1. An Introduction to Understanding the OT and OTA Fieldwork Performance Evaluations (FWPEs)
SLIDE EXPLANATION
This PowerPoint presentation is a brief overview to help you understand the OT and OTA Fieldwork Performance Evaluations (FWPEs). The purpose of these evaluations is to measure entry-level competency of OT and OTA students’ ability to engage in the process of delivering occupational therapy services in a variety of practice settings. The process of occupational therapy as described in the Occupational Therapy Practice Framework: Domain and Process includes the process of evaluating, intervening, and targeting intervention outcomes, all with a primary focus of engagement in occupation.
To fully understand and accurately use the FWPEs, further education and training will be required. A manual will be available from AOTA in June 2003, which will assist in understanding and use of the FWPEs.
Included in this presentation are notes for you as the trainer. The notes provide an overview of the process used to develop the evaluations, a review of key characteristics of the evaluations, and suggestions for interactive learning activities to assist the learner in understanding the concepts found in the FWPEs for the OT and OTA student.
NOTES TO TRAINER
In addition to the downloadable documents provided, the following documents will be helpful to you as the trainer to fully understand the conceptual foundation of the new forms; it is recommended that aspects of these materials be incorporated into handouts for the learner:
Copies of the FWPEs for OT and OTA students
Occupational Therapy Practice Framework: Domain and Process
Standards for an Accredited Educational Program for the Occupational Therapist
Standards for an Accredited Educational Program for the Occupational Therapy Assistant
Standards of Practice for Occupational Therapy
NBCOT Practice Analysis Results
Karen Atler, MS, OTR
Colorado State University, Fort Collins, CO
Roberta Wimmer, OTR/L
Pacific University, Forest Grove, OR
 2003 The American Occupational Therapy Association, Inc

2. Task Force Members Carole Dennis, PhD, OTR Carole Hays, MA, OTR
Ithaca College, New York
Carole Hays, MA, OTR
Springfield Hospital Center, Maryland
Becky Robler, MEd, OTR
Pueblo Community College, Colorado
Karen Atler, MS, OTR, Co-Chairperson
Colorado State University
Roberta Wimmer, OTR, Co-Chairperson
Pacific University, Oregon
SLIDE EXPLANATION
The criteria for task force membership was identified by the AOTA Commission on Education (COE). After the COE appointed the chairpersons of the task force, names of potential task force members were provided to the co-chairpersons to contact. Task force members were selected because of their knowledge, skills, and abilities in the occupational therapy process. In addition, members were chosen based on geographic location: The co-chairpersons and COE wanted a task force with broad geographical representation.
Carole Dennis was our research consultant, bringing expertise in assessment development and statistical analysis. She also was the gatekeeper to ensure the instruments’ integrity.
Carole Hays was our fieldwork educator expert and historian. She has extensive experience in a variety of practice settings, has supervised an abundance of OT and OTA students, and has been a member of almost every AOTA committee and task force related to fieldwork education, therefore bringing to the task force occupational therapy life experiences, supervisory expertise, and an essential historical perspective so that the task force did not “reinvent the wheel.”
Becky Robler was our expert in OTA education and practice who was intimately knowledgeable and aware of the current practice and education of OTAs as a result of her long-term commitment to the education of OTAs. She also has been an item writer for the National Board for Certification in Occupational Therapy (NBCOT).
Karen Atler has had a strong interest in fieldwork education for many years, participating in an AOTF-funded grant related to fieldwork that resulted in the development of the Fieldwork Experience Assessment Tool (FEAT) ( participating in developing and supervising Level I fieldwork students, and developing and supervising students in Level II fieldwork in emerging practice areas.
Roberta Wimmer also has had a strong interest in fieldwork education, first as a fieldwork educator and now as an academic fieldwork coordinator and part-time fieldwork educator. She brought her experience in developing Level I and II fieldwork assessments for use in nontraditional settings.
In addition, this project could not have been completed without the assistance and contribution of the following individuals and groups. Their willingness to volunteer their time, efforts, and expertise were invaluable to the completion of this project—without their contribution, this project would not have been accomplished.
Doris Gordon, MPH, OTR, Former Director of Academic and International Affairs, AOTA, joined the task force in January Her strong support ensured that this project was seen to completion.
Patients at the Springfield Hospital Center assisted with formatting, printing, collating, and packaging many of the pilot testing forms. Their contribution resulted in a substantial cost savings for AOTA.
Anne G. Fisher, ScD, OTR, FAOTA, Professor, and Brenda Merritt, MS, OTR, Doctoral Candidate, both from Colorado State University, volunteered many hours of time and expertise to guiding the Rasch analysis of the pilot test results.
Student employees from Colorado State and Pacific Universities inputted all the data from the pilot tests, ran errands, and assisted with collating and sending out the first OTA pilot test. Their assistance resulted in a more timely pilot testing process.

