On-line version ISSN 0038-2337
S. Afr. j. occup. ther. vol.45 n.2 Pretoria Aug. 2015
Jane ErasmusI; Nicola VermeulenII
IB OT (US); Clinical Teaching Coordinator, University of the Western Cape
IIBScOT (UWC), MSc OT, (UWC); Associate Lecturer, Occupational Therapy Department University of the Western Cape
Charlotte Danielson developed a framework for teaching to assist novice educators. Her framework considers four domains, namely Planning and Preparation, The Classroom Environment, Instruction and finally Professional Responsibilities. This article describes the adaptation of Danielson's Framework in the development of a new fieldwork setting for third year occupational therapy students. The description of the process that was followed illustrates how the four domains were used to guide the development of a new fieldwork setting, which would meet the requirements of the university as well as the needs of a group of six third year occupational therapy students who were doing their first fieldwork practice in this new setting. The conclusion shows that this Framework proved to be a suitable one to guide the process of developing a fieldwork setting.
Keywords: Fieldwork site development, Danielson's Framework, Student training and supervision
The undergraduate occupational therapy curriculum requirements as set by the World Federation of Occupational Therapists (WFOT) Revised Minimum Standards for the Education of Occupational Therapist state that every training institution must include a field-work component which encourages integration of theory and practice and provides a platform in which to develop clinical skills. To this end, students from the University of the Western Cape (UWC) are placed in a variety of fieldwork settings during the course of the four year training programme. The interventions provided by the students in these settings can be with either individual clients or groups of clients or both, depending on the needs of the setting.
As interest in and understanding of the field of Occupational Therapy grows, so do the number of students enrolled in the BSc. Occupational Therapy course at UWC. The result of this growth in numbers is that existing fieldwork settings are over-subscribed, thus new fieldwork settings need to be developed to address the clinical needs in training. This is not just a local or South African phenomenon, but a worldwide predicament. The South African Minimum Standards for the training of Occupational Therapists2 requires that third year occupational therapy students be placed in a fieldwork setting where they are supervised by an occupational therapist. Thomas, Penman and Williamson3 suggest that having a practising occupational therapist to guide the students within the fieldwork setting will facilitate the quality of learning achieved.
As a result, with three training institutions within the Western Cape, such fieldwork settings tend to become 'over supplied' with students, causing the supervising therapists to feel overwhelmed by the constant stream of students needing supervision. Cook and Cusick4 agree that the number of students placed within fieldwork settings impacts on the willingness of clinicians to supervise students. Clinicians acknowledge that student supervision is expected of them but that supervising students increase their workloads. This all highlights the importance of developing an increased number of fieldwork settings.
In May 2011 the principal of a primary school approached the occupational therapy department with a request to place students at the school. He understood the value of occupational therapy within the school setting, and as there was no occupational therapy services offered in either the school or surrounding area, he felt that the department might be able to provide the service he required. The UWC occupational therapy department felt that developing this fieldwork setting would begin to address the need for added fieldwork sites. As one of the clinical fieldwork supervisors (CFS) the first author was given the task of developing this setting and she used Danielson's Framework5 as a guideline in this development.
Charlotte Danielson5 explains the importance of guiding and developing teachers' professional practice by means of the teaching framework she developed. The framework considers the complex activities required by teachers and structures these into a variety of components, which are then divided into the four domains required in the practice of teaching. This framework was designed to provide a guide for teachers (novice and experienced) in the development of their own professional practice. As the framework was designed to enhance and guide the professional development of teaching practice, we wondered if it would provide us with similar guidelines in the supervision of occupational therapy students in a new fieldwork setting. We found the components too specific to the requirements of the teaching profession and decided to use the components of the framework as an overall guide rather than making use of them individually. Upon reflection of the various domains and their headings, the first author began adapting the framework to better suit the development of an occupational therapy fieldwork setting and the supervision of students at the setting.
This article will describe the process in the development of one such fieldwork setting based at a primary school in one of the suburbs of Mitchells Plain, Cape Town. The article will also highlight how the Framework developed by Danielson5 was used to guide this process.
