Method of Intervention Outcomes of Intervention Theory/ Frames of Reference/ Models of Practice Direct Services/case load for Biomechanical Occupational performance level OT Cognitive - Behavioral Adaptation One-to-one: Cognitive Disability Health & Wellness group(s): Model of Human Occupation (MOHO) Participation Large group: Occupational Adaptation Prevention Person/ Environment/ Occupation (P-E-O) Quality of Life Discharge Outcomes of clients Person-Environment-Occupational Performance Role Competence Home (PEOP) Self-Advocacy Another medical facility Rehabilitation Occupational Justice Home Health Sensory Integration Social Learning Theory OT Intervention Approaches Stages of change / Transtheoretical Model Create, promote (health promotion) Establish, restore, (remediation) Maintain Modify, (compensation, adaptation) Other (please list): Prevent, (disability prevention) Please list most common screenings and evaluations used in your setting: Identify safety precautions important at your FW site (Double Click on boxes to check) Medications Swallowing/ choking risks Post-surgical (list procedures) Behavioral system/ privilege (locked areas, grounds) Contact guard for ambulation Sharps Fall risk 1:1 safety/ suicide precautions Other (describe): Please list how students should prepare for a FW II placement such as doing readings, learn specific evaluations and interventions used in your setting: Target caseload/ productivity for fieldwork students: Documentation: Frequency/ Format (briefly describe) : (Double Click on boxes to check) (Double Click on boxes to check) Productivity % per 40 hour work week: Hand-written documentation: Computerized Medical Records: Caseload expectation at end of FW: Time frame requirements to complete documentation: Productivity % per 8 hour day: # Groups per day expectation at end of FW: Administrative/ Management duties or responsibilities of Student Assignments. Students will be expected to successfully the OT/ OTA student: complete: Schedule own clients Research/ EBP/ Literature review Supervision of others (Level I students, aides, OTA, In-service volunteers) Case study Budgeting Participate in in-services/ grand rounds Procuring supplies (shopping for cooking groups, client/ Fieldwork Project ( describe): intervention related Field visits/ rotations to other areas of service Participating in supply or environmental maintenance Observation of other units/ disciplines Other assignments (please list):
Method of Intervention Direct Services/case load for OT One-to-one: group(s): Large group: Discharge Outcomes of clients Home Another medical facility Home Health OT Intervention Approaches Create, promote (health promotion) Establish, restore, (remediation) Maintain Modify, (compensation, adaptation) Prevent, (disability prevention) Outcomes of Intervention Occupational performance Adaptation Health & Wellness Participation Prevention Quality of Life Role Competence Self-Advocacy Occupational Justice Theory/ Frames of Reference/ Models of Practice Biomechanical Cognitive - Behavioral Cognitive Disability Model of Human Occupation (MOHO) Occupational Adaptation Person/ Environment/ Occupation (P-E-O) Person-Environment-Occupational Performance (PEOP) Rehabilitation Sensory Integration Social Learning Theory Stages of change / Transtheoretical Model Other (please list): Please list most common screenings and evaluations used in your setting: Identify safety precautions important at your FW site (Double Click on boxes to check) Medications Post-surgical (list procedures) Contact guard for ambulation Fall risk Other (describe): Swallowing/ choking risks Behavioral system/ privilege level (locked areas, grounds) Sharps 1:1 safety/ suicide precautions Please list how students should prepare for a FW II placement such as doing readings, learn specific evaluations and interventions used in your setting: Target caseload/ productivity for fieldwork students: (Double Click on boxes to check) Documentation: Frequency/ Format (briefly describe) : (Double Click on boxes to check) Productivity % per 40 hour work week: Caseload expectation at end of FW: Productivity % per 8 hour day: # Groups per day expectation at end of FW: Hand-written documentation: Computerized Medical Records: Time frame requirements to complete documentation: Administrative/ Management duties or responsibilities of the OT/ OTA student: Student Assignments. Students will be expected to successfully complete: Schedule own clients Supervision of others (Level I students, aides, OTA, volunteers) Budgeting Procuring supplies (shopping for cooking groups, client/ intervention related Participating in supply or environmental maintenance Research/ EBP/ Literature review In-service Case study Participate in in-services/ grand rounds Fieldwork Project ( describe): Field visits/ rotations to other areas of service Observation of other units/ disciplines Other assignments (please list):
AOTA%20FIELDWORK%20DATA%20FORM%20GOTEC%20version%20Belmont%20modified%20MSOT%20-%20Word%20document.docx