Qualitative research methodology was used to explore the purpose of level I fieldwork among occupational therapy students, clinical educators, and faculty respondents at one academic program. Differences in purposes among the three groups of respondents created different fieldwork expectations and outcomes. These differences underlined the importance of communication among students, clinical supervisors, and faculty in planning fieldwork to meet the needs of all three groups. Interpersonal skills, rather than academic skills, emerged as most important to student success in clinical education. Other factors that promote optimal level I fieldwork experience are understanding the purpose, level of commitment, clarity of expectations, timing, structure, and evaluation of the experience.
Over the past 15 years, the number of occupational therapists entering the practice area of mental health has greatly declined. To determine the possible reasons for this decline, a random sample of 450 occupational therapy students who graduated in 1986 was surveyed to identify those factors that influence practice choice. Participants were asked to indicate their practice preferences at five points in time: before admission to the academic program, after completion of the academic program, after completion of Level I fieldwork, after completion of Level II fieldwork, and at first employment. The results from 212 questionnaires (a 47% response rate) indicated that the distribution of practice choices remained relatively consistent over time. After completion of the academic program, the choice of mental health practice was seen as negative. Specific negative influences were topic content, teaching methods, and teacher effectiveness. Level I fieldwork was perceived as a negative experience in all five practice areas, but was perceived most negatively in mental health. Level II fieldwork most influenced practice preferences. Specific positive factors were the student supervisor and the patient caseload.
A continual decline in the number of occupational therapists selecting mental health as their practice area has resulted in a personnel shortage. This study aimed at examining admission criteria to one occupational therapy program and the relationship of these criteria to practice preferences at admission. The question of whether current admission criteria are biased against those applicants preferring mental health practice is pertinent if the personnel shortage in mental health is to be alleviated. An analysis of the differences in practice preferences between accepted, alternate, and rejected groups of applicants indicated that such a bias did not exist. When admission was recalculated with only grade point average instead of the current procedure of a weighted combination of grade point average and interview, it was found that the admitted class would have contained more students preferring mental health practice. Additional research is recommended to further examine admission criteria and their relationship to practice.
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