Level II FW

Touro University Nevada
Occupational Therapy
Evaluator:
Sheila Marquez - Fieldwork Educator
Subject:
Tonya DeDera - Level II
Activity:
OCCT 660
Site:
Heights of Summerlin
Evaluation Type:
Fieldwork Performance Eval for OT Student - Final
Completion Date:
02/05/2016
Request Date:
01/08/2016
Period:
OCCT 660 - Fall 2015
Dates of Activity:
10/26/2015 To 02/07/2016
Subject Participation Dates:
10/26/2015 To 02/07/2016
Please select the option that best matches your level of agreement with this evaluation.
Comments entered above may be viewed by your program director or advisor and may be a part of a printed report.
AOTA
Fieldwork Performance Evaluation for the Occupational Therapy Student
Touro University Nevada, School of Occupational Therapy
FINAL EVALUATION
Student Name: (Last, First, Middle)
(Question1of39-Mandatory)
DeDera, Tonya
College or University:
(Question2of39)
Selection
Option
Touro University Nevada, School of Occupational Therapy

Other
Name of Organization/Facility:
X The Heights of Summerlin
Address (Street or PO Box):
10550 Park Run Drive
City, State, Zip:
Las Vegas, NV, 89144
Type of Fieldwork:
Selection
Option
1-1 In-Patient Acute

1.2 In Patient Rehab
1.3 SNF/Sub-acute/Acute Long-term Care

1.4 General Rehab Outpatient
1.5 Outpatient Hands
1.6 Pediatric Hospital/Unit
1.7 Pediatric Hospital Outpatient
1.8 In-Patient Psych
2.1 Pediatric Community
2.2 Behavioral Health Community
2.3 Older Adult Community Living
2.4 Older Adult Day Program
2.5 Outpatient/Hand Private Practice
2.6 Adult Day Program for DD
2.7 Home Health
2.8 Pediatric Outpatient Clinic
3.1 Early Intervention
3.2 School
Other (explain below)
If "Other" please explain:
(Question7of39)
Order of Placement: (AtTouroUniversityNevada'sSchoolofOTtherearetwopossibleplacementsatthislevel.Answershouldbe1of2or2of2.)

(Question8of39)
Selection Option
X
IIA (1 of 2)
IIB (2 of 2)
Start Date: (DatesofPlacement)
11/17/2015
End Date:
02/05/2015
Number of Weeks Completed:
12
Pass / No Pass:
(Question12of39)
Selection Option
------
Pass
No Pass
Final Passing Score: 122 points and above

Final Not Passing Score: 121 points and below
Final Score:
(Question13of39)
155
SUMMARY COMMENTS: (Addressesstudent'sclinicalcompetence)
(Question14of39)
Miss DeDera showed exceptional skills with evaluating and providing occupational therapy services to patients expected for an entry level OT . Time
management and gaining further confidence with her assessments in terms measuring components in an OT evaluation with more accuracy which
only exposure and years of experience can help develop .
SIGNATURES
Digital Signature of Student:
(Question15of39)
Tonya DeDera
I understand that be checking this box I am certifying that I have read this report.
Selection
Option
I confirm I have read this report
(Question16of39)
FIELDWORK EDUCATOR(S):
Number of Persons Contributing to this Report:
(Question17of39)
Digital Signature of Rater #1:
Sheila Marquez, OTR/L , CPAM ,C/NDT
I understand that by checking this box, I am certifying the authenticity of this evaluation.
Selection
Option
I hereby certify the authenticity of this evaluation
Credentials/Position:
(Question20of39)
OTR/L
Digital Signature of Rater #2 (if applicable):
(Question21of39)
I understand that by checking this box, I am certifying the authenticity of this evaluation.
Selection
Option
I hereby certify the authenticity of this evaluation
Credentials/Position:
(Question22of39)
(Question23of39)
RATING SCALE FOR STUDENT PERFORMANCE

4 - Exceeds Standards
supervised.
is highly skilled and self-initiated. This rating is rarely given and would represent the top five percent of all the students you have
3 - Meets Standards Performance is consistent with entry-level practice. This rating is infrequently given at midterm and is a strong rating at final.
2 - Needs improvement Performance is progressing but still needs improvement for entry-level practice. This is a realistic rating of performance at midterm,
and some ratings of two may be reasonable at the final.
1 - Unsatisfactory:
performance
Accepted:
Selection
Performance is below standards and requires development for entry-level practice. This rating is given when there is a concern about
(Question24of39)
Option
I have read and understand this information
I. FUNDAMENTALS OF PRACTICE
Exceeds Standards Meets Stardands Needs Improvement Unsatisfactory
4
>> 4 <
3.0
2.0
1.0
Adheres to ethics : Adheres consistently to the American

