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TouroUniversityNevada
OccupationalTherapy
TraineeEvaluation
Evaluator:

AnnMarieWarrenFieldworkEducator

Subject:

DaniellePalmerLevelI

Activity:

OCCT651A

Site:

EasterSealsSouthernNevada

EvaluationType:

EducatorEvaluationofLevelIFieldworkStudent CompletionDate: 08/20/2015

RequestDate:

08/06/2015

Period:

OCCT651ASummer2015

DatesofActivity: 07/27/2015To08/21/2015

SubjectParticipationDates: 07/27/2015To08/21/2015
FieldworkEducator:(Question1of7)
AnnMarieWilliams

TypeofFieldwork:(Specialty/PracticeArea)(Question2of7Mandatory)

Selection

Option

1.1InPatientAcute

1.2InPatientRehab

1.3SNF/SubAcute/AcuteLongTermCare

1.4GeneralRehabOutpatient

1.5OutpatientHands

1.6PediatricHospital/Unit

1.7PediatricHospitalOutpatient

1.8InPatientPsych

2.1PediatricCommunity

2.2BehavioralHealthCommunity

2.3OlderAdultCommunityLiving

2.4OlderAdultDayProgram

2.5Outpatient/handprivatepractice

2.6AdultDayProgramforDD

2.7HomeHealth

2.8PediatricOutpatientClinic

3.1EarlyIntervention

3.2School

Other(seebelow)

Other(Question3of7)

IfOtherwasselectedforTypeofFieldwork,pleasespecify:

Indicatethestudentslevelofperformanceusingthescaleprovided
4Exceeds
Standards:

Frequentlycarriesouttasksandactivitiesthatsurpassrequirements.Attimes,performanceisexceptional.

Carriesoutrequiredtasksandactivities.Thisratingrepresentsgood,solidperformanceandistypicallyusedmorethan
alltheotherratings.
Opportunitiesforimprovementexisthowever,studenthasnotdemonstratedadequateresponsetofeedback.Workis
2BelowStandards:
occasionallyunacceptable.
1WellBelow
3MeetsStandards:

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Standards:

Performanceisweakinmostrequiredtasksandactivities.Workisfrequentlyunacceptable.

(Question4of7Mandatory)

Organization
Considerabilitytosetpriorities,bedependable,beorganized,follow
throughwithresponsibilities

Exceeds
Meets
Below
Standards Standards Standards
4

>>X<<

3.0

2.0

Well
Below N/A
Standards
1

1.0

SelfDirectedLearning
Considerabilitytotakeresponsibilityforownlearningdemonstrate
motivationawareofownstrengthsandareasforimprovement

>>X<<

3.0

2.0

1.0

veryinterestedin
workingwiththe
individualsand
whatshecando
topassist.

>>X<<

3.0

2.0

1.0

arriveddailywith
theattitudethat
shehappyto
supportthe
individualsand
sheappearedto
eagertoinvest
thetime

>>X<<

3.0

2.0

1.0

willaskquestions
whennotsure
andwillfollowup
withaplan.

4.0

3.0

2.0

1.0

>>X<<

3.0

2.0

1.0

Reasoning/ProblemSolving
Considerabilitytouseselfreflection,willingnesstoaskquestionsabilityto
analyze,synthesizeandinterpretinformationunderstandtheOTprocess
demonstratesinquiryskillsappropriatetothestudentsstageofeducation
andtraining

WrittenCommunication
Considergrammar,spelling,legibility,successfulcompletionofwritten
assignments,documentationskills

Initiative
Considerinitiative,abilitytoseekandacquireinformationfromavarietyof
sources

ObservationSkills
Considerabilitytoobserverelevantbehaviorsforperformanceareasand
performancecomponentsandtoverbalizeperceptionsandobservations

>>X<<

3.0

2.0

1.0

Didnotgetthe
>>X<< opportunitytosee
written
documentation.
0

Danielleasked
question
regardingthe
individuals

Observationskills
aregood
accordingtothe
staffthatsatwith
Danielle.thestaff
statedDanielle
willobservea
situationandthen
giveherimput.
shewouldalso
askquestions.

>>X<<

3.0

2.0

1.0

Daniellehasgreat
communication
skillswhen
communicating
withthe
individualsand
thestaff.