3. Objectives Describe the Begin to score items on the FWPE
Entry-level practice competencies for OT and OTA students
Purpose, format, content, and scoring of the companion evaluation forms
New concepts and terminology used in the FWPE from the OT Practice Framework
Begin to score items on the FWPE
SLIDE EXPLANATION
The objectives give an overview of content that will be reviewed as well as an outline of the sequential order of the presentation.
NOTES TO TRAINER
During the development of the FWPEs, the task force followed the development of the Occupational Therapy Practice Framework: Domain and Process to incorporate key concepts and terminology from the document. Explain how the Occupational Therapy Practice Framework: Domain and Process has replaced Uniform Terminology III.
Throughout the presentation, take opportunities to assist fieldwork educators in translating the language used in their own practice setting to the new terminology of the Occupational Therapy Practice Framework.
Understanding the documents used to develop the FWPEs will assist fieldwork educators in clearly seeing the connection between the purpose of fieldwork and AOTA documents that guide education and current practice. Because the new FWPEs are designed from these concepts, reviewing and becoming familiar with these documents will assist fieldwork educators in evaluating whether students are competent for entry-level practice.

4. Task Force’s Charge
Revise/develop evaluation tools to measure assistant and professional Level II fieldwork student performance.
Expectations
Conduct review of literature across disciplines
Synthesize feedback on current AOTA FWE/OT forms
Incorporate 1997 NBCOT Practice Analysis results
Address identified desired characteristics
SLIDE EXPLANATION
These charges were given to the task force by the COE.
The literature on the topics of competency, clinical reasoning, fieldwork, and measurement across the disciplines of occupational therapy, physical therapy, speech–language pathology, social work, psychology, and medicine was reviewed. Included in the literature review were national and international publications. The literature reviewed assisted the task force to (a) examine key concepts to be incorporated into the evaluations and (b) learn how occupational therapy professionals in other countries and other health-related disciplines are measuring student performance.
The task force reviewed the two previous fieldwork evaluation forms—the Fieldwork Evaluation for the Occupational Therapist (FWE/OT) and the Fieldwork Evaluation Form for the Occupational Therapy Assistant Students (FWE/OTA)—to determine the strengths and weaknesses of these instruments. Only one study was found that had examined the validity or reliability of these forms (Stutz-Tanenbaum, Gaffney, Bundy, & Fisher, 1993). The authors examined the appropriateness of the FWE/OT items, investigated the relevance of the FWE/OT items across fieldwork sites and practice areas, analyzed the FWE/OT grading system, and made recommendations for changes. Results indicated that the FWE/OT did not readily differentiate levels of competence because of repetition of concepts across all three categories of Performance, Judgment, and Attitude and because the scoring scale tended to equate with academic grades, resulting in inflated scores. The authors recommended that (a) the rating scale be changed from a 5-point scale to a 2-point scale, (b) the number of items be reduced to eliminate overlap, and (c) the terminology that was not compatible with settings outside the medical model be reconsidered.
REFERENCE
Stutz-Tanenbaum, A., Gaffney, D., Bunday, A., & Fisher, A.G. (1993). Report of the Task Force on
Fieldwork Evaluation (Unpublished document). Bethesda, MD: American Occupational Therapy
Association.

5. Desired Characteristics
Companion documents for assistant and professional level that
Measure entry-level competence
Focus on occupation-based practice
Reflect current and future practice
Can be used in a variety of settings
Provide feedback to students
Can be easily used in a timely manner
SLIDE EXPLANATION
These characteristics were originally identified by the COE. Additional feedback was gathered from a variety of occupational therapy constituents, including fieldwork educators, academic fieldwork coordinators, recent graduates, and OT and OTA students. Their feedback was consistent with the desired COE characteristics: (a) ease in scoring, (b) reflect current practice, and (c) use across all practice settings.
NOTE TO TRAINER
Transition statement to next slide: “After the review of all the literature and related documents, the task force decided to use the NBCOT Practice Analysis, Standards of Practice for Occupational Therapy, and the ACOTE Standards as the guiding documents for the development of the FWPEs. All three documents address professional expectations for entry-level practice. In addition, key concepts from the Occupational Therapy Practice Framework also were incorporated. The following slides provide a brief summary of these documents.

6. NBCOT Practice Analysis 1997
What OTs & OTAs Do
Determining needs/priorities for interventions
Identifying/designing interventions
Implementing interventions
Reporting/evaluating intervention effectiveness
Providing OT services for populations
Managing delivery of OT services
Advancing effectiveness of the OT profession
What OTs & OTAs Need To Know
Human development and performance
Principles/strategies in the identification/evaluation of strengths and needs
Principles/strategies in intervention/treatment planning
Principles/strategies in intervention
Nature of occupation and occupational performance
Service management
Responsibilities as a professional
SLIDE EXPLANATION:
In addition to the refinement of the certification examinations for the OT and OTA student, the NBCOT Practice Analysis also identified specific tasks done by OTs and OTAs in practice settings and the knowledge and skills required to do these tasks. This information assisted the task force in developing evaluations that reflected practice across all settings.
Occupational Therapists
Specific domains/doing aspects of an entry-level OT include (a) determining needs/priorities for interventions, (b) identifying/designing interventions, (c) implementing interventions, (d) reporting/evaluating intervention effectiveness, (e) providing occupational therapy services, (f) managing delivery of occupational therapy services, and (g) advancing effectiveness of the occupational therapy profession.
The knowledge areas for the entry-level OT include (a) human development and performance, (b) principles/strategies in the identification/evaluation of strengths and needs, (c) principles/strategies in intervention/treatment planning; (d) principles/strategies in intervention, (e) nature of occupation and occupational performance, (f ) service management, and (g) responsibilities as a professional.
Occupational Therapy Assistants
Specific domains/doing aspects of an entry-level OTA include (a) determining needs/priorities, (b) identifying/designing interventions, (c) implementing interventions, (d) reporting and evaluating intervention effectiveness, (e) providing occupational therapy services, (f) managing delivery of occupational therapy services, and (g) advancing effectiveness of the occupational therapy profession.
The knowledge areas for the entry-level OTA include (a) human development and performance, (b) principles/strategies in the identification/evaluation of strengths and needs, (c) principles/strategies in intervention/treatment planning, (d) principles/strategies in intervention, (e) nature of occupation and occupational performance, (f) service management, and (g) responsibilities as a professional.
NOTE TO TRAINER
Emphasize that both the “specific domains/doing aspects” and the “knowledge areas” reflect key steps in the occupational therapy process that apply to all practice settings.

