AOTA =~
Fieldwork Performance Evaluation
For The Occupational Therapy Student
Ord U NV
mee ye NV
FIELDWORK SETTING:
wc
Woora iv [NOWBER OF PERSONS CONTAIBUTING TO THIS REPORT
PEL
AOZ Lave tA
a
tnpatend ecnab —
‘ORDER OF PLACEMENT )2 3 4 OUTOF {C293 4
»-_|| tl 2 1/40) |F
ines OF PLACEMENT
ae
NONBER OF HOURS! oe PRINT NAMEIOREDENTIALS POSITION
‘SIGNATURE OF RATER #2 (F APPLICABLE)
FNAL SCORE
‘PASS: _ V NO PASS:.
‘SUMMARY COMMENTS:
(ADDRESSES STUDENT'S CLINICAL COMPETENCE)
‘AOTA gran poison pete fo Felder Pomenc Eatin fr he
Ozamatrs! Tey Sarr rigpurpesas ey Tag purpose encomesst
ge PAPE lms in tun rca and ang mara cl eto
Sl in ring sens fr practoers cha rope se ng scoring oa fm, a
{or curso aplee sara ug thr Slo ting Persson use
(totems mat be ibang acnyFieldwork Performance Evaluation
For The Occupational Therapy Student
“This evaluation isa revision of the 1987 American Occupational Therapy
Association, Inc. Fieldwork Evaluation Form for the Qocupatonal
“Therapist and was produced by a commitee of the Commission on
Education
PURPOSE
“The primary purpose ofthe Fieldwork Perfmanos Evaluation fr tho
(Occupational Therepy Student i o measure entyevel competence of
‘he occupational therapy studnt. The evaluation is dsigned to dieren-
{ato the competent student from the incompetent student and i not
designed to dferentiat levels above enty level competence For further
Ctitiation on entry vel compotency ofr othe Standards of Practice
{or Occupational Therapy
‘The evaluation is designed to measure the performance ofthe oocupae
‘ional therapy process and was not designed to measute the specific
‘occupational therapy task in isolation. This evaluation reflects the 1998
Accreditation Counel for Occupational Therapy Eduction Standards!
and the National Board for Catfication in Occupational Therapy, Inc.
Practice Analysis resus’. In action, this evaluation allows students to
evaluate their own strengths and challenges in relation to their perform
ance as an occupational therapist.
USE OF THE FIELDWORK PERFORMANCE EVALUATION
FOR THE OCCUPATIONAL THERAPY STUDENT
‘The Feldwark Performance Evaluation i intended to provide the student
with n accurate assessment of hstber competence for enty-leve prac-
fice. Boh the student and fedwork educator should recognize that
growth occurs overtime. The midterm and final evaluation scores will
reflect development of student competency and growth. In ote 10
cectvely use this evakatin to assoss student competence, ste-
specie cbjectves need to be developed Uti this evaluation as a
framework to assist in ensuring that all key performance areas are
related inthe ste-specic objectives.
Using this evaluation at midtorm and fina, its suggested that the stu
‘dent complete a soltevaivaion of hiser own performance. During the
miter review process, the student and fieldwork educator should col
laboratvely develop a plan, which would enable the student to achieve
entry evel competence by the end ofthe fieldwork experience. This plan
should incude spectic objectives and enabling activites to bo usod
by the student and fieldwork educator in order to achieve the desired
competence,
The Fleldwork Educator must contact the Academic Fieldwork
Coordinator when: (1) a student exhibits unsatisfactory behavior in @
‘substantial number of tasks or (2) a students potontal fr achieving
ceniryevel competence by the end ofthe aflation isin question.
DIRECTIONS FOR RATING STUDENT PERFORMANCE
+ There are 42 performance items.
«Every tem must be scored, using the one to four point rating scale (see
belo
+The rating scales should be carelully studied prior to using this
evaluation, Definitions of tho coals are given atte top of each page.
‘Circle the number that corresponds tothe description that best
describes the student’ performance.
