OTD Fieldwork Manual

Fieldwork Office Contact Information:


Teri Gilley, DHSc, OTR/L, BCP
Academic Fieldwork Coordinator
EHC School of Health Sciences
OTD Program
565 Radio Hill Road
Marion, VA 24354
tgilley@ehc.edu
phone: 276-944-6734
fax: 276-944-6343

General Guidelines
Level 1 and Level 2 Fieldwork 2
Purpose

The purpose of fieldwork education is to apply OT evaluation and intervention principles learned in didactic courses to clients with a variety of occupational needs. 

Philosophy

All fieldwork education courses are viewed by the faculty as being of equal importance with the didactic courses offered by the Program and permit the student to apply the knowledge from the classroom experiences to the clinic. Fieldwork education is a series of structured learning experiences designed to allow students to develop and improve clinical skills, to identify personal attitudes and feelings, and to be socialized into the profession. The goal of fieldwork education is to look beyond the information learned in the classroom to discover new meanings and relationships within the profession. (C.1.1.)

Experience

The OTD Program at Emory & Henry College (EHC) is committed to the idea that professional education requires a sound academic preparation that is enhanced and enriched by strong fieldwork experiences. Fieldwork education is based on an integrated model; that is, experiences are integrated into the curriculum throughout the entire course of study. Each fieldwork experience is designed to correlate with the academic preparation of the student by increasing the number of skills and complexity of problem solving required. The occupational therapy program requires both Level 1 and Level 2 fieldwork experiences. 

Fieldwork sites should create learning situations that guide students to expand their knowledge, attitudes, and skills. Fieldwork sites should provide the students with an awareness of fiscal responsibility as it impacts their services. Level 1 fieldwork is an integral part of the didactic portion of the educational program. Students are exposed to diverse settings to increase their understanding of occupational therapy, emerging practice areas, and/or the traditional healthcare arena. Level 2 fieldwork is the culminating educational experience for the Emory & Henry College  occupational therapy student.

The fieldwork experience will include exposure to realistic environments to allow practice in interdisciplinary communication, documentation, supervision of support personnel, problem solving, and ethical/legal aspects of service delivery. Fieldwork is regarded as an integral part of the collegial environment in which our students are educated. In this partnership each gives of his/her expertise toward the goal of perpetuating, evolving, and maturing the profession of Occupational Therapy. Fieldwork provides opportunities for real life development and growth of the students’ therapeutic skills under the leadership of the fieldwork educator(s). The academic institution has a responsibility to support the fieldwork educator(s) and incorporate assessment on students’ progress and growth. The Program is committed to a plan for the development of OT educators, which includes both academic faculty and fieldwork educators, and is designed to incorporate a variety of elements leading to professional growth. This exchange of services by the academic faculty and fieldwork educators promotes a cooperative attitude among all that are involved in the preparation of our future colleagues. The fieldwork education experience is thereby an essential ingredient of the curriculum. (C.1.1)

Communication with Academic Fieldwork Coordinator

A system of ongoing communication between the AFC and the clinical fieldwork educator is critical to the success of fieldwork experiences. The AFC will be available to assist potential fieldwork facilities with their development of fieldwork programs and to discuss fieldwork issues with individual fieldwork educators. If feasible, the AFC will make arrangements for an onsite visit during Level 2 experiences. If this is not possible, the AFC will contact the student’s clinical fieldwork supervisor by telephone at least once during each Level 2 Fieldwork experience.

During Level 1 and Level 2 Fieldwork experiences, the student should address minor difficulties with his/her fieldwork educator in supervision meetings. If the student is having difficulties with the fieldwork educator that cannot be resolved, it is imperative that the AFC be contacted as soon as possible to avoid putting the student’s grade or experience in jeopardy. All difficulties with Level 1 and Level 2 experiences should be addressed to the Academic Fieldwork Coordinator. He/she will involve the necessary faculty members and fieldwork educators in assisting to remediate the problem(s) that have been identified.

Communication between Program and Facilities

Effective communication between the Program and fieldwork sites must be maintained at all times to assure ease in scheduling fieldwork experiences, updating information for the students who will be assigned to sites, and mutual understanding as problems are discussed.

A. Accurate information must be kept up-to-date with the Program including changes in
staffing (especially fieldwork educators), phone numbers, addresses, email addresses,
student objectives, housing, and other information related to the fieldwork education
program.

B. Prompt and timely responses to requests for information (patient care protocols,
administration information, etc.), updating materials, clinical appointments, and
scheduling of students are required by all fieldwork facilities.

C. Important telephone/ email communications between the fieldwork site and the program will be documented.

E-Value Online Software System

The E-Value program is a system used to enhance each student’s experience in clinical rotations. Each student will have an individual account and will maintain all documentation needed for fieldwork sites such as immunizations, BLS certification, safety training, background check information, etc. Students will be responsible for updating their own personal information in the system.

E-Value online software will be used for the following, but not limited to the following:

  • Maintaining current personal records required by fieldwork facilities.
  • Logging time at fieldwork rotations and experiences including comments about the
    experiences.
  • Completion of evaluations completed by students and clinical instructors regarding
    performance, behavior and experiences.
  • Look up basic site information for potential fieldwork experiences.
  • Scheduling all fieldwork experiences.

Environment

Fieldwork education provides the environment in which critical thinking can be practiced and concepts and techniques integrated to provide quality occupational therapy services. To this end, the fieldwork education program seeks to provide for its students opportunities in stimulating environments to further augment the student’s professional development.

Liability Insurance

Emory & Henry College maintains liability for students who are on their fieldwork experiences. Students may choose to purchase additional liability insurance for fieldwork opportunities. In the future students may be required to purchase this insurance.

Travel and Transportation Issues

Students are expected to have a reliable means of transportation to and from classes and
fieldwork experiences. Level 1 experiences occur within an hour’s drive of the School of Health Sciences campus; while Level 2 fieldwork can occur anywhere in the United States. It is, therefore, imperative that the student budget for related transportation expenses.

Housing during Fieldwork

During the student’s Level 2 Fieldwork, he/she may be placed in a site that is not within
commuting distance of his/her school residence. Very few sites provide free housing. Fieldwork sites can sometimes give the student information on possible temporary housing. It is the sole responsibility of the student to arrange for their housing prior to the commencement of their fieldwork experience.

Educators

Fieldwork education is a partnership between the student, the academic faculty, and the
fieldwork educator(s). Level 1 and 2 fieldwork experiences are an integral part of the
occupational therapy curriculum at Emory & Henry College.