1. Occupational Therapy Association Code of Ethics (4) and site's
policies and procedures including, when relevant, those related to
human subject research.
Adheres to safety regulations: Adheres consistently

2. to safety regulations. Anticipates potentially hazardous situations
and takes steps to prevent accidents.
>> 4 <
3.0
2.0
1.0
Uses judgment in safety : Uses sound judgment in

3. regard to safety of self and others during all fieldwork-related
activities.
>> 4 <
3.0
2.0
1.0
Comments on strengths and areas of improvement:
(Question26of39)
Miss DeDera demonstrates awareness of patient's rights and boundaries of OT practice , adheres to safety rules of facility and exercises safety and
knowing when to ask for assistance .
II. BASIC TENETS

Exceeds Standards Meets Standards Needs Improvement Unsatisfactory
4
Clearly and confidently articulates the values and

1. beliefs of the occupational therapy profession to clients,
families, significant others, colleagues, service providers and the
public.
>> 4 <
3.0
2.0
1.0
Clearly, confidently and accurately articulates the

value of occupation as a method and desired outcome
of occupational therapy to clients, families, significant others,
colleagues, service providers and the public.
>> 4 <
3.0
2.0
1.0
communicates the
roles of the occupational therapist and
occupation therapy assistant to clients, families,
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
2.0
1.0
2.
Clearly, confidently and accurately

3.
significant others, colleagues, service providers and the public.

4.
Collaborates with client, family and significant others

throughout the occupational therapy process.
Comments on strengths and areas for improvement:
(Question28of39)
Miss DeDera , adequately explains role of occupational therapy with clients and their families , collaborates with family and staff to adequate provide
good service to patients.
III. EVALUATION AND SCREENINGS

1.
Articulates a clear and logical rationale for the
2.
Selects relevant screening and assessment

methods while considering such factors as client's priorities,
evaluation process.
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
context(s), theories and evidence-based practice.

3.
Determines client's occupational profile and
4.
Assesses Client Factors and contexts(s) that
5.
Obtains sufficient and necessary

information from relevant resources such as client, families,
performance through appropriate assessment methods.

support or hinder occupational performance.
significant others, service providers and records prior to and during

the evaluation process.
6.
7.
Administers assessments in a uniform manner to

ensure findings are valid and reliable.
Adjusts/modifies the assessment

procedures based on client's needs, behaviors and culture.
8.
Interprets evaluation results to determine client's
9.
Establishes an accurate and appropriate

plan based on the evaluation results, through integrating multiple
occupational performance strengths and challenges.
factors such as client's priorities, context(s), theories and

evidence-based practice.
Documents the results of the evaluation
10. process that demonstrates objective measurement of client's

occupational performance.
(Question30of39)
Miss DeDera explains to client regarding purpose of evaluations and execute measures correctly however she still needs to gain more confidence in
accurately assessing some components of evaluation which only exposure and experience can further develop .
IV. INTERVENTION
4
1.
Articulates a clear and logical rationale for the
2.
Utilizes evidence from published research and relevant
3.
Chooses occupations that motivate and challenge
4.
Selects relevant occupations to facilitate clients
intervention process.
resources to make informed intervention decisions.
clients.
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
2.0
1.0
5.
Implements intervention plans that are

client-centered.
>> 4 <
3.0
2.0
1.0
6.
Implements intervention plans that are

occupation-based.
>> 4 <
3.0
2.0
1.0
7.
Modifies task approach, occupations and the

environment to maximize client performance.
>> 4 <
3.0
2.0
1.0
Updates, modifies or terminates the

intervention plan based upon careful monitoring of the
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
8.
meeting established goals.
client's status.
9.
Documents client's response to services in a

manner that demonstrates the efficacy of interventions.
(Question32of39)
Miss DeDera implements interventions relevant to OT goals set and obtains good rapport with her patients to effectively provide OT services however
she still needs a little reminder to highlight levels of function in her documentation .
V. MANAGEMENT OF OCCUPATIONAL THERAPY SERVICES:

1.
Demonstrates through practice or

discussion the ability to assign appropriate
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
responsibilities to the occupational therapy assistant and

occupational therapy aide.
2.
Demonstrates through practice or

discussion the ability to actively collaborate
with the occupational therapy assistant.
3.
Demonstrates understanding of the costs

and funding related to occupational therapy services at this
site.
Accomplishes organizational goals by

