyone. EVERYONE! Don’t just introduce yourself to all the therapists in the department and neglect everyone else. Don’t forget to be friendly to the receptionist, housekeeping staff, the CNA, the nurse, etc. These people are valuable team members who have a wealth of knowledge about your patients that you likely will not find in your medical charts.. Plus, they usually have the best inside perspective and knowledge of the facility.

4. Take notes.

On day one, your fieldwork supervisor and others will likely cover a lot of information about the facility, services, and clients to help you with your rotation. It is impossible to remember everything, so be sure to take plenty of notes. Some students bring mini-clipboards that fit in their lab coats or scrubs so they always have their notes on them.

5. Bring modified study guides.

There are no rules stating you cannot bring a helpful guide to assist until you have mastered it. You will learn more about the type of assessments and diagnoses that you need to master, and a modified study guide will help you form your own cheat sheet.

6. Look at all of the department’s tools and resources. All of them.

Typically, there is one area where therapists keep their intervention tools and supplies. Become familiar with all of the tools that your facility has to offer. Pull them out and understand what you have to work with. If you do not know what a particular assessment is or how to use an intervention, then ask. You will likely find other practitioners in the room making comments about how they did not know the facility had a certain item or assessment. Not only does it show you are passionate about learning, but it might facilitate a good discussion and icebreaker to engage with other team members.

7. Ask questions.

Show that you are eager to learn! Ask thoughtful questions about the material you need to master, the ins and outs of services at the facility, pointed questions about your new caseload, and how your fieldwork is going to be structured for a successful experience. Not asking questions can be construed as disinterest or apathy. However, also be careful to not ask too many questions related to material that you can learn on your own through a little research during your down time. There is plenty to learn, so ask appropriate questions and initiate conversations with other members of the team.

8. At the end of the day, review.

Before you head to bed after your first day, take time to review and reflect. You were just introduced to a new style of paperwork, people, procedures, etc.—it was a lot. Take time to figure out what you understand and do not understand so you can ask your fieldwork educator some intelligent follow-up questions the next day. 

OT Fieldwork Advice

Your success starts even before you set foot into the clinic on day 1 of your fieldwork. Justine Rehak (2016), MS, OTR/L, an OT and fieldwork educator/supervisor, urged fieldwork students to ask the following questions of the supervisor to kick start their fieldwork efforts.

• What standardized assessments do you use most often?
• What conditions do you see most often in the clients you treat?
• How many clients do you typically treat in a day? 
• Can you send me a couple of examples of documentation at your site? Do you have electronic, paper, or hybrid documentation? Do you use desktops, laptops, or mobile devices?
• What is the dress code? 
• At what time would you like me to start? 
• Is there anything in particular you’d recommend that I study in order to prepare?
• Do you prefer coffee or tea (bagels or donuts, dark or milk chocolate)? Showing up on Day 1 with a small token of appreciation is always a welcomed way to earn brownie points!!!

And for all the days after your first day of OT fieldwork, Karen Dobyns (2015), MOT, OTR/L, an occupational therapist and blogger, believes that these top 12 strategies will keep you winning!

1. Be proactive and reactive.

If you’re scheduled to see a patient with a condition you haven’t treated before, research it in advance. Maybe you can present your supervisor with some helpful resources you found, and you will be better prepared for next time.

2. Continue to ask questions and know when to ask them. 

Questions are a great sign that you care and are able to process and synthesize information. But when you and another therapist are with a client, use your best judgment as to whether it’s an appropriate time to ask a question. If in doubt, don’t. Write it down so you don’t forget, or at least scribble a “trigger word” reminder for later. Collaborate on finding a good time every week to go over questions.

3. You will make mistakes, and it’s okay, but own them.

I’m not talking about safety here, I’m talking about basics: forgetting where you put your pen, being unable to open a simple container, or bumping into something. You are nervous and on your best behavior. You are trying so hard to impress your supervisor, which means you will make dumb mistakes. We get it. We were there, too. We aren’t judging you harshly for mistakes that we know come from nervousness.

4. Safety comes first.

Stupid mistakes with opening a container are fine, but dropping a patient is not. If you don’t feel safe with a patient for any reason, you need to ask for guidance. You may hesitate because you don’t want your supervisor to realize you don’t know how to do something you probably should know by now, or you may not want to hassle him or her for help. Keep in mind that it causes them far more trouble, and they will likely have far less confidence in your abilities, if you make a mistake that hurts a patient because you were more concerned about yourself than about doing the job safely.

5. Create your OT documentation “cheat sheet.”

Common abbreviations, alarm codes, locations, phone numbers, little tidbits of information… jot it all down. Keep an index card on your clipboard or in your pocket. When you’re stressed, you are going to have trouble remembering the little things you usually don’t have issues with. It’s appreciated when you don’t have to ask your supervisor every 5 minutes for a code they’ve given you twice now.

6. Be extra helpful.

Your supervisor will eventually be helped by your presence, but at first you are extra work, no matter how amazing you are. See something you can easily put back in place, or clean off, or make more efficient? See a little errand you could run? Offer to do it, or ask permission. 

7. Focus on learning, even during downtime at work.

If you have down time in your work day beyond your break or lunch, you should be actively learning. It’s so tempting to get on your phone for a while and veg out during a gap in treatments. Instead, use your time researching, cleaning, formulating questions, updating your cheat sheet, or doing something else that shows determination and drive. 