7. Standards of Practice for Occupational Therapy
Identifies minimum standards
Identifies key performance areas for the OT and OTA
Professional standing and responsibility
Referral
Screening
Evaluation
Intervention plan
Intervention
Transition services
Discontinuation
SLIDE EXPLANATION
This document identifies the minimum or entry-level roles and responsibilities for the OT and OTA that are delineated by key performance areas. Together, all the key performance areas listed in the slide are aspects of the occupational therapy process used in all practice settings. The Professional Standards and Responsibility subset address ethical practice and professional behaviors.
NOTE TO TRAINER
Have the Standards of Practice for Occupational Therapy available for review or as a handout for all participants. The document can be downloaded from the AOTA Web site at

8. ACOTE: Minimum Standards and Outcomes
Be a generalist
Achieve entry-level competence
Articulate, apply, and justify occupation interventions
Supervise and collaborate with the OTA
Keep current with best practice
Uphold the ethics, values, and attitudes of the profession
Be an effective consumer of research and knowledge
OTA
Be a generalist
Achieve entry-level competence
Work under the supervision of and in cooperation with the OT
Articulate, apply, and justify interventions related to occupation
Keep current with best practice
Uphold the ethics, values, and attitudes of the profession
SLIDE EXPLANATION
The mission of the Accreditation Council for Occupational Therapy Education (ACOTE) is to foster the development and accreditation of quality occupational therapy education programs.
ACOTE sets the minimum standards for education, including fieldwork education, to develop the basic skills for entry-level competence for the OT and OTA. Basic skills for the OT are (a) direct care provider, (b) educator, (c) advocate, (d) consultant, (e) manager, and (f) researcher. Basic skills for the OTA are (a) direct care provider, (b) educator, and (c) advocate. The Standards identify what an entry-level OT and OTA student must be prepared to do.
This slide compares the similarities and differences between the OT and OTA Standards. Reviewing these concepts will help fieldwork educators to appreciate that the design of the FWPEs as companion documents supports key concepts related to both OTs and OTAs.
Highlighted words are the key performance areas that all entry-level OTs and OTAs must possess no matter where they choose to practice.
NOTE TO TRAINER
Have the sections that address fieldwork education available for review (Section B.9 for OTA, Section B.10 for OT). To view the ACOTE Standards:
Standards for an Educational Program for the Occupational Therapist
Standards for an Educational Program for the Occupational Therapy Assistant

9. Goal of Level II Fieldwork Education for the OT and OTA Student
Develop competent, entry-level generalists
Include an in-depth experience in delivering occupational therapy services
Be designed to promote reasoning, enable ethical practice, and develop professionalism
SLIDE EXPLANATION
Refer to the ACOTE Standards for the specific information; there are key concepts in the Standards that will assist the fieldwork educator in understanding and appreciating these standards and to see the relevance to their practice. Section B.10.0 addresses fieldwork-related issues in the Standards for an Accredited Educational Program for the Occupational Therapist, and Section B.9.0 addresses fieldwork-related issues in the Standards for an Accredited Educational Program for the Occupational Therapy Assistant.
Fieldwork education = develops competent, entry-level generalists
Delivering occupational therapy services = use of the occupational therapy process
Promote reasoning = clinical reasoning or the thinking process OTs and OTAs use to carry out the occupational therapy process
Ethical practice and professionalism = professional behavior
The ACOTE Standards assist with delineating the required characteristics of Level II fieldwork for the OT and OTA student. Both OT and OTA Level II fieldwork experiences are to be designed to provide opportunities for students to engage in delivering occupational therapy services to clients, with a focus on the application of purposeful and meaningful occupation. In addition, Level II fieldwork education for the OT student should also focus on research, administration, and management.
NOTE TO TRAINER
Emphasize the highlighted words and how these concepts cross all practice settings.
Compare the focus of Level II fieldwork for the OT and OTA to help fieldwork educators appreciate the differences in the items found on the FWPE/OT and the FWPE/OTA.
Conclude this section of the presentation by highlighting that the occupational therapy process, which is addressed in the 1997 NBCOT Practice Analysis, the AOTA Standards of Practice for Occupational Therapy, the ACOTE Standards for Accredited Educational Programs, and the Occupational Therapy Practice Framework is the conceptual model for both the OT and OTA fieldwork performance evaluations. Thus, this is where the concept of the evaluation forms as companion documents comes from.