* The ratings for the Ethics and Safety items must be scored at3 or
‘above on the final evaluation forthe student to pass the fieldwork
experience. IF the ratings are below 3, coninue to comploto to
Fialdviork Performance Evaluation to provide feedback tothe student
‘on hethis performance,
‘+ Record midterm and fina ratings on the Periormance Rating Summary
Sheet,
+ Compare overall mictorm and final sore tothe scala below,
OVERALL MIDTERM SCORE
Salislactory Performanos .... 90 and above
Unsatstactory Performance .........+.- 89 and below
OVERALL FINAL SCORE
PHSB... eoseee 122 points and above
No Pass. 121 points and below
RATING SCALE FOR STUDENT PERFORMANCE
4—Excaeds Standards: Parxmance is hight sklled and sel-niiated.
This tng is rarely given and would represen the top 5% of all the
students you have supenised.
‘3 —Meets Standards: Perormance is consistent wth entry-level pracie.
‘This tng is infrequently given at midterm ands a strong rating at
final.
2 Needs improvement: Peosmance Is progressing but sil acd
improvament or onty-eelpracice This ralistic ating of
performance at midterm, an some ratings of 2 may be reasonable at
the ina
1 —Unsatistactory:Perormanos is Below standards and roques
‘evelopment or entevel practice This rating is gon when there Is
' concem about performance,RATING SCALE FOR STUDENT PERFORMANCE.
4— Exceeds Standards: Perormance i highly skied and slated,
This ating is rarely given and would represent the top 5% of ll the
students you hve supervised,
‘3 —Mests Standards: Performance is consistent wih entry evel practice.
Tis ratings inequentiy oven at midterm andi @ strong rating at
‘inal
2 Needs improvement: Priormanco is progressing but sll reads
improvement or entyevl practice. Ths 2 realistic ating of
performance at miderm, and some ratings of 2 may be reasonable at
the fal
11 —Unsatstatory: Paormanceis below standards ar requces
‘evelopment or enty-evel practice This ring is Gen when there Is
‘a concem about performance.
|, FUNDAMENTALS OF PRACTICE:
Al tems inthis area must bo scored at 2 #8 or above on the fal
‘evaluation inorder to pass fework.
1. Adheres to ethics: Adheres consistently othe American
‘Occupational Therapy Assocation Code of Ethics‘ and site's
policies and procedures including when relevant, those related to
‘human subject research.
near eee Ve
ne ek Gye
2. Adheres to safety regulations: Adhores consistently to safety
‘equations. Antcipats potontaly hazardous stations and takos
slop to prevent accidents
aa Os
ra (102 s\
8. Uses judgment in safety: Usos sound judgment in regard to safe-
ty of salf and thers during al fildwork-flated activites.
re neko a
Sea Teese)
‘Comments on strengths and areas for improvement:
Receeereueh :
1, BASICTENETS:
4. Cleaty and confidently articulates the values and beliefs ofthe
‘occupational therapy profession to cients, families, significant oth-
ers, colleagues, service providers, and the public.
Wao 12 4
Ones
Pratt oii eee Ca)
5. Clearly, confident, and acouratly articulates the value of occu
pation as a method and desired autcome of occupational therapy
to cients, famites, significant others, colleagues, service providers,
‘and the publ.
foo ee ae
Final 1 2 3 &
6. Clearly, confident, and accurately communicates the roles of
the occupational therapist and occupational therapy assistant
to cients, families, signticant others, colleagues, service providers,
‘and the publi
mom 1 2 SQ 4
mi \\ 2 9 oO)
Collaborates with cient, family and significant others throughout
the occupational therapy process,
Maes 1-2 3 @
Fina 1 a OA)
Comments on strengths and areas for improvement:
ty goook with,
oli ents
Final A ob
“coud Nave Se ots 40 ANG Ney 9
CORR OF AMIE or
+ Final
sayet C
+ qyeok puctgerne rf Wy
ootlofooead yy with
cen fay
cours Nave ULF HRA AG
The Code OF CAS, MORATING SCALE FOR STUDENT PERFORMANCE
4— Exceeds Standards: Performance is highly sled and stint.
“This ating is rarely glven and would represent the top S% of all the
students you hve supeised.
8—Meets Standards: Pedermanceis consistent wih entyevel practice.
Tas rains infrequently glen at midterm ends a strong rating at
‘inal
2 — Needs improvement: Perfomance is progressing but sll oeds
improvarent or enty-ovl practice. This a relist rating of
performance at midterm, ar some ratings of2 may be reasonable at
the fn,
1 —Unsatistactory: eroxmanceis below standards ae requtes