Monday, May 15, 2017

Supporting Level 1 Students

Today marks the first day of placement for our Level 1 students as they head out for seven weeks in the field for OccTh 525.  I can tell you they are a very excited group - keen on learning, participating and applying what they have learned over the last nine months.

The course outline indicates the expectation for the students at this level is about 25% of typical caseload in a timely, competent, and safe manner with moderate to maximal supervision.  On the Competency Base Fieldwork Evaluation, the target the competency rating (numerical) rating would be in the 1-3 range, though there can be variations based on student experience, practice setting, and available opportunities.

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"Application of Knowledge" is the focus of learning for this placement and the first experience (other than the one week shadow last fall) students have with clinical reasoning.  At this level, students are beginning to use "procedural" reasoning.  This is the "how to" type of concrete reasoning that helps them gather and categorize information.

Questions that can help students develop this include:

  • What did you learn? 
  • How was this client similar to the last one?
  • How were they different?
  • What are two things that went well? How can you tell? (what's the evidence?)
  • What are two things you would try to do differently next time? 

As students become more comfortable with the concrete reasoning, preceptors can encourage them to start to develop more "interactive" reasoning.  This is the type of reasoning that helps them recognize individual differences and meaning, how to practice in a client centered manner, and why there is rarely only one way to help a client achieve their goals.   Questions that can help students develop this include:
  • What do you think the client learned?
  • How do you think they responded to your intervention/questions/plan? (evidence?)
  • How does this client's presentation differ from what you learned in school? 
  • What would you try and do more of with this client next time? 
To read more about different types of reasoning, have a look at the CAOT publication by Lisa Mendez and Jodene Neufeld "Clinical reasoning:What is it and why should I care?"  (CAOT Publications, 2003).  A few other tips for preceptors from this publication:

  • Talk out loud!  Students can't learn simply by watching your actions - try and share your continuous thought revisions.
  • Have your student 'predict' what a client will look like based on information they have gathered.
  • Encourage 'what' and 'why' questions
  • Give a homogeneous caseload (so much as is possible)
We hope everyone has a great first week and look forward to any questions you might have for the fieldwork team!