Date Presented 04/01/2022

Narrative record analysis from Level II southwest university fieldwork rotations revealed two OT student fieldwork failure themes. Students failing the Level II fieldwork experience struggled with clinical reasoning and soft skills. Results directed program decisions, revealing the need to examine the qualitative experiences of students who fail Level II fieldwork. Moreover, research that analyzes data using the updated 2021 Fieldwork Performance Evaluation is vital to supporting future fieldwork success.

Primary Author and Speaker: Marie Patterson

Additional Authors and Speakers: Shannon Levandowski

PURPOSE: The FW-II experience is ‘an integral and crucial part of the overall educational experience that allows the students an opportunity to apply theory and techniques acquired through the classroom and Level I fieldwork learning’ (American Occupational Therapy Association, 2012, p. S75). ACOTE requires a student to work under a fieldwork educator’s supervision and a university-provided academic fieldwork coordinator (AFWC). During the Level II fieldwork, communication typically occurs between three team members: AFWC, FE, and the student. When a student is identified as struggling or not developing at a conducive rate for developing competency and progress, the AFWC and FE have an academic and professional responsibility to determine the appropriate student support collaboratively. This learner deficiency often results in an abundance of records reflecting how the team experienced and understood the student’s fieldwork failure. These interactions discuss the student’s exhibited challenges, the perceived hard and soft skill deficits, and other valuable details. As Creswell and Creswell (2018) demonstrated, ‘the basic generation of meaning is always social, arising in and out of interaction with a human community. The process of qualitative research is largely inductive; the inquirer generates meaning from the data collected’ (p. 8). Hence, researchers must pay attention to the student’s experiential narrative.

DESIGN: A qualitative retrospective narrative analysis of English-language program data of 16 OT students at a Master of Occupational Therapy program was conducted. The data was acquired from a single university in the Southwestern United States of America.

METHOD: Nineteen de-identified and decoded student data sets were entered and transcribed verbatim into NVIVO 12 statistical analysis package to determine if significant patterns existed between students Level II lived experience and failure. Statements, words, scores, and quotes were coded, or noted for data pattern, for similarities until categories emerged. After coding all data, the author further analyzed and grouped the overarching patterns until prevalent themes emerged. Coding was complete when no new categories emerged.

RESULTS: Thematic analysis revealed seven superordinate categories describing student’s difficulties during Level II fieldwork. Further investigation led to grouping these seven categories into the two themes of clinical reasoning and non-cognitive interpersonal soft skill deficits. Two classes related to Clinical Reasoning Deficits, and five pertained to Non-Cognitive Interpersonal Soft Skill Deficits thus answering the studies aim: What do narratives from level II fieldwork rotations from a southwest university reveal about OT student fieldwork failure?

CONCLUSION: Common research themes indicated students who failed a Level II fieldwork placement were perceived to have demonstrated deficits in clinical reasoning and non-academic interpersonal soft skills. Further examination of attributes like clinical reasoning, interpersonal soft skills, and professional hard skills deficits may provide valuable insight into why fieldwork fieldwork students fail and what factors put them at risk for poor performance. Identifying students at risk for Level II fieldwork failure earlier would guide future instruction and advising, alter pre-admission criteria, and promote curriculum change. Collectively, OT experts have not determined useful predictors of student clinical performance. Although many interesting relationships between fieldwork performance and the failing students’ narrative records were elucidated, continued research to further understand elements predicting student fieldwork performance is recommended.


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