Fieldwork Sites and Supervisors

The OT Program at Emory & Henry College evaluates and selects fieldwork sites according to specific criteria that meet the needs of the curriculum and to assure that the facility is able to provide adequate supervision and experiences to enable the student to successfully meet the requirements of the AOTA Fieldwork Performance Evaluation for the Occupational Therapy Student . The scope of fieldwork sites ranges from traditional settings in pediatrics, geriatrics, physical disabilities and mental health, to emerging practice settings in community health. All sites utilized for student fieldwork placement meet the requirements and learning objectives of the curriculum. A contractual agreement is completed with all facilities.

The Academic Fieldwork Coordinator (AFC) and fieldwork educators collaborate on objectives, practice activities and the advising of students. (C.1.3.) (C.1.15) In order for a fieldwork site to be established and retained, it must provide a quality educational experience for the students and meet Commission on Education (COE) requirements for Level 1 or 2 fieldwork sites. In addition, the OT Program at Emory & Henry College and students must conscientiously cooperate and fulfill the duties/requirements of the contract. (C.1.2)

Student

Each student is expected to actively participate in the fieldwork education process, and to share in the planning and evaluation of the learning experience. They should question, explore, teach, and motivate during their fieldwork experience to reinforce and enhance their education. Occupational therapy fieldwork sites expect students to come prepared with the necessary skills to work with clients.

Requirements to Participate in Fieldwork Experience

(See the Emory & Henry College OT Student Handbook regarding academic policies dealing with grades, passing, failing and remediation of courses.)

A. Successful completion of all preceding coursework is considered prerequisite for
fieldwork education.

B. Student must attend Fieldwork 1:1 Workshop prior to beginning this rotation during
the first summer semester, a Fieldwork 1:2 Workshop prior to beginning this rotation
during the second spring semester, a Fieldwork 1:3 Workshop prior to beginning this
rotation during the second summer semester, and a Fieldwork 2 Workshop prior to
beginning these rotations in the third fall semester.

C. Students must furnish the AFC with proof of current healthcare provider’s
adult-child-infant CPR certification prior to attending the initial fieldwork experience.
If the CPR certification expires prior to any fieldwork experience, the student must
become recertified and provide proof of recertification. Individual sites may require
certification from a particular provider. It is the student’s responsibility to ensure that
the proper certification is obtained.

D. The student must be aware of and meet all health and other requirements of the
fieldwork site. This information will be shared with fieldwork site and faculty. It is
the student’s responsibility to obtain and upload all required documentation to the
E-Value system as well as submit to the fieldwork site. Requirements may include
but are not limited to :

  1. Proof of HIPAA, OSHA, and Patient Safety training.
  2.  Proof of student health insurance.
  3. Proof of physical examination.
  4. Proof of current TB screening.
  5. Proof of completion of the Hepatitis B series or statement of declination.
  6. Proof of MMR vaccination or rubella immunizations.
  7. Healthcare Professional CPR. (Facility may have specific requirements.)
  8. Criminal background check. (May need a current background check at the
    time of fieldwork.)
  9. Drug screen. (May need a current drug screen at the time of fieldwork.)
  10. Other requirements as directed by the assigned facility. 

Preparation for Fieldwork Experience

When a student receives confirmation for a fieldwork assignment, each student is expected to

  1. For a Level 2 Fieldwork placement, contact the site within 2 weeks of receipt of this
    confirmation, to make initial contact with the fieldwork educator. The purpose of this call
    is for the student to introduce himself/herself and to gather information regarding dress
    code, schedule, resources for housing, etc. Thereafter, it is the student’s responsibility to
    maintain contact with the fieldwork site as appropriate until the start of the assignment.
    *NOTE: Securing housing is the responsibility of the student.
  2. Read the objectives and evaluation tool to be used during the fieldwork experience
    and come to the fieldwork preparation sessions prepared to discuss the upcoming
    experience with the AFC.
  3. Take responsibility for the timely submission and completion of initial goals for a
    particular fieldwork placement to the AFC.

Disclosure of Information

Emory & Henry College cannot discuss a student’s past academic or fieldwork performance with fieldwork educators without a written release of information from the student. It is, therefore, the student’s responsibility to let the fieldwork educator know if any accommodations are needed due to a disability. Faculty cannot discuss the academic progress and/or need for accommodations due to disability of a student unless a FERPA form has been signed.

Non-discrimination in fieldwork placements 

The student has the right to be treated fairly and not be discriminated against in the selection of fieldwork facilities or by any representative of the academic or fieldwork facility. See the Emory & Henry College Policy on Non-Discrimination.

During the Fieldwork Experience

 

  1. Notify the fieldwork facility and academic educational program of current address
    and telephone number.
  2. Obey all policies and procedures of the facility unless exempted, including prompt
    notification of unplanned or planned (as permitted) absences.
  3. Fulfill all duties and assignments made by the fieldwork educator within the time
    specified.
  4. Complete and submit all required forms and evaluations to the fieldwork educator and
    the AFC in a timely manner.
  5. Fax evaluation of student’s performance to AFC on the last day of directed clinical
    experience in order to expedite processing of grades.
  6. All students are required to maintain ongoing communication with the AFC at Emory
    & Henry College.
  7. All students are required to complete assignments made by the AFC or EHC OTD
    faculty within the time specified.
  8. If problems occur that might interfere with successful completion of the fieldwork
    experience, students should contact the AFC immediately for directions or
    intervention on student’s behalf.
  9. Following the fieldwork experience, the student must write a letter of appreciation to
    the fieldwork educator with a copy to the AFC acknowledging the educational
    opportunities provided by the facility within three weeks following completion of the
    experience. A copy of this letter should be submitted to the EHC fieldwork office no
    more than four weeks after the fieldwork experience

Attendance

Excessive absences, regardless of the reason, will contribute to lack of preparation for fieldwork experiences. Students should budget their study time accordingly so that they do not need to “skip” classes and/or fieldwork to study for a test in another class. Excessive absences and/or tardiness should be reported to the AFC and will be dealt with by the Academic Fieldwork Coordinator (AFC) and/or the Program Director (PD). The student must realize that absences may prohibit him/her from progressing in the program.

