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WFIELDWORK OBSERVATION OF STUDENT PERFORMANCE

I

Student's Name: Ashley Thayn Fieldwork Facility: _Summit Hand Thera

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Supervisor's Name: Larson OTD, OTR/L- Dates of FW: June 19th - 2
-Jacob
Please check the most rati
Professional Behavior Needs Not
The student: Outstanding Adequate lmprovement Observed
1. Conforms to institution's dress code X
2. ls responsible and dependable in attendance and promptness X
3. Communicates effectively with other professionals/staff. Listens and speaks at X
times
4. Contributes toward open communication with supervisor. Gives and receives feedback X

5. Establishes and maintains therapeutic relationships with clients and their families x
6. Demonstrates professional values and ethics. X
7. Maintains the confidentiality of others X
8. Seeks information and asks relevant questions x
Uses resources and time
9. Follows through with suggestions made by supervisor. X
10. Seeks challenges and demonstrates enthusiasm for fieldwork experiences. X
1 1. Demonstrates independence when appropriate X
12. Flexible: effectively adjusts to changes; adjusts priorities without difficulty x
Related to Educational Obiectives Needs Not
The student has: Outstanding Adequate lmprovement Observed
13. Developed an increased comfort level interacting with persons who have disabilities, x
emotional or c disorders.
14. Described the needs of clients served by the agency/facility x
15. Demonstrated respect for the values and diversity of persons with disabilities, x
staff and volunteers.
16. Demonstrated an attitude of inquiry to enhance creativity and problem solving skills. x
17. Observed staff interactions, assessments and/or treatment sessions with agency/facility x
clients.
18. Participated in group or individual treatment sessions as appropriate depending on the x
skill level of the student and the of the client's llness
19. Observed OTR/COTA role delineation when Certified OccupationalTherapy Assistants X use of
are employed by the agency/facility. Aides at
site
Strengths of th€ 8ludent noted at lhis fieldwork:
Ashley notes a high level of skills required to become an excelleri therapist. She is talenled in manual therapy and has an excellent personality and
is very congeniel and respec'tfulwith the clients.

Areas the student could wolk toward improving during remaining fieldwork experienc$:
Ashley will continue to do an excellent job in her subsequent fieldworks and has noted a high level of compassion for ihe patiEnt and a desire to
facilitate their rehabilitational potential.

Additional comments:
Ashley will be well prepared for the future in whichever field she chooses, including hand therapy if desired

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Student Signature Supe Signature

Please give to the student to return, or mailto:

Jeanette Koski, OTR/L

Academ ic Fieldwork Coordinator
Division of Occupational Therapy
University of Utah
520 Wakara Way
Salt Lake City, UT 84108-1290