Fieldwork placements provide an opportunity to integrate theoretical and practical knowledge and to develop professional behaviours and clinical skills. Students are required to complete a minimum of 1000 hours of fieldwork according to the requirements of the Canadian Association of Occupational Therapists.
Students must also complete at least one ‘LEAP’ placement during Year 2. LEAP stands for:
- Program Planning and Evaluation
Fieldwork learning opportunities in Fieldwork 3 will primarily consist of LEAP placements, however, students may also have opportunity to complete a LEAP placement during Fieldwork 2 or Fieldwork 4. See definitions below.
• Role-emerging Placements: Students are placed in an organization where there is no established occupational therapy program or role. Students on these placements have two preceptors: an on-site non-OT professional and an off-site OT practitioner. Most role-emerging placements are developed by the university but there is opportunity for students to develop their own role-emerging placement in partnership with the OS&OT Role-emerging Fieldwork Coordinator if desired.
• Role-enhancing Placements: Students are placed in an organization where there is an established occupational therapy program or role but occupational therapy services could be enhanced to better serve clientele. Students on these placements have an on-site OT preceptor that is on staff at the organization.
• Leadership and Unique Role-established Placements: Students are placed in an organization where there is an established or newly established unique occupational therapy role and/or with an OT Professional Practice Leader. Role-established placements occur in ‘traditional’ fieldwork settings, international settings, private practice, and in OT associations/organizations. These placements provide learning opportunities for students to observe, demonstrate, and develop unique leadership and advocacy skills in addition to other core practice competencies. Preceptors are leaders within the profession, practice setting, or organization.
LEAP placements allow students to continue with their development of the same professional competencies as required in all fieldwork learning experiences but with increased opportunities for the development of leadership and advocacy skills.
To ensure a variety of placement types, students should independently track their fieldwork experiences on the Fieldwork Record (see Appendix F for form and specific requirements). The template can be also be found on the Fieldwork Quercus site.
Occasionally a placement is coded incorrectly or the actual content of the placement unexpectedly varies from its coding. In this case, the student may request in writing a change in coding, giving details about caseload and assessments and treatments administered. This request must be submitted via email to the Director of Clinical Education, or the University Fieldwork Instructor, no later than one week after completion of the placement. The student’s preceptor (and site fieldwork coordinator) must be copied on the email. Students must consult the descriptions of the codes (see Appendix O) prior to making the request to ensure that the placement is represented accurately by the newly suggested coding. The request must be verified by the preceptor and on-site fieldwork coordinator and a final decision regarding coding will be made by the University fieldwork office and communicated to the student. Electronic fieldwork records regarding the placement will be changed as indicated.
Students should review their completed fieldwork record before choosing preferences for each placement period to ensure that they are exposed to a variety of experiences and will fulfill the P, M, and B requirements as outlined above.
Overview of Fieldwork Placement Process
- Student assignment of placements is carried out through a computer-assisted process involving student preferences, program requirements, and previously approved student special consideration requests. Although efforts are made to place students in their preferred practice areas and/or geographical areas, it is not always possible to do this. The Department of Occupational Science and Occupational Therapy reserves the right to place students in specific facilities/areas of therapy in order to meet individual students’ learning needs and provide students with an appropriate balance of fieldwork education experiences. Students must be prepared to attend placement at any fieldwork organization within the University of Toronto catchment area including:
- Toronto (downtown and all suburbs)
- Peel Region (Brampton, Mississauga)
- Durham Region (Ajax, Whitby, Pickering)
- York Region (Aurora, Central York Region, Maple, Markham, Newmarket, Richmond Hill, South West York Region, South East York Region, Stouffville, Thornhill, Vaughan)
- Students who would like to complete Fieldwork 2, 3, or 4 out of the University of Toronto catchment area must fill in the appropriate forms and submit them to the fieldwork office prior to announced deadlines. See section entitled, ‘Placement Requests Outside the University of Catchment Area’ for further information.
- A mandatory student pre-placement meeting is arranged by the University Fieldwork Instructor to discuss course-specific objectives and issues and placement offerings as well as to review general fieldwork policies and procedures.
- For Fieldwork 2, 3 and 4, students will be asked to complete a web-based survey to communicate their fieldwork preferences to the fieldwork instructors. Any information the students would like to be taken into account (e.g., access to a vehicle, etc.) during placement matching should be included within this survey. Students must complete and submit a Request for Special Consideration Form for any medical information to be considered during placement matching (See Appendix G). Please note that for the Introductory Fieldwork Experience no preferences will be submitted.
- Students who have applied for out-of-catchment placements (national or international) will be instructed regarding submission of preferences and participation in the placement match if their placement has not been finalized (e.g. Placement Agreement signed and permission to proceed given by the Directory of Clinical Education or the Fieldwork Course Instructor). If, by four to six weeks prior to the beginning of placement, the out-of-catchment placement has not been finalized, the student will be required to stay in the University of Toronto catchment area and will be matched to an unfilled placement.
- The matching of student to placement offer is carried out through a computer-assisted process (see ‘Fieldwork Selection and Assignment’ for further detail). A match to one of the student’s preferred practice areas or geographic locations is desirable but cannot be guaranteed.
- After the placement matching process is completed, an email will be sent to each student to indicate the placement to which they have been assigned.
- No exchange of placements between students is allowed.
- Once the placement list is finalized, information regarding the student placement assignment will be emailed by the university to the participating facilities. Students will be copied on this email.
- Students are required to write an “Introductory” letter to the placement facility by the date specified by the University Fieldwork Instructor. For details of suggested content for the letter, please see ‘Pre-placement Communication with Fieldwork Facilities’ within this fieldwork manual.
- If a placement is cancelled after a student has selected it, the student will be notified by the Fieldwork Office and another placement will be assigned.