The following attendance requirements will apply:

  1.  Attendance at fieldwork assignments is required as scheduled. Students are governed
    by the rules and regulations of the facility. Credit for Level 2 Fieldwork education is
    based on an average of 40 hours/week, which may include holiday and weekend hours.
  2. n the event of illness or emergency, the student must contact the fieldwork site and
    the AFC prior to the start of the work day.
  3. In the event of two (2) or more absences due to illness during the fieldwork
    experience, a signed medical excuse must be provided.
  4. In the event of illness or injury that may affect the student’s ability to fully participate
    in the fieldwork education experience, the student must also provide a medical release to
    return to full participation in the fieldwork education experience.
  5. Absences will be made up at the discretion of the AFC with input from the fieldwork
    educator. It is the student’s responsibility to make arrangements when make-up days are
    required. Students must notify the AFC of any such arrangements.
  6. Absence or tardiness from fieldwork education will likely result in an unsatisfactory
    grade. Not notifying the AFC of absences will result in cancellation of the fieldwork
    education experience and student will then be subject to additional decisions by the OTD
    Program’s Promotion and Retention Committee.
Dress, Appearance and Professional Behavior

Professional attire and behavior are expected at all times. Non-compliance may result in
termination from the program. Students may consult with the AFC or their Academic Advisor for clarification as needed.

  1. Students are expected to conform to the dress code of the fieldwork site. If the site
    does not provide a dress code, students are expected to conform to the EHC OTD
    program dress code, as described in the Student Handbook. Students may not
    wear jeans to clinic at any time . Students must wear closed toe, rubber-soled
    shoes. Men are to wear shirts with collars.
  2. Students MUST wear a name tag indicating student status at all times.
  3. Students should refrain from use of their cell phones and all functions available
    on their phones while treating patients within the clinic.
  4. Good personal hygiene is an important part of professional attire.
  5. The following are not appropriate dress:
  • See-through clothes, tops with spaghetti straps
  • Shorts, short skirts (knee length or above not permitted), capris, leggings,
    low-waisted pants that may expose undergarments when bending or squatting
  • Midriff or halter tops, or short tops that expose student’s skin when bending.
  • Women’s cleavage should not be visible.
  • Hats or caps, unless outdoors
  • Flip-flop rubber sandals, open toe shoes, or excessive heel height
  • Excessive jewelry that could interfere with treatment, i.e. no dangle earrings,
    (earrings should dangle less than one inch and be less than the size of a
    quarter), no more than two rings, necklaces and bracelets are not
    recommended
  • Long finger nails
  • Noticeable perfumes that could cause others displeasure due to allergies,
    headaches, etc.

Patient’s Rights

Students should always familiarize themselves with the facility’s patient rights policy. Patients have the right to be treated fairly, with dignity and respect , and without discrimination by all students of occupational therapy from Emory & Henry College. Students must always identify themselves as students from EHC during contact with patients.

Patients have the right to refuse evaluation or treatment by a student of occupational therapy from EHC. If a patient refuses to be treated by a student, the student will immediately transfer care of the patient to their fieldwork educator and remove themselves from any interaction with that patient. 

If a patient is being treated by a student of occupational therapy at EHC and feels they have been treated inappropriately or in a discriminatory manner, the patient should register a complaint with the fieldwork educator. The fieldwork educator should then contact the AFC to report the complaint. The patient also has the right to directly notify the AFC of the complaint; the fieldwork educator must provide contact information to allow the patient to do so. The fieldwork educator should put the complaint in writing in an incident report to be put in the student’s file at the facility and EHC. When the AFC receives the complaint, a determination will be made between the AFC and the fieldwork educator about the legitimacy of the complaint and whether the student should be immediately removed from the fieldwork site; this will be done within one business day of receiving the complaint. If the AFC is not available, the Program Director will respond within one business day. Should a student be removed from the fieldwork site, the entire core faculty of the Program will determine whether the complaint is severe enough to warrant failure of the fieldwork experience and possible dismissal from the program. If it is determined the student will remain at the fieldwork site, counseling of the student regarding the complaint will occur between the fieldwork educator and any other appropriate personnel. A plan for remediation regarding the complaint as well as goals and objectives to avoid future complaints will be devised. Depending on the nature of the complaint, the student may be placed on academic probation or fail the experience at the discretion of the AFC and Program Director.

Confidentiality

It is the policy of the OTD Program that all patient/student information is treated with the appropriate level of confidentiality regardless of HIPAA regulations. This includes but is not limited to, information shared during fieldwork experiences, labs, and lectures. To the greatest extent possible, patient releases should be obtained for images/videos and any information to be used in the academic/research setting. Students are always required to follow the policy on confidentiality of their fieldwork placement.

  1. Students who feel they have witnessed a violation of the confidentiality policy
    should contact their fieldwork educator, AFC, or the course instructor
    depending on the setting of the incident.
  2. The fieldwork educator, AFC, or course instructor should discuss the situation
    with those involved and share with them the policy on confidentiality.
  3. This discussion should be documented and placed in the appropriate file at the
    fieldwork site and in the fieldwork education file in the academic setting.
  4. Repeated violations should be reported to the appropriate person in the fieldwork setting and to the AFC if a student on fieldwork experience is
    involved or in the academic setting to the Program Director.
  5. The AFC, Program Director, and fieldwork educator will discuss an
    appropriate plan of action for repeated violations in a fieldwork placement.

Client/Family Confidentiality and Coworker Privacy

Students are allowed to discuss client cases with fieldwork educators and academic faculty;
however, cases should not be discussed in public places or with persons who have no need to know the information. Protecting the dignity and privacy of the client/family is a critical part of the development of professional behavior and is also required by HIPAA regulations. Students must also get written permission to use photos/videos or case information about clients with whom they work.

Students should also note that their supervisors, co-workers, and other students in the facility have a right to confidentiality and privacy. Use discretion when speaking of them out of their presence or disclosing information of a personal nature.

Conflict of Interest

Students who receive tuition or other assistance from a facility in return for post-graduation employment will be scheduled at other facilities for Fieldwork 2. This does not interfere with a student’s eligibility to receive a stipend. This will ensure consistent student role expectations and objective student evaluations. Additionally, students will not be scheduled to participate in a Fieldwork 2 experience under the direct supervision of a family member or close friend.
Counseling students with difficulties during fieldwork experiences
A. Fieldwork educators and/or students should identify problems early to allow time for
the student, fieldwork educator, and/or AFC to collaboratively discuss student
performance and devise goals to foster the successful completion of fieldwork.
B. Through telephone consultation or on-site consultation with the fieldwork educator
and the student, the AFC may assist in identifying and clarifying issues related to
fieldwork placement. The AFC may also assist with the development of a plan to
resolve fieldwork issues.
C. Students who need academic and/or personal counseling during Level 1 or Level 2
fieldwork are still eligible for the services offered at Emory & Henry College;
however, geographic location for the fieldwork site may prohibit access to these
services. If the student is in a placement not within driving distance to Emory &
Henry College, he/she is encouraged to seek counseling services in the local
community.