8. Expect and welcome feedback.

You’re a student. You aren’t expected to know everything. You will make mistakes you don’t even know you’re making. Keep in mind that the goal of your fieldwork is to grow. Criticism may sting, especially when you are trying your best and have such good intentions. Try to understand the intent of the person giving you feedback, which is likely just to make you be a better OT. Don’t be defensive. Nod and be appreciative for the feedback.

9. Your placement or therapist might not be ideal, but you can still learn a lot.

Maybe you really, really wanted to do pediatric fieldwork, but instead you were assigned a hand specialty. Maybe you have a supervisor who is super stern or who has a conflicting personality type, versus the warm and fuzzy supervisor you craved. You will still learn a lot, even if it’s a lot of what not to do, or just how to work in the face of adversity. A lot of employers ask their potential employees about a time they had a conflict with a coworker, and this experience will provide you with a great response!

10. You will sometimes feel like an imposter.

You may feel like you have no idea what you’re doing, but if you are doing it safely; look confident; have thought through the reasons for doing it a certain way; and your supervisor, colleagues, and patients are not giving you negative feedback, you’re probably just fine. Give yourself some credit, and remember that even the most experienced practitioners had a first patient.

11. Refill your cup daily.

This may look like exercise or a yoga class, a meditation session or church, a good friend, family, a hobby, the internet or social media, mentors, textbooks, whatever. Plan to have something that gives you confidence in your knowledge, lets you decompress and relax, or gives you support in whatever form you need so you can get up the next day feeling refreshed to do it all again. All the resources you need are out there. Find them. Remember, you can do this, and it’s so worth it because it means you become an occupational therapist, your ultimate goal!

12. You will get it eventually–appreciate the challenge!

You may feel overwhelmed at first—you think you will never understand it all, that it’s just way too much, and you will fail. Everyone else can do it, and something is wrong with you. All your schooling was worthless because you won’t get through the fieldwork. You will be scared. You will be so convinced that it won’t click. But guess what? It will and it does. It takes at least a week to start to get a picture of anything, and by the end of the second week you’ll have so much more knowledge than you would have guessed. With every week, more and more scaffolding will help you learn. At the same time, your supervisor will be increasing your independence, so it’s somewhat of a balancing act. Keep telling yourself out loud, over and over again, whether you believe it or not, that you will get through it. Because you will. I didn’t think I could do it because I have so much trouble with anxiety, but I got through it, hour-by-hour, day-by-day. It’s possible. You can do it. Remember that once you’re out of fieldwork, you can choose a more comfortable setting, and you won’t have someone constantly watching you.

Characteristics of Effective Fieldwork Students

Fieldwork success can also be achieved through your emotional intelligence and understanding of the perspectives and expectations of your fieldwork educators and supervisors. Thomas, Beyer and Sealey (2018) expressed that these five soft skills contributed to increased success during fieldworks:

1. Personability (i.e., cultural awareness and keeping communication lines open)
2. Verbal communication (i.e., being sensitive to others and transparent about situations)
3. Flexibility (i.e., scheduling)
4. Professionalism (i.e., using discretion with clients and co-workers, being mentally and physically present)
5. Positive attitude (i.e., managing emotions, leaving personal problems at home)

In addition, Cheryl Boop (2015), OTR/L, an OT fieldwork educator, revealed that the most sought after qualities of the ideal fieldwork student from a clinical instructor perspective are:  being passionate, self-directed, open-minded, humble, client-centered, communicative, empathetic, and honest. Kirke, Layton, and Sim (2007) further determined that clear goal setting, balanced expectations, and active participation in the learning experience will also make you stand out during fieldwork. Campbell et al. (2015) surveyed fieldwork educators to determine the essential professional behavioral attributes for level II fieldwork students. 

This study found that fieldwork educators mostly valued students who demonstrated:

• Adaptability
• Clinical competence
• Strong communication skills
• Ethics
• Responsibility
• Time efficiency

Other favored attributes were being able to receive constructive criticism, good interpersonal skills, a positive attitude, and a student’s ability to be an empathetic, enthusiastic, and organized team player!

Now you are fully in the know and well equipped to completely ROCK your fieldworks! Best of luck and when in doubt…ASK!

References:

Boop,C. (February 2015). Qualities of the ideal fieldwork student: Perspectives from a fieldwork educator.

Campbell, M. K., Corpus, K., Wussow, T. M., Plummer, T., Gibbs, D., & Hix, S. (2015). Fieldwork educators’ perspectives: Professional behavior attributes of level II fieldwork students. The Open Journal of Occupational Therapy, 3(4).

Dobyns, K. (May 2015). Top 12 tips for mastering fieldwork.

Kirke, P., Layton, N., & Sim, J. (2007). Informing fieldwork design: Key elements to quality in fieldwork education for undergraduate occupational therapy students. Australian Occupational Therapy Journal, I, S13–S22. doi:10.1111/j.1440-1630.2007.00696.x

Rehak, J. L. (May 2016). Top 10 questions to ask your fieldwork educator before day 1.

Rodriguez, N. (n.d.). 8 tips for a successful first day of fieldwork.

Thomas, J., Beyer, J., & Sealey, L. (2018). Emotional intelligence: Developing soft skills to increase students’ success during fieldwork experience and as practicing clinicians. SIS Quarterly Practice Connections, 3(2), 8–10.