Fieldwork Site Contact
Unless communicating with a fieldwork site after being matched to that site, students are prohibited from contacting any Canadian fieldwork sites or clinicians to arrange observation opportunities or to solicit a fieldwork placement. Any such arrangements will not be honoured. The Director of Clinical Education, the Fieldwork Course Instructors, and the Fieldwork Administrative Assistant are responsible for coordinating and liaising with all fieldwork facilities. This rule (that applies to students in all Canadian OT programs) is put in place so that our fieldwork sites are not inundated with individual student requests and applies to any local, provincial, or national fieldwork site. Students are also prohibited from contacting other Canadian university fieldwork coordinators regarding out-of-catchment placements.
Students must be prepared to travel to any fieldwork facility within the Toronto catchment area to attend their placement. The University of Toronto catchment area includes facilities in areas outside of Toronto, such as Brampton, Mississauga, York Region, and Whitby, as outlined in the introduction to the ‘Overview of Fieldwork Placement Process’.
In order to ensure that students receive a variety of placement opportunities and to allow all students to have fair access to all facilities, students will only be allowed to do one placement within the same facility.
For the purposes of this policy, organizations that have multiple campuses may be considered separate. Students may attend a maximum of one placement in each of the two columns listed for the multi-site organizations below:
|Acute Care||Rehab / Complex Continuing Care (CCC)|
|Sinai Health System||
|Unity Health Toronto||
This policy does not apply to the Introductory Fieldwork Experience placements. In other words, students are allowed to have a second placement at the same facility where they had their Introductory Fieldwork placement.
Students who wish to have a second placement at a facility outside of the core Toronto area may be able to do so and should consult the Director of Clinical Education or the Fieldwork Course Instructor with such a request.
Fieldwork Placement Travel Allowance
Students placed at community fieldwork sites which require a vehicle, are eligible to apply for a car allowance. Students are eligible for this car allowance if the fieldwork placement site within the University of Toronto catchment area specifies in the fieldwork description that the student ‘requires’ a vehicle for travel during the placement.
International Fieldwork Travel Allowance: The International Fieldwork Travel Allowance is available to support students who are engaging in international fieldwork placements during Fieldwork 2, Fieldwork 3, or Fieldwork 4. Each student participating in an international fieldwork placement will be given up to $1000 regardless of whether the placement is an exchange, student-initiated, or an International Centre for Disability and Rehabilitation (ICDR) placement. Allowable expenses include airfare to and from the placement destination, accommodations while on placement (not including food) and preceptor fees if applicable, up to a maximum of $1000. The eligibility criteria for this international fieldwork travel allowance are as follows:
• The student must be approved by the International Fieldwork Coordinator to undertake this placement
• The student must submit the international fieldwork application, including reference letters.
• The student must meet all preparation requirements, e.g. attend the mandatory Safety Abroad meeting and any other mandatory meetings.
• The student’s fieldwork site must have a valid Placement Agreement with the University of Toronto
Please see Appendix K for further details of this allowance.
Travel Allowance: Students must complete a “Travel Allowance Request Form” (see Appendix I) to request a car allowance and submit this form to the Fieldwork Administrative Assistant at their respective campus for approval three weeks prior to the start of placement. Once placement is completed, students must submit a log of Google Maps that shows calculation of daily mileage and/or parking receipts to the Fieldwork Administrator. Students will then complete a second form that will be given to them at that time. As part of this form, students must declare that they did not receive any funding from your fieldwork placement site for travel. For extenuating financial circumstances, please contact the Director of Clinical Education. Also, please note, even if mileage calculation is more than the maximum allowance, students will not receive any extra payment than the maximum allowable amount.
Eligible mileage includes trips from home directly to client, from facility to client, from client to facility, and from client to client. Trips from home to facility or from client to home or facility to home are NOT eligible. Gas receipts are not to be submitted. Google Maps mileage is the only thing used to calculate amount of re-imbursement based on mileage. Original receipts for parking costs can be submitted.
Please note that Travel Allowance will be distributed after submission of all necessary receipts and completion of all forms. Reimbursement will not occur until several weeks after placement has ended due to cheque processing time.
Please see Appendix J for the International Fieldwork Travel Allowance process.
There are also ‘role-enhancing’ fieldwork placements available for students. These placements occur in an organization that employ OTs but desires to enhance OT services within the organization. Students on these placements assist the organization in this aim through research, program planning, implementation, and/or evaluation of those OT services.
Students will be introduced to role emerging and role enhancing placements in the Occupational Therapy Practice 3 course.
The University of Toronto catchment area includes the geographic region extending from Mississauga (West) to Whitby (East) and Newmarket (North) to Lake Ontario (South). Students from the University of Toronto have priority for placements in this region. Similarly, students from other universities have priority for placements in their respective catchment areas.
Students may apply for a placement outside the Toronto catchment area if they have:
- Maintained a ‘B’ average with no course failures
- Demonstrated good performance in all previous placements, with no reported concerns raised about professional interactions or other competencies
- Come to the University of Toronto from the requested region and/or the student has and interest in employment in the requested region upon graduation
- Completed the Introductory Fieldwork Experience (OCT1131H) and Fieldwork 1 (OCT1183Y).
Please note that all out of catchment placements will not be finalized until the fieldwork site has signed a University of Toronto Placement Agreement. If the fieldwork site refuses to sign the Placement Agreement, then the student will not be able to participate in the out of catchment placement.
Students will be notified by the Director of Clinical Education of application procedures and deadlines before each placement block. Out of catchment placements must be confirmed 4-6 weeks prior to the start of placement, with a signed Placement Agreement in place in order for the placement to proceed. If a student is assigned a within catchment placement while awaiting an out of catchment placement, students are required to contact the GTA catchment site to keep them updated about the out of catchment placement request.
Southern Ontario and Canada
University of Toronto students do not have priority for placements in other Canadian OT university catchment areas; however, there may be some opportunity to have a placement in another province and/or area of Southern Ontario. Students will be informed of these opportunities and how to apply for them via email and at pre-placement meetings. A non-refundable application fee of $250 is required for Canadian placements that are outside of the U of T catchment area.
