STUDENT LEVEL-II FIELDWORK FAILURE - STRATEGIES FOR INTERVENTION

Objective. This report describes how common student communicative and behavioral characteristics that appear to predict the existence of pot ential problems during Level II fieldwork were identified in order to develop and implement preventative interventions during the academic c urriculum at New York University (NYU). Record review. A record review of NYU professional level occupational therapy students from 1986 to 1995 was completed to identify, common factors among students who perf ormed well academically but failed clinical fieldwork. Eight communica tive and behavioral characteristics were identified: (a) rigidity of t hinking, (b) discomfort with the ambiguity that accompanies clinical r easoning (c) lack of psychological insight, (d) difficulty interpretin g feedback, (e) externalization of responsibility, (f) difficulty lear ning from mistakes, (g) discomfort with the physical handling of patie nts, and (h) dependence on external measures for self-esteem. Interven tion. On the basis of the identified characteristics, Jive interventio n strategies were adopted: (d) academic seminars that address professi onal behavior and interpersonal skills, (b)faculty feedback to student s regarding problematic behaviors, (c) clinician and senior student co unseling with identified students, (d) student remediation programs co nsisting of community service, and (e) student learning contracts base d on specific behavioral objectives. These strategies were administere d before Level II fieldwork to IO students in the 1996 class who exhib ited the characteristics indicative of potential fieldwork failure. Ou tcome. Of the 10 students in the 1996 class, 7 passed fieldwork withou t further difficulty, two failed fieldwork midterm assessments but wen t on to achieve passing final evaluations, and one failed the final fi eldwork assessment but passed an additional third fieldwork experience . The class of 1996; which was the first to receive formal interventio n designed to decrease fieldwork failure, demonstrated lower fieldwork failure rates than did all other classes in the past 10 years.