>>X<<

3.0

2.0

1.0

Daniellealways
appearedtobe
calmandreacted
professionally.

Daniellewillask
questionwhen
sheisunsureof
whatis
confidential.

greatattitudeand
managesstress
wellandshe
demonstrates
flexibilitywhen
needed.

VerbalCommunicationandInterpersonalSkills
Considerabilitytointeractappropriatelywithindividuals
(patients/clients/staff/caregivers)suchaseyecontact,empathy,limitsetting,
respectfulness,useofauthoritydegree/qualityofverbalinteractionsuseof
bodylanguageandnonverbalcommunicationexhibitsconfidence

ProfessionalandPersonalBoundaries
Considerabilitytorecognize/handlepersonal/professionalfrustrations
balancepersonal/professionalobligationshandleresponsibilitiesworkwith
otherscooperatively,considerately,effectivelyresponsivenesstosocial
cuesadherestoAOTACodeofEthics

UseofProfessionalTerminology
Considerabilitytorespectconfidentialityappropriatelyapplyprofessional
terminology(PracticeFramework)inwrittenandoralcommunication

AttitudeandProfessionalAppearance
Considerabilitytomanagestressorsinconstructivewaysdemonstrates
flexibilityasrequiredfollowsprogramguidelinesfordressandhygiene

danieelearrived
dailyorganized
withapleasant
smileand
followedthrough
onassignment.

EngagementintheFieldworkExperience
Considerthestudentsapparentlevelofinterest,levelofactiveparticipation
whileonsiteinvestmentinindividualsandtreatmentoutcomesseeksways
toimproveselfperformancefollowssafetyprecautions

Comments

>>X<<

>>X<<

3.0

3.0

2.0

2.0

1.0

1.0

daniellearrived
ontimedailyand
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TimeManagementSkills

>>X<<

3.0

2.0

1.0

Considerabilitytobeprompt,arriveontime,completeassignmentsontime

ParticipationintheSupervisoryProcess
Considerabilitytogive,receiveandrespondtofeedbackseekguidance
whennecessaryfollowproperchannels

>>X<<

3.0

2.0

1.0

didnotleaveuntil
herdesignated
timetoleave.
Danielle
demonstratedthat
shecanlistento
suggestionsand
followthrough
accordingly.

StudentLearningObjectivesforThisFieldworkExperience:
(Question5of7Mandatory)

Date
Completed

Student
LearningObjectives

1. 7232015

selectanassessmentwithanindividual

2. 7302015

completeaprofile

3. 862015

createanactivity

FieldworkEducatorComments:(Question6of7)
ItwasapleasuretohaveDaniellecompleteherfieldexperiencewithEasterSeals.shehasaverykindandpleasantdemeanorandshefitsrightin
withtheEastersealsfamily.Theindividualsreallyenjoyedhersupportsandengagementwithactivities.
thestaffhadnothingbutpositivethingstosay.

WehavebothreviewedtheEducatorEvaluationofStudent,StudentEvaluationofEducator,andStudentEvaluationofFacility.
(Question7of7Mandatory)
Selection Option
Yes
X

No

ThepurposeofaLevelIFieldworkexperienceistoprovideanopportunityforexposuretooccupationaltherapyinterventionandprogramming
or,inthecaseswherenoOTservicesarecurrentlybeingprovided,exposuretopotentialgrowthareasforOT.Weencourageasmuchhands
onaspossibleandappropriatewithineachexperience.Itisexpectedthatprofessionalbehaviorsareupheldinallsettings.
Thankyouforyourparticipationinourprogramandyourassistanceintheeducationalprocessofouroccupationaltherapystudents.
PleasenotifytheAcademicClinicalCoordinatorimmediatelyifthisstudentisnotperformingtothefacilitiesexpectationsforLevelIFieldwork.
AshleyFechtOTD,OTR/L
AcademicClinicalCoordinator&AssistantProfessor
(702)7774762Office
(702)3701328Cell
ashley.fecht@tun.touro.edu
(AdaptedfromColoradoStateUniversityLevelIStudentPerformanceEvaluation,PhiladelphiaRegionFieldworkConsortium,Washington
UniversitySchoolofMedicinePrograminOccupationalTherapy)

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