Fwfinal

Touro University Nevada
Occupational Therapy
Evaluator:
Cristy Luft - Fieldwork Educator
Subject:
Josee Lundquist - Level II
Activity:
OCCT 660
Site:
HealthSouth Desert Canyon Rehabilitation Hospital (Corporate: HealthSouth

Rehabilitation Hospital)
Evaluation Type:
Fieldwork Performance Eval for OT

Student - Final
Completion
Date:
01/26/2015
Request Date:
01/07/2015
Period:
OCCT 660 - Fall 2014 *
Dates of
Activity:
11/03/2014 To 02/06/2015
Subject Participation
Dates:
11/03/2014 To 02/06/2015
Please select the option that best matches your level of agreement with this evaluation.
Comments entered above may be viewed by your program director or advisor and may be a part of a printed report.
AOTA
Fieldwork Performance Evaluation for the Occupational Therapy Student
Touro University Nevada, School of Occupational Therapy
FINAL EVALUATION
Student Name: (Last, First, Middle)
(Question1of39-Mandatory)
Lundquist, Josee
College or University:
(Question2of39)
Selection
Option
Touro University Nevada, School of Occupational Therapy

Other
FIELDWORK SETTING
Name of Organization/Facility:
X HealthSouth Desert Canyon Rehabilitation Hospital (Corporate: HealthSouth Rehabilitation Hospital)
Address (Street or PO Box):
9175 Oquendo Rd
City, State, Zip:
Las Vegas, NV
Type of Fieldwork:
Selection
Option
1-1 In-Patient Acute
1.2 In Patient Rehab

1.3 SNF/Sub-acute/Acute Long-term Care
1.4 General Rehab Outpatient
1.5 Outpatient Hands
1.6 Pediatric Hospital/Unit
1.7 Pediatric Hospital Outpatient
1.8 In-Patient Psych
2.1 Pediatric Community
2.2 Behavioral Health Community
2.3 Older Adult Community Living
2.4 Older Adult Day Program
2.5 Outpatient/Hand Private Practice
2.6 Adult Day Program for DD
2.7 Home Health
2.8 Pediatric Outpatient Clinic
3.1 Early Intervention

3.2 School
Other (explain below)
If "Other" please explain:
(Question7of39)
Order of Placement: (AtTouroUniversityNevada'sSchoolofOTtherearetwopossibleplacementsatthislevel.Answershouldbe1of2or2of2.)

(Question8of39)
Selection Option
X
IIA (1 of 2)
IIB (2 of 2)
Start Date: (DatesofPlacement)
11/04/2014
End Date:
01/26/2015
Number of Weeks Completed:
12
Pass / No Pass:
(Question12of39)
Selection Option
------
Pass
No Pass
Final Score:
(Question13of39)
134
SUMMARY COMMENTS: (Addressesstudent'sclinicalcompetence)
(Question14of39)
Josee is very professional and manages her time well. She excels in communication and interpersonal skills. Josee responds well to
changes/challenges and demonstrates good safety.
SIGNATURES
Digital Signature of Student:
(Question15of39)
Josee Lundquist
I understand that be checking this box I am certifying that I have read this report.
Selection
Option
I confirm I have read this report
FIELDWORK EDUCATOR(S):
(Question16of39)
Number of Persons Contributing to this Report:
(Question17of39)
Digital Signature of Rater #1:
Cristy Luft
I understand that by checking this box, I am certifying the authenticity of this evaluation.
Selection
Option
I hereby certify the authenticity of this evaluation
Credentials/Position:
(Question20of39)
OTR/L
Digital Signature of Rater #2 (if applicable):
(Question21of39)
I understand that by checking this box, I am certifying the authenticity of this evaluation.
Selection
(Question22of39)
Option
I hereby certify the authenticity of this evaluation
Credentials/Position:
(Question23of39)
RATING SCALE FOR STUDENT PERFORMANCE

4 - Exceeds Standards
supervised.
is highly skilled and self-initiated. This rating is rarely given and would represent the top five percent of all the students you have
3 - Meets Standards Performance is consistent with entry-level practice. This rating is infrequently given at midterm and is a strong rating at final.
2 - Needs improvement Performance is progressing but still needs improvement for entry-level practice. This is a realistic rating of performance at midterm,
and some ratings of two may be reasonable at the final.
1 - Unsatisfactory:
performance
Accepted:
Performance is below standards and requires development for entry-level practice. This rating is given when there is a concern about
(Question24of39)
Selection
Option
I have read and understand this information
I. FUNDAMENTALS OF PRACTICE
Exceeds Standards Meets Stardands Needs Improvement Unsatisfactory
4
4.0
>> 3 <
2.0
1.0
Adheres to safety regulations: Adheres consistently