Assignments

  1. Level 1 and 2 fieldwork experiences will include related assignments from the academic
    faculty at EHC, including completion of checklists, reflections, and other related tasks.
  2. Students may be required to complete an assignment for individual fieldwork sites, which may include a project or presentation.
  3. Level 2 students will participate in online courses during the first (Fieldwork 2:1) and
    second (Fieldwork 2:2) experience. OTD 811 Fieldwork Seminar will be completed
    during Fieldwork 2:1 and OTD 823 Clinical Reasoning 3 will be completed during
    Fieldwork 2:2.

Evaluations

The student’s academic advisor from EHC or the AFC will make contact with the fieldwork educator and/or student during the midpoint of the placement to verify that the fieldwork experience is progressing according to plans and expectations. Any problems that are identified during the contact will be followed up by the AFC. Students are encouraged to evaluate themselves and the fieldwork experience on an ongoing basis. If problems are identified, they need to be addressed early. (C.1.15.)

  1. Students are encouraged to discuss problems with their fieldwork educator.
  2. When problems are identified, the AFC should be contacted immediately.
  3. The AFC and the fieldwork educator will work toward a satisfactory
    resolution with the student.
  4. Premature termination of the fieldwork experience is at the discretion of the
    AFC and the fieldwork educator.
  5. Additional evaluations may be conducted depending on the level of the
    fieldwork experience or setting.

Fieldwork Experience Remediation

  1. Students may be granted the opportunity to remediate an unsatisfactory fieldwork
    education experience at the discretion of the AFC and/or Program Director. Remediation of a fieldwork placement results in delayed graduation. This is necessary to allow time for remediation of the failed course and successful completion of the required fieldwork education experience. If a student fails or withdraws from a fieldwork experience, he/she has only one (1) more opportunity to complete the assignment within 12 months. Both Level 2 fieldwork experiences must be completed within 12 months after the start of the first Level 2
    fieldwork.
  2. The design and schedule of the remediation experience are at the discretion of the
    AFC and/or Program Director, based upon the identified needs of the individual
    student. Practical examination may be required to evaluate the student’s readiness
    to return to a fieldwork education experience. Failure to pass the practical examination may result in fieldwork education course failure; therefore the student would earn a grade of “Fail” or “U” for unsatisfactory.
  3. Before the remediation experience begins, the student, with input from the AFC,
    will develop goals and a formal plan of action. The final plan requires approval
    from the AFC. In cases where the remediation arrangements include a fieldwork
    site, the AFC and/or the fieldwork educator at that site will be apprised of all
    areas in which the student requires remediation and the approved plan will be
    shared with them.
  4. If the student does not successfully complete the remediation experience, he/she
    will be dismissed from the program.

Withdrawals

Leaving a fieldwork site without notifying and receiving a written or direct telephone response from the clinical fieldwork educator and the OTD Program at Emory & Henry College is viewed as a serious infraction of professional ethics and is considered abandonment of one’s professional responsibilities to the patients and facility. The student will receive a failing grade in the fieldwork and will not have the option to petition to re-enter the program.

Dismissal from the Program

The same rules and regulations regarding failure of classes and administrative withdrawal from the program that apply to the didactic courses apply to the fieldwork education courses. Incidents of unethical and/or unprofessional behavior may result in dismissal from the Program.

Fieldwork Collaboration

The Fieldwork Confirmation & Student Memorandum of Understanding form is sent to
fieldwork educators along with EHC OTD program fieldwork objectives a minimum of two
months prior to the starting dates for Level I and II fieldwork experiences. The form includes opportunities for fieldwork educators to indicate review and acceptance of EHC OTD program fieldwork objectives, share site-specific objectives with the AFC, or set up a collaboration session with the AFC to determine appropriate fieldwork objectives for the experience. This data is recorded and tracked using spreadsheets (C.1.3) .

Student progress is closely monitored during both Level I and II fieldwork experiences. The
AFC and EHC OT program faculty make contact with students and fieldwork educators through email, phone calls, and site visits at least once per fieldwork rotation. Students are required to log time and experiences using the program’s E*Value system. On Level II fieldwork rotations, students are also monitored by EHC OTD faculty during online courses. For Fieldwork 2:1, students are engaged in OTD 811 Fieldwork Seminar . During Fieldwork 2:2, students are enrolled in OTD 823 Clinical Reasoning III. On Level I fieldwork experiences, students are formally evaluated at the end of each rotation using the EHC MOT Fieldwork 1 Professional Behaviors Evaluation form and/or the EHC MOT Fieldwork 1 Competencies Evaluation . On Level II fieldwork experiences, students are formally evaluated at mid-term and at the conclusion of the fieldwork experience using the AOTA Fieldwork Performance Evaluation for the Occupational Therapy Student (C.1.3) (C.1.10) .

Level 1 Fieldwork

Level 1 Fieldwork Overview

Level 1 fieldwork experiences are completed during the third (Level 1:1), fifth (Level 1:2), and sixth (Level 1:3) semesters. Level 1:1 will offer students experiences in mental health and pediatrics. Level 1:1 fieldwork experiences will follow OTD 751 OT Process in Mental Health and OTD 752 OT Process in Pediatrics courses in the curriculum. (C.1.7.)

Level 1:2 fieldwork experiences will primarily consist of faculty-led immersions and simulation labs. Additional immersions in traditional, non-traditional, and emerging practice settings will be supported. Students concurrently take OTD 822 Clinical Reasoning II course and OTD 801 Advanced Practice in OT. This curricular setup further promotes students’ clinical and professional reasoning in adults and older adults while applying specialized knowledge in various specialties (pediatrics, hand therapy, mental health, etc.) and emerging practice areas such as pre-driving program, free clinic rehab, etc. Level 1:3 will offer students experiences in serving adult clients with physical disabilities. Level 1:3 fieldwork experiences will follow OTD 854 OT Process in Adults/Older Adults and OTD 855 OT Process in Hand/UE Rehabilitation. (C.1.8.)

