Goodbye for the Last Time

All placements must come to an end. 

After weeks of working closely with a client, who wouldn’t wonder - what happened to my client who I saw daily for therapy? What happened to my client who became tearful when they spoke about their fears? What happened to that equipment funding request I helped write? Your student’s genuine curiosity and concern could be endless but cannot be appeased as we must abide by strict legislation to protect personal information.

As a therapist, you have faced a variety of similar experiences where the end to a therapeutic, client relationship felt unfinished. Modelling ways to gain closure will support your student’s ability to cope as a clinician later.

So how can you, as fieldwork educators, facilitate a sense of closure for your student during placement?

Here are a few suggestions:

·      Remind your student to tell clients of their eventual departure with a specific end date to establish boundaries,

·     Protect time at the end of placement for your student to individually say goodbye to clients and suggest sharing: 

§  Something they have learned from the client,

§  Ways in which the client helped shape their professional growth,

§  How they have appreciated their work together,

§  Strict boundaries regarding communication moving forward,

§  How you, as the therapist, have been updated on what was being worked on and will continue to provide services.

·     Allow time to close your own student-educator relationship during the final evaluation as you would for a client (above),

·     Consider being open and honest about your own feelings and strategies you use to cope with lack of closure or difficult goodbyes as they occur in real-time during placement.

Goodbyes are hard but it is a hard we need to learn to cope with as therapists as one goodbye makes room for a hello with a new client. And if that’s not encouraging enough, remind your student of the timeless wisdom of Dr. Seuss - “Don’t cry because it’s over. Smile because it happened.”

Julie

NB: 'client' is being used to symbolize individual persons, patients/residents, caregivers/support systems, and communities.

Talk about being wrong

While listening to the radio, I was made aware of a TED talk called "Doctor’s Make Mistakes. Can we talk about that?" by Dr. Goldman. I have since checked it out and would recommend  you do too.

Although the focus of the TED Talk was on “medicine’s culture of denial” that keeps doctors from talking about their mistakes, I could see the link with other health professions. 

It got me thinking about some of the mistakes I’ve made in my practice.  While I realize that my mistakes haven’t had “life or death” consequences, my mistakes are ones that I hope wouldn’t happen again.  And when you expand the word “mistakes” to “things that I should have done better”, or “things I’m not proud of”, or “I should have known better” the list gets even longer.

What stood out most to me was a tip Dr. Goldman was sharing with physicians (which I think can be applied to you):

TALK ABOUT BEING WRONG. 

And for those of us who have practiced for a while--don’t just talk about the mistakes you made when you first got into practice.  Talk about the recent mistakes.  Mistakes don’t just happen to us in the first few years of practice.  They can happen at any time.

Talk about where you think you went wrong.  

Talk about what you learned.  

Talk about how this has changed what you do.

I think a few things might happen:

• You will help create a safe learning environment for the student.  You expect that mistakes will be made.  Mistakes that you can talk about and learn from. 

• You will alleviate the pressure the student might feel to have “the right answer” or to be “perfect”.  Although you are an educator in a mentoring/coaching role, you are still seen as the evaluator.

• You might be able to prevent a future mistake.  Perhaps your student can learn from your mistake too.

Around the 17 minute mark, Dr.Goldman says (the bolding is mine):

The redefined physician is human, knows she's human, accepts it, isn't proud of making mistakes, but strives to learn one thing from what happened that she can teach to somebody else. She shares her experience with others. She's supportive when other people talk about their mistakes. And she points out other people's mistakes, not in a gotcha way, but in a loving, supportive way so that everybody can benefit.

We are human.  We make mistakes.  But we can choose to learn from these mistakes.  And we can share this learning with others, including our students.

Lisa

Revised by Julie, 2024.

The importance of creating a safe learning environment

As OTs, we understand the impact the environment can have on our clients functioning.  The same goes for student learning.  When we, as educators, create a safe and positive environment, we set the stage for our students to feel ready to take on safe risks.  

But once again, don’t take my word for it…here are some thoughts from OTs in our community:

The feedback I have received from students in the past is that I create a supportive environment - where they do not feel afraid to try out their skills and have things not go "perfectly". Most students have said this has helped them build confidence....because a "failure or hiccup" is just an opportunity to debrief and learn from. My hope is that I make their placement feel like a partnership that we are in together.

I would hope they would say I encourage people to try and make mistakes in a safe supportive environment, I know for me I usually learn the lesson better and never forget it.

I try to be approachable and let the students know that this is a safe place to ask any questions no matter how silly they think they may be.  I always take them seriously and make sure we laugh a lot too.

Lisa

Revised by Julie, 2024

Use the F word as often as you can

Just in case you did not figure it out - the 'F' word stands for FEEDBACK.

True story:

OT Fieldwork educator thinks: Wow, am I ever giving a lot of Feedback.

OT student thinks: Hmm, I wish I could get more Feedback.

As a fieldwork educator, you may be providing the student with a lot of feedback throughout the day.  Sometimes, we have found students only “hear” your comments as feedback when they occur in a formal feedback session. You are very likely providing the student with many tips, suggestions, and opportunities for improvement throughout the day.  Sometimes, you don’t have to necessarily provide more feedback … just highlight the feedback moments throughout the day that you are already providing.

Rather than saying: “The next time you open your interview, you may want to try….”

Try: “I’m going to give you some feedback for the next time you open your interview…”

If saying the F word all day long is too offensive for you, negotiate another feedback cue.  Something that says, “ok here’s some feedback” like waving a feedback flag, tugging your ear, or doing a cartwheel.  Really, it’s up to you.

Lisa

Updated by Julie, 2024