2. to safety regulations. Anticipates potentially hazardous situations
and takes steps to prevent accidents.
4.0
>> 3 <
2.0
1.0
Uses judgment in safety : Uses sound judgment in

3. regard to safety of self and others during all fieldwork-related
activities.
4.0
>> 3 <
2.0
1.0
Adheres to ethics : Adheres consistently to the American

1. Occupational Therapy Association Code of Ethics (4) and site's
policies and procedures including, when relevant, those related to
human subject research.
Comments on strengths and areas of improvement:
(Question26of39)
Josee adheres to ethics and safety regulations and demonstrates good judgment in safety
II. BASIC TENETS

Exceeds Standards Meets Standards Needs Improvement Unsatisfactory
4
>> 4 <
3.0
2.0
1.0
Clearly, confidently and accurately articulates the

value of occupation as a method and desired outcome
of occupational therapy to clients, families, significant others,
colleagues, service providers and the public.
4.0
>> 3 <
2.0
1.0
communicates the
roles of the occupational therapist and
occupation therapy assistant to clients, families,
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
Clearly and confidently articulates the values and

1. beliefs of the occupational therapy profession to clients,
families, significant others, colleagues, service providers and the
public.
2.
Clearly, confidently and accurately

3.
significant others, colleagues, service providers and the public.

4.
Collaborates with client, family and significant others

throughout the occupational therapy process.
Comments on strengths and areas for improvement:
(Question28of39)
Josee clearly and confidently articulates the values and beliefs of occupational therapy. She collaborates well with the client and family and
communicates the role of the occupational therapist.
III. EVALUATION AND SCREENINGS

1.
Articulates a clear and logical rationale for the
2.
Selects relevant screening and assessment

methods while considering such factors as client's priorities,
evaluation process.
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
4.0
3.0
>> 2 <
1.0
context(s), theories and evidence-based practice.

3.
Determines client's occupational profile and
4.
Assesses Client Factors and contexts(s) that
5.
Obtains sufficient and necessary

information from relevant resources such as client, families,
performance through appropriate assessment methods.

support or hinder occupational performance.
significant others, service providers and records prior to and during

the evaluation process.
Administers assessments in a uniform manner to
4.0
>> 3 <
2.0
1.0
Adjusts/modifies the assessment

procedures based on client's needs, behaviors and culture.
4.0
>> 3 <
2.0
1.0
8.
Interprets evaluation results to determine client's
4.0
>> 3 <
2.0
1.0
9.
Establishes an accurate and appropriate

plan based on the evaluation results, through integrating multiple
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
6.
7.
ensure findings are valid and reliable.
occupational performance strengths and challenges.
factors such as client's priorities, context(s), theories and

evidence-based practice.
Documents the results of the evaluation
10. process that demonstrates objective measurement of client's

occupational performance.
(Question30of39)
Josee uniformly administers assessments and modifies them based on the client's needs. She establishes an appropriate treatment plan and
documents the evaluation well.
IV. INTERVENTION
1.
Articulates a clear and logical rationale for the
2.
Utilizes evidence from published research and relevant
3.
Chooses occupations that motivate and challenge
4.
Selects relevant occupations to facilitate clients
5.
intervention process.
resources to make informed intervention decisions.
clients.
meeting established goals.
Implements intervention plans that are

client-centered.
4.0
>> 3 <
2.0
1.0
4.0
3.0
>> 2 <
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
6.
Implements intervention plans that are

occupation-based.
4.0
>> 3 <
2.0
1.0
7.
Modifies task approach, occupations and the

environment to maximize client performance.
4.0
>> 3 <
2.0
1.0
Updates, modifies or terminates the

intervention plan based upon careful monitoring of the
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
8.
client's status.
9.
Documents client's response to services in a

manner that demonstrates the efficacy of interventions.
(Question32of39)
Josee implements interventions that are occupation-based and client-centered. She modifies tasks and the intervention plan based upon the client
needs.
V. MANAGEMENT OF OCCUPATIONAL THERAPY SERVICES:

1.
Demonstrates through practice or

discussion the ability to assign appropriate
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
responsibilities to the occupational therapy assistant and

occupational therapy aide.
2.
Demonstrates through practice or

discussion the ability to actively collaborate
with the occupational therapy assistant.
3.
Demonstrates understanding of the costs

and funding related to occupational therapy services at this
site.
Accomplishes organizational goals by

4. establishing priorities, developing strategies and meeting
deadlines.
5.
Produces the volume of work required in the

expected time frame.
(Question34of39)
Josee demonstrates good collaboration with occupational therapy assistants and occupational therapy aids. She accomplishes organizational goals
and produces the volume of work demonstrating good time management.
VI. Communication:
1.
Clearly and effectively communicates

verbally and nonverbally with clients, families,
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
significant others, colleagues, service providers and the public.

