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Fieldwork Attendance Form

FACILITY NAME & AREA OF PRACTICE: SPINAL DECOMPRESSION CLINIC

STUDENT’S NAME NATALIA PERRY DATES OF PLACEMENT: SEPTEMBER 14 TH /2020- DECEMEBER 18 TH / 2020

Date OTA hours PTA hours Preceptor Signature & Comments

completed completed
each day each day (examples: exemplary work/observation, cell phone use, late arrival)

09/14/2020 8 hours Physioplus Coronavirus Disease Programme

09/16/2020 8 hours Physioplus Coronavirus Disease Programme

09/21/2020 8 hours Spinal decompression & The DRX9000

09/23/2020 8 hours Spinal decompression & The DRX9000

09/28/2020 8 hours Infographic for patients about the spine: structure such as the
vertebrae and discs, conditions such as sciatic nerve pain, abnormal
spinal curvatures, foraminal stenosis

09/30/2020 8 hours Infographic for patients about the spine: structure such as the
vertebrae and diskcs conditions such as sciatic nerve pain, abnormal
spinal curvatures, foraminal stenosis

10/5/2020 8 hours Detail description of the interdisplinlary team at the spinal

decompression center, and then being able to convert the detailed
write up into an infographic for patients at the clinic

10/ 7/2020 8 hours Detail description of the interdisplinlary team at the spinal
decompression center, and then being able to convert the detailed
write up into an infographic for patients at the clinic

10/12/2020 8 hours Explanation of the 4 principles of energy conservation and its

benefits it has towards a patient when doing their ADLS & IADLS

10/14/2020 8 hours Explanation of the 4 principles of energy conservation and its

benefits it has towards a patient when doing their ADLS & IADLS

10/19/2020 8 hours Explanation of the 4 principles of energy conservation and its

benefits it has towards a patient when doing their ADLS & IADLS.
Using the research developing infographic about the 4 P’s and their
benefits. In addition, creating an infographic with two ADLS/IADLS
that can be used using this model for clients
10/21/2020 8 hours Explanation of the 4 principles of energy conservation and its
benefits it has towards a patient when doing their ADLS & IADLS.
Using the research developing infographic about the 4 P’s and their
benefits. In addition, creating an infographic with two ADLS/IADLS
that can be used using this model for clients

11/2/2020 8 hours Researched about client who suffer from pressure sores. Created an
informational handout about skin integrity and pressure sores.
Images were also needed to further demonstrate the visual context
of different types of sores.

11/4/ 2020 8 hours Researched about client who suffer from pressure sores. Created an
informational handout about skin integrity and pressure sores.
Images were also needed to further demonstrate the visual context
of different types of sores

11/9/2020 8 hours Develop a handout in relation to strengthening and stretching

exercise for posture, back pain & balance for clients

11/11/2020 8 hours Develop a handout in relation to strengthening and stretching

exercise for posture, back pain & balance for clients

11/16/2020 8 hours Develop a handout in relation to strengthening and stretching

exercise for posture, back pain & balance for clients

11/18/2020 8 hours Develop a handout in relation to strengthening and stretching

exercise for posture, back pain & balance for clients

11/23/2020 8 hours Created an educational handout on two different methods on how

to recover from a fall independently.

11/25/2020 8 hours Created an educational handout on two different methods on how

to recover from a fall independently.

11/20/2020 8 hours Elaborated from the previous week and created a 10 video to
demonstrate ways to recover from a fall. Added in text, and different
auditory cues to make it easy to understand and watch for a client at
home.

12/03/2020 8 hours Elaborated from the previous week and created a 10 video to
demonstrate ways to recover from a fall. Added in text, and different
auditory cues to make it easy to understand and watch for a client at
home.

12//072020 8 hours Created a case study about a 16-year-old patient with spondylolysis.
Develop a patient history and determinants of health. Then went
into depth of the effect of spondylolysis and its how it can be
encountered. Using the information gathered I created an ICF model
about the patient with this impairment.

12/09/2020 8 hours Created a case study about a 16-year-old patient with spondylolysis.
Develop a patient history and determinants of health. Then went
into depth of the effect of spondylolysis and its how it can be
encountered. Using the information gathered I created an ICF model
about the patient with this impairment.

12/14/2020 8 hours Typed reflection of the placement and what was learned. Areas of
improvement and areas of strength.

12/16/2020 8 hours Typed reflection of the placement and what was learned. Areas of
improvement and areas of strength.
 Instructions for Preceptor: The student is responsible for maintaining and submitting this record. To verify that
students have attended the required hours, sign in the appropriate space each time the student attends placement.

Upon placement completion sign the bottom of the form to verify total hours completed and to confirm that the
student was successful on placement. Students are required to submit all pages of this form electronically, with
hours totaled, as evidence of placement hours within 24 hours of placement completion.

Total OTA Hours on Placement: ___________ Total PTA Hours on Placement: 208 Hours

Preceptor signature: _______________________________ Date: _________________________________

Student signature Natalia Perry Date: Decemeber 2020