Form Name: AOTA - Fieldwork Performance Evaluation Final OTS Exported July 28, 2021 1:17 PM

Submission Time: July 28, 2021 1:17 pm

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Unique ID: 840580980
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Fieldwork Performance Evaluation (FWPE)

PERSONAL INFORMATION
STUDENT OR FIELDWORK EDUCATOR FIELDWORK EDUCATOR

STUDENT NAME Daniel Ethington

STUDENT EMAIL danielethington1984@gmail.com

FIELDWORK EDUCATOR NAME Derek Larsen

FIELDWORK EDUCATOR MOTR/L

CREDENTIALS

FIELDWORK EDUCATOR'S EMAIL u0164092@utah.edu

COLLEGE OR UNIVERSITY University of Utah

ARE THERE ADDITIONAL FIELDWORK No

EDUCATOR(S) WORKING WITH THIS
STUDENT?

FIELDWORK SETTING
TODAY'S DATE Jul 28, 2021

TYPE OF FIELDWORK Level II Fieldwork

NAME OF ORGANIZATION/FACILITY University of Utah Medical Center

CITY Salt Lake City

STATE Utah

ORDER OF PLACEMENT 1

OUT OF 2

FROM May 10, 2021

TO Jul 30, 2021

TOTAL NUMBER OF WEEKS 12

I. FUNDAMENTALS OF PRACTICE

Unique ID: 840580980

1. Adheres to the American 3
Occupational Therapy Association’s
Code of Ethics and all federal, state, and
facility regulations. (Examples:
Medicare, Medicaid, client privacy,
social media, human subject research)
(Final)

1. Adheres to the American 2

Occupational Therapy Association’s
Code of Ethics and all federal, state, and
facility regulations. (Examples:
Medicare, Medicaid, client privacy,
social media, human subject research)
(Mid-term)

2. Adheres to safety regulations and 3

reports/documents incidents
appropriately. (Examples: fire safety,
OSHA regulations, body substance
precautions, emergency procedures)
(Final)

2. Adheres to safety regulations and 2

reports/documents incidents
appropriately. (Examples: fire safety,
OSHA regulations, body substance
precautions, emergency procedures)
(Mid-term)

3. Ensures the safety of self and others 3

during all fieldwork related activities by
anticipating potentially unsafe
situations and taking steps to prevent
accidents. (Examples: body mechanics,
medical safety, equipment safety, client
specific precautions, contraindications,
community safety) (Final)

3. Ensures the safety of self and others 2

during all fieldwork related activities by
anticipating potentially unsafe
situations and taking steps to prevent
accidents. (Examples: body mechanics,
medical safety, equipment safety, client
specific precautions, contraindications,
community safety) (Mid-term)

II - BASIC TENETS OF OCCUPATIONAL THERAPY

Unique ID: 840580980

4. Articulates the values, beliefs, and 3
distinct perspective of the occupational
therapy profession to clients and other
relevant parties clearly, confidently, and
accurately. (Examples: families,
caregivers, colleagues, service
providers, administration, the public)
(Final)

4. Articulates the values, beliefs, and 2

distinct perspective of the occupational
therapy profession to clients and other
relevant parties clearly, confidently, and
accurately. (Examples: families,
caregivers, colleagues, service
providers, administration, the public)
(Mid-term)

5. Articulates the value of occupation as 3

a method and desired outcome of
occupational therapy to clients and
other relevant parties clearly,
confidently, and accurately. (Examples:
families, caregivers, colleagues, service
providers, administration, the public)
(Final)

5. Articulates the value of occupation as 2

a method and desired outcome of
occupational therapy to clients and
other relevant parties clearly,
confidently, and accurately. (Examples:
families, caregivers, colleagues, service
providers, administration, the public)
(Mid-term)

6. Articulates the role of occupational 3

therapy practitioners to clients and
other relevant parties clearly,
confidently, and accurately. (Examples:
families, caregivers, colleagues, service
providers, administration, the public)
(Final)