Students are not permitted to contact potential placement sites or preceptors in an attempt to make their own arrangements for fieldwork placements. Such arrangements will not be honoured. This rule is put in place so that our fieldwork sites are not inundated with individual student requests and applies to any local, provincial, or national fieldwork site. Students are also prohibited from contacting other Canadian university fieldwork coordinators regarding out-of-catchment placements.
Please note that placements in Newfoundland/Labrador and in New Brunswick are only available to students who have residence in these provinces. Placements in Quebec require students to be fluently bilingual. Students should speak with the Director of Clinical Education during Year 1 if they are from these provinces and would like to have a placement in their home province at any point in the program.
All clinical placements in rehabilitation sciences in Northern Ontario are coordinated through the Northern Ontario School of Medicine (NOSM). Please see the NOSM website for information. NOSM distinguishes between Northeastern and Northwestern Ontario. Northeastern NOSM is considered to be Huntsville, Parry Sound, Sault Ste Marie, Wawa, and north up to Moosonee. Northwestern NOSM is considered to be west of Wawa and includes Thunder Bay, Dryden, Kenora, Sioux Outlook, etc.
Before applying, students MUST contact the Director of Clinical Education for details on application procedures. Students are not to complete the NOSM online application form until instructed to do so by the Director of Clinical Education. There are a limited number of fieldwork placements in Northern Ontario which provide funding for housing and travel. In the event that more than one student is interested in a particular funded placement, applications will be reviewed by the University Fieldwork Instructors to determine which student application will be forwarded on to NOSM. When the student applies online to NOSM, they will state their choices as to geographical area and practice setting and NOSM will attempt to find a placement based on student preference.
Please note that University of Toronto students do not have priority for placements in other catchment areas; there is no guarantee from NOSM that a placement in the requested area can be arranged.
Applications for Northern Ontario placement requests are generally due 4 to 5 months prior to the start of placement. Exact deadlines dates will be communicated to students by a member of the Fieldwork Team. There is no application fee for NOSM placements.
Please note: If you wish to do an international placement, please read this section thoroughly before contacting the International Fieldwork Coordinator or the Fieldwork Administrative Assistant.
The opportunity to participate in an out-of-country placement is considered to be a privilege which may be negotiated for a second year student with good academic standing (B average) who has a record of excellent performance in all previous fieldwork placements.
Students who are interested in participating an out-of-country placement will be able to request particular placements. However, there is no guarantee that a placement in the requested area can be arranged.
The department has established relationships with a variety of international fieldwork partners that offer student placements. Students will be informed of these opportunities through information meetings led by the U of T International Fieldwork Coordinator in October/November of first year. The Department of OS & OT has developed guidelines for the prioritization of international placements and these guidelines will be reevaluated yearly and shared with students. The placements currently prioritized are those linked with the International Centre for Disability and Rehabilitation (see www.icdr.utoronto.ca for more information on this centre which is part of the Rehabilitation Sector). These placements are in lower and middle income countries that have established partnerships with ICDR and the OS & OT Department. We also have exchange agreements with several international universities in countries such as Sweden, Holland, Australia and Hong Kong. Students must contact the International Fieldwork Coordinator for permission and guidance if they wish to arrange their own international placement as this option is only available on a very limited basis and once the listed priority placements have been filled. The following resources can be used to help the student find an appropriate placement:
- A list of programs and schools approved by the World Federation of Occupational Therapists (WFOT) can be found at http://www.wfot.org
- A database of placements completed by students in previous years is available on Quercus in the fieldwork courses.
Deadlines for submission of appropriate documentation for students wishing to have an international fieldwork experience will be communicated by the University International Fieldwork Coordinator and/or the Fieldwork Administrative Assistant. Please use the International Placement Forms (See Appendix K) to make sure you have all documentation required before submitting to the Fieldwork Office.
Student Responsibilities and Timelines
|Accept responsibility for all costs, including:
|If developing a self-initiated placement (these do NOT include any ICDR sites and/or formal exchanges that the department already has) – make preliminary contact with prospective facilities (if approved to do so by the University International Fieldwork Coordinator) to obtain written documentation as follows:
||6 – 12 months prior to placement|
|The student must submit to the fieldwork office:
The International Fieldwork Coordinator will bring these to faculty for approval of the student’s request.
|Deadline set by the fieldwork coordinator (approx. 4 months before placement commences)|
|Once students have been assigned their placement, they must register with the Safety Abroad Office and
During an international placement, students are to immediately contact the Safety Abroad Office for any accidents, illness, theft and breach of security, harassment or sexual assault, etc. Safety Abroad Office has 24 hour assistance accessed by phoning 416-978-2222. They will take a collect call. Students are also asked to contact the International Fieldwork Coordinator, Director of Clinical Education and the Administrative Assistant – Clinical Education via email as soon as possible after the incident.
|Deadline set by the Administrative Assistant – Clinical Education (approx.1 to 2 months before placement begins)|
|Apply for a placement in Canada if directed by Fieldwork Coordinator; in the event that the international placement is canceled for any reason (host country cancels, student does not maintain academic/fieldwork standing), the student will still be able to complete the required fieldwork||As directed by University Fieldwork Coordinator|
Facility Responsibilities and Timelines
Commit to a placement Approx. 5 months prior to placement
|Provide the following information in writing, in order to meet the approval criteria:
A description of their OT service;
An abbreviated résumé of the supervising therapist.
|When requested by student|
International Fieldwork Coordinator Responsibilities and Timelines
|Meet with University Fieldwork Coordinator who is responsible for that fieldwork block to review applications and decide student eligibility.
Review all of the information submitted by the student and ensure that the University Placement Agreement has signed and returned to the Fieldwork or Rehabilitation Sector Office.
