UNIVERSITY OF UTAH OF COLLEGE ® HEALTH | Division of Occupational Therapy FIELDWORK I OBSERVATION OF STUDENT PERFORMANCE, Student's Name: \itianne Noemand Fieldwork Facility: Supervisor's Name: Hevinie Lacey ore Dates of FW: March SI 2.018 Please check the most appropriate rating: iMc- nea nt Pelle Face ky Professional Behavior The student: Outstanding Adequate Needs Improvement Not Observed 1. Conforms to institution's dress code. vy 2. Is responsible and dependable in attendance and promptness. v 3. Communicates effectively with other professionals/staff. Listens and speaks at appropriate times. 4 4, Contributes toward open communication with supervisor. Gives and receives feedback appropriately. 4 5. Establishes and maintains therapeutic relationships with clients and their families. 6, Demonstrates professional values and ethics, 7. Maintains the confidentiality of others. 8. Seeks information and asks relevant questions. Uses resources and time effectively. 9. Follows through with suggestions made by supervisor. 0. Seeks challenges and demonstrates enthusiasm for fieldwork experiences. 11. Demonstrates independence when appropriate. 12, Flexible: effectively adjusts to changes; adjusts priorities without difficulty. Related to Educational Objectives The student ha: Outstanding Adequate Needs Improvement Not Observed 13, Developed an increased comfort level interacting with persons who have disak emotional problems, or psychiatric disorders. v 14, Described the needs of clients served by the agency/acility. 15. Demonstrated respect for the values and diversity of persons with disabilities, caregivers, staff and volunteers. 4 16. Demonstrated an attitude of inquiry to enhance creativity and problem solving skills, 17. Observed staff interactions, assessments and/or treatment sessions with agency/facility clients. 18. Participated in group or individual treatment sessions as appropriate depending on the skill level of the student and the severity of the client's disability/iliness. mat 79. Observed OTRICOTA role delineation when Certified Occupational Therapy Assistants are employed by the ageney/facility. \se te te mee wll a dieeey fet tet Enthusashe, pestveyable to relate well to. padverc P ate “Yad worker Areas the student could work toward improving during remaining fieldwork experiences: Corhnaeto work on Flevialiby ia tx, grading lawn We stills, ete . Additional comments: Joule genre, db bean inerebl ot! Mo Eanes g ‘Supervisor Signature Student Signature Please give to the student to return, or mail to: Jeanette Koski, OTR/L Academic Fieldwork Coordinator Division of Occupational Therapy University of Utah 520 Wakara Way Salt Lake City, UT 84108-1290UNIVERSITY OF UTAH | COLLEGE HEALTH. Student's Name: Se eee a N mM ldwork Facility: ‘Supervisor's Name: Dates of FW: Please check the most ee rating: SS]... Division of Occupational Therapy FIELDWORK | OBSERVATION OF STUDENT PERFORMANCE oa ee Professional Behavior The student Outstanding | Adequate | improvenen | ose 1. Conforms to institution's dress code, joesened 2. Is responsible and dependable in attendance and promptness. 1} ‘3. Communicates effectively with other professionalsistaff. Listens and speaks at appropriate times. vA 4. Contributes toward open communication with supervisor. Gives and receives feedback appropriately. vw 5. Establishes and maintains therapeutic relationships with clients and their families. vo 6. Demonstrates professional values and ethics. 7. Maintains the confidentiality of others. 8. Seeks information and asks relevant questions, Uses resources and time effectively. VA 8. Follows through with suggestions made by supervisor. 10. Seeks challenges and demonstrates enthusiasm for fieldwork experiences. 17, Demonstrates independence when appropriate. Vv 12. Flexible: effectively adjusts to changes; adjusts priorities without difficulty Related to Educational Objectives Needs Wot The student has: Outstanding | Adequate | improvement | Observed 13. Developed an increased comfort level interacting with persons who have disabilities, ‘emotional problems, or psychiatric disorders. v 14, Described the needs of clients served by the agency/faciliy. aa 15. Demonstrated respect for the values and diversity of persons with disabilities, Y, caregivers, staff and volunteers. ea 16. Demonstrated an attitude of inquiry to enhance creativity and problem solving skills. v 17. Observed staff interactions, assessments and/or treatment sessions with agency/facilily v7, clients. | 18. Participated in group or individual treaiment sessions as appropriate depending on the skill level of the student and the severity of the client's disability/liness. Vv 19. Observed OTRICOTA role delineation when Certified Occupational Therapy Assistants 74 are employed by the agency/facility.