Unique ID: 840580980

6. Articulates the role of occupational 2
therapy practitioners to clients and
other relevant parties clearly,
confidently, and accurately. (Examples:
families, caregivers, colleagues, service
providers, administration, the public)
(Mid-term)

III - SCREENING AND EVALUATION

7. Articulates a clear and logical 3
rationale for the evaluation process
based on client information, contexts,
theories, frames of reference, and/or
practice models. (Final)

7. Articulates a clear and logical 2

rationale for the evaluation process
based on client information, contexts,
theories, frames of reference, and/or
practice models. (Mid-term)

8. Obtains sufficient and necessary 3

information from relevant sources
throughout the evaluation process.
(Examples: record or chart review,
client, family, caregivers, service
providers) (Final)

8. Obtains sufficient and necessary 2

information from relevant sources
throughout the evaluation process.
(Examples: record or chart review,
client, family, caregivers, service
providers) (Mid-term)

9. Selects relevant screening and 3

assessment tools based on various
factors. (Examples: client priorities,
needs, and concerns about
occupational performance and
participation, theoretical support,
evidence, practice context, funding
sources, cultural relevance) (Final)

Unique ID: 840580980

9. Selects relevant screening and 2
assessment tools based on various
factors. (Examples: client priorities,
needs, and concerns about
occupational performance and
participation, theoretical support,
evidence, practice context, funding
sources, cultural relevance) (Mid-term)

10. Determines the client’s occupational 4

profile and occupational performance
through interview and other appropriate
evaluation methods. (Final)

10. Determines the client’s occupational 3

profile and occupational performance
through interview and other appropriate
evaluation methods. (Mid-term)

11. Evaluates and analyzes client 3

factors and contexts that support or
hinder occupational performance.
(Final)

11. Evaluates and analyzes client 2

factors and contexts that support or
hinder occupational performance.
(Mid-term)

12. Administers standardized and 4

non-standardized assessments and
surveys accurately and efficiently to
ensure findings are valid and reliable.
(Examples: follows assessment
protocols, adheres to time guidelines)
(Final)

12. Administers standardized and 3

non-standardized assessments and
surveys accurately and efficiently to
ensure findings are valid and reliable.
(Examples: follows assessment
protocols, adheres to time guidelines)
(Mid-term)

13. Modifies evaluation procedures 3

based on client factors and contexts.
(Examples: uses a quiet space, breaks
up evaluation into smaller parts,
provides multisensory instructions)
(Final)

Unique ID: 840580980

13. Modifies evaluation procedures 2
based on client factors and contexts.
(Examples: uses a quiet space, breaks
up evaluation into smaller parts,
provides multisensory instructions)
(Mid-term)

14. Interprets evaluation results to 3

determine the client’s occupational
performance strengths and challenges.
(Final)

14. Interprets evaluation results to 2

determine the client’s occupational
performance strengths and challenges.
(Mid-term)

15. Synthesizes and documents the 3

results of the evaluation process
clearly, accurately, and concisely, using
systematic methods to record the
client’s occupational performance.
(Final)

15. Synthesizes and documents the 2

results of the evaluation process
clearly, accurately, and concisely, using
systematic methods to record the
client’s occupational performance.
(Mid-term)

IV - INTERVENTION
16. Articulates a clear and logical 4
rationale for the intervention process
based on the evaluation results,
contexts, theories, frames of reference,
practice models, and evidence. (Final)

16. Articulates a clear and logical 3

rationale for the intervention process
based on the evaluation results,
contexts, theories, frames of reference,
practice models, and evidence.
(Mid-term)

Unique ID: 840580980

17. Establishes an accurate and 3
appropriate client-centered plan based
on the evaluation results, contexts,
theories, frames of reference, and/or
practice models. (Final)

17. Establishes an accurate and 2

appropriate client-centered plan based
on the evaluation results, contexts,
theories, frames of reference, and/or
practice models. (Mid-term)

18. Uses evidence from research and 4

relevant resources to make informed
intervention decisions. (Final)

