Date Presented 04/21/2023

Analysis of the impact of traditional or simulation-based Level I fieldwork (FW) on Level II FW performance will be reviewed. Results add to the growing body of evidence regarding the efficacy of simulation and propose an alternative to the national FW shortage.

Primary Author and Speaker: Rebecca Ozelie

Additional Authors and Speakers: Maggie Moeller, Taylor Newmark

PURPOSE: Fieldwork (FW) is an essential component of occupational therapy (OT) curriculums. Level I FW can be delivered through simulated environments, standardized patients, faculty practice, faculty-led site visits, or supervision by a FW educator in a practice environment. Despite this variety, the US has reported a growing shortage of FW availability (Mattila et al., 2020; Schafer-Clay, 2019) which was exacerbated by COVID-19. In response, educators implemented non-traditional FW experiences including simulation. While research is emerging on the use of simulation-based FW, there is no known evidence about the impact of simulation-based level I FW on level II FW performance. The objective was to analyze the impact of a simulation-based level I FW experience on OT students’ performance on level II FW.

DESIGN: This study was a retrospective analysis of a purposive sample of 37 OTD students from a private, midwestern university that completed a traditional or simulation-based level I FW. All subjects also completed two, 12 week level II FWs.

METHODS: Analysis of student performance on the AOTA FW Performance Evaluation (FWPE) was performed using independent t-tests to compare differences in level II FW performance between students that completed the traditional and simulation-based Level I FW.

RESULTS: Results found no statistically significant difference in level II FW performance between the two groups (p = .683).

CONCLUSION: The use of simulation-based level I FW is comparable to in-person FW and may be a practical solution to the national shortage of FW availability and the lingering impacts of COVID-19 on FW.

IMPACT STATEMENT: The findings from this study align with current perspectives in healthcare regarding the effectiveness of simulations as a teaching methodology. This timely study adds to the growing body of knowledge regarding the effectiveness of simulation in OT curricula and proposes an alternative to the national FW shortage crisis.


Mattila, A., Martin, R. M., & DeIuliis, E. D., (2020). Simulated fieldwork: A virtual approach to clinical education. Education Sciences, 10(10), 272.

Preissner, K., Duke, K. B., Killian, C., Ouyang, R. L., Jarek, E. D., & Kottorp, A. (2020). The revised American Occupational Therapy Association Fieldwork Performance Evaluations: Evaluation of content validity—Part 1. The American Journal of Occupational Therapy, 74(6), 7406205090p1–7406205090p13.

Schafer-Clay, Jacqueline S. (2019). What stops some occupational therapy practitioners from providing fieldwork education? Occupational Therapy Doctorate Capstone Projects. 49.