The OT Practice Framework: Domain and Process (3 rd edition) can assist the student in gaining client and clinical observation skills in each of the four practice areas of Fieldwork 1 experience. The areas include mental health, physical rehabilitation, geriatrics, and pediatrics. Students should be aware that Level 1 Fieldwork cannot be used as a substitute for Level 2 Fieldwork.

Commission on Education Guidelines for Level 1 Fieldwork

The AOTA Standards describe the goal of Level 1 Fieldwork “to introduce students to the
fieldwork experience, and develop a basic comfort level with an understanding of the needs of clients.” Level 1 Fieldwork is not intended to develop independent performance, but to “include experiences designed to enrich didactic coursework through directed observation and participation in selected aspects of the occupational therapy process.” Services may be provided to a variety of populations through a variety of settings. Experiences may include those directly related to OT as well as other situations to enhance an understanding of the developmental stages, tasks, and roles of individuals throughout the lifespan. Day care centers, schools, neighborhood centers, hospice, homeless shelters, prisons, community mental health centers, and therapeutic activity or work centers are among the many possible sites. (C.1.7.)

Level 1 Fieldwork may also include services management and administrative experiences in occupational therapy settings, community agencies, or environmental analysis experiences. Populations may include disabled or well populations and age-specific or diagnosis-specific clients. Qualified personnel for supervision of Level 1 Fieldwork may include, but are not limited to, academic or fieldwork educators, occupational therapy practitioners initially certified nationally, psychologists, physician assistants, teachers, social workers, nurses, physical therapists, recreation therapists, activities directors, counselors, etc. (C.1.9.) The supervisors must be knowledgeable about occupational therapy and cognizant of the goals and objectives of the Level 1 Fieldwork experience. See more at: http://www.aota.org/Education-Careers/Fieldwork/LevelI.aspx#sthash.zb839r6a.dpuf

There are a variety of fieldwork models that can be utilized, depending on the preferences of the fieldwork educator, the nature of the fieldwork site, and the learning needs of the students.
Fieldwork models exist on a continuum from the traditional apprenticeship model in which one fieldwork educator has one student to a more collaborative approach in which a group of students work with one fieldwork educator. Each fieldwork model has an inherent theoretical approach to learning. The more collaborative the fieldwork model, the more active student learning occurs. Fieldwork models can also be classified as either role-established, which is a more traditional fieldwork site, or role-emerging, where occupational therapy services are being introduced and/or developed. The OTD program recommends a fieldwork educator to student ratio not exceed 1:4 for Fieldwork 1:1 and 1:2; 1:2 for Fieldwork 1:3, and 1:2 for Fieldwork 2 experiences. (C.1.4)

Level 1 Fieldwork Placement Process

Fieldwork 1 assignments are made by the Academic Fieldwork Coordinator (AFC). Students will be placed in locations within an hour’s drive of the School of Health Sciences campus. Students are required to inform the AFC of any disability accommodations needed during a fieldwork experience to allow for appropriate fieldwork placement.

Level 1 Fieldwork Placement Appeals Process

The appeal process is designed to meet the occasional need of students for whom the placement process would prove disruptive to their family responsibilities and would result in the student’s probable discontinuation of their education. Petitions for appeals are not to be made lightly. Students should consider the gravity of their appeal and submit an appeal only if they feel they could not continue in the program and complete their training if the appeal were denied. Appeals for special consideration in placement are based on demonstrated need for one of the following reasons: dependent care, extreme personal issues, and students with disabilities who have identified themselves to Emory & Henry College’s Powell Resource Center. Appeals cannot be made for financial or marital status reasons. Appeals found to be made on false claims will be overturned and denied, and students may be removed from the program for this highly unethical behavior. Students who falsify appeal claims will be placed in any remaining site at the conclusion of the placement process. Students will be informed of the dates of the Appeal process. Appeal decisions are made subject to the availability of fieldwork sites. All decisions of the faculty are final.

New Fieldwork Site Request Process

All prospective and contracted fieldwork sites are considered a resource of the OTD Program at Emory & Henry College, not the individual student. Therefore students shall not contact fieldwork sites, currently or prospectively contracted with the Program, with the intent to establish personal fieldwork placement without prior consent of the AFC. Students wishing to obtain a fieldwork site in a specific location must first contact the AFC to determine if a contract already exists with the facility. If no contract exists, the student and/or AFC may contact the site and initiate a clinical affiliation agreement. While the ability to place the student is not guaranteed, if a clinical affiliation is obtained with a requested site, the student must go to that site for their fieldwork rotation.

Cancellation or Changes by the Fieldwork Site

Students must understand that many of the fieldwork placements are arranged well in advance of student placement. Occasionally, facilities will cancel contracts and scheduled placements with little notice to the Program. In the event this occurs, the AFC will do his/her best to find another suitable and timely placement. While attempts will be made to accommodate student preferences, this may not be possible with short notice in arranging alternative placements. The OTD Program at Emory & Henry College cannot assume responsibility for delays in completion of the program if the student fails to accept or complete a scheduled fieldwork assignment, or if the fieldwork site cancels a scheduled placement.

Level 1 Fieldwork Evaluation

Students will receive a grade for Level 1 fieldwork education. The site fieldwork educator will complete the EHC OT Fieldwork 1 Professional Behaviors Evaluation form and/or the EHC MOT Fieldwork 1 Competencies Evaluation. The AFC will review the student’s completion of a student evaluation of fieldwork experience and related reflection activities. The AFC has final approval of all student fieldwork grades. Grade appeals are to be completed according to the student handbook guidelines. Please refer to the syllabi for Level 1 fieldworks. (C.1.10)

Forms used by Level 1 Fieldwork Students

Fieldwork forms can be located in E*Value or obtained from the AFC. Forms will be reviewed prior to each fieldwork experience during the fieldwork workshop session before the initiation of each fieldwork experience.

Level 2 Fieldwork

Level 2 Fieldwork Education Overview

Level 2 Fieldwork occurs during the third fall and spring semesters of the EHC OTD curriculum. All didactic courses must be completed prior to the start of Level 2 Fieldwork. (C.1.11) All occupational therapy students must complete the minimal equivalent of two 12-week (480 hours), full-time clinical rotations for a required total of 24 weeks of Level 2 Fieldwork experience. In special circumstances, fieldwork may be completed on a part-time basis per ACOTE guidelines. However, Fieldwork 2 rotations must be completed within one year after initiation of Fieldwork 2 experiences. Fieldwork 2 experiences are more structured and require more active participation from OT students than Fieldwork 1 experiences. Specific assignments and duties may be given by the fieldwork educator and/or the AFC. (C.1.13.)

