Supporting Student's Active Role

There is no clear-cut right answer on how much independence to give (unless “it depends” counts as the right answer).   While we know students are at varying levels in their education and experience, we need to balance that with the learning curve that occurs over the two years of the program. 

When I think of giving advice to educations, I think the best tip is to approach learning opportunities for your student with your OT brain.

By this, I mean: 

If I broke this client interaction into steps, which parts would be appropriate for my student to do independently?  This not only helps with identifying areas where the student can be involved but also helps the student to not be overwhelmed with everything that can occur in a single OT interaction! For example,

• You interpret the assessment and develop the intervention, however the student carries it out (especially if these are interventions an aide would carry out).
• When you go into the home visit, have the student focus on the layout of the home and how it facilitates/presents barriers to function.
• After a client interaction, have the student come up with one issue that is important to address, the barriers/resources to overcoming this issue and possible interventions for the future

If the student isn’t able to do _______ independently, would it still be safe if I was there as a “standby assist?”

• Have your student lead the initial interview or client education.  You can jump in if the student gets stuck

If the student isn’t able to do this independently in the “real world,” is there a simulated way for this skill to be developed?

• Can the student practice the assessment on a fellow student before completing it with a client? 
• If a chart note is too complex (or there isn’t time) for the student to write, can he/she write a practice chart note and then compare it to yours.

Some extra bonus tips that come to mind:

• When deciding which clients or tasks to share with your student, focus on the 5-6 “things” that make up 80% of your day and allow the student to take the lead.  This nurtures students to recognize patterns among your clients, build confidence, and competence.
• Allow your student to spend extra time to build a skill or technique if your setting allows. Our skills grew in efficiency with repeated practice and exposure; we can try to foster the same opportunities for our students. For example, protect time for your student to be with clients longer than you would usually schedule so that they can practice their interviewing and communication skills.  
• Be intentional about thinking out loud whenever you can. Basic has been voted “Placement I am most likely to lose my voice”, but being explicit about the reasoning that is going on in your head is a fabulous way for students to learn.

Lisa

Revised by Julie, 2024

 

 

 

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