To all the OT fieldwork students, this blog post is for you! I have had the privilege of getting to supervise several students over the last few weeks. What a weird thing to be on the other side of the fence, but it has really validated some key areas that I think are good talking points to current and future students. Fieldwork can bring up an array of feelings and everyone has very individualized experiences with fieldwork. There are many things that can impact your fieldwork experience. Some being your CI (clinical instructor), caseload, student expectations from your site, your mindset, the setting you are working in etc. But all that aside, focus on the things that you can control…YOURSELF. As I have been able to observe how my students have interacted with patients and their treatment styles, it proves to show that there is NO right way to approach treatments. Everyone looks at things differently and has different perspectives which is the beauty of being a therapist. No two therapists are the same. That’s a GOOD thing! We have different therapeutic styles, we have different ideas, and we have different interventions. As the students are there to learn from me, I also get to learn from them. Which has been so fun! There is always something to learn in OT, always things to learn in life. You will never know it all, or even close to it, so humble yourself, be able to take some constructive criticism and GROW from it.
Key concept #1. Be able to take feedback and make something of it. More often than not, most CI’s are 100% on your side and there to guide you in the best way possible. You aren’t expected to be perfect in your fieldwork rotation. In fact, you’re expected to be the opposite. This is your time to make mistakes and to correct them. This is your time to ask questions, all 500 of them (but ask questions that you have already tried to problem solve). Be a problem solver and use those critical thinking skills that you spent the last few semesters developing. Fieldwork should be your safe space, yet a space where you take every opportunity to grow. Remember that growth is uncomfortable. It’s new and it’s somewhere you’ve never been before. Try interventions that may not work. Learn how to grade activities up and down. LEARN ALL THAT YOU CAN in those short few months. I may do things differently than my students would and I may have interpreted something in a way that is different from how they would. And THAT’S OKAY. As long as safety is taken into account and they are taking the necessary safety precautions, I am going to let you do you. That’s how you grow as a therapist, especially as student. You get to observe different ways of doing things and then get to make it your own and figure out your own treatment style. That being said… there are some things that I have noticed in some students that can really impact the success within their rotation.
Key concept #2. Be confident. Be confident when you speak to your patients, be confident in your interventions, be confident in what you’re telling them. Because if you don’t? Your patients pick up on the nerves, they can tell when you don’t know what to do with them. Sometimes they will defer treating with a student for this exact reason. They want to work with someone “experienced”. You just studied your butt off and went through a whole year+ of specialized training for this exact moment, you know where to start, now start. You have more experience than the patient, you have the knowledge. Try talking to them and ask them where they feel they are struggling the most, that’s always an easy way to start a treatment plan with a client-centered approach. “ I was thinking we could work on ___, ___, ___ today, is there anything specifically that you would like to work on?” vs “What do you want to work on today.” Your verbiage of how you speak to your patient/CI is a reflection of your confidence.
Key concept #3. Take initiative. You know what CI’s love? A student that takes charge and does without being told. With all safety precautions applied, go get your patient, start them off on a warm-up intervention, help get them dressed etc. Don’t be timid. Be a student that is willing to try new things, dives into treatment plans without being asked, initiates interactions with patients without being prompted. You will have much better rapport with your patients if you are assertive. Deliver more than you are expected.
Key concepts #4. Research innovative treatment ideas, have a loose plan with some ideas that can be modified. Pinterest can be your best friend. Depending on what setting you’re in, a lot of the treatment concepts are the same. You may just need to adapt them. For example, in inpatient rehab. Most likely you will be working on activity tolerance, UE strengthening, FMC, cognition. There’s your starting point. Now start looking for ideas. You can grade activities in many different ways. Add weight, decrease weight, sitting vs standing, altering resistances, increasing/decreasing size etc. Don’t be afraid to use resources to get ideas!
The question I get the most, “how long did it take you to be able to treatment plan on the spot?” To be honest, I don’t have a set point in time where I realized that I was able to treatment plan without having to plan. But with anything, the more you do something, the better you get. Were there ever interventions that I did where patients thought they were stupid, or it failed miserably? Hell yes there were. Lots of times like that. Sometimes having simple interventions still have an agenda behind them. Explain that agenda! Explaining your treatment ideas can often change the mindset of a patient because they can now understand why they are picking marbles out of theraputty or why they are picking up pom poms with tweezers. “To increase hand strength and improve fine motor skills/motor control which is necessary for you to be able to go back to work as a cashier.” I find it more often than not, when you explain your interventions to your patients, they are much more engaged and willing to participate and you as a therapist also start to really understand the purpose underlying your interventions.
Lastly, I highly recommend creating a morning routine. You will thank me for this in the long run. Have a set time you wake up each day, create consistency with your week. Get yourself a LARGE coffee with your favorite creamer. Start each day with a mindset that today is going to be a good day. Whatever that may mean for you, have some morning you time. On your car ride to work, put on your favorite play list, pray, manifest a good day, a good week, use that time for you. Self-care is so much more important than we realize. Fieldwork, being a student and being a therapist can all have days where it’s stressful and can be a lot. But know that fieldwork is temporary, make the best of it, control what you can, let go what you can’t and remember why you want to be in this field. I will 100% honest with you, there are days where I go home and just feel mentally exhausted. Then there are days where I feel so grateful to be in a field where I get to make an impact in people’s lives and it’s truly the best feeling in the world and make up for all those hard days. Don’t let the hard days win.
Hang in there, you got this and go be the best you know how to be!