Level 2 fieldwork educators must be currently licensed or credentialed occupational therapists who have a minimum of 1 year of practice experience subsequent to initial certification and are adequately prepared to serve as fieldwork educators. In addition to the program educational goals and Level 2 Fieldwork goals, the AOTA Fieldwork Performance Evaluation for Occupational Therapy Students (completed by the fieldwork educator) is also used as a guideline for establishing goals, objectives, and competencies for Fieldwork 2 experiences. Level 2 fieldwork is graded on a pass/fail basis.

Progression through Level 2 Fieldwork and Relationship to Graduation Requirements

Students must complete each Fieldwork 2 experience with a passing grade before progressing to the next Fieldwork 2 experience. The equivalent of twenty-four weeks of Fieldwork Level 2 are mandated for accreditation. The student must pass both Fieldwork 2 rotations to graduate from Emory & Henry College. It should be noted that most employers require graduation from an accredited school, including Level 2 fieldwork, and in most cases completion of the NBCOT certification examination prior to permanently hiring a newly graduated occupational therapist. Many states will issue a provisional license to practice as long as the student has applied to take the NBCOT exam.

Level 2 fieldwork rotations may be completed on a part-time basis; however students must have successfully completed both Level 2 fieldwork experiences within one year. Students may also be eligible for remediation of a failed Level 2 fieldwork experience. Remediation of Level 2 fieldwork must also be completed within that same one year period. (C.1.13.)

Commission on Education Guidelines for Level 2 Fieldwork

The ACOTE Standards (2012) describe fieldwork as “a crucial part of professional preparation.” The goal of Level 2 Fieldwork is to develop competent, entry-level, generalist occupational therapists (AOTA, 2012).

The Level 2 Fieldwork experience, an integral part of OT education, should be designed to
promote clinical reasoning and reflective practice, to support ethical practice through
transmission of the values and beliefs of the profession, to communicate and model professionalism as a developmental process and a career responsibility, and to expand
knowledge and application of a repertoire of occupational therapy assessments and interventions related to human occupation and performance. Through the fieldwork experience, students learn to apply theoretical and scientific principles learned in the didactic portion of the academic program to address actual client needs and develop a professional identity as an occupational therapy practitioner within an interdisciplinary context.

1. The fieldwork experience shall meet requirements in accordance with the Standards for an Accredited Educational Program for the Occupational Therapist (AOTA, 2012). (C.1.11.)
a. The fieldwork experience should be an extension of the educational program into
the clinical or community setting. The objectives should reflect both the
curriculum design of the educational program and the model of service delivery of
the fieldwork setting.
b. Level 2 Fieldwork must be integral to the program’s curriculum design and must
include an in-depth experience in delivering occupational therapy services to
clients, focusing on the application of purposeful and meaningful occupations.
Throughout the fieldwork experience, the fieldwork educator should structure 2
opportunities for informal and formal reflection with the student regarding the OT
process in action with the client population. (C.1.18.)
c. The OT student should have the opportunity to develop increased knowledge,
attitudes, and skills in advocacy, administration, management and scholarship.
i. Skills in administration and management may be attained through the
actual supervision of support staff, volunteers, or Level 1 Fieldwork
students in certain tasks or work assignments and involvement in
administrative/staff/team meetings.
ii. Scholarship may be enhanced as students learn to use evidence to inform
their professional decision making and to generate new evidence through
independent or collaborative research at the fieldwork site. This may be
accomplished through investigation of the effectiveness of an intervention,
the reliability, validity or utility of assessment tools, and publication or
presentation of scholarly work.
iii. Inter-professional practice competencies should be encouraged throughout
the fieldwork experience through engagement of OT students in
interactive learning with students of different professions.