Danielson's framework for teaching
The framework developed by Danielson is used to identify the aspects that teachers should consider in their teaching that aim to promote student learning. Due to the complex nature of teaching, the framework can be used as an outline which teachers can use to develop their areas of competence in their profession. Danielson has divided these areas of competence into twenty-two components which are grouped into four domains of teaching responsibility. These are: Planning and Preparation; The Classroom Environment; Instruction and Professional Responsibility.
The first domain of Planning and Preparation highlights the teacher's design of the content that she expects students to learn. Included in this are the content and pedagogy; the ability to demonstrate knowledge of the students; selecting instructional goals and knowledge of resources. The teacher should also be able to design comprehensible instruction and methods of assessing student learning.
The second domain of The Classroom Environment highlights the non-instructional interactions that occur in a classroom. In this domain teachers are required to create an environment of respect and understanding among the students and towards the teacher. This domain also includes establishing a culture for learning, managing classroom procedures, managing student behaviour as well as organising the physical space of the classroom.
The third domain of Instruction consists of the core of teaching - the engagement of students in learning. The aspects of this domain include clear communication and the ability to correctly use questioning and discussion techniques to engage students in learning as well as to provide clear feedback to students while demonstrating flexibility and responsiveness.
The fourth and final domain of Professional Responsibilities highlights the teachers' responsibilities outside of the classroom arena. This includes the teachers' ability to reflect on their teaching while growing and developing professionally as well as consistently showing professionalism. It is also vital that teachers maintain accurate records, communicate with families and contribute to the school and district.
The following section will highlight how the framework was adapted to suit the supervision of third year occupational therapy students during their fieldwork practice. Each domain will be discussed by highlighting the adapted components of the fieldwork placement and the supervision of the students.
Domain 1: Planning and preparation
According to Danielson5 the first domain relates to the planning and preparation that teachers need to do in order to prepare for what the students will need to learn. As part of planning and preparation of the fieldwork placement, consideration was given to the context of the school, the staff and the OT students to be placed in the school.
The selected primary school is a mainstream school situated in Westridge, one of the more affluent suburbs of Mitchells Plain6. The township of Mitchells Plain6 was developed during the apartheid era in the early 1970's as a result of the forced removal of the so called coloured people from the white suburbs. Currently Mitchells Plain is divided into various suburbs ranging from more wealthy areas with houses and gardens and amenities to those with a lower socio-economic standing. Drug abuse and gangsterism is a problem specifically in the poorer areas. Mitchells Plain houses a population of approximately 1.8 million people. Health and education needs are provided for by Primary Health Clinics and a number of primary and secondary schools. The primary school in which we were developing the fieldwork placement caters for learners from Grade R to grade 7. It is a predominantly English speaking school with approximately 1185 learners enrolled.
After meeting with the school Principal, and in agreement with the school's Governing Body, the next step was to set up a meeting with the educators of Grade R, 1, 2 and 3 as interventions were to be provided to the learners in the Junior Primary phase. The educators were provided with an overview of the process the third year students would engage in and were guided to select appropriate learners for intervention. In line with the universities fieldwork expectations of a third year student, each student would be responsible for providing occupational therapy intervention to two selected learners as well as facilitating and co-facilitating a gross motor group with ten learners, twice a week for the six weeks.
Preparation of the occupational therapy students to be placed at the school
Prior to the inception of the fieldwork practice, third year students received the necessary theory lectures in terms of occupational therapy process and paediatric clients. These lectures cover theory about normal development of children, appropriate levels of play and the various assessments appropriate to use within a paediatric setting. Third year students are also orientated to fieldwork and provided with a fieldwork manual which contained all the necessary information required for fieldwork training. Bonello7 states that fieldwork is where students can integrate their academic knowledge with the application of skills and that it is important to adequately prepare students for their training.
Domain 2: The classroom environment
This domain is concerned with the classroom environment and the components considered by Danielson5 are those which relate to the actual physical space, classroom procedures and the management of learners. In the consideration of this domain, the first author specifically reflected on the physical space allocated to the students, their time management and the creation of a conducive learning environment.
