SECTION 3: THE FIELDWORK EDUCATOR

Fieldwork Educator Qualifications

The program is responsible for ensuring that all fieldwork educators are qualified to supervise level I & II fieldwork students. Fieldwork educators must meet the following criteria:

1. Level I: Currently licensed or otherwise qualified personnel (including but not limited to occupational therapists, occupational therapy assistants, psychologists, physician assistants, teachers, social workers, physicians, speech-language pathologists, nurses, physical therapists, case managers, intervention specialists, and art / music therapists)
2. Level II: Currently licensed or otherwise regulated Occupational Therapist or Occupational Therapy Assistant (under the supervision of an OT). In settings without OT or OTA personnel, refer to the Student Supervision Policy.
3. Minimum of 1 year full-time (or its equivalent) practice experience subsequent to the initial certification or 3 years if serving as an educator in a facility where no Occupational Therapy services currently exist. This criteria must be met prior to the start of the experience.
4. Adequately prepared to serve as a fieldwork educator, which includes education and training regarding Kent State University Occupational Therapy Assistant Program mission and philosophy, fieldwork policies, procedures, program and curriculum design, objectives. Licensure verification of occupational therapy professionals is conducted via licensure board website. Documentation is maintained for qualified personnel who are not OT professionals via degree/training, licensure, and/or certification in their respective profession.

Ratio of Fieldwork Educators to Students

The program has determined that the appropriate ratio of fieldwork educator to student varies from 1:1-4 for the level I psychosocial rotations. Supervision increases to 1:1, 1:2, or 2:1 supervision for the level I physical dysfunction rotations. This progressive change is consistent with the program philosophy following Bloom’s Taxonomy or “learning domains” which increase in complexity as the student progresses through the program. Initially, the higher ratio allows the students to transition from the classroom setting to the clinical setting with opportunities to collaborate with other students and develop interpersonal/communication skills, problem solving, and confidence as related to the fieldwork experience. The ratio of supervision for level II fieldwork experiences is 1:1 or 2:1 to facilitate development of clinical reasoning, critical thinking, and use of evidence-based practice. A 1:2 ratio is considered and executed in special circumstances when students and fieldwork educators understand and are prepared for the use of the collaborative fieldwork model.

Fieldwork Educator Responsibilities [FWE]

1. Notify the AFWC of probable availability or commitment to fieldwork experience dates and of changes in terms of the affiliation (such as immunizations required, etc.).
2. Maintain current contracts with KSU OTA Program, update facility data every 2 years and assure fieldwork educator’s licensure status is current.
3. Contact the AFWC immediately, at the first indication of a problem or concern regarding a student during the fieldwork experience. Provide the AFWC with written documentation of critical incidents or anecdotal records. Updates must be provided on a regular basis until the problems have been resolved.
4. Provide the following information to the student on the first day:
   1. Departmental information
      1. Facility policies and procedures
      2. Safety regulations
      3. Handling of body substances and hazardous materials
      4. Security and evacuation procedures
      5. Access to emergency services
      6. Equipment safety procedures
   2. Orientation to the facility.
5. Other guidelines to follow with the student include:
   1. Appropriate supervision as required by state law, AOTA guidelines, and Medicare regulations, if appropriate.
   2. Supervision should be direct and then decrease to less direct as appropriate for the setting, client’s condition, and ability of student.
   3. Appropriate and varied fieldwork experience to the student.
   4. Instruction in Occupational Therapy techniques, skills, and intervention rationale.
   5. Frequent feedback regarding performance
   6. Complete the fieldwork performance evaluation at mid-term and final.
   7. Formal meetings at mid-term and final to review and assess progress and goals of the fieldwork experience.
   8. Maintain awareness of resources that support student well-being.
6. FERPA (Family Educational Rights and Privacy Act)
   Just as your patients’ rights are protected under HIPAA, students are protected under FERPA. What does this mean for you? Any information regarding the student and their performance in fieldwork experience(s) is considered confidential, except for statistical purposes.
7. Evaluate AFWC performance when requested.

Resources for Fieldwork Educators

The OTA Program shares resources to assist the fieldwork educators to be adequately prepared. These educational opportunities will ensure that the fieldwork sites are meeting the program’s curriculum goals and the fieldwork educators are effectively meeting the learning needs of the students. We will also provide opportunities for the fieldwork coordinator and fieldwork educator to collaborate in establishing fieldwork objectives, etc.

Many valuable resources can be found on the AOTA Website here, including how to manage your current program or how to start your own fieldwork program. You can continue to develop your skills with more Resources for FW Education. AOTA also offers advanced training through the Fieldwork Educators Certificate Workshop. The Ohio Occupational Therapy Association also offers valuable workshops and topics that can be accessed through OOTA.