2. The fieldwork placements should provide the student with experience with various
groups across the lifespan, persons with various psychosocial and physical performance
challenges, and various service delivery models reflective of current practice in the
profession. (C.1.12.)
a. Within the required total of 24 weeks for the occupational therapy student, there
should be exposure to a variety of traditional and emerging practice settings and a
variety of client ages and conditions. In all settings, psychosocial factors influencing engagement in occupation must be understood and integrated for the development of client-centered, occupation-based outcomes. If placement is not a mental health setting, the fieldwork educator should assist the student in addressing any psychosocial issues the client may have. This will help to ensure that the student will have developed some entry-level competencies in mental health practice even if they do not complete a fieldwork experience in a mental health setting. (C.1.12.)
b. Students are responsible for compliance with site requirements as specified in the
fieldwork site student handbook developed by the site as well as the affiliation agreement between the fieldwork site and the academic program. This typically includes completion of prerequisite requirements (health requirements, background checks, HIPAA training, orientation to site documentation system, etc.) and attention to state regulations impacting student provision of client services. In addition to providing the required occupational therapy services to clients, students are also responsible for active participation in the supervision process, which includes the creation, review, and completion of learning objectives; completion of assigned learning activities and assignments; proactive and ongoing communication with the assigned fieldwork educator; continual self-assessment and reflection; and participation in formal and informal assessments directed by the fieldwork educator. By the end of the fieldwork experience, the student should demonstrate the attitudes and skills of an entry-level practitioner, including assumption of responsibility for independent learning.
3. Fieldwork educators responsible for supervising Level 2 Fieldwork occupational therapy
students shall meet state and federal regulations governing practice, have a minimum 1
year of practice experience subsequent to initial certification, and be adequately prepared
to serve as a fieldwork educator. If supervising in a role-emerging site where there is no
on-site occupational therapy practitioner, the fieldwork educator should have a minimum
of 3 years of practice experience after initial certification. (C.1.14) (C.1.17.)
4. There are a variety of fieldwork models that can be utilized, depending on the preferences of the fieldwork educator, the nature of the fieldwork site, and the learning needs of the students. Fieldwork models exist on a continuum from the traditional apprenticeship model in which one fieldwork educator has one student to a more collaborative approach in which a group of students work with one fieldwork educator. Each fieldwork model has an inherent theoretical approach to learning. The more collaborative the fieldwork model, the more active student learning occurs. Fieldwork models can also be classified as either role-established, which is a more traditional fieldwork site, or role-emerging, where occupational therapy services are being introduced and/or developed. The OT program recommends a fieldwork educator to student ratio not exceed 1:4 for Fieldwork 1:1 and 1:2; 1:2 for Fieldwork 1:3, and 1:2 for Fieldwork 2 experiences. (C.1.4)
5. The fieldwork site should meet all existing local, state, and/or federal safety and health
requirements, and should provide adequate and efficient working conditions. The
occupational therapy practitioner should comply with state regulations governing the
scope of practice for OT services.
6. Ideally, the fieldwork site will have a stated philosophy regarding service delivery which
serves as a guide for the delivery of services, scholarly activities, and education for
individuals and groups. Where occupational therapy services are already established, the
occupational therapy philosophy/mission/vision regarding practice and education
programs should be stated in writing and should reflect the specific contribution
occupational therapy makes to the overall agency. Where established, the occupational
therapy philosophy/mission/vision guides the development of learning objectives for the
fieldwork experience. Ideally, the established occupational therapy program will
articulate a philosophy/mission/vision of service delivery reflective of best practices in
the profession. Best practices in the profession result in services which are
client-centered, occupation-based, and supported by research evidence. The EHC OTD
Program will work with the fieldwork site to provide resources to support best practice
ideals as needed. (C.1.15) 
7. At fieldwork sites where occupational therapy services are already established, there
should be occupational therapy representation in planning programs and formulating
policies which would affect occupational therapy practice and delivery of services or
involvement.
8. The fieldwork agency should recognize that the primary objective of the fieldwork
experience is to benefit the student’s education.
9. Opportunities for continuing education and professional development of occupational
therapy staff and students should be encouraged to support life-long learning. (C.1.15)
10. Both the ACOTE Standards and the OT Model Curriculum documents address the need for collaboration between the fieldwork site/fieldwork educator and the academic program. The ACOTE Standards require that the Academic Fieldwork Coordinator and the fieldwork educator collaborate when establishing fieldwork objectives, identifying fieldwork site requirements, and communicating students’ performance and progress during fieldwork (AOTA, 2012). The OT Model Curriculum documents describe how fieldwork experiences need to be planned in such a way that they are integrated into the academic program’s mission and curriculum design. The reader is referred to the OT Model Curriculum and the ACOTE Standards for more information. Since the occupational therapy fieldwork education experience exists within the philosophy and policies of the fieldwork agency, it is essential that the administration and staff accept and support the program. (C.1.15.) 
11. Supervision guidelines - There are multiple sources of supervision guidelines that are
applicable to Level 2 fieldwork. The first source are state laws and state practice acts that
govern the practice of occupational therapy. These documents will specify if there are
any specific requirements for supervision that need to be upheld in that state. Another
source of supervision guidelines are federal regulations such as Medicare that specify
what type of supervision must be provided to fieldwork students in certain healthcare
settings and with certain types of Medicare coverage. The AOTA website is a good
source for the most up-to-date information on Medicare regulations for student supervision. The ACOTE Standards specify that during Level 2 fieldwork, students must be supervised by a licensed or credentialed occupational therapy practitioner with at least 1 year of experience who is adequately prepared to serve as a fieldwork educator. (C.1.14) Further, the Standards state that supervision should initially be direct, and then progress to less direct supervision as is possible given the demands of the fieldwork site, the complexity of the client’s condition being treated, and the abilities of the fieldwork student. The COE and Commission on Practice (COP) Fieldwork Level 2 position paper (COE/COP, 2012) additionally recommends that supervision of occupational therapy students in Fieldwork Level 2 settings will be of the quality and scope to ensure protection of consumers and provide opportunities for appropriate role modeling of occupational therapy practice, and that the supervising occupational therapist must recognize when direct versus indirect supervision is needed and ensure that supervision supports the student’s current and developing levels of competence (COE/COP, 2012). (C.1.16.) Specific to the role-emerging fieldwork placement, where the site does not employ an occupational therapist on staff and the fieldwork is designed to promote the
development of occupational therapy services, supervision guidelines specify that students be supervised daily on site by another professional familiar with the role of occupational therapy and 8 hours of direct supervision should be provided weekly by an occupational therapist with at least three years of experience. (C.1.17.) It is recommended that the Academic Fieldwork Coordinator (AFC), fieldwork educator (FWEd), the on-site coordinator (if identified), and student maintain regular formal and informal communication during the fieldwork experience (AOTA, 2001) (C.1.15.) .
12. It is recommended that students collaborate with their fieldwork educator(s) to develop
learning objectives which stem from the site-specific learning objectives for the
individual fieldwork site. This may be accomplished through the use of learning contracts
which are both a teaching strategy and an assessment tool used to encourage self-directed
learning. Learning contracts allow for shared responsibility in the planning of learning
experiences offered in fieldwork. Proactive learning contracts are an effective teaching
strategy and encourage students to become intrinsically motivated to attain competence in
the fieldwork experience.
13. The student shall be evaluated and be kept informed on an ongoing basis of his/her
performance status. (C.1.18.)
14. Fieldwork experiences should be implemented and evaluated for their effectiveness by
the educational institution and the fieldwork agency.

Level 2 Fieldwork Placement Process

The OTD Program at Emory & Henry College chooses fieldwork sites for students based on: (a) the quality of educational experience available at the site; (b) the educational needs of the occupational therapy students; and (c) availability of sites. Fieldwork sites are at a premium and are a valuable resource of the OTD Program. The School has established fieldwork policies (i.e., Appeals, Assignment Process) designed to serve the largest good in the fairest possible manner. Students are reminded that they have been informed, since admission, that they are responsible for completing a minimum of six (6) months of Level 2 fieldwork. Students have been informed that they are responsible for the financial burden of this part of their training, that this training may take place anywhere in the United States, and that the student is responsible for planning and preparing for this expensive part of their education. Students may not contact any fieldwork site (scheduled or potential) without AFC approval.

Fieldwork Assignment Process

Site assignment is completed by the AFC. The AFC first confirms all sites that have returned reservation forms indicating slots available for EHC OTD students. Sites that are eligible to take students must ensure that therapy is supervised by a certified and/or licensed occupational therapist and that education of students is pragmatically or philosophically supported by the administration of the facility. Students wishing to request a specific geographic location or a facility not currently under contract with EHC need to follow the assignment appeals or new fieldwork site request processes outlined in this manual. Students must comply with fieldwork policies regarding student contact with fieldwork sites. Students are responsible for arranging their own transportation, housing, and financing for their fieldwork experiences. 