10. The Process Began with OTA evaluation Reviewed by experienced panel
Submitted to COE
Made revisions
Completed pilot studies (2 OTA, 1 OT)
SLIDE EXPLANATION
The task force was charged by the COE to start with the revision of the OTA evaluation because of the “out-datedness” of the evaluation form. It was last updated in 1983.
Drafts were developed in an effort to capture the occupational therapy process, the format best suited for measuring entry-level performance, and the ease of use for the fieldwork educator. Forms were sent out for review by an experienced panel of OT and OTA fieldwork educators, the Regional Fieldwork Consultants, OT and OTA academic fieldwork coordinators, recent graduates, and the Fieldwork Issues Committee.
Feedback from these constituents were incorporated into both evaluation forms, and the forms were submitted to COE for approval. COE provided feedback that was incorporated into the forms and then approved the forms for pilot testing.
Following each of the three pilot studies, quantitative (statistical analysis) and qualitative (student and fieldwork educators’ feedback) results were incorporated into the next phase of development. The format, number, and clarity of items and the rating scale were developed over time based on the results of the three pilot studies.

11. Design and Analysis of Pilot Studies: The Rasch Measurement Model
SLIDE EXPLANATION
The Rasch measurement model was used to develop and analyze the FWPEs. Key features or expectations of the FWPEs include the following:
The FWPE measures a single construct—entry-level competency. Analysis of the pilot studies supported the results of the Stutz-Tanenbaum et al. (1993) study, which indicated that Performance, Judgment, and Attitude were not separate constructs. For this reason, the three separate areas are not found on the FWPEs.
The single construct is conceptualized across a “continuum” of competencies (reflected by the items) that range from basic (simple, concrete) to more difficult (abstract, requiring greater integration of concepts). For example, implementing intervention is a basic competency that students generally achieve before being able to articulate clearly the rationale for selecting the intervention (a more complex competency). The figure in this slide (a probability curve; actual data from the second pilot study) illustrates the pattern of performance expected when a well-functioning 4-point scale differentiates between student ability across item difficulty. The figure illustrates the probability of how students ranging in ability (less able to more able) will score. As you can see, students who are less able are more likely to score 1s and 2s, whereas students who are more able are more likely to score 3s and 4s. In general, the two basic beliefs from the Rasch model that explain the pattern of performance are that basic (simple, concrete) items are more likely to be “basic” for all students and the more able the student, the more likely the student will get a higher score on the more difficult items.
NOTES TO TRAINER
For a greater understanding of the Rasch measurement model and a complete overview of the pilot study results, refer to the manual that will be available from AOTA in June 2003.
less able Student Ability more able

12. Results of Pilot Studies
Good representation in pilot samples
Students and educators preferred new form
Good scale and response validity
Inaccurate use of scale
SLIDE EXPLANATION
Pilot Study Samples
Responses received during pilot study represented
a variety of settings that employ OTs and OTAs,
a broad geographical representation of fieldwork education across the United States, and
fieldwork educators who participated in the pilot studies who had a number of years experience in both practice and supervising fieldwork students.
Preference for the New Form
OT and OTA students preferred the new form.
Not only did the OT and OTA fieldwork educators prefer the new form, but also the majority agreed that
the tool measures entry-level competence,
the scale is simple and helps differentiate performance, and
the tool can be used in a variety of settings.
Good Scale and Response Validity and Inaccurate Use of Scale
Good scale and response validity means the evaluation measures what it was designed to measure. Rasch analysis indicated that the FWPEs for the OT and OTA student differentiate between levels of student ability (less competent to more competent). Further interpretation of the statistical results indicates that the “small error” found is due to inaccurate use of the rating scale, or in other words, fieldwork educators in the pilot studies tended to rate student’s performance high. The table in this slide reflects how often each rating was used during midterm and final scoring and indicates that fieldwork educators tend to give more 3s and 4s than 1s and 2s. According to how the rating scale reads, a score of 2 would be an appropriate score at midterm. Complete descriptions of each score include the following:
4 Exceeds Standards: Performance is highly skilled and self-initiated. This rating is rarely given and would represent the top 5% of all the students you have supervised. 
3 Meets Standards: Performance is consistent with entry-level practice. This rating is infrequently given at midterm and is a strong rating at final.
2 Needs Improvement: Performance is progressing but still needs improvement for entry-level practice. This is a realistic rating of performance at midterm and some ratings of 2 may be reasonable at the final.
1 Unsatisfactory: Performance is below standards and requires development for entry-level practice. This rating is given when there is concern about performance.
NOTES TO TRAINER
Emphasize the importance of using the rating scale accurately. The evaluations appear to differentiate levels of fieldwork student performance, but the greatest variable in creating a valid evaluation form is fieldwork educators. Analysis revealed that a need still exists to assist with helping fieldwork educators in using the rating scale as intended. It may be helpful to review some examples of the tendency of fieldwork educators to be too lenient when evaluating students. Not using the scale as intended interferes with the evaluation’s ability to differentiate competent or not competent for entry-level practice.
Rating Scale Usage in Pilot Studies II and III
4 = Exceeds Standards
3 = Meets Standards
2 = Needs Improvement
1 = Unsatisfactory
Rating Scale Descriptors 29 34 53 56 13 10
% Usage OTA
% Usage OT

