Occupational Therapy Commons^™

A Hand Therapy Quick Reference Guide: Supporting Level Ii Fieldwork Experiences ​, Raven I. Gammage, Rebecca Caudrillier, Mary Greer

Summer 2026 OTD Capstone Symposium

Occupational therapy students often begin Level II hand therapy fieldwork with limited preparation. This capstone project developed an evidence-informed Hand Therapy Quick Reference Guide to support students and clinicians with foundational knowledge and clinical resources. Following implementation, feedback from hand therapists, fieldwork educators, and students indicated the guide was organized, practical, and applicable across clinical settings. The guide has the potential to improve fieldwork preparedness and support successful entry into hand therapy practice.

Professional Standards As Gateways, Not Barriers, In Occupational Therapy, Ryan Thomure

The Open Journal of Occupational Therapy

No abstract provided.

Integrating Fieldwork Educators Into Didactic Coursework: Impact On Occupational Therapy Students’ Readiness For Level Ii Fieldwork, Tara Mansour, Victoria Denovellis

Journal of Occupational Therapy Education

Level II fieldwork represents a critical transition from didactic learning to clinical practice in occupational therapy education, yet students frequently report challenges related to applying knowledge, managing expectations, and navigating complex clinical environments. Many of these challenges reflect aspects of the “hidden curriculum,” including implicit expectations related to communication, professional behaviors, and feedback that are often not explicitly addressed in coursework. This study examined the impact of integrating fieldwork educator–led sessions into a didactic seminar to support student readiness. A mixed-methods survey using a retrospective pre–post design was administered to 33 students (97% response rate). Quantitative analyses demonstrated significant improvements …

Assessment Of Level Ii Fieldwork Performance (Alf): Development And Refinement Of A Level Ii Assessment Tool For Use In Occupational Therapy Curricula, Suzanne Marasco, Karen Weis, Zachary A. Myers

Journal of Occupational Therapy Education

The Assessment of Level II Fieldwork Performance (ALF) is a new tool developed for use in occupational therapy programs to evaluate students’ performance during Level II fieldwork. The present study reports on the development of the ALF and revisions of the tool based on two rounds of expert review utilizing a modified Delphi methodology. An expert panel of sixteen occupational therapists who had previously utilized the tool while serving as fieldwork educators was recruited to review the ALF and complete online surveys related to the tool’s content, pragmatics, and clinical value. Based on expert consensus, the ALF was modified and …

Reliability And Generalizability Of An Occupational Therapy Fieldwork Assessment Tool In Japan, Keiko Takeuchi, Hirotaka Onishi

Journal of Occupational Therapy Education

Occupational therapists require high-quality clinical education to develop the skills needed for safe and effective practice. In Japan, the duration of occupational therapy education is shorter than in many other countries and the rapid expansion of training schools has created new challenges for assuring the quality of fieldwork. Assessment tools used in long-term clinical training must therefore provide sufficient reliability to support fair pass–fail decisions and meaningful feedback. This study examined the reliability of two conventional learner assessment tools used in one Japanese occupational therapy program: a 17-item supervisor rating form and a 10-item faculty rating form completed after debriefing …

Student And Recent Graduate Perceptions Of Single Versus Multiple Supervision Models In Occupational Therapy Level Ii Fieldwork: A Descriptive Survey Study, Ricardo G. Altahif Jr., Kirsten Davin, Kelli Easley

Journal of Occupational Therapy Education

As occupational therapy programs increase in number, the need for increased fieldwork capacity has led to growing interest in alternative supervision models. Understanding how supervision structure influences student perception of the fieldwork experience is essential for ensuring quality educational experiences. This descriptive, cross-sectional study examined occupational therapy students’ and recent graduates’ perceptions of single versus multiple supervision models during Level II fieldwork. A 23-item online survey was developed and distributed nationally via professional networks and academic channels. Participants rated their experiences across three domains: satisfaction and mentoring quality, communication and feedback, and development of clinical and professional skills. Descriptive statistics …

Change In Perception Of Cultural Self-Efficacy Among Graduate Students In An Occupational Therapy Academic Program, Emma Edwards, Selena E. Washington, Zidong Zhang

Journal of Occupational Therapy Education

Culturally responsive care is essential to improving healthcare access and outcomes; however, the extent to which occupational therapy students are prepared to deliver such care remains unclear. Experiential learning embedded within occupational therapy curricula, including fieldwork, is considered a key pathway for developing cultural self-efficacy. This quantitative study examined changes in cultural self-efficacy among graduate occupational therapy students across didactic and experiential learning experiences within a Master of Occupational Therapy program. Using the Multidisciplinary Healthcare Provider version of the Transcultural Self-Efficacy Tool, perceived self-efficacy across the cognitive, practical, and affective domains was assessed across three cohort-based administration periods aligned with …