Subject to approval of the above, send an email of confirmation to the facility, which will include the following:
|3 months prior to placement|
|Notify the student to finalize travel and accommodation arrangements once everything is finalized (signed Placement Agreement, etc.).
Code placement to enter into electronic database
|3 months prior to placement
1 month prior to placement
|Initiate contact with facility via phone or fax at midterm to obtain feedback re: progress in placement.||Midterm of placement|
|Write a letter of appreciation to facility.||After completion of placement|
All students are expected to write an introductory letter to the facility to which they have been assigned a fieldwork learning experience.
Students will be copied on the confirmation email to the facility regarding the student match and so in that way will have the contact name and e-mail addresses of the person to whom the introductory letter should be written. In the case of a role-emerging placement, the student must contact both the on-site contact and the off-site (Occupational Therapist) preceptor. Students must use their utoronto email account for all correspondence with sites as emails to facilities from gmail and hotmail may be automatically filtered into junk mail folders.
The purpose of the introductory letter is to provide information to the facility in order for them to plan more effectively for the student’s placement and for the student to understand how to best prepare for the placement. The letter should summarize the student’s previous fieldwork or other relevant experiences, identify personal strengths and outline specific interests related to the placement. Any questions the student may have regarding dress code, health requirements, criminal record check and any required readings prior to the commencement of the fieldwork placement should be addressed in this letter. Students are also encouraged to inquire as to how they can best prepare for the placement, i.e. suggested readings, etc. Current information regarding fieldwork placement sites is obtained and maintained by the Fieldwork Office and is made available to the students via the fieldwork Quercus websites. Students are required to read all information pertaining to their assigned facility prior to writing the introductory letter.
It is the responsibility of the student to e-mail the introductory letter to the facility Fieldwork Coordinator contact approximately three or four days after receiving the Confirmation email or as directed by the University Fieldwork Instructor.
Pre-Placement Information for Preceptors
Prior to each placement, pre-placement information is sent out to all facility Fieldwork Coordinators who forward it on to the fieldwork preceptors. Curriculum issues are discussed in addition to specific objectives for the placement and evaluation procedures. Powerpoint slides and the Fieldwork Course Outline are attached to the email and are also posted on the OS&OT Fieldwork Website for easy access by preceptors and facility Fieldwork Coordinators. Other resources and tutorials are available on the department fieldwork website (here).
Fieldwork Learning Objectives
Learning objectives are developed for each fieldwork course. The purpose of these objectives is to assist students and preceptors in planning and implementing the learning experience. Detailed objectives specific to each fieldwork are listed in each fieldwork course outline and are available on the fieldwork website here. Students and preceptors are encouraged to review and discuss the objectives in the fieldwork course outline throughout the placement.
Throughout the fieldwork program, students are expected to build upon skills that were developed during previous placements. Preceptors and students should review the university objectives from the previous placement levels as required to understand learning and skill progression.
Based on their specific learning needs, students negotiate personal learning objectives with preceptors to identify specific objectives to be met in the placement. It is expected that the student will have 3 to 4 specific learning objectives in total, each listed under a different competency (as per the Competency Based Fieldwork Evaluation for Occupational Therapists). These learning objectives should be finalized by the beginning of the second week of placement. See Learning Objectives section of this manual for further details.
Interprofessional education (IPE) for students occurs when individuals from at least two different roles or professions learn about, from and with each other to collaborate effectively as team members in working towards best outcomes. As part of the U of T IPE curriculum, MScOT students develop competencies for IPE through participation in specific learning activities in clinical settings. In order to fulfill their clinical education IPE requirements, students must complete at minimum during the total span of their fieldwork courses, either:
- One Structured IPE Placement (includes interprofessional student group project / presentation)
- OR Three Flexible IPE Learning Activities (including reflection papers).
If completing the Flexible IPE Activities (in lieu of a Structured IPE placement), the schedule for completion is described below. Students may participate in a Structured IPE placement during any fieldwork course, which automatically includes a project/presentation component. No additional project is required in these cases:
|Fieldwork Course||Flexible IPE activity requirements||Project requirements|
|Fieldwork 1||No project requirements|
|Fieldwork 2||Flexible Activities #1, #2, and #3||Project may also be required|
|Flexible Activity #3 (if not completed during Fieldwork 3)||Project|
|Fieldwork 4||Flexible Activity # 3 (if not completed during Fieldwork 2 or 3)||Project|
Structured IPE Placement
Structured IPE placements have these primary elements:
- A group of students from different professions come together in a student team while on placement,
- Students participate in a series of weekly patient-themed tutorials, and
- Students prepare and share the delivery of a joint presentation or project.
Structured IPE placements are offered by various fieldwork sites. The placement description may indicate if the placement is a structured IPE placement, or if a structured IPE placement is open for registration, based on availability.
Flexible IPE Activities
Flexible IPE activities can be done at almost any fieldwork site. The activity descriptions and requirements are provided in Appendix E.
Reflection papers are reviewed with the preceptor and then submitted through Quercus within the Mentorship Course.
Note: Any modifications to the IPE component of fieldwork will be communicated to students via Quercus by the fieldwork team.
Students are required to purchase the Competency Based Fieldwork Evaluation for Occupational Therapists (CBFE-OT) manual in term 1. An electronic copy of the CBFE-OT will be made available to students after purchasing the manual. Students will then forward the electronic copy of the CBFE-OT to their preceptor for use during the placement. The CBFE-OT will be completed at both the midterm point of placement and at the end of placement, by inputting comments and scores for each competency. Signed copies must be submitted by the student electronically through Quercus at the end of placement. The student’s preceptor(s) must also submit a copy of the final CBFE-OT directly to the fieldwork administrative assistant at email@example.com.
Students must ensure that all required preceptor and student signatures are present on pages 1 and 16 of the CBFE-OT form after the completion of each fieldwork placement before submission through Quercus. Students should make copies of completed CBFE-OT forms for their own personal use and reference.