13. The FWPEs for OT and OTA Students
Companion documents
Terminology
Content layout
Purpose
Design
Rating scale
Scoring system
SLIDE EXPLANATION
To understand and accurately use the FWPEs, the fieldwork educator needs to understand the concept of companion documents, the terminology, how the content layout parallels the occupational therapy process, the purpose of the evaluations, the design, and the intended use of the rating scale and scoring system in determining competent or not competent for entry-level practice. This slide outlines the sequential order that these aspects of the evaluation will be reviewed in the following slides.
NOTES TO TRAINER
Before reviewing the details of the FWPEs for the OT and OTA, it would be a good time to engage participants in a discussion that will help them to recognize the important aspects about fieldwork education that are common across all settings (see the learning activity below). No matter what setting the student is completing his or her fieldwork, all settings require OTs and OTAs to engage in the clinical reasoning process and to follow the occupational therapy process. The occupational therapy process involves the following:
An evaluation that includes the occupational profile, analysis of occupational performance, and analysis of client and contextual factors that support or hinder performance
An intervention that involves the planning of strategies to meet the client’s goals and desires, implementing the strategies, and reviewing the strategies effectiveness
Measurement of the targeted outcome that is engagement in occupation to support participation in life
Therefore, competency is measured by the student’s ability to demonstrate not only professional behaviors, but also actual competence in engaging in the occupational therapy process through reasoning and thinking from an occupational therapy perspective.
LEARNING ACTIVITY
Have participants complete the front page of the handout entitled “Individualizing the Fieldwork Performance Evaluations.” This activity provides participants with an opportunity to reflect on their practice setting. Engaging participants in a discussion helps them to recognize that all settings require students to engage in the occupational therapy process. This reflection will assist participants in translating language used in their practice setting to the terminology used in the FWPEs.

14. FWPEs OT and OTA Companion Documents
Focus
The occupational therapy process
The clinical reasoning process
Roles and responsibilities of the OT and OTA
Structure
Collaborative process—student and FW educator
Same layout
Same rating/scoring system
SLIDE EXPLANATION
The process of delivering occupational therapy services is a collaborative one throughout which OTs, OTAs, and clients interact. As stated earlier, the occupational therapy process includes evaluating, intervening, and targeting intervention outcomes. Across all practice settings, the process of delivering occupational therapy services is the same, with the outcome focused on helping clients to engage in occupations to support participation in a variety of contexts (Occupational Therapy Practice Framework). However, certain aspects of the process may be labeled differently, reflecting the culture of the setting that the OT and OTA work. For example, when considering intervention planning in a school setting, the practitioner will participate in developing an individualized education program (IEP), whereas in a hospital the practitioner will develop a treatment plan.
Because the process of delivering occupational therapy services is similar in all settings, and both the OT and the OTA participate, the occupational therapy process was chosen as a model for the FWPEs. In addition, while engaging in the evaluation, intervention, and targeting of outcomes, the OT and OTA use evidence and all aspects of clinical reasoning to guide their actions. This reasoning process also is reflected in the FWPE items, sometimes overtly and at other times more subtly. The reasoning process is the thinking behind why we choose to do what we do based on evidence from the literature, the client’s condition, the client’s story, the practice setting, and the effectiveness of interventions we have used in the past.
Throughout the occupational therapy process, clients, OTs, and OTAs work collaboratively. Because of the collaborative nature of the occupational therapy process, the structure of the FWPEs for the OT and OTA were created as companion documents. The same layout and rating system was used in both evaluation forms.
In keeping with this focus on collaboration, the fieldwork evaluations have been designed to promote collaboration between the fieldwork educator and the fieldwork student.

15. Terminology of the FWPEs
Reflects
Standards of Practice for Occupational Therapy and ACOTE Education Standards
Occupational Therapy Practice Framework
The glossary
SLIDE EXPLANATION
Fieldwork education is the experience that combines education and practice. Therefore, the language used in the FWPEs reflect the ACOTE Standards, the Standards of Practice for Occupational Therapy, and the Occupational Therapy Practice Framework.
To assist the fieldwork educator in understanding the language used in the fieldwork performance evaluations, a glossary is included in both forms.
NOTE TO TRAINER
Assisting fieldwork educators in learning the new terminology is essential. Translation of terms needs to be facilitated not only from the old to new fieldwork evaluations, but also from one setting to another. For example, some individuals may be using the terms purposeful activities or tasks, which are now being called occupation(s).
LEARNING ACTIVITY
The learning activity and handout “Individualizing the Fieldwork Performance Evaluations,” completed with Slide 13, provided participants with an opportunity to reflect on practice in their settings. Take this opportunity to help them become aware of the terminology used and on page 2 of the handout; a format is provided to assist fieldwork educators in translating terms. Additional examples of translating terminology are given. Dividing participants into small groups to work can be helpful. In addition, discussing differences in terminology across practice settings can be helpful.

16. Content Layout of FWPEs
Summary Sheet
Overview/instructions
Organization of items
Space for comments—midterm and final
Performance Rating Summary Sheet
SLIDE EXPLANATION
The Summary Sheet (cover page) is similar to the one used in the previous fieldwork evaluation forms and is self-explanatory.
It is critical that fieldwork educators read and understand the purpose and instructions on the FWPEs. The instructions assist the fieldwork educator in the accurate use of the forms.
The items on the FWPEs were sequenced according to the occupational therapy process, with ethics and safety intentionally listed first.
Space is provided for comments throughout the forms at the end of each section. This space allows for the inclusion of specific examples to clarify the rating of the items and to give the student specific examples of performance areas of strength and those that require further development.
The Performance Rating Summary Sheet provides an “at a glance” numerical summary of the student’s overall performance.

