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TouroUniversityNevada
OccupationalTherapy
TraineeEvaluation
Evaluator:
JodieTaylorFieldworkEducator
Subject:
DaniellePalmerLevelI
Activity:
OCCT526A
Site:
SummerlinOutpatientTherapy
Center
EvaluationType:
EducatorEvaluationofLevelIFieldwork Completion
Student
Date:
RequestDate:
01/27/2015
Period:
OCCT526AFall2014
SubjectParticipation
Dates:
01/12/2015To02/13/2015
Datesof
Activity:
02/12/2015
01/12/2015To02/13/2015
FieldworkEducator:(Question1of7)
JodieTaylor,OTR/L
TypeofFieldwork:(Specialty/PracticeArea)(Question2of7Mandatory)
Selection
Option
1.1InPatientAcute
1.2InPatientRehab
1.3SNF/SubAcute/AcuteLongTermCare
1.4GeneralRehabOutpatient
1.5OutpatientHands
1.6PediatricHospital/Unit
1.7PediatricHospitalOutpatient
1.8InPatientPsych
2.1PediatricCommunity
2.2BehavioralHealthCommunity
2.3OlderAdultCommunityLiving
2.4OlderAdultDayProgram
2.5Outpatient/handprivatepractice
2.6AdultDayProgramforDD
2.7HomeHealth
2.8PediatricOutpatientClinic
3.1EarlyIntervention
3.2School
Other(seebelow)
Other(Question3of7)
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1/4
2/13/2015
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IfOtherwasselectedforTypeofFieldwork,pleasespecify:
Indicatethestudentslevelofperformanceusingthescaleprovided
4Exceeds
Standards:
3Meets
Standards:
2Below
Standards:
1WellBelow
Standards:
Frequentlycarriesouttasksandactivitiesthatsurpassrequirements.Attimes,performance
isexceptional.
Carriesoutrequiredtasksandactivities.Thisratingrepresentsgood,solidperformanceandis
typicallyusedmorethanalltheotherratings.
Opportunitiesforimprovementexisthowever,studenthasnotdemonstratedadequate
responsetofeedback.Workisoccasionallyunacceptable.
Performanceisweakinmostrequiredtasksandactivities.Workisfrequentlyunacceptable.
(Question4of7Mandatory)
Exceeds
Meets
Below
Standards Standards Standards
Well
Below N/A Comments
Standards
4.0
>>X<<
2.0
1.0
Organization
Considerabilitytosetpriorities,be
dependable,beorganized,followthrough
withresponsibilities
EngagementintheFieldwork
Experience
Considerthestudentsapparentlevelof
interest,levelofactiveparticipationwhileon
siteinvestmentinindividualsandtreatment
outcomesseekswaystoimproveself
performancefollowssafetyprecautions
4.0
>>X<<
2.0
1.0
4.0
>>X<<
2.0
1.0
4.0
>>X<<
2.0
1.0
Danielle
always
asked
appropriate
questions
andseeked
more
information
asneeded.
SelfDirectedLearning
Considerabilitytotakeresponsibilityforown
learningdemonstratemotivationawareof
ownstrengthsandareasforimprovement
Reasoning/ProblemSolving
Considerabilitytouseselfreflection,
willingnesstoaskquestionsabilitytoanalyze,
synthesizeandinterpretinformation
understandtheOTprocessdemonstrates
inquiryskillsappropriatetothestudentsstage
ofeducationandtraining
WrittenCommunication
Considergrammar,spelling,legibility,
successfulcompletionofwrittenassignments,
documentationskills
4.0
3.0
2.0
1.0
Thiswas
>>X<< notpartof
anyofthe
objectives.
Danielle
used
resources
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Initiative
Considerinitiative,abilitytoseekandacquire
informationfromavarietyofsources
4.0
>>X<<
2.0
1.0
4.0
>>X<<
2.0
1.0
withinthe
clinicto
expandher
knowledge
whentime
allotted.