Evaluation for the Introductory Fieldwork Experience
The evaluation for Introduction to Fieldwork has been adapted specifically for this placement based on the CBFE-OT. For the purposes of this placement, only certain components of key competencies will be evaluated: This specialized evaluation form will be provided by the university fieldwork office. Students are not required to develop their own learning objectives within this evaluation.
Evaluation for Fieldwork 1
For students completing a virtual Fieldwork 1, there will be no midterm CBFE-OT requirements. The CBFE-OT requirements will be explained by the course instructors.
Evaluation for Fieldwork 2, 3, and 4
As part of the fieldwork orientation, the preceptor and student(s) should discuss the evaluation forms and timeframes and processes for completion. At both midterm and final, students must complete a self-evaluation, providing comments and examples of how they think they have demonstrated the expected behaviours under each competency area. Students do not include scores during this process. Students then forward their self-evaluation to their preceptor for review along with any additional comments and a score for each competency area.
At midterm, the completed CBFE-OT outlining the student’s performance thus far and progression on the specific learning objectives that have been identified within the competencies are reviewed.
All of the CBFE-OT competencies must be scored by the preceptor by circling/choosing whole numbers. All seven competencies on the CBFE-OT must be scored and commented on, even if a personal learning objective is not identified within that competency. In addition, an overall score must be provided where indicated on the evaluation form. The preceptor and student meet to discuss the evaluation form and the completed the online ‘Student Report on Fieldwork Placement’(please see the following section). The reports are discussed and signed by both the fieldwork preceptor(s) and student. The CBFE-OT comment section is highly valued by both students and faculty. It is important that all comments be specific and objective and clearly describe the student’s performance. The comment section is beneficial to the University Fieldwork Instructor in monitoring each student’s progress.
The student’s performance should be considered satisfactory at midterm if the student is performing at the required level of competency for the corresponding stage of development (as per the CBFE-OT manual and the Course Outline) and the student is reasonably on their way to meeting the course learning objectives and their personal learning objectives. If, however, the student has been experiencing significant difficulty during the first half of the placement and has not achieved the required level of competency for the stage of development for that placement, performance should be rated as unsatisfactory and this should be noted.
If the student’s performance has been rated as unsatisfactory at midterm, the University Fieldwork Instructor must be promptly informed and will meet with the preceptor and student to discuss strategies to help the student improve her/his performance. Please see ‘Procedures for Unsatisfactory Fieldwork Performance’ for a full explanation of the process required when a student’s fieldwork performance does not meet required standards.
At the end of the placement (final evaluation), the evaluation process is repeated. Additionally, the preceptor(s) will recommend that the student passes or fails the placement. Unsatisfactory performance will be rated as a failure. Poor performance may result in course failure as determined by the University Fieldwork Instructor.
If the student’s performance is rated as a failure, the University Fieldwork Instructor must be contacted by the preceptor immediately. Additionally, students and preceptors should refer to ‘Policy on Unsatisfactory Performance’ and ‘Procedures for Unsatisfactory Performance’ in this manual and to the “Policies and Regulations” section of the MScOT Graduate Student Handbook.
Students should keep copies of all fieldwork evaluations for their records. Facilities must obtain the student’s consent in order to maintain a copy of the CBFE-OT. Please note that the CBFE-OT is copyrighted and so preceptors are not permitted to keep the CBFE-OT template on their computer unless they themselves have purchased the CBFE-OT manual.
Personal Learning Objectives
Personal learning objectives are to be included in the CBFE-OT form and are developed by the student following a thorough orientation to the site/program to which she/he is assigned. The learning objectives reconcile the requirements from the University and the facility with the learner’s own goals and objectives. These should be discussed with the preceptor during the first week of placement. The preceptor reviews the learning objectives and changes are negotiated. The learning objectives outline specific skills that the student will learn, how this will be accomplished, within what time period and the specific criteria for evaluating each objective.
The following guidelines are recommended for the development of the learning objectives:
- The student receives a thorough orientation to their placement prior to determining their learning objectives;
- The student identifies her/his own learning needs;
- The student develops a total of three or four learning objectives relating to the competencies outlined in the CBFE-OT. There should not be more than one learning objective under the same competency. Students in a group model will develop both individual and shared learning objectives;
- For each objective, the student specifies their specific learning resources/strategies;
- The student specifies what the evidence will be that indicates achievement of each objective;
- The student and preceptor specify how the evidence will be evaluated;
- The student’s learning is evaluated by the student, their peers and clients (if appropriate) and the preceptor.
- When in a split supervision placement, students must complete a total of three to four learning objectives between the two preceptors.
The Learning Objectives Evaluation Guide and a Learning Objectives template are included in Appendix M. Students should refer to their OCT1132H course notes to ensure that they are writing their learning objectives in the correct manner with the expected level of detail.
Student Report on Fieldwork Placement
At midterm and the end of the placement, students must complete the online ‘Student Report on Fieldwork Placement’ form. The completed report will give the preceptor and facility feedback on the supervisory process, orientation, student resources, learning climate, etc. and enable them to enhance their teaching and student program. The ability to give feedback effectively is a component of the Professional Interactions Competency of the CBFE-OT and students are encouraged to provide professional and constructive in their feedback, as appropriate.
Students should complete report individually and present it to their preceptor at the same meeting time as the discussion of CBFE-OT given by the preceptor (that is, at both midterm and final meeting times). Students are encouraged to bring any concerns about the process of completing the “Student Report on Fieldwork Placement” to the attention of their fieldwork instructor and site fieldwork coordinator, as appropriate.
The ‘Student Report on Fieldwork Placement’ must be completed, reviewed and signed copy by both the student and preceptor before submission electronically by the student through Quercus.