17. Content of OT and OTA Evaluations
Fundamentals of practice (3)
Basic tenets (3)
Evaluation/screening (5)
Intervention (6)
Communication (2)
Professional behavior (6) OT
Fundamentals of practice (3)
Basic tenets (4)
Evaluation/screening (10)
Intervention (9)
Management of OT services (5)
Communication (4)
Professional behavior (7)
SLIDE EXPLANATION
This slide not only compares the number of items found in the FWPEs for the OT and OTA (identified in parentheses), but also illustrates the difference in roles of the OT and OTA.
NOTES TO TRAINER
This is a good time to compare and contrast items of the FWPE for the OTs and OTAs. The following is a quick overview of the major item areas:
Fundamentals of Practice Section contains items addressing ethical and safe practice. Every student must pass all items in this section to complete the fieldwork experience successfully. Items on both evaluation forms for the OT student and the OTA student are identical, except the ethics section for the OT student includes issues related to human subject research, when relevant.
Basic Tenets Section contains items addressing the philosophical concepts of the profession, including occupation, client-centered practice, collaboration, and the unique roles of the OT and the OTA.
Evaluation Section contains items addressing the process used in gathering and interpreting information related to the domain of occupational therapy practice. This process includes identifying the client’s occupational profile, analyzing occupational performance, and determining the factors (client, context) that support or hinder engagement in occupations. State licensure laws dictate the roles and responsibilities of the OT and OTA in practice, which always supersede AOTA guidelines.
Intervention Section contains items addressing the process used in delivering occupational therapy services, including (a) planning interventions where the client’s needs and desires are identified and prioritized in relation to the engagement in occupations, (b) implementing strategies to achieve the client’s desired goals, and (c) reviewing of intervention effectiveness continually.
Management of OT Services Section (for the OT student only) contains items addressing entry-level knowledge and skills related to funding and cost issues, supervision of occupational therapy and non–occupational therapy personnel, and timeliness and volume of work.
Communication Section contains items addressing verbal and nonverbal communication and documentation required for effective and efficient performance across practice settings.
Professional Behavior Section contains items addressing the basic work skills and behaviors required of any professional, such as time management, respect for diversity, and interpersonal responsibilities for effective performance of job duties.

18. Primary Purpose of the FWPEs
Measures entry-level competence
Designed to differentiate the competent student from the incompetent student
Not designed to differentiate levels above entry-level competence
SLIDE EXPLANATION
Remind participants that the guiding documents used to develop the FWPEs (NBCOT Practice Analysis, Standards of Practice for Occupational Therapy, and the ACOTE Standards for Accredited Educational Programs) all address entry-level practice.
The purpose of the FWPEs is to measure entry-level competence. This concept is new for both fieldwork educators and students. It is important to remember that the purpose of evaluating the student is to give feedback on whether the student is at entry-level or not rather than evaluating the degrees of performance above entry-level.
Students as well need to be told that the design of this evaluation does not equate to the typical grading system that they are use to in academic programs. Scoring at entry-level is adequate and represents a solid score. The rating scale does not equate to the “grading system” used in colleges and universities.

19. Purpose (continued)
Provides student with accurate assessment of his or her competence for entry-level practice over time
Growth occurs over time
Midterm and final scores reflect this change
Midterm scores: Satisfactory–unsatisfactory
Final scores: Pass–no pass
SLIDE EXPLANATION
Fieldwork education is the opportunity for students to demonstrate their application of their academic knowledge over an extended period, with a resulting increase in ability to perform the occupational therapy process from the beginning of the fieldwork experience through the end.

20. Purpose (continued) Provides feedback to student
Provides opportunity for student self-assessment
SLIDE EXPLANATION
For a student’s performance to improve and increase, a student requires feedback from the fieldwork educator. The evaluation form is designed to provide a place, both at midterm and at final, for the fieldwork educator to provide written feedback for the student in areas of strengths and areas that need improvement. Fieldwork educators are encouraged to use this evaluation as one way to provide feedback to the student.
In addition, the FWPE was designed to allow the student to complete his or her self-assessment by evaluating his or her progress at midterm and at final. The evaluation is intended to be completed by both the student and the fieldwork educator so that during the midterm and final, both parties can bring their reflection and assessment together. Engagement in self-reflection and self-assessment is an important step to increase one’s competence and growth as a professional.
NOTE TO TRAINER
Take this opportunity to provide examples of other methods to provide feedback to students.

