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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 acny Fieldwork 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, MO RATING 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

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