4. establishing priorities, developing strategies and meeting
deadlines.
5.
Produces the volume of work required in the

expected time frame.
(Question34of39)
Miss DeDera had little opportunity to collaborate with COTAs since fieldwork educator is not supervising one at this time however Tonya did have
opportunity to communicate concerns with rehabilitation staff as needed. She finishes patient treatment within the time frame allotted but still needs to
be faster with completed required documentation within an 8 hour day which will only with further exposure and experience .
VI. Communication:
4
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4. the information, including but not limited to funding agencies and

regulatory agencies.
>> 4 <
3.0
2.0
1.0
(Question36of39)
1.
Clearly and effectively communicates

verbally and nonverbally with clients, families,
significant others, colleagues, service providers and the public.
2.
Produces clear an accurate documentation
3.
All written communication is legible, using
according to site requirements.

proper spelling, punctuation and grammar.
Uses language appropriate to the recipient of
Miss DeDera effectively communicates with patient and staff however she still needs more exposure to further hone her abilities to accurately measure
components of an OT evaluation .
VII. PROFESSIONAL BEHAVIORS:

4
1.
Collaborates with supervisor(s) to maximize the
2.
Takes responsibility for attaining

professional competence by seeking out learning
learning experience.
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
2.0
1.0
opportunities and interactions with supervisor(s) and others.

3.
Responds constructively to feedback.

Demonstrates consistent work behaviors
4. including initiative, preparedness, dependability and worksite

maintenance.
5.
Demonstrates effective time management.

Demonstrates positive interpersonal skills
6. including but not limited to cooperation, flexibility, tact and

empathy.
Demonstrates respect for diversity factors of

7. others including but not limited to socio-cultural, socio-economic,
spiritual and lifestyle choices.
Comments on strengths and areas of improvement:
(Question38of39)
Miss DeDera observes professionalism with communicating and treatment of staff and patients. Effectively manages treatment time but still needs to
finish electronic documentation within given time frame.
REFERENCES
1. American Occupational Therapy Association, (1998), Standards of practice for occupational therapy, AmericanJournalofOccupationalTherapy,52, 866-869.
2. Accreditation Council for Occupational Therapy Education, (1999). Standards for an accredited educational program for the occupational therapist. American
JournalofOccupationalTherapy,53, 575-582.
3. National Board for Certification in Occupational Therapy, (1997). NationalStudyofOccupationalTherapyPractice,ExecutiveSummary.
4. American Occupational Therapy Association. (2000). Occupational therapy code of ethics (2000). AmericanJournalofOccupationalTherapy,54, 614-616.
5. American Occupational Therapy Association (2002). Occupational therapy practice framework: Domain and process. AmericanJournalofOccupational
Therapy,56, 606-639.
GLOSSARY
Client Factors:
Those factors that reside within the client and that may affect performance in areas of occupation. Client factors include body functions and body structures
Body functions (a client factor, including physical, cognitive, psychosocial aspects)the physiological function of body systems (including psychological
functions) (WHO, 2001, p. 10)
Body structuresanatomical parts of the body such as organs, limbs and their components [that support body function] (WHO, 2001, p. 10)
(Occupational therapy practice framework: Domain and process. AmericanJournalofOccupationalTherapy,56, 606-639.) (5)
Code of Ethics: Refer to
http://www.aota.org/~/media/Corporate/Files/AboutOT/Ethics/Code%20and%20Ethics%20Standards%202010.ashx
Collaborate: To work together with a mutual sharing of thoughts and ideas. (ACOTE Glossary)
Competency: Adequate skills and abilities to practice as an entry-level occupational therapist or occupation therapy assistant.
Context: Refers to a variety of interrelated conditions within and surrounding the client that influence performance. Contexts include cultural, physical, social,
personal, spiritual, temporal and virtual. (Occupational therapy practice framework: Domain and process.AmericanJournalofOccupationalTherapy,56, 606-639.) (5)
Efficacy: Having the desired influence or outcome (from Neistadt and Crepeau, Eds. Willard&SpackmansOccupationalTherapy, 9 th edition, 1998).
Entry-level Practice: Refer to:
http://www.aota.org/~/media/Corporate/Files/Practice/OTAs/ScopeandStandards/Standards%20of%20Practice%20for%20Occupational%20Therapy%20FINAL.ashx
Evidenced-based Practice: "Conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The
practice of evidence-based [health care] means integrating individual clinical expertise with the best available external clinical evidence from systematic research."
Occupation: Groups of activities and tasks of everyday life, named organized and given value and meaning by individuals and a culture; occupation is everything
people do to occupy themselves, including looking after themselves (self-care), enjoying life (leisure), and contributing to the social and economic fabric of their
communities (productivity); the domain of concern and the therapeutic medium of occupational therapy. (Townsend, editor, 1997, EnablingOccupation:An
OccupationalTherapyPerspective, p. 181)
Occupational Performance: The result of a dynamic, interwoven relationship between persons, environment and occupation over a person's lifespan; the ability to
choose, organize, and satisfactorily perform meaningful occupations that are culturally defined and age appropriate for looking after oneself, enjoying life, and
contributing to the social and economic fabric of a community. (Townsend, editor, 1997, EnablingOccupation:AnOccupationalTherapyPerspective, p.181)
Occupational Profile: A profile that describes the clients occupational history, patterns of daily living, interests, values and needs. (Occupational therapy practice
framework: Domain and process, AmericanJournalofOccupationalTherapy,56, 606-639.) (5)
Spiritual: (a context)The fundamental orientation of a person's life; that which inspires and motivates that individual. (Occupational therapy practice framework:
Domain and process. AmericanJournalofOccupationalTherapy,56, 606-639.) (5)
Theory: "An organized way of thinking about given phenomena. In occupational therapy the phenomenon of concern is occupational endeavor. Theory attempts to
(1) define and explain the relationships between concepts or ideas related to the phenomenon of interest, (2) explain how these relationships can predict behavior or
events, and (3) suggest ways that the phenomenon can be changed or controlled. Occupational therapy theory is concerned with four major concepts related to
occupational endeavor: person, environment, health, and occupation." (Neistadt and Crepeau, Eds. Willard&Spackman'sOccupationalTherapy, 9 th edition, 1998,
p. 521)
Accepted:
(Question39of39)
Selection
Option
I have read and understand this information