21. Design of the FWPEs
The “doing” of the occupational therapy process is evaluated, not the individual tasks in isolation
NOT all items are equal in level of difficulty (i.e., simple to complex)
Evaluation is supplemented with development of site-specific objectives
SLIDE EXPLANATION
The FWPEs are designed to measure the student’s performance of the occupational therapy process across settings. The occupational therapy process involves a variety of competencies; some are more simple to perform, and some require more synthesis and integration of knowledge and abilities in order to perform. The Rasch analysis of the pilot studies provided the continuum of competencies ranked from basic (simple) to more difficult (abstract, requiring greater integration of concepts). During the analysis phase, both the task force members and the pilot study participants reviewed the results and agreed with the initial ordering of the items.
The occupational therapy process involves different skills, depending on the setting; therefore, site-specific objectives need to be developed to clarify and delineate the expectations of performance for the fieldwork student for skills unique to the fieldwork educator’s practice setting.
NOTE TO TRAINER
The following slides show the ordering of the items on the FWPEs on the continuum from simple to complex. Here is another opportunity to explore with the fieldwork educators the occupational therapy process and the terminology of the evaluation forms.

22. RASCH Ordering of Items OT- 2- 1- 0-
-1-
-2-
Interpersonal; 41
OTbeliefs 4 Obtain inf 12 Role of OT; 6
Client centered interv 22
Clear documentation; 33
Occ prof 10, Adjst ass 14
Est Plan 16, Assess ftr 11
Updates; 25, Evidence 19 Interprets eval reslts; 15
Selects rel asses methd; 9
Timemng40; Legible 34
Language reflects 35 Documents eval rslts 17
Occupn based inter 23
Org goals 30; verbl 32 Documents intrv; 26
Workbeh 39, safety 2
Modifies approach 24
Collaborates OTA 28
Assigns resp OTA; 27
Administer asses 13
Underst finances; 29
Selects rel occu; 21
Collaborates clnt; 7
Artic ratinal eval; 8
Respnds 2 fdbk 38
Produces work; 31
Collab c super;36
Steps 3,Resp; 37
Rationale Tx 18,
Artic value occ 5
Diversity; 42
Ethics; 1
HARD
RASCH Ordering of Items OT
SLIDE EXPLANATION
This slide demonstrates how the doing of the occupational therapy process involves both simple and complex tasks. The evaluation was designed with both easy and hard items to assist with measuring entry-level competency. The numbers following the phrases correspond to the item number on the evaluation form. An important concept to understand is that all items are not equal in their level of difficulty. Therefore, one would not expect students to score equally across all items at midterm or at the final.
NOTES TO TRAINER
Handouts of the “Rasch Ordering Continuum” can be downloaded and printed. Handouts will assist participants in reading the items and examining the concepts. Spend some time allowing participants to think about the various aspects of the occupational therapy process and to “see” how some aspects are harder than others. Participants will need a copy of the FWPE as they review the continuum in order to look up the entire item description. Guiding this reflection may help enhance their understanding of how students progress in skill development over the course of fieldwork and may provide for discussion on how to grade expectations of students on fieldwork.
The ordering continuums reflect results of the pilot studies, so some differences between language and item numbering may be found if compared with the published FWPEs due to final changes made.

23. Rasch Ordering of Items OTA
Easier 2 - 1
Cultural competence; 25
Ethics; 1
Interpersonal skills;24
Responds to Feedback;21
Safety; 2 and 3
Work Behaviors; 22
Therapeutic Use Self;16
Written Communication;19
Verbal Communication; 18
Self-responsibility; 20 I
Implements intervntn; 14
OT/OTA Roles 5DataGather
Selects Intervention;13
Activity Analysis; 15
Evidence BasedPractic 6
Plans Intervention; 12
Reports; 10
OT Philosophy; 4
Administer Assessmnts;8
Establishes Goals; 11
Modifies Intrven Plan;17
Interprets Assessment;9
Harder
Rasch Ordering of Items OTA
SLIDE EXPLANATION
This slide demonstrates how the doing of the occupational therapy process involves both simple and complex tasks. The evaluation was designed with both easy and hard items to assist with measuring entry-level competency. The numbers following the phrases correspond to the item number on the evaluation form. An important concept to understand is that all items are not equal in their level of difficulty. Therefore, one would not expect students to score equally across all items at midterm or at the final.
NOTES TO TRAINER
Handouts of the “Rasch Ordering Continuum” can be downloaded and printed. Handouts will assist participants in reading the items and examining the concepts. Spend some time allowing participants to think about the various aspects of the occupational therapy process and to “see” how some aspects are harder than others. Participants will need a copy of the FWPE as they review the continuum in order to look up the entire item description. Guiding this reflection may help enhance fieldwork educators’ understanding of how students progress in skill development over the course of fieldwork and may provide for discussion on how to grade expectations of students on fieldwork.
The ordering continuums reflect results of the pilot studies, so some differences between language and item numbering may be found if compared with the published FWPEs due to final changes made.

24. Rating Scale of FWPEs 4 = Exceeds Standards 3 = Meets 2 = Needs
Improvement
1 = Unsatisfactory
Performance is highly skilled and self-initiated. This rating is rarely given and would represent the top 5% of all the students you have supervised.
Performance is consistent with entry-level practice. This rating is infrequently given at midterm and is a strong rating at final.
Performance is progressing but still needs improvement for entry-level practice. This is a realistic rating of performance at midterm and some ratings of 2 may be reasonable at the final.
Performance is below standards and requires development for entry-level practice. This rating is given when there is concern about performance.
SLIDE EXPLANATION
It is critical and essential that fieldwork educators understand the rating scale and use it as it is intended. The rating scale is designed to measure entry-level competence and not above entry-level competence. Even though it is a 4-point scale, it is not designed to reflect a grade.
If an OT or OTA program must give a grade for fieldwork, it is up to the program to determine its own grading strategy and configuration.