The physical environment
The school's population consisted of more than l000 learners and physical space at the school was very limited, with no school hall or free classroom space to offer the third year students as a venue in which to provide their interventions. There was however a prefabricated structure which had been earmarked as a library but was not yet in use. The structure was a free standing building separate to the rest of the school, but placed on the playground near to some of the class rooms. This was to be the physical setting in which the students would provide their occupational therapy service. The venue contained shelves of books, six round tables each with six wooden chairs around each table, and a desk on which was placed the computer and printer. On their first day at the school the third year students rearranged the furniture in the library in order to create a 'therapy area'. Gross motor activities were done in either the middle of the room and weather permitting outside in a courtyard and on the grass playground. All equipment was either provided by the third year students or by the UWC occupational therapy department.
Students' use of time
The duration of fieldwork for the six third year students lasted for a period of six weeks, from Monday to Thursday, 08h00 to l5h00. Students were provided with the expectations for the fieldwork placement in terms of written work deadlines, dates and times for evaluation opportunities and general expectations of how time would be spent. Roger et al8discuss the importance of students having a clear understanding of the placement and their expectations. Students were required to adhere to the prescribed school timetable, and needed to plan their intervention sessions with the educators so that the learners would not miss out on too much teaching time. Each learner was seen for a period of thirty minutes daily and the gross motor groups (with ten learners) were held twice a week, also for a thirty minute time slot. Students were encouraged to use the time in between sessions for preparation and evaluation. They also had to factor in time in their daily programme for meetings with their CFS as well as time to meet with the educators. Each intervention session was discussed prior to the session and evaluations were done after the session with the CFS. Students thus evaluated their sessions verbally using the evaluation guidelines as set out in their fieldwork manual. They also provided written evaluations which were recorded in each learner's school file. The students were also expected to spend time in the classroom observing the learners occupational engagement in learning as well as outside during recess to observe the learners engagement during playtime. The students had the added responsibility of having educational sessions with the educators on classroom structuring and how to effectively apply adaptations within the classroom context to assist in addressing the learners' problems within the context.
The educational environment
Due to the physical environment, the students' first fieldwork training experience and the minimal contact they had with their CFS, building interpersonal relationships and developing an environment of mutual respect and a safe space to learn were vital. Initially the students were very anxious about 'performing' in front of each other, but as noted by Svidén9 as their confidence in their own abilities grew, and the professional relationship with the CFS developed, they were more comfortable in discussing and explaining to each other and the CFS what they were planning to do in their interventions and why and how it all linked to the theory. In this way they were able to consolidate their own learning and apply theory to practice. As the space in the venue was limited the students were often running an intervention session with their learner while being observed by, not only their CFS, but their peers as well. It took some time for them to develop their levels of trust in each other and to make use of the feedback given by myself and their peers. Students who were able to interact with other students and made use of the feedback and comments given were able to see just how much they knew or had learned. Flood, Haslam and Hocking10 acknowledge the value of peer learning in terms of the students' confidence in their clinical abilities as well as in their abilities to share and clinically reason around their assessments and interventions.
Domain 3: Instruction
Danielson5 describes this domain as one where students are engaged in the tasks of learning and the teacher in the tasks of teaching. This aspect of Danielsons5 framework was considered in the CFS's role, when looking at the facilitation of the students learning within this fieldwork setting. As previously mentioned, third year students must be supervised by a full time clinician, and as there was no occupational therapy clinician working at the school, it was expected of the CFS to supervise the students in the practical situation as would a clinician, and also to facilitate their academic learning as would a CFS. The CFS therefore assumed both roles.
The role as a clinician
As a clinician the CFS was responsible for overseeing each student's practical application of occupational therapy assessments and interventions with their clients. Acting as a role model to the students as suggested by Tompson and Ryan11 meant that the CFS had to be available daily to the students to facilitate their application of theory into practice and practically facilitate their learning through 'hands on' demonstrations of various assessment and intervention skills where necessary. This meant that even though the CFS was not actively engaged in treating the different learners as would a clinician, she had to be available to practically assist the students in their use of assessment and intervention skills, provide support, guidance and facilitate their practical learning, a duty usually assigned to clinicians. This role included more than what was usually expected of a CFS.
The role as CFS
The role of the CFS is as a liaison between the university and the fieldwork setting. This ideally entails visiting the students once or twice a week during their fieldwork placement, making sure that all the fieldwork expectations were being met in terms of academic requirements and liaising with the clinician to ensure the students were beginning to integrate the theory into practice while in fieldwork.