Assessing Supports And Barriers To Equitable Participation In Occupational Therapy Fieldwork For Students From Minoritized Backgrounds: A Mixed Methods Analysis, Kristin M. Nxumalo, Coalition Of Occupational Therapy Advocates For Diversity Cotad, Alexia Rebne, Janis Yue, Ryan Thomure, Ricardo D. Ramirez

Journal of Occupational Therapy Education

Fieldwork experiences in occupational therapy (OT) and occupational therapy assistant (OTA) education introduce students to novel environments that they must successfully navigate. When examining the experiences of OT and OTA students from minoritized backgrounds, it is critical to understand their fieldwork experiences so that fieldwork educators and partners can create inclusive, supportive environments that promote success for all students. Within this study, a needs assessment was conducted to explore factors that impacted the OT and OTA fieldwork experiences of students from minoritized backgrounds. Using a mixed methods design, a cross-sectional survey was completed by non-faculty OT practitioners (n=48), Academic Fieldwork …

Virtual Reality’S Impact On Occupational Therapy Student Confidence And Fieldwork Performance, Kayla Collins, Kirsten Davin, Marian Gillard

Journal of Occupational Therapy Education

Occupational therapy students often experience confidence gaps as they transition from academic preparation to real-world practice settings. This quasi-experimental study investigated whether the integration of immersive virtual reality (VR) simulations into the didactic portion of an Occupational Therapy Doctoral (OTD) program affected student confidence and subsequent Level II fieldwork performance. Data from 65 students across three cohorts were analyzed using the Student Confidence Questionnaire (SCQ) and the Fieldwork Performance Evaluation (FWPE). While no significant differences were observed in total confidence or fieldwork scores, students who completed VR simulations reported significantly higher confidence in five subdomains: adaptability, risk-taking, supervision, clinical practice, …

From Classroom To Care: A Pilot Level I Fieldwork Experience Building Acute Care Self-Efficacy, Hannah Y. Oldenburg, Jennifer Bergstrom, Traci Kruse, Tamra Trenary, Corey Mcgee

Journal of Occupational Therapy Education

Level I fieldwork provides an opportunity for occupational therapy students to be exposed to the occupational therapy framework and process across various practice settings. This study addresses a gap in the literature regarding introductory fieldwork experiences for occupational therapy students in complex medical settings, specifically acute care. Researchers implemented a seven-week Level I fieldwork experience at two Midwest trauma centers, utilizing a mixed-methods, two-cohort design with 12 students and 16 practitioners. The program featured a blended Level I fieldwork supervision model, combining faculty-led and traditional on-site supervision. Over the seven-week period, students showed significant improvement in their perceived self-efficacy regarding …

Examining The Relationship Between Musculoskeletal Knowledge And Fieldwork Performance Among Canadian Student Occupational Therapists, Madelyn Walther, Viansa Guiotto, Rhona Anderson, Emily S. Ho

Journal of Occupational Therapy Education

To evaluate the physical aspects of occupational performance, occupational therapists must understand the anatomical structure and function of the body. As such, occupational therapy academic programs must provide sufficient foundational musculoskeletal (MSK) education to prepare student occupational therapists for successful clinical practice. There is a paucity of research on MSK educational needs, and the relationship between student occupational therapists’ MSK academic outcomes and fieldwork performance. This study examined the relationship between MSK anatomy course academic grades and fieldwork performance indicators on the Competency-Based Fieldwork Evaluation for Occupational Therapists (CBFE-OT) of student occupational therapists. A mixed-methods sequential explanatory design was conducted …

Prevalence Of Incivility And Bullying In Occupational Therapy Fieldwork, Edwin Myers, Kaitlyn Cremer

The Open Journal of Occupational Therapy

The prevalence of incivility and bullying in the domain of occupational therapy warrants attention. The long-term effects of incivility and bullying can be profound and multifaceted. These may include job dissatisfaction, depressive symptoms, heightened hostility, and an increased likelihood of malpractice. Despite the implications of such behavior, there remains a noticeable gap in existing literature. This study investigated the prevalence of incivility and bullying occurring during occupational therapy (OT) fieldwork. The Negative Acts Questionnaire-Revised (NAQ-R) was completed by 702 occupational therapists, occupational therapy assistants, and students regarding their fieldwork experiences. Over 80% of participants reported being exposed to bullying or …

Bridging The Gap: A Structured Curriculum For Occupational Therapy Students On Level Ii Fieldwork In Acute Care, Caroline Cameron, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Students achieve entry-level competence through didactic education and fieldwork (Accreditation Council for Occupational Therapy Education [ACOTE], 2023). However, transitioning from student to practitioner can be challenging (Mason et al., 2020). Research has identified challenging areas globally across fieldwork settings environment (Knecht-Sabres et al., 2013; Mason et al., 2020) and specifically in the acute care. These challenges indicate a compelling need to cultivate lacking skills and close the gap between students' didactic curriculum and clinical placement in acute care, where supervisors have the highest expectations for students (Kemp & Crabtree, 2018).

