4.1 Demonstrates the ability to give constructive and timely feedback. I gave constructive and timely feedback in both settings of my level II fieldwork rotations. This feedback was given to ensure that my patients were safe during our sessions. There were many times during my acute care rotation where I was able to provide feedback on not only how to complete a task, but also how to make it easier to complete a task. For example, when working with a patient that had recently had a stroke, I instructed her that she should dress the affected side first. This helped her grow in confidence and independence while performing an activity she was going to do daily after leaving the hospital. During my outpatient pediatric rotation, I gave feedback consistently during a session when instructing a child how to hold scissors correctly and safely, encouraging a quadruped or tripod grasp, or even while performing ADL's such as brushing teeth. Giving feedback in a constructive and timely manner can help the patient achieve their goals and impact one's performance for improving independence and safety.
4.2 Modifies behavior in response to feedback; seeks opportunities to apply feedback. Below I am attaching feedback on my final evaluation from my fieldwork educator during my first level II fieldwork rotation. Throughout this rotation, I was able to work closely with many different disciplines. I sought out advice from these more seasoned therapists and was able to apply the feedback to make necessary adjustments. This was extremely beneficial because I was able to analyze my performance and seek ways for improvement during my rotation. Being a student, I knew I wanted to soak in as much advice and guidance as possible before I left. I am so glad that I was in an environment that supported and fostered a great learning experience for me through the constructive and thorough feedback I was given.
4.3 Productively uses knowledge of own strengths and weaknesses. I was nervous when beginning level II fieldworks, especially for my acute care rotation. I had little experience with such a fast-paced setting or medically complex patients. Learning how to be quick on my feet for patients and also to complete my documentation to meet productivity standards was a weakness of mine at first. However, as time progressed, I learned what worked best for me. Point of service documentation was very beneficial for me during evaluations as well as making small notes to elaborate on more at a later time. I was able to use my strengths of advocating for the distinct value of occupational therapy during this rotation as well. Please read my discussion board post about a time I was able to communicate the importance of OT with other professionals.
4.4 Maintains balance in personal and professional life while prioritizing professional responsibilities and commitments. Before my first level II fieldwork rotation, I joined a gym near my house called "Hotworx". After work, I would workout by myself or with a friend which always gave me a positive outlet to focus on myself and my physical health. I looked forward to getting to workout after work and sweat out any negative thoughts or scenarios that may have happened after a long day at work. During my second level II fieldwork rotation, I was able to leave the clinic during lunch time. I found a track that was no too far from my site where I went daily to walk during lunch. I would typically walk 4-5 laps during my break and listen to music. This rotation took place during the spring time so the fresh, warm air was nice to feel after being inside all morning. I went to the track so often, I even began to meet new friends who also walked the track during their lunch time. I came back from lunch feeling energized and with a clear mind to finish out the afternoon. Prioritizing my physical health during both of my level II rotations affected my professional well-being in a positive way as well.
4.5 Demonstrates functional level of confidence and self assurance. During my first level II fieldwork rotation, I remember a specific scenario that gave me the confidence and self assurance that I am prepared to become an independent occupational therapy practitioner. Upon arrival for a follow-up session with a patient, the patient's brother was present in the room. I introduced myself to the family member and explained my purpose in her recovery. I was also co-treating in this session with a physical therapy assistant. At the end of the session, the patient's brother began asking questions such as "when will she be able to leave" and "how is she progressing with therapy". I took the lead in answering his questions because I had worked more with the patient than the PTA had. I explained the patient's progress in laymen's terms and gave advice on who else to speak to regarding questions out of my scope of practice (i.e. case manager, MD, etc). My rotation in acute care allowed me to grow not only in my communication skills with patients, but also with family members to establish rapport and trust with them as well.