18. Uses evidence from research and 3

relevant resources to make informed
intervention decisions. (Mid-term)

19. Selects client-centered and 4

occupation-based interventions that
motivate and challenge the client to
achieve established goals that support
targeted outcomes. (Final)

19. Selects client-centered and 3

occupation-based interventions that
motivate and challenge the client to
achieve established goals that support
targeted outcomes. (Mid-term)

20. Implement client-centered and 4

occupation-based intervention plans.
(Final)

20. Implement client-centered and 3

occupation-based intervention plans.
(Mid-term)

21. Chooses and, if needed, modifies 4

intervention approach to achieve
established goals that support targeted
outcomes. (Examples: prevention,
restoration, maintenance, promotion)
(Final)

Unique ID: 840580980

21. Chooses and, if needed, modifies 3
intervention approach to achieve
established goals that support targeted
outcomes. (Examples: prevention,
restoration, maintenance, promotion)
(Mid-term)

22. Modifies task and/or environment to 3

maximize the client’s performance.
Examples: upgrades/downgrades task;
arranges client’s workspace for optimal
performance (Final)

22. Modifies task and/or environment to 2

maximize the client’s performance.
(Examples: upgrades/downgrades task;
arranges client’s workspace for optimal
performance) (Mid-term)

23. Modifies the intervention plan and 3

determines the need for continuation or
discontinuation of services based on
the client's status. (Final)

23. Modifies the intervention plan and 2

determines the need for continuation or
discontinuation of services based on
the client's status. (Mid-term)

24. Documents the client's response to 3

services in a manner that demonstrates
the effectiveness of interventions.
(Final)

24. Documents the client's response to 2

services in a manner that demonstrates
the effectiveness of interventions.
(Mid-term)

V - MANAGEMENT OF OCCUPATIONAL THERAPY SERVICES

Unique ID: 840580980

25. Demonstrates through practice or 4
discussion the ability to collaborate
with and assign appropriate tasks to the
occupational therapy assistant,
occupational therapy aide, or others to
whom responsibilities might be
assigned, while remaining responsible
for all aspects of treatment. (Examples:
paraprofessionals, nurses’ aides,
volunteers) (Final)

25. Demonstrates through practice or 3

discussion the ability to collaborate
with and assign appropriate tasks to the
occupational therapy assistant,
occupational therapy aide, or others to
whom responsibilities might be
assigned, while remaining responsible
for all aspects of treatment. (Examples:
paraprofessionals, nurses’ aides,
volunteers) (Mid-term)

26. Demonstrates through practice or 3

discussion an understanding of costs
and funding systems related to
occupational therapy services, such as
federal, state, third party, and private
payers. (Final)

26. Demonstrates through practice or 2

discussion an understanding of costs
and funding systems related to
occupational therapy services, such as
federal, state, third party, and private
payers. (Mid-term)

27. Demonstrates knowledge about the 4

organization. (Examples: mission and
vision, accreditation status, licensing,
specialty certifications) (Final)

27. Demonstrates knowledge about the 3

organization. (Examples: mission and
vision, accreditation status, licensing,
specialty certifications) (Mid-term)

28. Meets productivity standards or 3

volume of work expected of
occupational therapy students. (Final)

Unique ID: 840580980

28. Meets productivity standards or 2
volume of work expected of
occupational therapy students.
(Mid-term)

VI - COMMUNICATION AND PROFESSIONAL BEHAVIORS

29. Communicates clearly and 4
effectively, both verbally and
nonverbally. (Examples: clients,
families, caregivers, colleagues, service
providers, administration, the public)
(Final)

29. Communicates clearly and 3

effectively, both verbally and
nonverbally. (Examples: clients,
families, caregivers, colleagues, service
providers, administration, the public)
(Mid-term)

30. Produces clear and accurate 3

documentation. (Examples: legibility,
spelling, punctuation, grammar,
adherence to electronic health
documentation requirements) (Final)

