Touro University Nevada
Occupational Therapy
Evaluator:
Amy LaPres - Fieldwork Educator
Subject:
Brandon Roberson - Level II
Activity:
OCCT 660
Site:
Clubhouse for Kids
Evaluation Type:
Fieldwork Performance Eval for OT Student - Final
Completion Date:
01/25/2015
Request Date:
01/07/2015
Period:
OCCT 660 - Fall 2014 *
Dates of Activity:
11/03/2014 To 02/06/2015
Subject Participation Dates:
11/03/2014 To 02/06/2015
Please select the option that best matches your level of agreement with this evaluation.
Agreed on 02/01/2015
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)
Roberson, Brandon
College or University:
(Question2of39)
Selection
Option
Touro University Nevada, School of Occupational Therapy
Other
FIELDWORK SETTING
Name of Organization/Facility:
(Question3of39-Mandatory)
X Clubhouse for Kids
Address (Street or PO Box):
(Question4of39-Mandatory)
2560 Montessouri ave
City, State, Zip:
(Question5of39-Mandatory)
Las Vegas NV 89117
Type of Fieldwork:
Selection
(Question6of39-Mandatory)
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)
(Question9of39-Mandatory)
11/03/2014
End Date:
(Question10of39-Mandatory)
01/23/2015
Number of Weeks Completed:
(Question11of39-Mandatory)
12
Pass / No Pass:
(Question12of39)
Selection Option
------
Pass
No Pass
Final Score:
(Question13of39)
SUMMARY COMMENTS: (Addressesstudent'sclinicalcompetence)
(Question14of39)
SIGNATURES
Digital Signature of Student:
(Question15of39)
I understand that be checking this box I am certifying that I have read this report.
Selection
Option
(Question16of39)
I confirm I have read this report
FIELDWORK EDUCATOR(S):
Number of Persons Contributing to this Report:
(Question17of39)
Digital Signature of Rater #1:
(Question18of39-Mandatory)
Amy M LaPres
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:
(Question19of39-Mandatory)
(Question20of39)
MS, 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
(Question22of39)
Option
I hereby certify the authenticity of this evaluation
Credentials/Position:
(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
(Question25of39-Mandatory)
Exceeds Standards Meets Stardands Needs Improvement Unsatisfactory
4
>> 4 <
3.0
2.0
1.0
>> 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.
Uses judgment in safety : Uses sound judgment in
3. regard to safety of self and others during all fieldwork-related
activities.
>> 4 <
Comments on strengths and areas of improvement:
3.0
2.0
1.0
(Question26of39)
II. BASIC TENETS
(Question27of39-Mandatory)
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.
4.0
>> 3 <
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.
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
2.
communicates the
roles of the occupational therapist and
occupation therapy assistant to clients, families,
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)
III. EVALUATION AND SCREENINGS
(Question29of39-Mandatory)
Exceeds Standards Meets Standards Needs Improvement Unsatisfactory
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.
4.0
>> 3 <
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
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.
Administers assessments in a uniform manner to
4.0
>> 3 <
2.0
1.0
Adjusts/modifies the assessment
procedures based on client's needs, behaviors and culture.
4.0
>> 3 <
2.0
1.0
8.
Interprets evaluation results to determine client's
4.0
>> 3 <
2.0
1.0
9.
Establishes an accurate and appropriate
plan based on the evaluation results, through integrating multiple
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
6.
7.
ensure findings are valid and reliable.
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.
Comments on strengths and areas for improvement:
(Question30of39)
IV. INTERVENTION
(Question31of39-Mandatory)
Exceeds Standards Meets Standards Needs Improvement Unsatisfactory
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.
meeting established goals.
4.0
>> 3 <
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
5.
Implements intervention plans that are
client-centered.
4.0
>> 3 <
2.0
1.0
6.
Implements intervention plans that are
occupation-based.
4.0
>> 3 <
2.0
1.0
7.
Modifies task approach, occupations and the
environment to maximize client performance.
4.0
>> 3 <
2.0
1.0
Updates, modifies or terminates the
intervention plan based upon careful monitoring of the
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
8.
client's status.
9.
Documents client's response to services in a
manner that demonstrates the efficacy of interventions.
Comments on strengths and areas for improvement:
(Question32of39)
V. MANAGEMENT OF OCCUPATIONAL THERAPY SERVICES:
(Question33of39-Mandatory)
Exceeds Standards Meets Standards Needs Improvement Unsatisfactory
1.
Demonstrates through practice or
discussion the ability to assign appropriate
>> 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 <
3.0
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.
Comments on strengths and areas for improvement:
(Question34of39)
VI. Communication:
(Question35of39-Mandatory)
Exceeds Standards Meets Standards Needs Improvement Unsatisfactory
4
>> 4 <
3.0
2.0
1.0
>> 4 <
3.0
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
Comments on strengths and areas for improvement:
(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
VII. PROFESSIONAL BEHAVIORS:
(Question37of39-Mandatory)
Exceeds Standards Meets Standards Needs Improvement Unsatisfactory
1.
Collaborates with supervisor(s) to maximize the
2.
Takes responsibility for attaining
professional competence by seeking out learning
learning experience.
4.0
>> 3 <
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 <
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)
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
[Link]
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 [Link],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:
[Link]
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
