1. Demonstrates the ability to give constructive and timely feedback. While placed at my first clinical rotation at an inpatient rehabilitation hospital, I gave constructive and timely feedback to my patients. I provided feedback whenever the patient had to complete an activity of daily living task such as a medication management arrangement activity. At my inpatient rotation, the medication management task would focus on the ability of the patient to correctly and accurately sort fake medications into a pill organizer. I would use actual old medical pill containers that had small beads inside to represent the medication. There would be instructions written on the outside of the bottle to mimic a real scenario that a patient would have to manage. To initiate the task, I provided instructions and visually presented the clients with an example to prevent any discrepancies. At the end, whenever my patients would incorrectly complete the task I provided reasoning to the mistake. I worked with the patients on how they got it incorrect and ways that we can ensure improved accuracy in the future. Unfortunately, a majority of my older patients would confide to me after completion of this task that they usually make mistakes at home such as in the clinic. I addressed these issues in a timely manner and educated the client on the importance of utilizing assistance from a partner or caregiver to prevent a life threatening mistake from occurring. I demonstrated constructive feedback to my clients in order to maintain their well-being and overall health while in the inpatient rehabilitation hospital setting.
2. Modifies behavior in response to feedback; seeks opportunities to apply feedback. As I progressed through my outpatient pediatric rotation, I was given feedback by my clinical instructors to improve my task analysis and documentation skills. Because I seemed to struggle the most in grading the activity, I completed a task analysis form for multiple patients to improve these skills. I broke down the complexities required for handwriting and scissor skills by describing the demands of the environment, body structures for each activity, and the sequencing required for the completion of the tasks. Then, I created at least 5 preparatory activities for each of my patients that I would implement into my treatment sessions. By utilizing this task analysis form, I responded positively to the feedback provided by my clinical instructors to improve the grading of my interventions. I also required fewer corrections on my documentation notes. I was able to break down the tasks and grade accordingly for these patients at my outpatient clinic. My clients progressively improved the skills required and targeted the goals that were set in place for increased school-readiness skills.
3. Productively uses knowledge of own strengths and weaknesses. Within the field of occupational therapy, a future practitioner has to recognize their own strengths and weaknesses. I created successful treatment sessions and retrieved the information I gathered from an evaluation. However, I lacked the expertise to decipher the purpose through the scope of occupational therapy services. When I was placed at my outpatient pediatric rotation, my clinical instructors reported that I needed to improve my skills on modifying assessments and interpreting evaluation results to better determine my patient's strengths and weaknesses. I was aware of these constructive criticisms and applied them into my documentation. I set a goal for myself to have less than five corrections on my clinic notes and selecting appropriate assessment measures. I used my free time while in the clinic to correct my documentation notes and collaborated with my clinical instructors to improve my use of occupational therapy related medical terms. I used my lunch period to review the relevant sections of PDMS-2 and compared the skills that were required in order to truly understand the purpose behind a particular milestone. At the end of my final week, my clinical instructors saw the progress I had made through my evaluations and documentation notes. My clinical instructors reported that I had developed the skills required for an entry level practitioner. I productively used my knowledge of my own strengths and weaknesses to become a well-balanced future occupational therapist. Below is a comment on my Midterm Evaluation then Final Fieldwork Evaluation from my clinical instructor:
4. Maintains balance in personal and professional life while prioritizing professional responsibilities and commitments. Throughout the last six months, I faced more challenges and obstacles than I imagined. However, I overcame these obstacles in part due to the support system that surrounded me. During my weekends I took the time to truly cherish the people that have helped shaped me into the future occupational therapist that I am today. I gave my dog some extra cuddles when I was feeling down about a poor treatment session. For the holidays, I visited back home to celebrate the festivities with my mother and younger siblings. My husband and I took our first vacation since our honeymoon to visit the beautiful city of Nashville and viewed their Christmas lights show. I also spent time with friends and give back to the community by participating in the Hamilton Eye Institution 5k. I even took a quick selfie with the buffalo at Shelby Farms. Though I struggled these past six months, it was all worth it. I maintained balance in my personal and professional life while still prioritizing my responsibilities.
