Dreams Therapy

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Touro University Nevada Occupational Therapy Evaluator: Activity: Evaluation Type: Request Date: Period: Subject Participation Dates:

Joshua Ringer - Fieldwork Educator OCCT 526A Educator Evaluation of Level I Fieldwork - Student 01/26/2013 OCCT 526A - Fall 2012 01/14/2013 To 02/08/2013

Subject: Site: Completion Date:

Yara Bezgina - Level I Dream Therapies 02/15/2013

Dates of Activity:

01/14/2013 To 02/08/2013

Fieldwork Educator:
Joshua Ringer

(Question1of7)

Type of Fieldwork: (Specialty/Practice Area) Selection Option


1.1 In-Patient Acute 1.2 In-Patient Rehab

(Question2of7-Mandatory)

1.3 SNF/ Sub-Acute/ Acute Long-Term Care 1.4 General Rehab Outpatient 1.5 Outpatient Hands 1.6 Pediatric Hospital/Unit

1.7 Pediatric Hospital Outpatient 1.8 In-Patient Psych 2.1 Pediatric Community 2.2 Behavioral Health Community 2.3 Older Adult Community Living 2.4 Older Adult Day Program 2.5 Outpatient/hand private practice 2.6 Adult Day Program for DD 2.7 Home Health 2.8 Pediatric Outpatient Clinic 3.1 Early Intervention 3.2 School Other (see below)

Other

(Question3of7)

If Other was selected for Type of Fieldwork, please specify:

Indicate the students level of performance using the scale provided 4 - Exceeds Standards: Frequently carries out tasks and activities that surpass requirements. At times, performance is exceptional.

3 - Meets Standards: Carries out required tasks and activities. This rating represents good, solid performance and is typically used more than all the other ratings. 2 - Below Standards: Opportunities for improvement exist; however, student has not demonstrated adequate response to feedback. Work is occasionally unacceptable. 1 - Well Below Standards: Performance is weak in most required tasks and activities. Work is frequently unacceptable.

(Question4of7-Mandatory) Exceeds Meets Below Well Below Standards Standards Standards Standards 4 Organization
Consider ability to set priorities, be dependable, be organized, follow through with responsibilities

N/A

Comments

3
>> X <

2
2.0

1
1.0
0

4.0

Engagement in the Fieldwork Experience


Consider the students apparent level of interest, level of active participation while on site; investment in individuals and treatment outcomes; seeks ways to improve self-performance; follows safety precautions

4.0

>> X <

2.0

1.0

Self-Directed Learning
Consider ability to take responsibility for own learning; demonstrate motivation; aware of own strengths and areas for improvement

>> X <

3.0

2.0

1.0

Reasoning/Problem Solving
Consider ability to use self-reflection, willingness to ask questions; ability to analyze, synthesize and interpret information; understand the OT process; demonstrates inquiry skills appropriate to the students stage of education and training

4.0

>> X <

2.0

1.0

Written Communication
Consider grammar, spelling, legibility, successful completion of written assignments, documentation skills

4.0

>> X <

2.0

1.0

Initiative
Consider initiative, ability to seek and acquire information from a variety of sources

4.0

>> X <

2.0

1.0

Observation Skills
Consider ability to observe relevant behaviors for performance areas and performance components and to verbalize perceptions and observations

>> X <

3.0

2.0

1.0

Verbal Communication and Interpersonal Skills


Consider ability to interact appropriately with individuals (patients/clients/staff/ caregivers) such as eye contact, empathy, limit setting, respectfulness, use of authority; degree/quality of verbal interactions; use of body language and non-verbal communication; exhibits confidence

>> X <

3.0

2.0

1.0

Professional and Personal Boundaries


Consider ability to recognize/handle personal/professional frustrations; balance personal/professional obligations; handle responsibilities; work with others cooperatively, considerately, effectively; responsiveness to social cues; adheres to AOTA Code of Ethics

>> X <

3.0

2.0

1.0

Use of Professional Terminology


Consider ability to respect confidentiality; appropriately apply professional terminology (Practice Framework) in written and oral communication

>> X <

3.0

2.0

1.0

Attitude and Professional Appearance


Consider ability to manage stressors in constructive ways; demonstrates flexibility as required; follows program guidelines for dress and hygiene

>> X <

3.0

2.0

1.0

Time Management Skills


Consider ability to be prompt, arrive on time, complete assignments on time

>> X <

3.0

2.0

1.0

Participation in the Supervisory Process


Consider ability to give, receive and respond to feedback; seek guidance when necessary; follow proper channels

4.0

>> X <

2.0

1.0

Student Learning Objectives for This Fieldwork Experience: (Question5of7-Mandatory)

Date Completed
1. 2. 3.

Student Learning Objectives Observe and participate with child engaged in occupation based activity that could be carried out with the family outside the treatment session Observe and participate in a client evaluation or reassment create 3 activities for a selected child

2/2/13 1/23/13 2/9/13

Fieldwork Educator Comments:

(Question6of7)

As a student, Yara was very professional and overall exceeded my expectations and made a great impression on the whole staff and all of the kids. Yara has a very bright future and is clearly setting a great example for all future students to follow.

We have both reviewed the Educator Evaluation of Student, Student Evaluation of Educator, and Student Evaluation of Facility. (Question7of7-Mandatory) Selection Option Yes X
No

The purpose of a Level I Fieldwork experience is to provide an opportunity for exposure to occupational therapy intervention and programming or, in the cases where no OT services are currently being provided, exposure to potential growth areas for OT. We encourage as much hands on as possible and appropriate within each experience. It is expected that professional behaviors are upheld in all settings. Thank you for your participation in our program and your assistance in the educational process of our occupational therapy students. Please notify the Academic Clinical Coordinator immediately if this student is not performing to the facilities expectations for Level I Fieldwork. Ashley Fecht OTD, OTR / L Academic Clinical Coordinator & Assistant Professor (702) 777-4762 Office (702) 370-1328 Cell ashley.fecht@tun.touro.edu (AdaptedfromColoradoStateUniversityLevelIStudentPerformanceEvaluation,PhiladelphiaRegionFieldworkConsortium, WashingtonUniversitySchoolofMedicinePrograminOccupationalTherapy)

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