As a CFS the first author was therefore responsible for the academic aspects of the students' fieldwork placement. The students were expected to follow the Individual Process Model as discussed by De Jongh12 and were required to write out the occupational therapy process they would follow accordingly. These case studies were structured in such a way that students followed a step by step approach, with a great deal of written feedback given every step of the way by the CFS. Formative feedback is described by Laight, Asghar and Aslett-Bentley13 as a process of providing immediate feedback (written and or verbal) which will guide, correct errors and provide for learning opportunities. As the case studies were marked on the day they were received and returned to the students the following day, they were receiving their written feedback immediately so that they could progress with their clinical interventions. Clinical reasoning skills were also developed this way, in that they had to be able to reflect on the feedback received and express what they were thinking and doing practically through their written work. During feedback sessions with the students the first author was also able to facilitate their clinical reasoning through discussions around the occupational therapy process and how they were making use of theory and its application within the practical setting, tying in with the importance given of this as described by Buchanan, Moore and Van Niekerk14. Another aspect of the role as CFS was that of evaluating students. They were provided with two evaluation opportunities, one during the middle of the fieldwork placement when they only received verbal feedback on their progress or lack thereof. From this evaluation opportunity they were able to understand how they were performing in terms of their knowledge, skills and attitudes. They were then expected to utilise the feedback given appropriately. At the end of the fieldwork placement the feedback was summative, with clear guidelines laid out in the form of a supportive document which guided the evaluation process. As both clinician and CFS, the manner in which feedback was given played a major role in the students learning. Students were able to make use of feedback, given in a constructive manner, addressing the problem and not the student as a person as suggested by Mulholland, Derdall, Roy15and Rodger et al16.
Domain 4: Professional Responsibilities
The final domain from Danielson's Framework5 discusses the teachers' professional responsibilities to their students, their place of employment and the wider body of teachers and the teaching profession. While the components developed by Danielson5 are specific to the teaching profession, the similar components were considered in the use of the Domain to the evolving fieldwork setting. In this regard the students responsibilities to the educators, the parents of the learners and the students' responsibilities towards the profession, were considered.
Communication with the educators
The students were expected to play an active role in the facilitation of the learners' occupational performance within the classroom setting. This entailed spending time in the classroom observing and assessing their learners' occupational performance during the daily educational process. From these assessments the students then had to draw up what they perceived the learners problems to be and give this feedback to the educators. Students provided the educators with information of the physical structuring of their classrooms, suggestions of where to place the learner within the classroom and general information on possible gross and fine motor activities that would be of benefit to all concerned. To do this effectively the students had to make use of literature which strengthened their argument. They were also required to use said information in drawing up an information file that was left at the school and served as a resource to the wider educator body. The students found that these planned sessions with the educators needed to take into account the fact that the educators had years of experience and that the students did not attempt to 'tell the teacher how to teach'. The students used literature on adult handling principles to guide them in presenting these sessions.
Communication with the parents
As the occupational therapy service was new to the school and the parents, the students had to get permission from the learners' parents before they could begin the occupational therapy process with each specific learner. Therefore, written consent forms were drawn up explaining briefly the service to be offered by the students.
Only once the forms had been returned with the necessary consent could the students begin with their occupational therapy process. As with most schools, time was set aside once a term when parents were invited to come and meet with their child's educator to discuss the learner's academic progress. The students were invited along to these meetings so that they could meet and give feedback to their specific learners' parents. The students were quite anxious about these meetings, worried that the parents would have expectations that they would be unable to meet. These meetings were in fact very successful and the students felt able to share information in a manner that the parents understood. They gave a brief overview of the assessment results, what their interventions entailed and were also able to discuss and make some suggestions to the parents with regard to basic home programmes and ways that they could assist their children at home.
The university had clear documentation on the expectations of students placed within the fieldwork setting. Students all received this information and were aware of their professional and ethical obligations. The six students had high expectations of themselves both academically and professionally as they felt they were leading the way in terms of this new fieldwork setting. During the course of the six week fieldwork placement the students made use of the various learning opportunities to begin to develop confidence in their abilities to problem solve, apply their knowledge in terms of the use of therapeutic activities and reason clinically17. They were able to provide an effective occupational therapy service to the school and its population which in turn fulfilled the expectations placed on them by both the school Principal and the CFS as the representative of the UWC OT department.