5. Demonstrates functional level of confidence and self assurance. Having the right amount of confidence and self assurance when facing adversity can be quite a challenge for an occupational therapy student, especially when it is so close to graduation. I came into my final clinical rotation at my outpatient pediatric rotation confident that I was more than prepared for this challenge. However, once I began my rotation the self assurance that I had declined rapidly. There was a sort of culture shock that I faced during the first half of my clinical rotation and felt pressure working for such a prestigious company. I begun to let those fears of failure create a negative state of mind. This impacted my performance in the clinic more than I had desired in the first place. I had to regain my confidence back or I would not be able to provide my clients with the therapy services that they deserved. I fought my insecurities and addressed my concerns with my clinical instructors. I knew that requesting help from others is the first step to become a more confident clinician. I gave myself the credit when I had a successful treatment session. I also did not take it personally when something had not gone as expected. It took me a couple of tries before I finally felt as thought I was finally on my way to becoming an occupational therapist. At the end of my clinical rotation I showed my clinical instructors that I demonstrated a functional level of confidence and self-assurance within the field.
Below is a comment on my Final Fieldwork Evaluation from my clinical instructor:
6. Uses humor to diffuse tension. The patients I had treated at my inpatient hospital rotation were faced with many trials to overcome before being discharged from the hospital. There were times where my patients had faced their obstacles head on with smiles on their faces. However, I had my fair share of patients that allowed their current situation to overtake their motivation to continue moving forward. These patients sometimes would outwardly express their anger. I used humor within the appropriate boundaries by referring to my own deficits in order to help diffuse the tension. For example, I used humor when a patient was unable to transfer from the bed to the wheelchair or wash themselves in the shower independently as once before. I recived positive responses from my patients when using humor. My patients recognized that anyone and everyone will face struggles with everyday tasks in their life time. My patients appreciated that I was open and honest with them whenever they had faced obstacles during their inpatient stay. I provided my patients with some humor to ease their feeling of vulnerability they faced in that moment.
7. Maintains professional behavior, regardless of problem or situation. Within the setting of my outpatient pediatrics rotation, there are times when professional behavior is required to handle a tense situation. For example, when a caregiver demonstrates frustration with their child who is unable to be consoled. I faced this situation once before with a parent who did not understand the sensory deficits that their child had when transitioning from different environments. In this situation, I took the time to recognize the caregiver’s feelings and provided education on how sensory processing deficits can affect the patient's ability to cope. As a future occupational therapist, it can be very hard to explain complex sensory processing reasons that cause a patient to become upset and unconsolable. Also, there are times when you tried your best with no positive outcome. This client experienced a transitional change from one setting to another, as well as a big change in routine. This client had not been coming for several weeks and previous documentation had reported this as a major concern for the caregiver. Unfortunately, despite efforts the caregiver refused to participate in the session any further, and did not want to discuss the situation. I maintained my professionalism although I knew I could have salvaged the treatment session if the caregiver had allowed it. I demonstrated professionalism through patience and a compassionate understanding of the situation.
Below is a discussion board post from my experience:
8. Takes risks to maximize outcomes. To take a risk as an occupational therapy student can be quite nerve racking. However, there are situations in which taking such risk will maximize outcomes for our clients. While I was at my outpatient pediatric rotation, I had a client who was diagnosed with Cerebral Palsy. This client was an older teenager and had goals that focused on self care and independent living skills. I was stuck on how to provide an intervention that was challenging enough, yet was within my scope of practice as an occupational therapy student. One day when I was looking through the therapy kitchen space I had found some cooking supplies and a cookie mixing box. I thought of a great idea to simulate a grocery shopping activity for my client's next therapy session. I was a bit nervous to attempt this task as I did not want my client to breeze through it or deem the activity to be a waste of time. However, I knew this would address the skills they needed and I decided to take the risk. I had all the necessary items needed to bake the cookies and placed sticky notes for a price tag. I then printed out small play dollar bills for the client to 'purchase' the ingredients. The client thoroughly enjoyed the activity and truly took it as a challenging task to complete. Through this activity, I determined the safety awareness and independence levels that my client possessed in order to maximize the outcomes that were desired within an outpatient pediatric setting.
