Most Frequently Asked Questions

The purpose of this information is to provide you with answers to frequently asked questions. Topics covered include levels of fieldwork, supervision requirements, allowed time off for students, grading and the fieldwork evaluation forms, student performance and failure, students with disabilities, reimbursement of student services and note-signing.

1. Who Sets Fieldwork Requirements?
As of July 1, 2000, the Standards for an Accredited Educational Program for the Occupational Therapist/ (or) Occupational Therapy Assistant will replace the Essentials and Guidelines for an Accredited Educational Program for the Occupational Therapist (or) Occupational Therapy Assistant as the official AOTA documents that govern the length and types of fieldwork required for all students. You may view these documents on AOTA's web site under Education and Accreditation or request to see a copy at your academic program.

2. What Is The Difference Between A Level I And Level II Fieldwork?
Level I Fieldwork, for both OTA and OT students, is designed to enrich didactic coursework through directed observation and participation in selected aspects of the occupational therapy process. The focus of these experiences is not intended to be independent performance. Each academic program structures these experiences slightly differently. It is best to discuss the learning objectives and activities with the student�s academic fieldwork coordinator.
The purpose of Level II Fieldwork is to develop competent, entry-level, generalist occupational therapists or occupational therapy assistants. Level II Fieldwork shall included an in-depth experience in delivering occupational therapy services to clients, focusing on the application of purposeful and meaningful occupation. For OT students only, not OTA students, Level II Fieldwork may also focus on research, administration and management of occupational therapy services.
For OT Students, the new Standards require "an equivalent of 24 weeks experience on full-time or part-time basis, but not less than half time as defined by the fieldwork site." Level II Fieldwork may be completed on full- or part-time basis, but may not be less than half time as defined by the fieldwork site. For OTA students, the Standards document increases the requirement for Level II Fieldwork from 12 weeks to 16 weeks.

3. Who Can Supervise A Level I And Level II Fieldwork Student?
Level I Fieldwork students may be supervised by a variety of qualified personnel including, but not limited to, occupational therapy practitioners initially certified nationally, teachers, nurses, social workers, physical therapists, physician's assistants. For Level II Fieldwork , OT students must be supervised by an occupational therapist who meets state regulations and has a minimum of one year of practice experience, subsequent to initial certification. For OTA students the supervisor must be an occupational therapy practitioner, OT or OTA, who meets state regulations and has a minimum of one year of practice experience, subsequent to initial certification.

4. Does The Fieldwork Educator Need To Be On-Site All The Time And/Or Every Day?
The new Standards state that "supervision should be direct, then decrease to less direct supervision as is appropriate for the setting, the severity of client's condition, and the ability of the students." Supervision should also be consistent with state licensure regulations, reimbursement guidelines such as Medicare and Medicaid, and facility policy. Unless specified by reimbursement guidelines or other regulatory requirements, supervision need not always be "line of sight." Telephones, mobile phones, or other communications technologies may supplement on-site supervision. Remember that other professionals can participate in student supervision, but the primary supervisor must be an OT practitioner. The new Standards permit half of Level II Fieldwork to be in a setting where there is no occupational therapist on site, 12 weeks for OT student and 8 weeks for OTA student. In such cases, the program must document that there is a plan for the provision of occupational therapy services. On-site supervision must be provided in accordance with the plan and state credentialing requirements, and the student must receive a minimum of six hours of occupational therapy supervision per week, including direct observation of client interaction. Additionally, the OT supervisor must be readily available for communication and consultation during work hours.

5. What Happens If The Fieldwork Educator Becomes Ill Or Goes On Vacation During Part Of The Fieldwork Experience?
This situation should be discussed with the student's academic fieldwork coordinator. Any time that the primary supervisor is away, another person must be designated as the responsible party and contact person to whom the student can go for guidance. Any state licensure regulations and reimbursement guidelines such as Medicare or Medicaid must be followed.

6. How Many Days May A Student Be Absent From A Level II Fieldwork?
The Level II Fieldwork site and the academic program together decide time off during fieldwork. The student is still responsible to meet the time requirements of the placement.

7. What Is The Passing Grade For Level II Fieldwork?
Each academic program is responsible for determining its grading criteria for Level II Fieldwork, and for assigning the final letter grade, pass/fail, and number of credit hours. Contact the student's academic fieldwork coordinator with any additional questions.

8. Where Should The Student's Fieldwork Evaluation Form Be Sent?
The completed Fieldwork Evaluation form is only sent to the academic fieldwork coordinator at the student's school. Please do not send this form to AOTA. AOTA National Office does not keep files of completed evaluations.

9. Can The Fieldwork Evaluation Form Be Modified To Fit Your Practice Setting?
Although both the Fieldwork Evaluation Form for Occupational Therapy Assistant Students and the Fieldwork Evaluation for the Occupational Therapist are official AOTA forms, neither is mandatory. The evaluation may be changed as long as the student academic program is informed and the final score can be determined. The academic program often requires a final score from the evaluation, which is then converted to a letter grade or pass-fail.

10. What Should You Do If You Think Your Student Is At Risk Of Failing Fieldwork?
The first step is to notify the student that he/she is at risk of failing fieldwork. Let the student know that you will now notify the academic fieldwork coordinator and encourage the student to call the coordinator as well. One of the roles of the academic fieldwork coordinator is to serve as a mediator between student and fieldwork educator concerns. The academic fieldwork coordinator can provide you with a different perspective, can advise you on possible solutions, and can guide you through the necessary steps.

11. How Many Times Can A Student Fail Level II Fieldwork?
Each academic program establishes policy on fieldwork failure and whether or how many times a student will be allowed to repeat fieldwork. You need to communicate with the students academic program on this question.

12. Does The Academic Program Have To Tell The Fieldwork Setting That The Student Has A Disability?
The academic program is not required to, nor should it, inform the fieldwork site of a students disability without the students permission. It is the student's decision whether or not to disclose a disability. The academic fieldwork coordinator will counsel students on the pros and cons of sharing this type of information prior to beginning fieldwork. If a student decides not to disclose, the academic fieldwork coordinator is legally not allowed to share that information with the fieldwork setting. A fieldwork setting cannot refuse to place a student with a disability unless that student is unable to perform the essential job functions with or without reasonable accommodations. To refuse placement solely on the student's disability is discriminatory and illegal.

13. How Should The Facility Bill For Services Provided By Students?
Billing for treatment provided by a student under OT practitioner's supervision will depend on the payor guidelines of each third-party payor, for example, a private insurance company or a government program such as Medicare or Medicaid. In talking about Medicare, there is no written policy that specifically refers to students. Therefore, for guidance we must rely on state law and regulation which sometimes references students (or aides) and Medicare policy concerning supervision of aides in skilled nursing facilities. For the most updated information, see AOTA's web page on reimbursement.