2.
Produces clear an accurate documentation
3.
All written communication is legible, using
according to site requirements.

proper spelling, punctuation and grammar.
Uses language appropriate to the recipient of
4. the information, including but not limited to funding agencies and

regulatory agencies.
(Question36of39)
Josee has excellent communication and documentation.
VII. PROFESSIONAL BEHAVIORS:

1.
Collaborates with supervisor(s) to maximize the
2.
Takes responsibility for attaining

professional competence by seeking out learning
learning experience.
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
opportunities and interactions with supervisor(s) and others.

3.
Responds constructively to feedback.

Demonstrates consistent work behaviors
4. including initiative, preparedness, dependability and worksite

maintenance.
5.
Demonstrates effective time management.
Demonstrates positive interpersonal skills
6. including but not limited to cooperation, flexibility, tact and

empathy.
Demonstrates respect for diversity factors of

7. others including but not limited to socio-cultural, socio-economic,
spiritual and lifestyle choices.
Comments on strengths and areas of improvement:
>> 4 <
3.0
2.0
1.0
4.0
>> 3 <
2.0
1.0
(Question38of39)
Josee excels with positive interpersonal skills and professional behavior.
REFERENCES
1. American Occupational Therapy Association, (1998), Standards of practice for occupational therapy, AmericanJournalofOccupationalTherapy,52, 866-869.
2. Accreditation Council for Occupational Therapy Education, (1999). Standards for an accredited educational program for the occupational therapist. American
JournalofOccupationalTherapy,53, 575-582.
3. National Board for Certification in Occupational Therapy, (1997). NationalStudyofOccupationalTherapyPractice,ExecutiveSummary.
4. American Occupational Therapy Association. (2000). Occupational therapy code of ethics (2000). AmericanJournalofOccupationalTherapy,54, 614-616.
5. American Occupational Therapy Association (2002). Occupational therapy practice framework: Domain and process. AmericanJournalofOccupational
Therapy,56, 606-639.
GLOSSARY
Client Factors:
Those factors that reside within the client and that may affect performance in areas of occupation. Client factors include body functions and body structures
Body functions (a client factor, including physical, cognitive, psychosocial aspects)the physiological function of body systems (including psychological
functions) (WHO, 2001, p. 10)
Body structuresanatomical parts of the body such as organs, limbs and their components [that support body function] (WHO, 2001, p. 10)
(Occupational therapy practice framework: Domain and process. AmericanJournalofOccupationalTherapy,56, 606-639.) (5)
Code of Ethics: Refer to
http://www.aota.org/~/media/Corporate/Files/AboutOT/Ethics/Code%20and%20Ethics%20Standards%202010.ashx
Collaborate: To work together with a mutual sharing of thoughts and ideas. (ACOTE Glossary)
Competency: Adequate skills and abilities to practice as an entry-level occupational therapist or occupation therapy assistant.
Context: Refers to a variety of interrelated conditions within and surrounding the client that influence performance. Contexts include cultural, physical, social,
personal, spiritual, temporal and virtual. (Occupational therapy practice framework: Domain and process.AmericanJournalofOccupationalTherapy,56, 606-639.) (5)
Efficacy: Having the desired influence or outcome (from Neistadt and Crepeau, Eds. Willard&SpackmansOccupationalTherapy, 9 th edition, 1998).
Entry-level Practice: Refer to:
http://www.aota.org/~/media/Corporate/Files/Practice/OTAs/ScopeandStandards/Standards%20of%20Practice%20for%20Occupational%20Therapy%20FINAL.ashx
Evidenced-based Practice: "Conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The
practice of evidence-based [health care] means integrating individual clinical expertise with the best available external clinical evidence from systematic research."
Occupation: Groups of activities and tasks of everyday life, named organized and given value and meaning by individuals and a culture; occupation is everything
people do to occupy themselves, including looking after themselves (self-care), enjoying life (leisure), and contributing to the social and economic fabric of their
communities (productivity); the domain of concern and the therapeutic medium of occupational therapy. (Townsend, editor, 1997, EnablingOccupation:An
OccupationalTherapyPerspective, p. 181)
Occupational Performance: The result of a dynamic, interwoven relationship between persons, environment and occupation over a person's lifespan; the ability to
choose, organize, and satisfactorily perform meaningful occupations that are culturally defined and age appropriate for looking after oneself, enjoying life, and
contributing to the social and economic fabric of a community. (Townsend, editor, 1997, EnablingOccupation:AnOccupationalTherapyPerspective, p.181)
Occupational Profile: A profile that describes the clients occupational history, patterns of daily living, interests, values and needs. (Occupational therapy practice
framework: Domain and process, AmericanJournalofOccupationalTherapy,56, 606-639.) (5)
Spiritual: (a context)The fundamental orientation of a person's life; that which inspires and motivates that individual. (Occupational therapy practice framework:
Domain and process. AmericanJournalofOccupationalTherapy,56, 606-639.) (5)
Theory: "An organized way of thinking about given phenomena. In occupational therapy the phenomenon of concern is occupational endeavor. Theory attempts to
(1) define and explain the relationships between concepts or ideas related to the phenomenon of interest, (2) explain how these relationships can predict behavior or
events, and (3) suggest ways that the phenomenon can be changed or controlled. Occupational therapy theory is concerned with four major concepts related to
occupational endeavor: person, environment, health, and occupation." (Neistadt and Crepeau, Eds. Willard&Spackman'sOccupationalTherapy, 9 th edition, 1998,
p. 521)
Accepted:
(Question39of39)
Selection
Option
I have read and understand this information

