AOT © The American Occupational Therapy BA. Association, inc. Fieldwork Performance Evaluation For The Occupational Therapy Student ust HALVORSON, MCCALL TAYLOR ‘SIGNATURES: NAME: (AST) (FIRST) (MIDDLE) "| HAVE READ THIS REPORT. UNIVERSITY OF UTAH COLLEGE OR UNWERSITY Ane rO2 (PeOnwerdon) SIGRATURE OF STUDENT FIELOWORK SETTING: tal Naliey Hospital = Lotermmounta ys, i _ ee NAME OF ORGANIZATIONFACLITY ‘NUMBER OF PERSONS CONTRISUTING TO THIS REPORT 1027A_N_GOO w__, Provo ‘ADDRESS: (STREET OR PO BOX) PROVO UTAK cas any STATE zP SIGNATURE Or PATER \npavient Acute Core /Rehal. Keath Coan, erste TPE OF FELOWORK PAINT RANEICREDENTIALSPOSTION ‘ORDER OF PLACEMENT: 1 2.3 4 OUTOF 129.4 row OS + \4 201% 1 OB 03-2018 DATES OF PLACEMENT Euil [NUMBER OF HOURS CONPLETED FINAL SCORE ‘SUMMARY COMMENTS: (ADDRESSES STUDENT'S CLINICAL COMPETENCE] No Pass: Weyer & Crocked SkeR Wil Cast & Seid) is of ghee FoR trineiag An , The Above quote i couse 2 Tunnpisrs pinieud € idan + Ske Propeenieg Do Pakenls Stop Proyressing aad ela¥au this percents? DY gummacy 16 TASH YOR zl just gna some wodom F trad ments hecasge wine OT te Royse do tre aight Hang ein if The Porfesion. You will do many g red of penile theovg your Careee ike assed! you atid very 9 93- be cqrodive , dont Se pet py eoundert (434 Ket Many), 20998 Hive, Vai ‘SIGNATURE OF RATER #2 (IF APPLICABLE} PRINT NAME/CREDENTALSIPOSITION J Al-oboudi, MoT, pt2!L ht Shadow * Laaleed to ceminel Yoo To thine deeply ood in such & buy yoo Savion ueeeisacily folwo Ha Crowns 6 Your ya eabien's, herd «be honest, on Bee and help smprove have Ae chance to hel hadesFieldwork Performance Evaluation For The Occupational Therapy Student “This evaluation i a revision ofthe 1987 American Occupational Therapy ‘Association, Inc, Fieldwork Evaluation Form for the Occupational ‘Therapist and was produced by a commitee of the Commission on Education PURPOSE ‘The primary purpose of the Fieldwork Performance Evaluation for the ‘Occupational Therapy Student is to measure ensy-level competence of the occupational therapy student. The evaluation is designed to diferen- tite the competent student from the incompetent student and is not designed to ciferentiate levels above entry level competence. For further Clarication on entry-level competency rferto the Standards of Practice for Occupational Therapy (1). ‘The evaluation is designed to measure the performance of the occupa tional therapy process and was not designed to measure the specific ‘occupational therapy tasks in isolation, This evaluation reflects the 1998 ‘Accreditation Council for Occupational Therapy Education Standards (@) and the National Board for Certtication in Occupational Therapy, nc. Practioe Analysis results (3). In addtion, this evaluation allows students to evaluate their own strengths and challenges in relation to their per- formance as an occupational therapist USE OF THE FIELDWORK PERFORMANCE EVALUATION FOR THE OCCUPATIONAL THERAPY STUDENT The Fieldwork Performance Evaluation i intended to provide the student with an accurate assessment of hisIher competence for entry-level prac: tice, Both the student and fieldwork educator should recognize that {groath occurs ever time. The midterm and final evaluation scores will reflect development of student competency and growth. In order to clectvely use this evaluation to assess student competence, slte- specific objectives need to be developed. Uilize this evaluation as a framework to assist in ensuring that all key performance areas are reflected in the ste-specfic objectives. Using tis evaluation at midterm and final, itis suggested that the stu- dent complete a so-evaluation of his/her own performance. During the midterm review process, the student and fletdwork educator should cok laboratvely develop a plan, which would enabie the student to achiove entry-level competence by the end of the etdwork experience, This plan should include spectc objectives and enabing actvtos to be used by the student and fieldwork educator in order to achieve the desited competence The Fleldwork Educator must contact the Academic Fieldwork Coordinator when: 1) a student exhibits unsatisfactory behavior in a substantial number of tasks or 2) a student's potential for achieving entry-level competence by the end ofthe afliaton isin question, DIRECTIONS FOR RATING STUDENT PERFORMANCE ‘There are 42 performance items. + Evety item must be scored, using the one to four point rating scale (see below) * The rating scales should be carefully studied prior to using this evaluation. Definitions of the scales are gion