Sustaining a High-Fidelity Simulation Assessment for Fieldwork Readiness: A Process Description and Quality Assurance Process

Document Type (Journals)

Educational Innovations

Abstract

Occupational therapy students often report feeling underprepared for the complex and integrative demands of Level II fieldwork, prompting increased use of simulation-based approaches to support clinical readiness. This process description outlines the design, implementation, and sustained quality assurance of the Occupational Therapy Student Performance Assessment (OTSPA), a multimodal, high-fidelity simulation required before fieldwork in a Southwestern occupational therapy graduate program. Grounded in a problem-based learning framework, the OTSPA integrates multiple levels of simulation fidelity and requires students to complete a full-cycle clinical experience, including referral review, interaction with a standardized patient, documentation, and intervention planning. Faculty evaluate performance using structured, competency-based rubrics supported by interrater calibration and secondary review procedures, while students engage in reflection and, when necessary, structured remediation. Programmatic quality assurance data collected over five years (2022–2026) include descriptive outcomes (pass rates and second attempts) and student feedback from Likert-scale and open-ended survey responses. Results indicate high overall success rates, with all students achieving competency within two attempts, and consistently strong perceptions of educational value, particularly associated with clinical reasoning, integration of skills, and preparedness for practice. The OTSPA functions as both a competency-based assessment and a continuous program evaluation tool, offering a scalable model for integrating high-fidelity simulation and ongoing quality assurance processes to support fieldwork readiness and curricular development in occupational therapy education.

Biography

Mary Thelander, Ph.D., OTR/L, ATP is a lecturer at the University of New Mexico and a fieldwork educator with the NM AgrAbility Project. She has coordinated the OT graduate assessment since 2019. Her scholarly interests include assistive technology and private practice. She has practiced in adult rehabilitation for 14 years.

Susan Iliff, PhD, OTR/L is an Associate Professor at Belmont University in Nashville, Tennessee. She has over 15 years of experience in OT education. Her scholarly interests include higher education, pediatrics, and participatory research. She has practiced pediatric OT for 25 years in a variety of settings.

Geneva Nolan, MOT, OTR/L is the academic fieldwork coordinator for the University of New Mexico. Geneva has coordinated the OT graduate assessment since 2023. Her scholarly interests are in equitable graduate education and assessment. She has practiced in adult rehabilitation for 10 years in a variety of settings.

Heidi Sanders, PhD, MA, OTR/L is the division chief of the Occupational Therapy Graduate Program in the University of New Mexico School of Medicine, where she has been a faculty member since 2004. Her research interests include supporting community-based, participatory approaches to OT education and ASD as well as supporting children with social, emotional and behavioral challenges. Her clinical work includes both inpatient and outpatient rehabilitation with children with multiple disabilities at Carrie Tingley Hospital.

Declaration of Interest

The authors report no declarations of interest.

Recommended Citation

Thelander, M. K., Iliff, S., Nolan, G. L., & Sanders, H. M. (2026). Sustaining a High-Fidelity Simulation Assessment for Fieldwork Readiness: A Process Description and Quality Assurance Process. Journal of Occupational Therapy Education, 10 (4). Retrieved from https://encompass.eku.edu/jote/vol10/iss4/18