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Document Type (Journals)

Educational Innovations

Abstract

Fieldwork is essential to occupational therapy education, yet placement demand and constraints on clinician capacity require programs to consider innovative approaches to practice-based learning. Home-based practice is especially difficult to offer as a traditional Level I placement because of travel and space constraints inherent to how services are delivered. This educational innovation describes and evaluates a structured virtual home-based Level I fieldwork model implemented through a partnership between an entry-level occupational therapy program and a national rehabilitation provider. Students completed five live virtual observations of services delivered in clients' living environments. The model, now in its fifth year, incorporated prebriefing, real-time chat facilitation, telesupervision, debriefing, and applied assignments, and gave students supervised experience in a technology-mediated encounter. Student perceptions were assessed using a mixed-methods survey; all 29 students consented to inclusion of their responses. Agreement was high that the model enhanced understanding of home-based practice, client needs, and professional reasoning, and that it supported engagement and telesupervision. Nearly all students (93.1%) endorsed continuing the model. The one item drawing divergent responses asked students to compare the experience with prior in-person fieldwork; qualitative responses described reduced immersion, fewer opportunities for direct interaction, and less exposure to the informal culture of a setting. Students credited their learning to the instructional scaffolding surrounding the observation rather than to remote access itself. Based on these students' perceptions, intentionally designed virtual observation can expand access to home- and community-based learning and it is best positioned as a complement to in-person Level I fieldwork.

Biography

Tara Mansour, OTD, MS-HPEd, OTR is Associate Program Director of Northeastern University’s DMSc Program in Healthcare Leadership. She previously served as Academic Fieldwork Coordinator at MGH Institute of Health Professions, with expertise in clinical education, healthcare education, educational innovation, and the integration of artificial intelligence in health professions education. 

Colleen Muse, OT, OTD, MHE, OTR, PNAP is an assistant professor at Mass General Brigham University of Health Professions in Boston. She has over 20 years of clinical experience and is passionate about supporting clients in home and community based settings. She has passion for building confidence in students and supporting professional behaviors development in clinical education. 

Nicole Williams, OTD, OTR/L, BCG is an OT with 25 years of experience, primarily with the older adult population. She earned an entry level Masters in OT from Virginia Commonwealth University in 2001 and a post professional Doctorate in OT from VCU in 2014. Nicole earned AOTA Board Certification in Gerontology in 2024.  

Rachel Pittmann, PhD, CCC-SLP, FNAP, CHSE is an Assistant Professor & Assistant Dean of Interprofessional Practice at the Mass General Brigham University of Health Professions. She oversees interprofessional practice in simulation and free care at the IHP. She teaches interprofessional didactic/simulated curricula and precepts multiple interprofessional practice experiences. Her research focuses on telehealth and simulation education in health professions. 

Declaration of Interest

Nicole Williams was employed by FOX Rehabilitation during the development and implementation of the educational innovation described in this manuscript. The remaining authors report no declarations of interest.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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