After placement is over:
Students should make use of the ‘Fieldwork Record’ tool to independently keep track of their placements and the coding associated with them. If the student would like to request a change in coding for any of their placements, they must send an email to the Fieldwork Course Instructor, copying their preceptor, giving details about caseload and assessments and treatments administered. This request must be submitted via email no later than one week after completion of the placement. Students must consult the descriptions of the codes (see Appendix N) prior to making the request to ensure that the placement is represented accurately by the newly suggested coding. The request must be verified by the preceptor and on-site fieldwork coordinator and a final decision regarding coding will be made by the University Fieldwork Instructor and communicated to the student. Electronic fieldwork records regarding the placement will be changed as indicated.
Issues or Conflicts Arising During Fieldwork Placement
Occasionally, issues or concerns may arise between the student and his/her preceptor. These issues need to be addressed in a professional and sensitive manner. Students and preceptors are advised to establish methods and times for open communication where such issues can be dealt with. If further assistance is required in solving an issue, the student and/or preceptor should speak with the on-site fieldwork coordinator. Further help can, and at times should, be obtained from the University Fieldwork Instructor. Please see Appendix L for flow charts that outline appropriate courses of action with regard to any issues or concerns arising on placement.
Policy on Unsatisfactory Fieldwork Performance
Supervised fieldwork is an integral component of the professional education of occupational therapy students. Learning in fieldwork education is viewed as a dynamic process in which learning from one placement is built upon in subsequent placements. Students progress through fieldwork placements in sequence and are expected to perform at progressively higher levels of competence and independence. Students will evolve from an entry-level student to an entry-level occupational therapist.
The Department of Occupational Science and Occupational Therapy sets learning objectives for students to meet at each level of fieldwork education within the fieldwork course outline. The Department of Occupational Science and Occupational Therapy’s Fieldwork Course Instructor is contacted immediately in the event of a possible failure of a student in a fieldwork placement and at least by midterm. This ensures that the student, fieldwork preceptor, on-site fieldwork coordinator (if present at the facility) and the university are fully aware of the performance of the student and that specific teaching/learning strategies are developed to help the student to improve her/his performance.
If there is documented evidence that learning strategies have been implemented and the student’s performance remains unsatisfactory (after a period deemed sufficient by the Fieldwork Course Instructor for evidence of improved performance) and/or the preceptor/fieldwork site report client safety, professional or ethical concerns, or there is significant disruption to team functioning the university may withdraw the student from the placement and the student may be considered to have failed the fieldwork course. Any student whose performance has been identified as unsatisfactory who is withdrawn at the mid-term of the placement or later will be considered to have failed the fieldwork course.
The Department of Occupational Science and Occupational Therapy at all times retains the ultimate decision for the pass/failure of the student in fieldwork courses. Students must successfully complete each fieldwork course prior to proceeding to subsequent fieldwork courses.
For further consequences related to failure in any course, fieldwork or academic, refer to the departmental MScOT Graduate Student Handbook.
Procedures for Unsatisfactory Fieldwork Performance
When unsatisfactory performance by the student is noted by the preceptor prior to and/or at midterm, the following steps should be taken:
- The preceptor or on-site fieldwork coordinator should contact the Director of Clinical Education/University Fieldwork Course Instructor.
- The preceptor must provide the student with verbal and written documentation of performance and behaviours that indicate unsatisfactory performance and potential failure of the placement.
- The University Fieldwork Course Instructor will meet with the student, the preceptor and the on-site fieldwork coordinator to identify problems. Utilizing the Fieldwork Course outline learning objectives and the CBFE-OT form (with learning objectives included), objectives and specific strategies to meet the objectives are developed.
- The University Fieldwork Instructor will maintain contact as necessary with both the fieldwork preceptor and the student to monitor student performance throughout the remainder of the placement.
- The University Fieldwork Instructor will attend midterm/interim/final evaluations as necessary.
When unsatisfactory performance is noted after midterm, the same procedure is to be followed as in the preceding section. If the failure is identified by the preceptor at a time that is too late to implement remediation strategies, the preceptor must document:
- the reasons that precluded the preceptor from noting the problems earlier, and/or
- the emergence of new behaviours/problems that led to failure late in the placement.
At any stage when a student is observed to be having serious problems in fieldwork practice, the Director of Clinical Education/University Fieldwork Course Instructor must be contacted immediately.
*Bossers, A., Miller, L.T., Polatajko, H.J., & Hartley, M. (2007). Competency Based Fieldwork Evaluation for Occupational Therapy CBFE-OT. Toronto, ON: Nelson Education.
Projects / presentations are reviewed by preceptors and feedback is provided, although there is no formal marking scale required by the university.
Students in Fieldwork 2, Fieldwork 3 and Fieldwork 4 should choose a subject for their presentation that is pertinent to their current fieldwork practice, is of benefit to the facility, and will aid them in their application of theory and practice. Examples of projects/presentations are:
- a comparison of alternate treatment approaches for a given client population;
- a comparison of individual clients within a client population and implications for treatment;
- a case presentation of an individual client (suggested guidelines on following pages);
- a project pertinent to occupational therapy and beneficial to facility.
The purpose of these presentations is to help students develop the skills to:
- Apply academic knowledge to clinical problems;
- Demonstrate an understanding of the role of Occupational Therapy in the placement context;
- Present in an organized, clear and professional manner;
- Stimulate discussion and sharing of information.
Case Presentations – Guidelines
When preparing case presentations, students are expected to follow the 7 Stages of the Occupational Performance Process as outlined in Enabling Occupation (1997, 2002). The Canadian Practice Process Framework (CPPF) should also be taken into account (CAOT, 2007).
1. Name, Validate and Prioritize Occupational Performance Issues (Screening)
Pertinent information about occupational performance is gathered with the client and others, e.g., family, community, etc. This may include an interview, use of the Canadian Occupational Performance Measure (COPM), community visits, environmental assessments, etc. Occupational Performance issues are confirmed with the client, then prioritized. If there are no occupational performance issues, the process ends.