In order to take student preferences into consideration, all students will complete the program’s fieldwork preparation module prior to the date of assignment. This is utilized to acquaint students with the proper procedure for completing and submitting their fieldwork preference form.

Students will consider the following in developing their list of preferences:
a. Students usually cannot complete more than one clinical course at the same site;
b. Students usually cannot be assigned to a facility where they have previously been
employed, volunteered for more than 100 hours, or have a work agreement;
c. Students usually cannot be assigned to a facility that is providing financial
assistance;
d. Students cannot be assigned to a facility where they will be supervised by any
individual in which a conflict of interest may arise; conflict examples may include family
members, friends, previous employers or others.

Students are to consult their faculty advisor for guidance in completing their fieldwork
preference form. This form will indicate a student’s preference for type of fieldwork placements (physical disabilities, pediatrics, mental health). Each student is required to complete one physical disabilities rotation. Students will be given the opportunity to indicate their preferred facilities. Students are not guaranteed any of their preferred facilities; but their requests will be taken into consideration.

The AFC may use an automated process with fieldwork education software to make tentative assignments based on students’ preferences, availability of sites, and site location. A software program may be used to assign each student to at least one of their top three preferences. The AFC will verify and/or modify each assignment as needed. Final placement decisions are based on the fieldwork site that is determined by the AFC, in consultation with the OT faculty, to be the most beneficial educational opportunity for the student and their learning needs.

Level 2 Fieldwork Assignment Change Process

The process of changing a fieldwork assignment is designed to meet the occasional need of
students for whom the assignment process to any facility in the United States would prove
disruptive to their family responsibilities and would result in the student’s probable
discontinuation of their schooling. Petitions for change are not to be made lightly. Students should consider the gravity of their request and submit a request only if they feel they could not continue in the program and complete their training if the request were denied. Special consideration in placement is based on demonstrated need for one of the following reasons: dependent care, extreme personal issues, and students with disabilities who have identified themselves to the EHC Powell Resource Center. Changes cannot be made for financial or marital status reasons. Requests found to be made on false claims will be overturned and denied, and students may be removed from the program for this highly unethical behavior. Students who falsify change requests will be placed in any remaining site at the conclusion of the assignment process. Students will be informed of the dates of the request process. Decisions are made subject to the availability of fieldwork sites. All decisions of the faculty are final.

After completion of the assignment process, students may exchange fieldwork assignments with each other, if both students can give reasonable explanation as to why the switch would be beneficial. This request is to be made in person by both students to the AFC. The AFC must approve all changes. If the change is deemed educationally inappropriate for either student, the AFC may refuse the change. The OTD Program at Emory & Henry College reserves the right to refuse requests for fieldwork placement changes after a given date prior to commencement of the fieldwork experience.

New Fieldwork Site Request Process

All prospective and contracted fieldwork sites are considered a resource of the OTD Program, not the individual student. Therefore students shall not contact fieldwork sites, currently or prospectively contracted with the Program, with the intent to establish personal fieldwork placement without prior consent of the AFC. Students wishing to obtain a fieldwork site in a specific location must first meet with the AFC to determine if a contract already exists with the facility. If no contract exists, the student and/or AFC may contact the site and initiate a clinical affiliation agreement. While the ability to place the student is not guaranteed, if a clinical affiliation is obtained with a requested site, the student must go to that site for their fieldwork rotation.

Cancellation or Changes by the Fieldwork Site

Students must understand that many of the fieldworks are arranged well in advance of student placement. Occasionally, facilities will cancel contracts with little notice to the Program. In the event this occurs, the fieldwork coordinator will do his/her best to find another suitable and timely placement. While attempts will be made to accommodate student preferences, this may not be possible with short notice in arranging alternative placements. The Occupational Therapy Program cannot assume responsibility for delays in completion of the program or eligibility for certification, if the student fails to accept or complete a scheduled fieldwork assignment, or if the fieldwork site cancels a scheduled placement.

Level 2 Fieldwork Evaluation

Students are required to complete a self-assessment, Student Evaluation of the Fieldwork
Experience for each Level 2 fieldwork placement. Students are also required to complete the AOTA Fieldwork Data Form for each Level 2 experience . (C.1.15.)

Level 2 Fieldwork is graded on a pass/fail basis using the AOTA Fieldwork Performance
Evaluation for the Occupational Therapy Student (FWPE) . This FWPE is used for both midterm and final grading of the fieldwork experience. Not receiving a passing score of 90 or above at midterm may or may not result in termination of the fieldwork experience. Students must obtain 122 points or above and a minimum score of 3 for questions 1, 2, 3 (fundamentals of practice section) at the final evaluation to be able to pass the fieldwork course. (C.1.18.)

Students may only repeat one Level 2 fieldwork experience. Students withdrawing from Level 2 fieldwork without the permission of the program director and the AFC will be placed on academic probation. Refer to the student handbook for further rules regarding academic
progression.

Forms used by Level 2 Fieldwork Students

Fieldwork forms can be accessed on E-Value or obtained from the AFC. Forms will be provided for use during each fieldwork experience during the orientation process prior to the start of each experience.

During Level 2 Fieldwork

Students will be off the EHC campus for both Level 2 fieldwork experiences. During Fieldwork 2:1, there will be an online course, OTD 811 Fieldwork Seminar that will include reflections from students on fieldwork experiences, professional reasoning, and integration of previous didactic material with current OT practice. During Fieldwork 2:2, there will be an online course OTD 823 Clinical Reasoning 3 that will provide reflection of fieldwork experiences including safe practice ideas, ethical considerations, therapeutic use of self, impact of contextual factors, and professional responsibility for fieldwork education. (C.1.11.)

International Fieldwork

International fieldwork experiences are possible for EHC OTD students. Requirements for
international fieldwork opportunities include a memorandum of understanding between the site and EHC OTD program. Students must be supervised by an occupational therapist who has graduated from a program approved by the World Federation of Occupational Therapists and has at least one year of experience in clinical practice. (C.1.19.)

Additional Level 2 Fieldwork Opportunities

Students may choose to pursue an additional semester of Level 2 fieldwork. AOTA sponsors a third Level 2 experience for students at AOTA headquarters in Bethesda, MD. Interested students must apply to AOTA for this specialized fieldwork opportunity. This fieldwork experience can not replace the Level 2 program set forth in the EHC OTD curriculum.