Objectives: This project aimed to develop an educational program …

Fieldwork Remediation Program: Enhancing The Professional Competency Of P3 Otd Students, Megan Ellison

Occupational Therapy Doctorate Capstone Posters

This capstone project addresses a critical gap between classroom learning and clinical readiness in Doctor of Occupational Therapy (OTD) students preparing for Level II Fieldwork (FW). While clinical reasoning and knowledge-based skills are emphasized in training, professional behaviors—such as ethical communication, conflict resolution, and clinical interaction—are often underdeveloped yet essential to success in practice. These "gray-area" skills are typically learned through experience and are difficult to teach directly.

The project, designed for the Eastern Kentucky University OTD Program, aimed to improve student readiness and success in fieldwork through a virtual remediation module focused on self-reflection, professional identity, and effective communication …

Identifying Predictors Of Student Success During Occupational Therapy Level Ii Fieldwork, Melissa R. Foster

Graduate Theses and Dissertations

The training paradigm for new occupational therapy (OT) practitioners includes both didactic classroom learning and clinical fieldwork experiences in order for them to establish clinical competency. However, many students struggle with the theory-to-practice gap of translating classroom knowledge to clinical experiences. When students struggle in this manner, it causes stress for all stakeholders involved, including the fieldwork educator, clinic managers, OT program faculty, as well as the student.

This study aims to avoid this stress by identifying predictors of student success by analyzing data from recent graduates of the University of Arkansas/University of Arkansas for Medical Sciences OT program through …

Utilization Of Digital Platforms To Enhance Usability And Knowledge For Fieldwork Educators; Increasing Access To The Intentional Fieldwork Education Model (Ifwem), Patrick C. Lewis

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Fieldwork education plays a pivotal role in shaping student outcomes in occupational therapy programs. The effectiveness of fieldwork education is significantly influenced by the fieldwork educator's communication style, teaching approach, learning preferences, competency, self-efficacy, and level of preparedness. The Intentional Fieldwork Education Model (IFWEM) and its associated IFWEM course provide an evidence-based framework designed to enhance fieldwork educators’ competency, self-efficacy, and preparedness prior to student fieldwork. In collaboration with the creators of the IFWEM, efforts were made throughout this capstone project to increase the usability, availability, and accessibility of the current IFWEM course. This project aimed to create a more …

Impact Of A Case-Based Learning Module: Integrating Authentic Treatment Videos, Electronic Documentation, And Hands-On Simulation, Emily Martin

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

INTRODUCTION: Developing student confidence and competence is essential for effective fieldwork preparation in occupational therapy (OT) education. Educators use diverse instructional methods to foster clinical readiness, including case-based learning (CBL), video cases, documentation practice, and simulation. CBL enhances critical thinking, clinical reasoning, self-awareness, and confidence. With advancements in technology, video CBL has become more accessible, using authentic patient videos to promote higher-level clinical reasoning, documentation, and communication skills, especially when paired with complementary learning activities. CBL video cases offer a logical opportunity to incorporate structured documentation training, an area in which health professions students often report feeling underprepared. Simulation …

Exploring Perceptions Of Accommodations In Ot Fieldwork: A Mixed Methods Study, Courtney A. Gohean, Courtney Gohean

West Chester University Doctoral Projects

This study employed a convergent parallel mixed-methods design to explore the perceptions and experiences of occupational therapy (OT) fieldwork educators, academic fieldwork coordinators (AFWCs), and Level II OT students with disabilities regarding accommodations during fieldwork. Quantitative data were collected through an online Qualtrics questionnaire completed by 45 fieldwork educators. Qualitative data were gathered through semi-structured interviews with seven AFWCs and seven OT students/new graduates who had used Section 504 accommodations during Level II fieldwork. Thematic analysis revealed key themes among students and AFWCs, including barriers to disclosure, variability in support and communication, the need for proactive planning, and concerns regarding …

Fieldwork Supervision, Motivation And Competency Among Norwegian Community-Based Occupational Therapists, Even E. Edvardsen, Tore Bonsaksen, Sissel Horghagen, Cathrine Arntzen, Unni Sveen, Astrid Gramstad, Ruca E. K. Maass, Linda Stigen

