01-23-06
The Future of Fieldwork
Donna M. Costa
It gives me great pleasure to write this inaugural fieldwork column on behalf of my colleagues on the American Occupational Therapy Association (AOTA) Commission on Education. The time to advance the practice of fieldwork, and perhaps even think about "The Year of Fieldwork Education" or "The Decade of Fieldwork Education," is now. Let us consider the kinds of things we could celebrate.
The profession will mark its 100-year anniversary in 2017, and many colleagues around the country are being asked to contribute to the crafting of a Centennial Vision. For nearly 100 years we have been providing academic and clinical education to those students who want to help people do the things they need and want to do. Basic professional education has moved from the on-the-job training the reconstruction aides received in the early 1900s, to the associate degree that occupational therapy assistants (OTAs) receive and the master's and doctoral degrees that occupational therapists (OTs) earn.
At a recent meeting of OT and OTA education program directors in Scottsdale, Arizona, participants were asked to participate in the AOTA Centennial Visioning process. One question focused on what fieldwork might look in 2017. Some of the responses were as follows:
- Fieldwork is residency-based, taking place after completion of entry-level education, rather than within program curricula.
- Fewer fieldwork placements occur in hospital settings because most health care is provided in natural communities, such as private practice, community-based, and other nonmedical settings.
- Role-emerging settings are the norm rather than the exception.
- Research done on fieldwork for the past 2 decades has yielded data about what works best for whom and in what setting, and how to prepare fieldwork educators to train students differently.
- There is less dependence on fieldwork supervisors, as preceptor and entrepreneur models have become increasingly utilized.
- Students frequently elect to pursue fieldwork in advocacy settings, such as AOTA.
- OT and OTA programs frequently use service learning as action research.
- More OTs and OTAs practice in mental health, and nearly all education programs require a mental health fieldwork placement.
- Because there is a strong occupational therapy presence in corporate settings, many students elect to do specialty fieldwork in corporate wellness or ergonomics.
- The gulf between academia and practice is a thing of the past; students are taught the same things in the classroom that they see in clinical settings, and fieldwork educators and academic program educators collaborate frequently in exploring research questions that provide exciting projects for students to learn research skills in vivo.
- Training in fieldwork supervision is routinely provided to all; some of this training is taught in the entry-level curricula because new graduates begin supervising students a year after passing their National Board for Certification in Occupational Therapy exam. Advanced training in fieldwork supervision is provided through regional fieldwork consortia, and supervisors are eligible to earn specialty certification in this area.
- Fieldwork supervision is delivered in many venues—group models are the norm, having replaced the long-standing 1:1 supervision model. Virtual supervision using video-streaming technology enables the supervisor to mentor multiple students concurrently at several community-based locations.
What will it take for any or all of the above scenarios to be effected? We need to start making some changes now in the way we provide fieldwork education to students. We need to begin research into fieldwork outcomes, yielding evidence for what works and what does not work. Collaboration between academic and fieldwork educators needs to start now, ending the long-standing chasm between academia and practice. There are so many things we could accomplish if we worked together. Think of the research projects that could involve students while they are on fieldwork, collecting data on outcomes in multicenter trials.
Students have the opportunity in their fieldwork placements to apply the theory, knowledge, and skills they have learned; thus fieldwork has been and will continue to be a core element in occupational therapy education. But fieldwork does not just prepare students for current practice; it needs to prepare them to practice in the future—in 2017 and beyond.
Donna M. Costa, MS, OTR/L, is the interim program director at Stony Brook University in Stony Brook, New York, and the Academic Fieldwork Coordinator Representative on AOTA's Commission on Education.
Reference Information:
Costa, D. M. (2006). The future of fieldwork. [Electronic Version]. OT Practice, 11(1), 10.
©Copyright 2006. The American Occupational Therapy Association. All rights reserved.