2. Select a Theoretical Approach(es)
A conceptual system is selected which will guide decision-making throughout the process. Approach is a general term used here to include models, tested theories, frameworks, etc. McColl, Law and Stewart (1993) provide annotated bibliographies for six categories of specific theoretical approaches which are consistent with the Canadian model of occupational performance. The theoretical approaches within the categories can be selected to guide practice with clients.
The six categories, with examples of theoretical approaches that fall within these categories are as follows:
- Physical rehabilitative: anatomy, physiology, kinesiology, biomechanics, orthopedics
- Neurointegrative: NDT, sensory integration, sensory stimulation, perceptual motor, PNF, neuro rehabilitation
- Psycho-emotional: behavioural, psychoanalytical, cognitive, social learning
- Socioadaptive: role theory, feminist theory, group theory, anthropology, sociology
- Developmental: cognitive development (Piaget), social development (Erikson), moral development (Kohlberg)
- Environmental: architecture and planning, general systems theory, economics, ecology, socio-political theory
3. Identify Occupational Performance and Environmental Conditions
Occupational performance components and environmental conditions that are relevant to the occupational performance issue(s) are assessed. Decisions about what one assesses and how one does it are guided by the theoretical approach that has been selected. Methods used to assess occupational performance components and environmental conditions can include: observations, a review of documents, standardized tools, etc. Findings are analyzed as they relate to occupational performance.
4. Identify Strengths and Resources
Personal strengths and environmental resources are identified. Personal strengths lie within any one of the three performance components: physical, cognitive or affective, while resources lie within any one of the four environmental conditions: physical, social, cultural, or institutional.
5. Negotiate Targeted Outcomes, Develop Action Plan
Priorities are determined in conjunction with the client, then targeted outcomes defined. The targeted outcomes should specify behaviours that can be observed and/or measured, and be realistic, understandable and achievable. Interim or short-term goals/objectives are developed, enabling the client to progress through graded steps. They should include the same features as the targeted outcome.
Action plans are then developed to meet the targeted outcomes. Changes to the theoretical approach can be reviewed at this time, and changed if necessary. Action plans may include strategies to: develop, restore, maintain or promote occupational performance, or prevent occupational performance dysfunction. Action plans can be designed to enhance occupational performance components e.g., increase knowledge about safety, increase muscle strength through meaningful occupations, enhance communication skills or overcome environmental barriers e.g., provide adaptations, purchase devices, seek funding for environmental changes, provide education to a corporation or system.
Finally, action plans are finalized including determining location, schedule, frequency, materials, and estimated duration of implementation.
6. Implement Plans Through Occupation
Actions are implemented in accordance with the plan. The occupational therapist continually adapts and grades occupations to enable progress towards the targeted outcomes. Throughout implementation of the plan, the occupational therapist monitors the client’s satisfaction with the process and outcomes, and makes changes to enhance satisfaction when needed.
The extent to which all occupational performance issues are resolved, relative to the targeted outcomes, is assessed on an ongoing basis with each client. Even though a targeted outcome may remain the same, the methods for reaching the target may vary from day to day as conditions change. When changes are made, they are communicated to team members and others. The occupational therapist strives to ensure that the best methods available for resolving or minimizing the occupational performance issue(s) are used.
7. Evaluate Occupational Performance Outcomes
The occupational therapist determines whether targeted outcomes have been met by comparing targeted outcomes with actual outcomes. Evaluation may also measure the degree of change in occupational performance over time, or in different settings. Evaluation methods can include any or all of the methods used in Stage 3.
The occupational therapist must also evaluate the process by documenting what was and was not done, with the reasoning for decisions. This may include who was involved, what actions took place, how occupational performance issues were prioritized, how theoretical approaches were selected, how strengths and resources in occupational performance were identified, and the availability of environmental resources and support services.
If targeted outcomes have been met, the occupational performance process is complete, unless other occupational performance issues are identified. If the targeted outcomes have not been met, the process continues.
Canadian Association of Occupational Therapists. (2007). Enabling Occupation II: Advancing an Occupational Therapy Vision for Health, Well-being, & Justice through Occupation. Ottawa ON: CAOT Publications ACE.
Canadian Association of Occupational Therapists. (2002). Enabling Occupation: An Occupational Therapy Perspective (Rev.ed.). Ottawa ON: CAOT Publications ACE.
Canadian Association of Occupational Therapists. (1997). Enabling Occupation: An Occupational Therapy Perspective. Ottawa ON: CAOT Publications ACE.
McColl, M.A., Law, M. & Stewart, D. (1993). Theoretical Basis of Occupational Therapy: An Annotated Bibliography of Applied Theory in the Professional Literature. Thorofare, NJ: Slack.
Students should ensure that they meet regularly with their preceptor to review expectations and progress toward fulfillment of placement objectives.
Tips for Successful Communication with Preceptors
This tip sheet was researched and compiled by Naomi Mitchell, MSc(OT) candidate and edited by Donna Barker, University Fieldwork Coordinator, June 2008
The first meeting
- Come prepared with a list of topics and points you would like to discuss at the meeting and ensure that you cover them all or plan to address them at another scheduled meeting.
- Be sure to discuss the curriculum, your general objectives for learning and the evaluation process.
- Inform your preceptor of any personal concerns that may affect performance or attendance while on placement.
- Discuss any previous experience or lack of experience specifically related to expectations for present fieldwork placement.
- Establish an agreement of the level of responsibility you will incur throughout the placement.
- Discuss your learning needs, goals and strategies for achieving these goals within your preceptor’s area of practice.
- Discuss your expectations of placement and encourage your preceptor to share their expectations as well. Collaborate to ensure that common expectations for learning are established.
- Establish a schedule of future meetings.
Communicating with your preceptor
- Present yourself as:
- Friendly, yet professional
- Be sensitive to the needs of others
- Be honest and trustworthy
- Ask appropriate questions as they surface
- Do not become defensive; keep an open mind
- Reflect with your preceptor, whether at a scheduled meeting or on the go. Verbalize your thought process, allowing the preceptor to understand how you are learning. They can then provide you with constructive feedback from their perspective.