4.6 Uses humor to diffuse tension During my second level II fieldwork rotation in outpatient pediatrics, behavior management was one of my weaknesses going in. I struggled with knowing when was an appropriate time to intervene or when to say nothing. I had one client that had many feeding goals related to sensory issues. He would often throw himself on the floor if the non-preferred food was around, gag, or try to elope. I had to find a way to make addressing the feeding goals fun so he would be more interested in participating. The little boy had a favorite stuffed animal he would bring to each session so I decided to incorporate that. His stuffed animal would sit at the table with us and do all the steps I asked my patient to do with his food. If I asked the patient to touch the food, the stuffed animal would touch the food. If I asked the patient to bring the food to his cheek, the stuffed animal would bring the food to their cheek. This went so on for all the steps of eating. When the stuffed animal would successfully complete the task that the therapist asked, he would get praised. We'd blow bubbles, do a happy dance, and play fun songs. The patient thought it was so funny when the stuffed animal would do all the steps too. This helped the patient be more comfortable trying new foods and allowed him to see it's not so scary after all.
4.7 Maintains professional behavior, regardless of problem or situation. On my first level II rotation in acute care, I experience an aggressive and disrespectful patient during my second week. The patient did not like all the personal questions I was asking him. This was a great learning experience for me to learn to stay calm and not take things personally. I also realized through this experience the importance in explaining your role and reason for being there. This gives the patient's autonomy in their medical treatment and allows them to be more comfortable establishing rapport with the therapist. Especially in the acute care setting, patients are in the hospital and are experiencing some really tough things. It is important as occupational therapy practitioners to be able to put yourself in their shoes as much as possible. On my second level II rotation in outpatient pediatrics, I had a client who was 7 years old with a diagnosis of autism and ADHD. She also had a lot of behavior issues. I noticed that when I would end the therapy sessions and take her to her mother, the mother would want to talk to me about all the things happening at home. These stories ranged from the child's father leaving them, the mother refusing to let him get his things from the home, them getting into fights in the front yard, the mother dying her hair out of spite of the child's father, etc. I began to feel like I was more of a therapist to the mother than the child. However, this did give me insight on where the child's behaviors may be coming from due to currently having instability at home. I used this as an opportunity to educate the caregiver on techniques to improve behavior at home, while also being understanding of how much they had going on at that time.
4.8 Takes risks to maximize outcomes. In order to challenge my clients, there were times I needed to take risks in order to help my clients reach their full potential. I would modify treatment sessions as the client progressed to ensure there wouldn't be any plateauing during our sessions. While on my first level II rotation in acute care, I always made sure to offer occupation-based activities. Depending on the client's deficits, I had many client's that would perform their ADL's while in supine in bed or sitting at the edge of the bed. As time went on, I would increase the challenge such as suggesting the client should transfer to a bedside chair to perform the ADL's. Doing this, we were able to work on functional transfers such as sit to stand transfers. If the client was previously performing their ADL's while standing, such as at a sink, then we would try to progress towards that. If I felt that the client would be able to safely perform their ADL's in standing, we were addressing standing balance, strength, and endurance to promote independence. I had many client's who were scared to get back on their feet after a fall, stroke, etc. However, it was my responsibility to push them to take risks that was needed for them to reach their full potential!
4.9 Uses knowledge and information in an innovative way. As mentioned on a previous page, I kept up with many resources that I collected throughout school and on my own in a binder. During my outpatient pediatric rotation, I took my pediatric binder with me to the site. I kept it at my desk in case I needed to refer to it for myself or provide a caregiver with a handout. I referred to the binder when I was treating a client who had feeding goals. I had collected a resource during school that included all the steps to eating such as touching to cheek, to lips, to teeth, and so on. I provided a copy of this to the client's mother so she would have a breakdown of how to address introducing new foods at home. Another time I provided resources was for another therapist. I had been talking to another occupational therapist about one of her client's who was a teen girl. She was struggling with what things to address with the client because the teen was at the age where they should start addressing life skills such as driving test, job searching, or college preparation. However, the client's mother was not interested in her learning how to do any of those things because she believed she was not ready. I had resources in my binder related to the teen transitioning process. This include various things to work on with this age group, as well as articles about how to handle the transition from childhood to adulthood when working with individuals with autism. The therapist made copies of these resources and provided them to the client's mother is hopes that it would encourage her to want to increase the client's independence as she begins to enter young adulthood.