The headings of the domains as described by Danielson5 proved to be an effective guide in the development of this new fieldwork setting. Keeping each of the different domains in mind a structure was provided on which to develop a new fieldwork setting. Danielson5 in Domain 1 discusses the importance of Planning and Preparation which were considered in terms of The Setting, The Educators and The Students. The junior primary staff and learners at the school were prepared for the arrival of the six students which added to the overall experience of their first fieldwork placement. The components of Communication with Educators and Professional Behaviour considered in Domain Four ensured that the educators were kept abreast of the students' interventions with the learners. The educators appreciated the involvement of the students within their classrooms and were keen to apply suggestions made by the students in terms of classroom structure, gross-motor activities and how best to assist the learners who were struggling with their engagements in learning occupations. Academically the students were prepared for the expectations of the placement, and were able to begin to apply their knowledge practically as suggested in Domain 1.
Domain 3 which considers the aspect of Instruction with the adapted components of The Roles of the Clinician and Fieldwork Supervisor suggests that supervision should involve one clinician to one or two students, and weekly supervisory visits by a fieldwork supervisor. In the context of establishing the new fieldwork setting where there was no clinician the CSF had to fulfil a dual role. As the supervisor student ratio was 1:6 the students had to be disciplined about making and keeping individual appointments, and as Martin and Edwards18 suggest, make use of peer learning opportunities. Students were able to take more responsibility for their own learning, provide emotional support to each other and began to feel that they could discuss their ideas and make use of the suggestions and feedback provided by their peers. These actions validated the Preparation and Planning component of The Students preparation in the first domain and the Professional Behaviour component of the fourth domain which highlighted the need for third year students to begin to integrate their theory knowledge practically.
It was important for the CSF that students felt at ease within the learning environment, as corroborated by Mulholland, Derdall and Roy16 and Rodger, Thomas and Holley et al17. The second and third domains which considered the Classroom Environment and the Instruction of the Students with the adapted components of The Students use of Time and the Roles of the Clinician and the CFS considered how to provide feedback, act as a role-model, when integrating theory into practice, provide emotional support, create learning opportunities and generally make sure that all the expectations of both the students and the university were met.
Using the Danielsons5 Framework as a guideline and adjusting the components to meet the needs of an occupational therapy fieldwork practice setting proved beneficial during this fieldwork process. The four domains of the framework are vital aspects to consider in the process of teaching and learning in a fieldwork context as well as important to consider when establishing new fieldwork placements.
CONCLUSION AND IMPLICATIONS FOR FURTHER PRACTICE
Fieldwork plays a vital role in the development and growth of occupational therapy students as this is where students get to apply the skills learned within the classroom setting. Here they are afforded the opportunity to observe clinicians in action and are able to put into practice their own knowledge, skills and attitudes. Marton and Saljol9 found that student learning in a real life context or setting provided more concrete and practical learning. The development of this fieldwork site meant that an environment was created in which the students were able to consolidate their learning, put into practice the skill learned and begin to develop their clinical and professional skills. The clients at the fieldwork site were provided with an occupational therapy service which fulfilled their occupational needs in educational barriers and provided meaningful interventions to all concerned.
Danielson's5 framework was a valuable guide in the process of having to develop a new fieldwork setting. Having applied the headings as suggested by Danielson5 the first author developed components that she felt would be more applicable to the professional development of occupational therapy students within the fieldwork context. This then provided a framework in which to develop the new fieldwork setting as well as the third year occupational therapy student professional development within their fieldwork placement. While it is not suggested that this adaptation to Danielson's5 Framework is the definitive one to apply in the development of other fieldwork settings, it proved to be a useful framework in the context of fieldwork setting development at UWC. As a result of the development of this placement the UWC OT department now has a five year collaborative agreement with the school. This agreement allows fourth year students to be based at the school and they would initiate an occupational therapy screening process for the reception phase learners and provide bi-weekly intervention sessions with individual learners, run educational groups with the educators and parents of the school as well as to assist the Principal and Governing Body in the development of the school as an Health Promoting School. The third year students will also continue to provide a more in depth service during their six week fieldwork placement as well as the continuation of the gross motor groups. The result of the described process is that now an occupational therapy service exists where previously there was none.
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Occupational Therapy Dept, University of the Western Cape
Private Bag Xl7, Bellville 7535