Fieldwork educators must be aware of resources to support student well-being. Kent State University offers the following resources (click links):

• Counseling services
• Campus food pantries (PDF)
• Diversity services - NO LONGER PERMITTED

For more details or additional information, please contact Kent State's Academic Fieldwork Coordinator.

Student Supervision During the Fieldwork Experience

Medicare Regulations

Over the past few years, the Centers for Medicare and Medicaid Services (CMS) have changed the payment systems to facilities. These changes with CMS have also brought about changes to the payment rules and regulations regarding payment for services provided by students. Students are allowed to treat patients, but a facility needs to know how and when student treatment may be billed. The fieldwork facility needs to understand whether Medicare payment rules will allow them to bill for student delivery of services. The facility also must understand the type and level of supervision that is required for services provided by a student to be paid. It is recommended that facilities and therapists keep current on all CMS rules and guidelines for the practice setting and payer sources.

Other Supervision Guidelines

Ohio Administrative Code - Occupational Therapy Section 

4755-7-02 Roles and responsibilities.

(C) Student occupational therapist and student occupational therapy assistant.
In accordance with section 4755.13 of the Revised Code, persons fulfilling the supervised fieldwork experience requirements pursuant to section 4755.07 of the Revised Code must, at the discretion of the supervising occupational therapist or supervising occupational therapy assistant, as appropriate, be
assigned duties or functions commensurate with their education and training.

4755-7-03 Delegation.

(C) Student occupational therapy assistant.
The student occupational therapy assistant must demonstrate appropriate skill and knowledge in the duties being delegated. The supervising occupational therapist or supervising occupational therapy assistant must demonstrate knowledge and competency in any procedure or services delegated to a student
occupational therapy assistant.

4755-7-04 Supervision.

(E) Student occupational therapy assistant.
(1a) A student occupational therapy assistant on level II fieldwork must be supervised by an occupational therapist or occupational therapy assistant who has completed at least one year of professional practice as a fully licensed occupational therapist or occupational therapy assistant.
(2) A student occupational therapy assistant must be at least eighteen years old to be supervised by an occupational therapist or occupational therapy assistant pursuant to Chapter 4755 of the Revised Code, effective January 1, 2021.This includes supervision for Level I and Level II fieldwork.
(3) The student occupational therapy assistant, who is being supervised in accordance with the laws and rules governing the practice of occupational therapy, may supervise unlicensed personnel.

4755-7-10 Documentation.

(D) All student occupational therapy assistants shall use one of the following to indicate student status: (1) Student occupational therapy assistant;
(2) Student OTA; or (3) S/OTA.

Occupational Therapy Assistants

OTA’s are allowed to be supervisors while providing services within their scope of work and performed under the direction and supervision of a licensed OT.

State Law

All OTA Program students and FWEs must follow the state licensure laws governing supervision in an occupational therapy setting in the state practice act where the fieldwork experience is taking place. 

See these websites for the latest information:
OH: https://otptat.ohio.gov/
WV: https://www.wvbot.org/
PA: https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/OccupationalTherapy/Pages/default.aspx

Other States

When a fieldwork experience is completed in another state, it is the student’s responsibility to research, understand, and adhere to the laws governing that state.

Amount of Supervision

To protect clients and consumers, initial supervision of Level II fieldwork students is to be “direct,” meaning that the clinical educator must be present and available to respond to the needs of the students and is responsible for co-signing all paperwork related to OT practice. As the student progresses, “less direct” supervision is required depending on the facility, skills of the student, and the severity of the client’s condition.

If students are placed in a setting where no occupational therapy services exist, supervision and provision of services will be provided by a currently licensed or otherwise regulated occupational therapist or occupational therapy assistant (under the direction of an occupational therapist) with at least 3 years’ full-time or its equivalent of professional experience prior to the Level II fieldwork. Supervision in this setting will include a minimum of 8 hours of direct supervision each week of the fieldwork experience. The occupational therapy supervisor will be available, via a variety of contact measures, to the student during all working hours. An on-site supervisor designee of another profession will be assigned while the occupational therapy supervisor is off site.

Effectiveness of Supervision

To determine the effectiveness of student supervision, the student must complete the Student Evaluation of Fieldwork Evaluation form and return it to the AFWC to determine the quality of the fieldwork site. If the site receives 2-3 unfavorable student evaluations, the AFWC will contact the site to discuss problems or situations presented by the students. If the problems cannot be resolved, use of this site will be discontinued. To enhance the quality of student supervision, the OTA Program will provide fieldwork sites educational materials on increasing supervisory skills and other continuing education opportunities related to fieldwork education.