30. Produces clear and accurate 2

documentation. (Examples: legibility,
spelling, punctuation, grammar,
adherence to electronic health
documentation requirements)
(Mid-term)

31. Collaborates with fieldwork 4

educator(s) to maximize the learning
experience. (Final)

31. Collaborates with fieldwork 3

educator(s) to maximize the learning
experience. (Mid-term)

32. Takes responsibility for attaining 4

professional competence by seeking
out learning opportunities and
interactions with fieldwork educator(s)
and others. (Final)

Unique ID: 840580980

32. Takes responsibility for attaining 3
professional competence by seeking
out learning opportunities and
interactions with fieldwork educator(s)
and others. (Mid-term)

33. Responds constructively to 4

feedback in a timely manner. (Final)

33. Responds constructively to 3

feedback in a timely manner. (Mid-term)

34. Demonstrates consistent and 4

acceptable work behaviors. (Examples:
punctuality, initiative, preparedness,
flexibility, dependability, professional
appearance) (Final)

34. Demonstrates consistent and 3

acceptable work behaviors. (Examples:
punctuality, initiative, preparedness,
flexibility, dependability, professional
appearance) (Mid-term)

35. Demonstrates effective time 4

management. (Final)

35. Demonstrates effective time 3

management. (Mid-term)

36. Manages relationships effectively 4

through therapeutic use of self and
adjusts approach to meet the needs of
clients and others. (Final)

36. Manages relationships effectively 3

through therapeutic use of self and
adjusts approach to meet the needs of
clients and others. (Mid-term)

37. Demonstrates respect for diversity 4

factors of others. (Examples: culture,
socioeconomic status, beliefs, identity)
(Final)

37. Demonstrates respect for diversity 3

factors of others. (Examples: culture,
socioeconomic status, beliefs, identity)
(Mid-term)

Unique ID: 840580980

PERFORMANCE RATING SUMMARY SHEET (FINAL)
FINAL TOTAL 128

Pass/Fail Pass

1. (Final) AOTA Code of Ethics 3

2. (Final) Safety Regulations 3

3. (Final) Safety of Self/Other 3

4. (Final) Articulates Values.... 3

5. (Final) Value Articulation 3

6. (Final) Role Articulation 3

7. (Final) Articulates the role 3

8. (Final) Obtains information 3

9. (Final) Selects relevant tools 3

10. (Final) Determines the profile 4

11. (Final) Evaluates and analyzes 3

12. (Final) Administers assessment 4

13. (Final) Modifies evaluation 3

14. (Final) Interprets eval.. 3

15. (Final) Synthesizes and documents 3

16. (Final) Articulates 4

17. (Final) Establishes plan 3

18. (Final) Uses evidence 4

19. (Final) Selects interventions 4

20. (Final) Implements plan 4

21. (Final) Chooses and modifies 4

22. (Final) Modifies task 3

23. (Final) Modifies plan 3

24. (Final) Documents 3

25. (Final) Collaborate 4

Unique ID: 840580980

26. (Final) Demonstrates 3

27. (Final) Demonstrates organization 4

28. (Final) Productivity 3

29. (Final) Communicates 4

30. (Final) Produces clear 3

31. (Final) Collaborates 4

32. (Final) Responsibility 4

33. (Final) Responds to feedback 4

34. (Final) Work behaviors 4

35. (Final) Time Management 4

36. (Final) Manages relationships 4

37. (Final) Demonstrates success 4

SUMMARY COMMENTS Daniel progressed well throughout this fieldwork. The ortho trauma unit can
be very overwhelming as the clients vary from the "simple" surgery of total
joints to complex/medically complicated trauma. Daniel was willing to adjust
to the work environment to help meet the needs of our clients. He has
developed good relationships with nurses, therapists, and clients which will
help him in future fieldworks and throughout his career. He does a good job
of explaining the role of occupational therapy to patients and family and
maintains an occupation based approach with his evaluation and
treatments.

Student was informed of this review Student was informed of this review

Fieldwork Educator Signature

Unique ID: 840580980