4.10 Empowers clients and team members. I noticed during my time in the acute care setting, there is typically a rhythm you get into for evaluations. We typically began with orientation questions, then social history, next ROM and MMT assessments, and lastly testing independence with ADLs such as dressing and transfers. However, as OT's we are flexible! One day, I was evaluating a female who had just undergone a TKA that morning. I went in with the intention to do my normal routine that I had for most evaluations. However, when I walked in the RN had just exited and set up the patient's PCA pump due to the patient reporting increased pain. When I walked in the room, the woman was hysterically crying and could not get comfortable. Instead of going in and just starting to ask questions, I decided my patient's care was more important. I started by reassuring the woman that I would help her and I was there to help her get more comfortable. I noticed she was holding her breath due to the pain and educated her on pursed lip breathing. I looked at the woman's knee immobilizer and it was on incorrectly, no ice was in the cyrocuff bucket, and her legs were externally rotated. I took off the knee immobilizer and encouraged the woman that sitting on the side of the bed may feel better. The patient was able to transfer from supine to sit with SBA and said that it felt much better. While the patient was at the EOB, I began to ask her social history questions due to her pain not being as severe and her not crying any longer. We sat at the EOB and then performed a sit to stand transfer with a RW and took a few steps. The woman and I began to speak affirmations to each other such as "I am strong" and "I can do hard things". I was assessing her functional mobility, safety awareness, balance and ROM throughout all these activities without the patient even noticing. Once we transferred back to the bed and back into supine, I was able to make sure her cyrocuff bucket has ice filled in it and was able to get her positioned for comfort. The patient said she wanted to be left in a L side lying position so I put a pillow between her legs to help prevent pressure sores and for comfort. Even though I did not follow my typical routine when I enter a room for an evaluation, I still provided client-centered care that took into account the patient's pain and emotional well-being by instilling confidence in her.
4.11 Actively participates in leadership or supportive roles in local, state, and/or national associations. While on my level II fieldwork rotations, I was also a part of a grant called RISE-CAY. This stood for Recruiting Interprofessional Scholars for Excellence in Childhood, Adolescence, and Young Adulthood. This grant served as a collaboration between the University of Memphis and UTHSC. Students involved in this program were from various disciplines such as social work, counseling, psychiatry, and occupational therapy. Through this grant, I attended synchronous training sessions that discussed topics such as cultural humility and competency, adverse childhood experiences, social determinants of health, and more. During these training, we were frequently split into groups that include someone from each different disciplines. This allowed us to all bring different backgrounds and thoughts to discuss topics that are beneficial to all of our scopes of practice. At the end of this program, I participated in a culminating case competition. I learned so much about myself through this opportunity, and also improved my ability to work within an interdisciplinary team.
4.12 Maintains values over self-promotion or profit. While on my rotation in outpatient pediatrics, we performed updates to plan of cares every 3 months and re-evaluations were performed yearly. While updating plan of cares, we were able to adjust the client's frequency that we suggested the client come to therapy. I ensured that I always did what was best for the family depending on their ease of transportation or availability to come to the clinic, not what was best for my schedule. When performing re-evaluations, this is also when I talked to the caregiver and decided whether they wanted to take a break from therapy or continue based on the results from the standardized assessments. Most of our client's will always qualify for therapy, but we did have client's that would score average or above average and not need our services. For these clients, we would not recommend therapy just to work on a few things. Instead, we would provide them with some at home exercises that they could do in their own time. While on my acute care rotation, there were times that a patient could not tolerate long treatments. I ensured that I was ethical when documenting how long I remained in the room working with the patient. I had one situation where I was co-treating with a PTA. When we exited the room, we wrote down our time out and it was 1 minute away from being another unit. The PTA said "let's just add a minute to get another unit to help with productivity". I explained to her that I did not feel comfortable doing that and would rather be truthful. I will continue to uphold high ethical standards for myself when I become an occupational therapy practitioner.