COLLEGES BEAUTE | piston of Occupations Therapy FIELDWORK | OBSERVATION OF STUDENT PERFORMANGE Student's Name: _ oso. Ypaclex, st appropriate rating FewtworkFacity: Leotsman Coreer losouad Supervisor's Name: _Leavwea Secvlnger Dates of FW: _2-24-le = 3-9 tly Please check the mot Professional Behavior Needs et ‘The student: Outstanding | Adequate | improvement | Observed 4. Conforms to institution's dress code. = 2. Ts responsible and dependable h attendance and prompiness. = ‘3. Communicates effectively with other professionalsltafl, Listens and speaks af aa ‘appropriate times. ee 4. Contributes toward open communicalion with supervisor. Gives and receives feedback C appropriately 5. Establishes and maintains therapeutic relationships with cients and ther families = 6. Demonstrates professional valves and ethics, c z 7. Maintains fe confidentaity of others. = ' Seeks information and asks relevant questions. a Uses resources and time effective aa 5; Follows through with suggestions made by supervisor 7 10. Seeks challenges and demonstrates enthusiasm for fieldwork experiences. = 11. Demonstrates independence when appropriate Se 12. Flexible: effectively adjusts to changes; adjusts proriies without GMfuly. = 7 Related to Educational Objectives Needs Not The student hast Outstanding | Adequate | improvement | Observed 13, Developed an increased comfort level Rieraciing with persons who have disables, ~| ‘emotional problems, or psychiatio disorders, a 74, Described the needs of clents served by the agency/faciy 7 18. Demonstrated respect for the values and diversity of persone with disables, caregivers staff and volunteers. eae 76. Demonstrated an atitude of inquity to enhance creativiy and problem solving sks 17. Observed staff interactions, assessments andlor treaiment sessions with agency/faciliy 7 cents. 18. Partcipated in group or individual weatment sessions as appropriate depending on The | kil Ievel of the student and the sever Tele delireation when Cerified Occupational Therapy Assistants A ‘are employed by the agencyffacity pikirenths ofthe student ote at his lino . Donen te warn, pares 3 Leia So WA petints and chuwrons trata Neale UAKEX ne vLs, woes very adaptable CaN ges 5 Pe ee ca ceel “Srabea Vandnags | Sektonting.: “ Feint ets fruchen Le ee eM elneereue wou core ° omek po , Ore webby. Combine to pre gress tguHh expamscon, of treatment plang 7 fone aorta bbe usectd = Suyppnt patent alucharye Rareld ‘reas the student could work toward proving dung remaining ietrkoxveriones marin 8 rE trans Pas ‘Adonal comments : Menta power ad oo aguek yp eo hin ata tied assnese : puetrearer: feotuet Qidives, ook an (iSearitiby, fo adept 40 wae Cnamegngg need Sf Hs a ly Bees gate alle ‘Signature Please give to the student to return, oF mailto: Jeanette Koski, OTRIL ‘Academic Fieldwork Coordinator Division of Occupational Therapy University of Utah 520 Wakara Way Sak Lake City, UT 84108-1200,