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Fieldwork - Remediation Ideas - Help When a Student is Failing
Occupational Therapy
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Failing a student is a very stressful experience for both the supervisor and the student. Often fieldwork supervisors report they are torn between their commitment to the student and their commitment to the clients. Supervisors want the student to be successful, however, they cannot pass a student who is not showing entry-level competencies. Students must take responsibility to change in order to meet the requirements for each fieldwork site. Supervisors should immediately take action when a student’s performance is not up to acceptable levels. Provide feedback regularly, as early as possible during the rotation, and in writing.

Kramer and Stern (1995) suggest that three things be done when a student is having difficulty:

  1. Supervisors should provide students with specific and direct feedback that can be used in systematic, goal directed way
  2. Supervisors should describe why these actions or behaviors interfere with development and are not conducive to meeting performance expectations
  3. If problems do not improve after the above two suggestions are implemented, contact the Academic Fieldwork Coordinator.
Mc Creedy & Graham (1997) identify a five-step process for dealing with students with problem behaviors. They suggest the following:

  1. Identify student problems and discuss with colleagues. Initiate the use of weekly feedback logs with the student.
  2. Try to resolve the problem. Meet with student and articulate concerns clearly and with examples. Keep notes of your meeting with the student and have both of you sign and date your summary of the meeting. Do not focus on student’s personal issues but focus on performance problems. Conclude with developing a plan of action that identifies what the student will do to remediate the deficit. Set measurable objectives for student performance. Utilize the weekly feedback logs with the student. Both the supervisor and the student should keep copies of these forms.
  3. Collaborate with school. Call the academic fieldwork coordinator, Paula Lowrey, and discuss the situation. Ms. O'Connor may decide to make a site visit to sit down with the fieldwork supervisor and the student to review the action plans and progress to date. You may collectively complete a behavioral contract at this time. Provide copies of weekly feedback forms. Don’t wait too long to make this call. The longer you wait, the more likely the student will not be successful within the time designated for completing level II fieldwork.
  4. Follow up meetings between supervisor and student. Meet regularly, preferably weekly or twice weekly to measure progress towards goals and to provide further feedback to student about performance. Keep accurate notes regarding these meetings.
  5. If the student is not making sufficient progress, a meeting between the fieldwork supervisor, the student, and the Academic Fieldwork Coordinator is warranted. Decisions may need to be made about the possibilities of success or failure for the student. Options to consider include extending the fieldwork time if student can make progress or termination of the fieldwork with a failing grade. These decisions will be made collaboratively between the school, the fieldwork site and the student.
Creating the paper trail

It can not be emphasized enough the importance of accurate and adequate documentation when a clinical rotation site may be failing a student The weekly feedback forms and behavioral contracts are the written documents providing evidence about the quality of the supervision and feedback provided to the student. It provides evidence that the student was informed early of the need to improve and provides objective measures of the student performance. Sites may want to save examples of the written work the student completed that was unacceptable. Also, you should add any written observations about the student’s performance. If you receive feedback from other departments, make a written note that includes the behaviors noted, the date and place they occurred, the person who witnessed the behaviors, and the outcomes. Be sure to follow up with the student on the weekly feedback logs and behavior contracts when warranted.

Look at your facilities employee handbook and identify policies about consequences of unprofessional behaviors. How would this employer handle similar behaviors in an employee? Use that as a guide. Any inappropriate and unprofessional behaviors that jeopardize a client’s safety or confidentiality should be immediately noted and dealt with. You may utilize the AOTA professional Code of Ethics and Standards of Practice as guides for writing up infractions. Any infractions of this nature should be reported immediately to the USA Academic Fieldwork Coordinator. Students should be asked to sign and date forms written about infractions to avoid the student denying that they received the information.

Academic Fieldwork Clinical Coordinator

Do not feel that you are alone in the process. The Academic Fieldwork Coordinator will guide you through the process of providing adequate supervision for the OT student. When things are going well, little intervention is warranted. However, when issues arise and the student does not make changes in performance, the AFC should be called immediately to help you both work through the issues, assure objective measures are being utilized, and provide resources for both of you. This mediation is absolutely necessary and should be utilized whenever needed.

Fieldwork Clinical Coordinator

Phone: (251) 445-9222
Fax: 251-445-9211
Email: otdept@southalabama.edu

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