Journal of Occupational Therapy Education

Occupational therapists’ supervision of students remains a critical component during occupational therapy education. This study aimed to examine supervision practice, motivation, and competency among community-based occupational therapists in Norway, exploring organizational and personal factors associated with formal and perceived supervision competency, willingness to serve as fieldwork educators, and collaboration with educational institutions. A cross-sectional survey was distributed among occupational therapists in community-based practice in Norway. A total of 617 occupational therapists participated in the study. Free-text responses were thematically analyzed and interpreted. Differences between fieldwork educators and non-fieldwork educators’ training, recency of being fieldwork educators, willingness to assume the role …

Factors Influencing Reflection And Self-Assessment Of Simulation Performance: Comparing Student And Preceptor Ratings, Kaitlin R. Sibbald, Diane E. Mackenzie

Journal of Occupational Therapy Education

Simulation with simulated patients is increasingly used in occupational therapy. Ensuring the debrief component meets student needs to develop their self-assessment skills for participating in a self-regulating profession is essential. This explanatory mixed-methods research sought to explore factors contributing to accurate and inaccurate self-assessment of simulation performance for novice occupational therapy learners in a part-time introductory fieldwork course. Self-ratings and preceptor-ratings of performance on eleven simulation objectives were compared for sixty-five novice occupational therapy students. Factor analysis was used to explore contributors to differences in ratings between students and preceptors. Students’ written plus-delta debrief reflections were analyzed to explore what …

Bridging Technology And Fieldwork Education: Developing An Electronic Medical Record For A Simulated Level I Experience, Ricardo G. Altahif Jr, Kirsten Davin, Yue Ma, Celina Casas

Journal of Occupational Therapy Education

This study explores the development and implementation of a custom-designed simulated Electronic Medical Record (sEMR) system integrated into a simulation-based Level I occupational therapy fieldwork experience. The sEMR was collaboratively developed by the Occupational Therapy Department and the University Learning Design Team to provide occupational therapy students with realistic exposure to electronic medical record navigation and documentation. First-year Doctor of Occupational Therapy students engaged in eight patient scenarios that simulated real-world settings—two of which utilized the sEMR for chart review and documentation while the remaining six used paper-based documentation. At the conclusion of the simulation, sixty-five students completed a modified …

Student Perceptions Of The Effectiveness Of Simulated Versus Clinical Experiences In Learning Clinical Skills, Joanne M. Baird, Tracy Van Oss, Maureen Hoppe, Jean Prast, Audrey Zapletal, Ketki Raina

Journal of Occupational Therapy Education

Occupational therapy education programs use simulation and clinical environments to teach students clinical skills. However, students’ perceptions of how these environments meet their learning needs are not known. The objective of this study was to explore entry-level occupational therapy students’ perceptions of the effectiveness of simulation and clinical environments in learning clinical skills. This was an observational study, measuring the students’ perceptions after engaging in simulations and clinical environments. Participants were occupational therapy students enrolled in Master's and Doctorate programs (N = 460) in five accredited entry-level occupational therapy programs. Students completed the Clinical Learning Environment Comparison Survey (CLECS). CLECS …

The Re-Design Of Level I Fieldwork To Foster Professional Competence And Career Adaptability, Cara A. Lekovitch, Ann Marsico, Ketki Raina

Journal of Occupational Therapy Education

Professional competence and career adaptability are essential for preparing students to meet modern healthcare demands. However, there is a paucity of evidence to guide teaching and learning of these constructs in the context of Level I fieldwork (FW). This paper details a Level I FW program re-design using a professional competence framework to foster adaptability. The re-design’s impact was assessed through student surveys before and after their participation (n = 53) compared to a historical cohort one-year senior (n = 60) using the Career Adapt-Abilities Scale – Short Form. Significant improvements were found in total and concern, curiosity, and confidence …

Exploring Occupational Therapy Assistant Student Experiences In Mental Health, Behavioral Health, And Psychosocial Level I Fieldwork, Tiffany L. Benaroya, Michelle Zechner, Meredith Cimmino, Ann A. Murphy, Margaret Swarbrick, Pamela Rothpletz-Puglia

Journal of Occupational Therapy Education

Occupational therapy services offered in behavioral health remain low despite the growing number of individuals with behavioral health and psychosocial needs who could benefit from these services. Concurrently, in academia, all occupational therapy and occupational therapy assistant students must complete at least one fieldwork focused primarily on mental health, behavioral health, and/or psychosocial needs. Research is limited regarding these fieldwork experiences, especially among occupational therapy assistant students. This project aimed to understand this gap better and comprehend how these experiences impact readiness to work with individuals labeled with a serious mental illness. Forty-five occupational therapy assistant students completed pre- and …