9. Uses knowledge and information in an innovative way. I noticed during my time at my inpatient hospital rotation that a majority of our clients had goals to focus on increasing their dynamic sitting, cognitive abilities, and their overall tolerance for an activity. My clinical instructor tasked me to create an intervention that would be useful for this population. I decided to design an innovative way to address all of these required skills into one simple task and created a modified rehab version of the Scrabble Board Game. To allow this craft to be used multiple times for various conditions of patients, I took a poster board and applied a thin layer of lamination all around it. I then placed velcro circles on the designated square tiles to set and remove the pieces. To utilize this activity in a functional therapeutic way, the patient would have to maintain a dynamic standing position to reach for the letter pieces and place onto the game board. This activity also targets the patient's ability to improve their tolerance for an everyday task that would require them to stand for a longer period of time. Some of our other board games did not have the versatility or the ability to grade the task up or down to meet the needs of the patient and to continue building those skills over time. I used my knowledge to address the needs of this population. I then utilized that information to create a truly innovative treatment intervention. This project can be applied for any condition a patient may possess to achieve a return of their previous functional performance levels.
10. Empowers clients and team members. As a student occupational therapist who has the experience of working within an inpatient rehabilitation hospital, one of the main influences of a client's therapy progress is their ability to be empowered to achieve their goals and be healthier than when they first arrived. For example, one of my patients at my inpatient rotation had came to the hospital with the inability to maintain any static standing tolerance. This patient was terrified when they had to complete a transfer of any kind. To address this deficit, the client would spend a majority of their treatment sessions at the parallel bars to increase their standing tolerance. The purpose of the parallel bars was to build up the strength in the client's arms and legs to push out of the chair. My clinical instructor attempted to have the client practice static standing while at the bars, but they would collapse back into their wheelchair. The client stated they had a fear of falling and I noticed my mentor was hitting a wall with this patient. I could have let the insecurities of my client stop them from reaching their full potential or not have stepped in to assist with my mentor. I instead used my therapeutic use of self to empower my client and team member to not give up. I took over the session while my clinical instructor was present and I gave the client a serious heart-to-heart to remind them what they have to look forward to once they go home. I also reminded the client how much their health will improve if they were to trust the tasks that I was requesting for them to complete. This client was hesitant at first, but because I communicated with them truthfully and honestly I empowered the client and my team member.
11. Actively participates in leadership or supportive roles in local, state, and/or national associations. All throughout my occupational student career, I participated in leadership through my local, state, and national associations. I am a member of the Tennessee Occupational Therapy Association (TNOTA), the American Occupational Therapy Association (AOTA), Student Occupational Therapy Association (SOTA), and the Coalition of Occupational Therapy Advocates for Diversity (COTAD). I served as the Honor Council Representative for the Class of 2023 and represented on the board of executives for the Rachel Kay Stevens Therapy Center (RKSTC). As a member of the SOTA and COTAD, I attended meetings and guest speakers throughout the course of my student career to address issues within the community and ways we can provide assistance. At the state level, I attended the TNOTA Conference 2023 in Memphis, TN and presented a poster topic to various currently practicing occupational therapists in the area, as well as future students who were out-of-state. I utilized the national association AOTA to gather, learn, and implement newly discussed evidence based practice into my level II clinical rotations in order to provide the most up to date care for my clients. As the Honor Council Representative, I was the standard for maintaining ethics for my graduate class of future occupational therapists. I also attended meetings to decide the academic fate of those who dishonored these ethical standards. While on the board for the RKSTC, I assisted in volunteering in our Paint Nights with children from the community and advocated for the role and value of occupational therapy.
12. Maintain values over self-promotion or profit. To become a well-rounded future occupational therapist, one must be able to maintain the core values over self-promotion or profit. There was a time during my inpatient hospital rotation when I maintained these values when a client on my caseload that requested to extended services. This patient had recently undergone a lower limb amputation and at the same time had received divorce papers from their partner. At the initial evaluation, this patient required minimal assistance to complete basic activities of daily living such as bathing and dressing. After their first week of intensive therapy this patient had met all of their goals and was more than prepared to be discharged home. The patient had pulled me aside at the beginning of their final week of therapy and to report that they requested to extend their stay due to facing a marriage conflict at home. I wanted to assist this patient to extend services in order to help their personal situation, but I knew that this would be unethical. I would be helping the patient's personal situations, but I would be the one to receive profit from their extension. If I extended services for therapy this patient it would be unethical because they were independent in completing their occupations. I decided to maintain my values over self-profit and reported at the patient's discharge team meeting that they were no longer required for therapy services. It was a hard decision to make, but in the end I made the ethical and moral choice as a future occupational therapist.