Expanding the Boundaries of Occupational Therapy Practice through Student Fieldwork Experiences: Description of a Provincially-Funded Community Development Project

Abstract

The numbers of occupational therapists in community practice are not yet large enough to provide fieldwork placements to accommodate all students. This article describes a project designed to educate community agencies that do not employ occupational therapists, about our service while at the same time securing new fieldwork placements. We used on-site different discipline and offsite same discipline supervision to provide students to selected agencies without cost. Funding for one year from the Ontario Ministry of Health to the Ontario University Programs in Rehabilitation Science enabled us to initiate and evaluate the project. Students in the project developed their ability to work independently and to see their potential role in health promotion and prevention. Despite the lack of ongoing government funding, four years later, community sites are not only being maintained, but the number of sites has increased from 28 to 39, providing a total of 75 student placements. By educating a growing number of community agencies about the work of occupational therapists, the project has also expanded the boundaries of practice.

Apprehension and interest

“…An area of concern raised by therapists' and students' groups within this study included the possibility that the student through completing a role-emerging placement may be missing out on the development of core occupational therapy skills due to a lack of direction and limited client contact. Similar concerns were raised by Friedland et al (2001) where students who had completed a role-emerging placement viewed skills acquired in the community setting to be of lesser value to skills acquired in more traditional settings.…”

A strategy for supervising occupational therapy students at community sites

“…The value of these community placements for student learning is well documented (Backman, 1994;Farrow, 1995;Bossers et al, 1997;Soltys et al, 1997;Friedland et al, 2001). Bossers et al (1997) interviewed students after the final week of their role-emerging placement and the results of these interviews indicated the unique learning opportunities afforded.…”

“…Some more recent examples include: inner city community drop-in centres and homeless shelters (Alsop and Donald, 1996;Heubner and Tr yssenaar, 1996;To tten and Pratt, 2001), seniors centres (Backman, 1994), schools (Hubbard, 2000;Zobay and Collins, 1996), and a Cancer Tr eatment and Research Foundation centre (Soltys et al, 1997). This type of fieldwork was initially introduced in an effort to address the shortage of placement opportunities available, and also to be responsive to the changing health care system and to ensure that students were exposed to community practices (Cohn and Crist, 1995;Alsop and Donald, 1996;Friedland et al, 2001). These types of placement have become increasingly common, perhaps in response to the continuing shortage of placements that expose students to community and health promotion practices.…”

The Development of a Role-Emerging Fieldwork Placement in a Homeless Shelter

“…Further, students who participate in role-emerging placements note some of the largest benefits as increased confidence, time management skills, and opportunities to engage in multidisciplinary teamwork (Clarke et al, 2014;Prigg & Mackenzie, 2002). Community organizations note the benefits of role-emerging fieldwork include: decreases in workload for other staff when students are able to take on a caseload; opportunities to keep clinician skills current through student in-services; and greater understanding and appreciation for the value of occupational therapy interventions for their populations, which can result in some sites hiring a full-time therapist following the experience (Friedland, Polatajko, & Gage, 2001;Thew et al, 2011;Thomas et al, 2007). Totten and Pratt (2001) described an example of role-emerging fieldwork, with the creation of a fieldwork placement at a homeless shelter with off-site faculty supervision from a nearby university.…”