2/13/2015

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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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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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