- Respect your preceptor’s schedule and responsibilities outside of your education and thus raise concerns at an appropriate time of day.
- Ask your preceptor how they prefer to communicate (e.g. e-mail vs. phone call) and respect their preference.
- Maintain continuous communication with your preceptor to ensure common expectations are maintained.
Meetings throughout the placement
- Bring an agenda to the meeting; verify with your preceptor that the agenda is also appropriate for them.
- Provide your preceptor with feedback, specifying how their teaching methods affect your learning experience. Remember to give positive and constructive feedback!
- Ask your preceptor to provide you with feedback related to your learning objectives and discuss your perspective of your progress.
- Refer to your learning objectives and collaborate with your preceptor to identify areas where future learning is needed. Create a plan for the following days which will accommodate your specific learning needs.
Providing and receiving feedback
- Take care to deliver constructive feedback in a professional and sensitive manner.
- When appropriate, provide your preceptor with constructive feedback promptly.
- Provide honest feedback to the site as this will help to ensure the quality of the placement. This is often best done by completing and discussing the ‘Student Report on Fieldwork Placement’ form with your preceptor and the site.
- Be prepared to discuss your feedback, with specific examples with your preceptor.
- If your preceptor is vague when providing you with feedback, encourage them to provide details. This will help you to better understand your performance levels and areas needing improvement.
- Listen carefully to feedback given to you and focus on areas of improvement.
- Be prepared with basic conflict resolution strategies prior to the beginning of your placement. This will lower potential for conflict that may hinder your learning experience.
- Ensure that your preceptor is aware of any potential for personal conflict related to the placement. Should a conflict arise due to personal issues, address this immediately to avoid negatively impacting your learning experience.
- Attend to any early indicators of conflict to prevent exacerbation of any problems. Discuss any issues regarding placement with your preceptor immediately. If issues persist, refer to the Student Concern Flowchart in Appendix L of the Fieldwork Resource Manual to address further issues appropriately.
- If you have questions around your preceptor’s practice, discuss this with the preceptor directly. Explain your concerns, giving specific examples. Listen carefully to your preceptor’s explanation. If speaking with your preceptor does not lower your concern refer to the Student Concern Flowchart in Appendix L of your Fieldwork Resource Manual in order to address the issue appropriately.
- Address any conflict immediately to avoid jeopardizing your learning experience.
Placements with split supervision (1 student to 2 preceptors)
- Early in the placement, meet with both preceptors to gain a clear understanding of how you will be supervised. Clarify each preceptor’s (as well as your) expectations of the placement. Guidelines and scheduled meetings should be determined at this point.
- Express your learning needs early in the placement and determine with your preceptors how you can best address these needs with respect to their separate areas of practice.
- Maintain clear communication with both preceptors throughout the placement and ensure that common expectations have remained or are collaboratively altered as necessary.
- Schedule separate and joint meetings with your preceptors to ensure optimum communication and ensure that your concerns and comments are heard.
- At mid-term, review any positive and negative aspects of the split preceptor experience. Encourage your preceptors to also express any concerns that they may have regarding the process. Maintain open communication in order to avoid unnecessary conflict.
- Encourage both preceptors to provide you with an equal amount of feedback throughout the placement, as well as at the final evaluation. Remind preceptors that they must agree on mid-term and final marks on the CBFE-OT evaluation, although comments can differ.
Alsop, A., & Ryan, S. (1996). Making the most of fieldwork education. Chapman & Hall: London.
Gaiptman, B. & Forma, L. (1991). Reflections on… The split placement model for fieldwork placements. Canadian Journal of Occupational Therapy, 58(2), 85-88.
Hogard, E., Ellis, R., Ellis, J., & Barker, C. (2005). Using a communication audit to improve communication on clinical placement in pre-registration nursing. Nurse Education Today, 25, 119-125.
Sinai, J., Tiberius, R.G., de Groot, J., Brunet, A., & Voore, P. (2001) Developing a training program to improve supervisor-resident relationships, step 1: Defining the types of issues. Teaching and Learning in Medicine, 13(2), 80-85.
Following the first week of placement:
- Learning objectives should be discussed with the preceptor and modified as required.
- An agenda of scheduled meetings for the student and preceptor should be determined for the remainder of the placement.
Regularly throughout placement:
- Re-visit learning objectives.
- Engage in feedback sessions with preceptor in which you, the student, both receives and provides feedback.
- Complete the CBFE-OT evaluation as a self-evaluation and forward to preceptor in advance of your evaluation meeting
- Meet with preceptor to discuss
- performance using the preceptor-completed CBFE-OT evaluation to guide discussion.
- Student Report on Fieldwork Placement
- Ensure that all necessary signatures are on both the CBFE-OT evaluation form as well as the ‘Student Report on Fieldwork Placement’ and submit the evaluation through the Quercus fieldwork site.
- Re-visit learning objectives and modify as required
- If you have not already done so, finalize the topic of your project / presentation
- Finalize plan for completion of IPE learning activities with your preceptor (primarily during Fieldwork 1).
During the last week of placement:
- Complete project / presentation and submit to preceptor
- Complete the CBFE OT evaluation as a self-evaluation and provide to your preceptor in advance of your final evaluation meeting
- Complete the final portion of the ‘Student Report on Fieldwork Placement’
- Meet with your preceptor to discuss
- your performance using the preceptor-completed final CBFE-OT evaluation
- Student Report on Fieldwork Placement
- Meet with the fieldwork coordinator if requested to do so
- Ensure that all necessary signatures are on both the CBFE-OT evaluation form as well as the ‘Student Report on Fieldwork Placement’ and submit these forms through the Quercus fieldwork site. Ensure that your preceptor has submitted the completed final CBFE-OT evaluation directly to the fieldwork administrative assistant at firstname.lastname@example.org