Some years ago, I was talking with a faculty colleague who taught in the nursing program, discussing the clinical education components of our professional programs. As she described the challenges nursing students faced, she said, “Well, you know we eat our young.” My eyebrows shot up, and I pressed my lips together as I considered this rather shocking remark. I had heard it before, but I did not expect a nursing educator to say it.
This exchange led me to think about occupational therapy’s culture and attitudes toward preparing our young practitioners. Perhaps I wear rose-colored glasses, but I view our professional culture as collaborative and nurturing, and dedicated to challenging learners at a “just right” level whenever possible. We work with our clients to achieve mutually agreed-upon outcomes, and I think this focus should extend to how we prepare our future colleagues, too.
This is not to say that serving as a clinical instructor for fieldwork students is about serving cookies and milk. Students enter fieldwork 2 having achieved the academic requirements of an accredited program, but that leaves a lot of room for variability in terms of their readiness for clinical training. Some come intrinsically prepared to interact professionally and personably with clients and co-workers, and others still are learning these skills. Most have exemplary work habits, but some need improvement. Some have the confidence and courage to get busy and apply what they have only read and talked about to actual practice, and others need a lot of support. The variables are many, and each student, clinical instructor and setting present a unique combination of traits that combine with more or less ease.
In truth, taking occupational therapy students for fieldwork presents risks to our daily operations, time management and stress levels. Daunting as these issues may be, serving as a clinical instructor usually is a great investment, and here is why:
• Bringing outsiders into our circle requires us to view our practices critically, and through new eyes. We then are motivated to tighten procedures that have become a bit lax or outdated, and their quality is improved.
• Explaining what we do and why we do it requires analysis and articulation of our clinical reasoning skills. It sharpens our thinking and our therapy.
• Students come from classrooms where they have learned the most up-to-date, evidence-based concepts and methods. While none of us wants to hear that our way of approaching the work is behind the times (and hopefully students have the good judgment never to be so tactless as to say so), as members of a science-based profession, our knowledge always is evolving and so must our practices. Students can be tremendous resources for updates on what is emerging, and they have the latest editions of texts and readings to share.
• Students bring fresh energy, and they often remind us of how exciting, challenging and rewarding our work really is. Their enthusiasm is infectious.
• Once they are in the swim of things at a clinical site, most students actually reduce the occupational therapy staff’s daily workload, thereby freeing therapists to tackle previously postponed long-term projects, or to catch up on tasks that have been piling up.
• Students look up to their clinical instructors as role models and mentors. If you want to feel wise and important, take on a fieldwork student and discover how amazing you can be.
• This is your chance to make a long-term contribution to futures clients, and to your profession. Each of us is limited in the number of people to whom we can personally provide great service; teaching one young therapist arguably doubles the number of people you can help. The math is easy; the more you teach, the more you reach.
Sometimes having a full-time student on board is just too much for a clinical team. Many fieldwork coordinators are eager to work with clinical instructors to invent combinations of fieldwork settings, resulting in exciting and well-rounded clinical experiences. If your site can handle a student two or three days a week, perhaps another site also can commit to part-time, and the result will be an excellent combination for a particular student.
What if you and a fieldwork student find that your setting and styles prove not to be a good match? The student’s fieldwork coordinator is an excellent resource, and should be brought into your confidence early on if there seems to be trouble. Other therapists on your team also may be able to help as advisers, or as alternative or supplementary clinical instructors. Early intervention is best, and most troubled situations can be improved with a bit of adjustment.
This year, approximately 160 OT and 90 OTA programs will be seeking fieldwork placement sites for their students. I encourage all qualified occupational therapy practitioners to step to the plate and offer their services as a clinical instructor for Level 1 or Level 2 students. In doing so, you can help to make the world a better place, while enhancing your own career satisfaction.
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