25. Scoring System of FWPEs
Each item must be scored
Ethics and safety items must be passed
Each item rating recorded on Performance Rating Summary Sheet
All items summed up at midterm and final
Score compared to scales provided
SLIDE EXPLANATION
Each item must be scored; there are no “not applicable” items. If a fieldwork educator determines that an item does not “fit” in his or her particular setting, specific objectives need to be developed by the site to indicate how a student will demonstrate his or her abilities related to that item. For example, with items mentioning OT/OTA responsibilities, if a setting does not have an OTA, the fieldwork educator could have the student present an in-service to staff describing the potential role of the OTA in that setting.
The items in the Fundamentals of Practice Section must be scored at 3 or above at the final evaluation in order for the student to pass the fieldwork rotation. It is essential that OT practitioners practice in a safe and ethical manner.

26. Midterm and Final Scores of the FWPEs
OTA
Overall Midterm Score
Satisfactory: 54 & above
Unsatisfactory: 53 & below
Overall Final Score
Pass: 70 & above
No Pass: 69 & below OT
Overall Midterm Score
Satisfactory: 90 & above
Unsatisfactory: 89 & below
Overall Final Score
Pass: 122 & above
No Pass: 121 & below
SLIDE EXPLANATION
This slide gives the cut-off scores for the midterm and final evaluations for the FWPEs for the OT and OTA. The evaluation is intended to show progress in a student’s performance over time. Therefore, it would not be expected that a student score the same at midterm and at final. To assist in providing feedback to the student as well as to evaluate whether the student is progressing in a manner that would lead to passing at the final, both midterm and final scores were determined and included in the final version of the evaluation. Midterm and final cut-off scores were determined by Rasch analysis of student performance and fieldwork educators’ perspective from the last two pilot studies.

27. Rating Performance Using the FWPEs
Case Scenarios
John—OT Evaluation
Mary—OT Intervention
Sandra—OTA Evaluation/Screening
David—OTA Intervention
SLIDE EXPLANATION
Four scenarios have been provided to assist you as the trainer in helping participants learn how to accurately rate student performance using the FWPEs. Download the handout “Learning to Score the Fieldwork Performance Evaluations.” In addition to the cases, answers are provided for you as the trainer. If time permits, have participants work in small groups to score the scenarios and then discuss scoring as a large group. If time does not permit work in small groups, use the cases and develop a few examples to share with the participants.

28. Individualizing the FWPEs
Designed for additional objectives to be written to add clarification
Site-specific objectives
NOT supervisor-specific
If an item is very clear and meets the RUMBA test, then there is no need to write another objective
SLIDE EXPLANATION
Individual objectives are required for those specific skills and tasks that are required as an entry-level therapist within the fieldwork educator’s practice setting. If the item(s) on the FWPEs are not specific enough for the fieldwork educator’s setting, then additional objectives must be written so that the student understands the specific expectations for his or her performance and the satisfactory completion of the fieldwork experience.
The RUMBA test is as follows:
R = Is the objective relevant to the practice setting, and is it an essential entry-level skill for the practice
setting?
U = Is the objective understandable to the student?
M = Is the objective measurable? Can the performance be measured?
B = Is the objective behavioral? Can the objective be seen?
A = Is the objective achievable within the desired time frame?

29. Objectives: An Example From FWPE for the OT Student
16. Establishes accurate and appropriate plan
School—Provides behavioral-based, measurable OT goals during IEP process
Acute Care—Overall intervention plan is achievable within client’s length of stay
SLIDE EXPLANATION
This slide provides an example of how objectives can be individualized to settings to help reflect the uniqueness of the practice setting and the expectations of the student.
This point in the training also is appropriate to back up the concept that all items must be scored. If a fieldwork educator determines that an item does not “fit” in his or her particular setting, this is where specific objectives need to be developed by the site to indicate how a student will demonstrate his or her abilities related to that item. For example, with items mentioning OT/OTA responsibilities, if a setting does not have an OTA, the fieldwork educator could have the student present an in-service to staff describing the potential role of the OTA in that setting.
LEARNING ACTIVITY
Continue to use the handout “Individualizing the Fieldwork Performance Evaluations.” The second page provides a method to help structure thinking about and writing objectives. Additional examples are given. Divide participants into small groups according to practice areas. Instruct each group begin to develop site-specific objectives that will reflect the uniqueness of their setting and to be prepared to report back to the large group. As the trainer, guide the reporting and discussion to assist participants in recognizing how the FWPEs can be used across various settings while still reflecting the uniqueness of each setting.
If time does not permit for small group work, provide a few more examples for the participants.

30. Summary
Evaluations designed to measure entry-level competence, NOT level of performance above competency
OT practice examined as a generalist
Evaluations reflect the occupational therapy process
Performance develops over time
SLIDE EXPLANATION
In conclusion:
The evaluations measure only entry-level competence.
The OT and OTA students must be able to perform the occupational therapy process across settings; they must have the knowledge, skills, and abilities to do the occupational therapy process, no matter which practice setting they may choose.
The application of what students have learned in school requires time to develop into entry-level performance.