Level II FW

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Touro University Nevada

Sheila Marquez - Fieldwork Educator

Tonya DeDera - Level II

Fieldwork Performance Eval for OT Student - Final

OCCT 660 - Fall 2015

Subject Participation Dates:

Touro University Nevada, School of Occupational Therapy

X The Heights of Summerlin

Address (Street or PO Box):

10550 Park Run Drive

City, State, Zip:

Las Vegas, NV, 89144

1-1 In-Patient Acute

1.3 SNF/Sub-acute/Acute Long-term Care

If "Other" please explain:

Order of Placement: (AtTouroUniversityNevada'sSchoolofOTtherearetwopossibleplacementsatthislevel.Answershouldbe1of2or2of2.)

Start Date: (DatesofPlacement)

Number of Weeks Completed:

Final Passing Score: 122 points and above

SUMMARY COMMENTS: (Addressesstudent'sclinicalcompetence)

I confirm I have read this report

Digital Signature of Rater #1:

Sheila Marquez, OTR/L , CPAM ,C/NDT

I hereby certify the authenticity of this evaluation

Digital Signature of Rater #2 (if applicable):

I hereby certify the authenticity of this evaluation

RATING SCALE FOR STUDENT PERFORMANCE

Adheres to ethics : Adheres consistently to the American

Adheres to safety regulations: Adheres consistently

Uses judgment in safety : Uses sound judgment in

Comments on strengths and areas of improvement:

II. BASIC TENETS

Clearly and confidently articulates the values and

Clearly, confidently and accurately articulates the

Clearly, confidently and accurately

significant others, colleagues, service providers and the public.

Collaborates with client, family and significant others

Comments on strengths and areas for improvement:

III. EVALUATION AND SCREENINGS

Articulates a clear and logical rationale for the

Selects relevant screening and assessment

context(s), theories and evidence-based practice.

Determines client's occupational profile and

Assesses Client Factors and contexts(s) that

Obtains sufficient and necessary

performance through appropriate assessment methods.

significant others, service providers and records prior to and during

Administers assessments in a uniform manner to

Adjusts/modifies the assessment

Interprets evaluation results to determine client's

Establishes an accurate and appropriate

occupational performance strengths and challenges.

factors such as client's priorities, context(s), theories and

Documents the results of the evaluation

10. process that demonstrates objective measurement of client's

Comments on strengths and areas for improvement:

Articulates a clear and logical rationale for the

Utilizes evidence from published research and relevant

Chooses occupations that motivate and challenge

Selects relevant occupations to facilitate clients

Implements intervention plans that are

Implements intervention plans that are