ObservationSkills
Considerabilitytoobserverelevantbehaviors
forperformanceareasandperformance
componentsandtoverbalizeperceptionsand
observations
VerbalCommunicationand
InterpersonalSkills
Considerabilitytointeractappropriatelywith
individuals(patients/clients/staff/caregivers)
suchaseyecontact,empathy,limitsetting,
respectfulness,useofauthority
degree/qualityofverbalinteractionsuseof
bodylanguageandnonverbal
communicationexhibitsconfidence
4.0
>>X<<
2.0
1.0
4.0
>>X<<
2.0
1.0
4.0
>>X<<
2.0
1.0
4.0
>>X<<
2.0
1.0
4.0
>>X<<
2.0
1.0
4.0
>>X<<
2.0
1.0
Thisisa
strengthof
Danielle's.
Ithinkshe
willdowell
working
with
familiesif
she
decidesto
workin
pediatrics.
ProfessionalandPersonal
Boundaries
Considerabilitytorecognize/handle
personal/professionalfrustrationsbalance
personal/professionalobligationshandle
responsibilitiesworkwithothers
cooperatively,considerately,effectively
responsivenesstosocialcuesadheresto
AOTACodeofEthics
UseofProfessionalTerminology
Considerabilitytorespectconfidentiality
appropriatelyapplyprofessionalterminology
(PracticeFramework)inwrittenandoral
communication
AttitudeandProfessional
Appearance
Considerabilitytomanagestressorsin
constructivewaysdemonstratesflexibilityas
requiredfollowsprogramguidelinesfordress
andhygiene
TimeManagementSkills
Considerabilitytobeprompt,arriveontime,
completeassignmentsontime
ParticipationintheSupervisory
Process
Considerabilitytogive,receiveandrespond
tofeedbackseekguidancewhennecessary
followproperchannels
StudentLearningObjectivesforThisFieldworkExperience:
(Question5of7Mandatory)
Date
Completed
Student
LearningObjectives
1. 1/15/15
Studentswillobserve/participatewithachildengagedinoccupationbasedactivityand
discusswiththefacilityfieldworkeducatoratleastonemethodinwhichtheactivity
couldbecarriedoutwiththefamilyoutsideofthetreatmentsession.
2. 1/22/15
Studentwillobserve(orparticipatein)aclientevaluationorreassessment.
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3. 1/22/15
Inordertoincreasemyknowledgeaboutselffeedinginpediatrics,Iwillobserveachild
engagedinaselffeedingactivityandafterwards,discusswiththefieldwork
coordinator,howthesessionwentandthegoalsofthechild.
FieldworkEducatorComments:(Question6of7)
ItwasapleasurehavingDanielleintheclinic.Sheautomaticallyjumpedintohelpoutatappropriatetimesandis
aselfmotivatorlearner.Ifeelshewoulddowellinthefieldofpediatricoccupationaltherapy.
WehavebothreviewedtheEducatorEvaluationofStudent,StudentEvaluationofEducator,andStudent
EvaluationofFacility.(Question7of7Mandatory)
Selection Option
Yes
X
No
ThepurposeofaLevelIFieldworkexperienceistoprovideanopportunityforexposuretooccupationaltherapy
interventionandprogrammingor,inthecaseswherenoOTservicesarecurrentlybeingprovided,exposureto
potentialgrowthareasforOT.Weencourageasmuchhandsonaspossibleandappropriatewithineach
experience.Itisexpectedthatprofessionalbehaviorsareupheldinallsettings.
Thankyouforyourparticipationinourprogramandyourassistanceintheeducationalprocessofour
occupationaltherapystudents.
PleasenotifytheAcademicClinicalCoordinatorimmediatelyifthisstudentisnotperformingtothefacilities
expectationsforLevelIFieldwork.
AshleyFechtOTD,OTR/L
AcademicClinicalCoordinator&AssistantProfessor
(702)7774762Office
(702)3701328Cell
ashley.fecht@tun.touro.edu
(AdaptedfromColoradoStateUniversityLevelIStudentPerformanceEvaluation,PhiladelphiaRegion
FieldworkConsortium,WashingtonUniversitySchoolofMedicinePrograminOccupationalTherapy)
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