atthe top of each page. * Circle the number that corresponds to the description that best describes the student's porlommance. * The ratings for the Ethics and Safety items must be scored at 3 or ‘above on the final evaluation forthe student to pass the fieldwork experience. If the ratings are below 3, continue to complete the Fieldwork Performance Evaluation to provide feedback to the student (on herihis performance. + Record midterm and final ratings onthe Performance Rating Summary Sheet * Compare overall midterm and final scare tothe scale below. OVERALL MIDTERM SCORE Satisfactory Performance, +90 and above Unsatisfactory Performance, 89 and below OVERALL FINAL SCORE Pass 122 points and above No Pass 121 points and below RATING SCALE FOR STUDENT PERFORMANCE «4 — Exceeds Standards: Performance is hight skilod and sol nated. “This rating i rarely glven and would represent the top 5% of ll the students you have supervise, 3 Meols Standards: Performance is consistent with entryivel practice. This ating i Infrequenty given at midterm ands strong rating at final 2— Needs improvement: Performance Is progressing but sill neds improvement for entry-level practice. This isa realistic rating of performance at midterm, and sore ratings of 2 may be reasonable at the fina 11 — Unsatisfactory: Petrmance is below standards and quires evelopment or entry! practie. This ating is Gven when there is ‘ concern about performance.RATING SCALE FOR STUDENT PERFORMANCE 4 — Exceeds Standards: Pciormance is highly stile and setitited. ‘This rag is rarely glen ard would represent the top 8% of all the students you have supensed Meets Standards: Performance is consistent with entry-level practice ‘This ating is infrequently given at midterm ands 2 strong rating et fina 2 —Needs imorovement: Parfoemance Is progressing but sti nesds Improvement fo entry ivel pacce This is @ realistic rating of performance at midterm, and some ings of may be easonable at tha final + Unsatisfactory: Performance is below standards and requires ‘evelopment fr entyove practice. This ratings gen when there is ‘ concer about performance. |. FUNDAMENTALS OF PRACTICE: Alters inthis area must be scored at a #8 or above onthe final ‘evaluation in order to pass fieldwork. 1, Adheres to ethics: Adheres consistent to the American Occupationat Therapy Assocation Code of Ethics (4) and site's policies and procedures including wien relevant, those related to human subject research, Midterm 4 2 Final 1 2 3 2, Adheres to safety regulations: Acheres consistently to safety, regulations. Anticipates potentially hazardous situations and takes steps to prevent accidents. Woon 1 Qo 84 Final 1 2 4 3. Uses judgment in safety: Uses sound judgment in regard to safe- ty of self and others during al fieldwork-related activities. Final 1 2 @ 4 U. BASIC TENETS: 4. Cleaty and conidenty articulates the values and beliefs ofthe cocrupatonal therapy profession ociens, amie, signieantoth- rs, coleagues, service provider, and the publ 5, Clearly, confidently, and accurately articulates the value of occu- pation as a method and desited outcome of occupational therapy toclients, families, signfcant others, coleagues, service providers, and te pubic. witem 1 @) 8 4 mt = 4 ok GA 6. Clearly, confidently, and accurately communicates the roles of the occupational therapist and occupational therapy assistant to clients, families, signifcantotners, colleagues, service providers, wctenae oom 1 Gk me «61 OOH 7. Collaborates with cient, family and significant others throughout the occupational therapy process. ion te 1 2 @ 4 Comments on sengts and ares fo improvenent : es snidtorm qhelall (5 Leaensing, 4aicels) Since a faine wrth me on Aut® Coe hat Gras. Ae she gains Conbidene tn She jus Nona School ced her foldwoadt T feel tnese Scons will go upe she WAS Able fo income har Ability hy ene inkepeudandty ith Perrente Final - | Comments on strengths and areas for improvement: sitdterm ©. MoCall + x have heen Moris om SHY \feenilits 2 ¥plaining OT. ia The deutte including patient handling being in Contre! of the Patient foawing SHH Ste began te Soe outcomes Session When will o putitat fall? T feel tet She Zach day aup innproving with her yudgement raksciqubing Vouuby of Sitsabions Final Code of Conduct fermc# | polity [Prverdnes eutekily “Veuecet ony wrinay POS On He pls Co ccumse ances + | Deschevye loemt@os [oe ees CNtnccawos ante to oxplaie tee TS Suh, Ae bale CoesbaS_ Aeon E feet, Jerse org lolose ce - Conde © Lessong vite CAties| Con od a sehdly dunes re profersconsl , 6-409 i* oes for axpearenet