The Development Of A Self-Reflection Training Module For Enhancing Students Professional Behavior Growth During Level Ii Fieldwork, Tarah Romano, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy students are expected to demonstrate competence in professional behavior skills, such as communication and incorporating constructive feedback, to be considered ready for entry-level practice. Poor professional behavior skills have been linked to challenges and failure during level II fieldwork (Gutman et al. 1998; James & Musselman, 2005). A growing body of research has supported the importance of students’ professional behaviors during fieldwork (Andonian, 2013; Brown et al., 2021; Jensen & Daniel, 2010; Mason & Mathieson, 2018); however, there is a gap in the occupational therapy research on effective methods for teaching professional behaviors to support fieldwork performance. …

Choosing Wisely® In Academia, Strategies For Clinical And Classroom Curricula, Jennifer Tokash, Glen Gillen, Virginia Koenig

The Open Journal of Occupational Therapy

Incorporating evidence-based practice (EBP) into occupational therapy (OT) program curricula is best practice and mandated by the Accreditation Council for Occupational Therapy Education (ACOTE). The Choosing Wisely® campaign, founded by the American Board of Internal Medicine (ABIM) and adopted by the American Occupational Therapy Association (AOTA), provides 10 recommendations for evidence-based OT. This project focused on the Choosing Wisely® campaign's incorporation into OT program curricula. A 40-min educational program focusing on the history of Choosing Wisely®, its adoption by the AOTA as a specialty society partner, and strategies to bridge the campaign's evidence-based recommendations from classroom to clinical experience were …

Preparing Occupational Therapy Students In A Role-Emerging Private School-Based Setting, Jerome Amigo

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project occurred in collaboration with Cornerstone Christian Academy in Las Vegas, Nevada. As a role-emerging area of practice, occupational therapy must focus on integrating services in private schools just as much as public schools. The need for resources to support future fieldwork students at Cornerstone Christian Academy makes it difficult for occupational therapy students to enhance their experiential learning opportunities and serve an underserved population of primary and middle school students.

The capstone project consisted of daily engagement with Cornerstone Christian Academy’s educational personnel, attending students, and the parents of the students for 14 weeks to ensure all …

Examining Minimal Important Change Of The Self-Assessment Scale Of Clinical Reasoning In Occupational Therapy, Sho Maruyama, Reiko Miyamoto, Satoru Amano, Takuto Nakamura, Peter Bontje

Journal of Occupational Therapy Education

The purpose of the study was to establish and quantify the minimal important change (MIC) value necessary to determine gains or losses in clinical reasoning during student fieldwork assignments as measured by the Self-Assessment of Clinical Reasoning in Occupational Therapy (SA-CROT). This multicenter prospective longitudinal study was conducted with students on their occupational therapy fieldwork in Japan. Two anchor-based methods were used to estimate the MIC values: a receiver operating characteristic-based method and a predictive modeling-based method. The MIC was adjusted based on the percentage of participants who exhibited improvement. Administered were the SA-CROT and the Global Rating of Change …

Evaluating Change In Skill Performance Over Time And Practice Context In Introductory Fieldwork Simulation, Kaitlin R. Sibbald, Diane E. Mackenzie

Journal of Occupational Therapy Education

Simulation has been recognized for its ability to develop competency-level skills and as a replacement for some introductory fieldwork (FW) hours. This study explored how occupational therapy competency-related skills developed over sequential in-person simulations across health practice contexts during Level 1 FW. Entry-to-practice occupational therapy students (N = 66) participated in six sequential, formative, Level 1 FW simulations. The first three sequential simulations (the same patient case evolves in each successive interaction) included a trained simulated patient in a community mental health context and the following three engaged a trained simulated inpatient in a physical health context. Evaluation rubric variables …

Perceptions Regarding Hand Therapy Content In Entry-Level Occupational Therapy Programs, Lauren Fiori, Karen Majeski

Journal of Occupational Therapy Education

There are a substantial number of Certified Hand Therapists reaching retirement age in the next decade, however, there are few newer graduates who are pursuing this specialty. Students’ lack of clinical knowledge has shown to be a barrier to successfully completing a hand therapy fieldwork affiliation. The purpose of the study is to investigate: (1) the perceptions of the clinicians working in hand therapy and students regarding the integration of hand therapy content in entry-level occupational therapy programs, and (2) the perceptions of both groups as to which content is deemed essential for a successful hand therapy fieldwork placement. This …