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Touro University Nevada

Cristy Luft - Fieldwork Educator

Josee Lundquist - Level II

HealthSouth Desert Canyon Rehabilitation Hospital (Corporate: HealthSouth

Fieldwork Performance Eval for OT

OCCT 660 - Fall 2014 *

Touro University Nevada, School of Occupational Therapy

X HealthSouth Desert Canyon Rehabilitation Hospital (Corporate: HealthSouth Rehabilitation Hospital)

Address (Street or PO Box):

City, State, Zip:

1-1 In-Patient Acute

1.2 In Patient Rehab

3.1 Early Intervention

If "Other" please explain:

Order of Placement: (AtTouroUniversityNevada'sSchoolofOTtherearetwopossibleplacementsatthislevel.Answershouldbe1of2or2of2.)

Start Date: (DatesofPlacement)

Number of Weeks Completed:

SUMMARY COMMENTS: (Addressesstudent'sclinicalcompetence)

I confirm I have read this report

Number of Persons Contributing to this Report:

Digital Signature of Rater #1:

I hereby certify the authenticity of this evaluation

Digital Signature of Rater #2 (if applicable):

RATING SCALE FOR STUDENT PERFORMANCE

I have read and understand this information

Adheres to safety regulations: Adheres consistently

Uses judgment in safety : Uses sound judgment in

Adheres to ethics : Adheres consistently to the American

Comments on strengths and areas of improvement:

II. BASIC TENETS

Clearly, confidently and accurately articulates the

Clearly and confidently articulates the values and

Clearly, confidently and accurately

significant others, colleagues, service providers and the public.

Collaborates with client, family and significant others

Comments on strengths and areas for improvement:

III. EVALUATION AND SCREENINGS

Articulates a clear and logical rationale for the

Selects relevant screening and assessment

context(s), theories and evidence-based practice.

Determines client's occupational profile and

Assesses Client Factors and contexts(s) that

Obtains sufficient and necessary

performance through appropriate assessment methods.

significant others, service providers and records prior to and during

Administers assessments in a uniform manner to

Adjusts/modifies the assessment

Interprets evaluation results to determine client's

Establishes an accurate and appropriate

ensure findings are valid and reliable.

occupational performance strengths and challenges.

factors such as client's priorities, context(s), theories and

Documents the results of the evaluation

10. process that demonstrates objective measurement of client's

Comments on strengths and areas for improvement:

Articulates a clear and logical rationale for the

Utilizes evidence from published research and relevant

Chooses occupations that motivate and challenge

Selects relevant occupations to facilitate clients

Implements intervention plans that are

Implements intervention plans that are

Modifies task approach, occupations and the