Creating community wellness

Level II fieldwork in the time of COVID

by Michele Berhorst  •  September 28, 2020

Left to right: The LifeBridge student team and their mentor: Christopher Gonzales, OTD/S '20; Maggie Armstrong, MSOT/S '20; Rachel Hanson, MSOT/S '20; Juli Harrison, OTD/S '20; Lisa Carson, OTD, OTR/L; and Micki Kleven, OTD/S '20.

The first COVID-19 cases were seen in Missouri in mid-March. Almost immediately, Level II Fieldwork sites across the country began notifying the Program in Occupational Therapy that student placements were either canceled or suspended indefinitely. With only a few short weeks before spring and summer fieldwork rotations were to start, Jessie Bricker, OTD, OTR/L, academic fieldwork and capstone coordinator, knew she had to act fast.

“A majority of these cancelations were mitigated by the Program’s swift action to adjust the course sequence for doctoral students graduating in 2021, but that still left 49 doctoral and master’s students set to graduate in December 2020 without a secure alternative,” explains Bricker. “There were some true emergency placements that needed to be made: two students had their bags packed in the car ready to drive across the country when their fieldwork sites canceled. Another student was in the first week of her rotation when the site was forced to close its doors.”

Colleague Lauren Milton, OTD, OTR/L, assistant professor of occupational therapy and medicine, joined Bricker in creating non-traditional fieldwork opportunities by partnering with local community agencies to deliver occupational therapy services to populations at risk for physical and mental health issues during the pandemic. Together, they developed the Level II Community Wellness Fieldwork proposal. The proposal assigned students to small teams of six, each supporting a community partner in the St. Louis area, to conduct remote visits with agency clients to address occupational needs. Each group would be supervised by a licensed occupational therapist, provided by the Program, and work with an agency liaison. In addition to client care, students would also participate in ongoing program development activities designed to promote health for clients, caregivers and agency staff as they transitioned in and out of face-to-face support services. After the proposal met all of the criteria set forth by the Accreditation Council for Occupational Therapy Education for Level II Fieldwork, Bricker and Milton reached out to community partners with the proposal. They were met with an overwhelmingly positive response.

“The community partners said, ‘Let’s do this!’ They were excited to have students, new ideas and hear about what occupational therapy could do to enhance their existing services,” says Bricker. “Ultimately, we partnered with four area agencies: Brain Injury Association of Missouri, LifeBridge Partnership, Missouri Department of Corrections (Community Supervision Center in Hannibal) and St. Louis Arc.”

Through the diligent efforts of Bricker and Leise Amann, the Program’s fieldwork administrative coordinator, only 19 students remained without a confirmed fieldwork reservation by the start of the summer term 12-week rotation. All 19 displaced students were able to continue their fieldwork rotations as scheduled through the Community Wellness option; no students chose to postpone fieldwork. The student team at LifeBridge consisted of students Maggie Armstrong, Christopher Gonzalez, Rachel Hanson, Juli Harrison and Micki Kleven, who were supervised by Lisa Carson, OTD, OTR/L. Heather Ward, LifeBridge’s chief program officer, served as the agency liaison. The organization serves the changing needs of people with disabilities by empowering them to develop skills for independence and to actively participate in their community.

“The students developed a COVID-19 safety and awareness program so that LifeBridge could resume in-person programming once county restrictions were lifted. They needed to ensure that every client would be able to follow through with safety precautions such as wearing a mask, washing their hands and maintaining social distancing,” says Carson. The students also helped Ward create a transportation safety video to show clients the updated health and safety procedures with regard to LifeBridge’s transportation services.

For the students, the Community Wellness option was a unique opportunity to gain program development skills while working in a community agency instead of “traditional” settings.

“I was originally placed at St. Louis Children’s Hospital in pediatrics for my Level II. I wanted to be in the St. Louis area, so this was a great alternative. LifeBridge has a very different population, but it gave me more experience and exposure so I have a better idea of what I want to look for in the job market,” says Harrison.

As the pandemic presented unprecedented fieldwork challenges, Bricker realized students were experiencing a new set of stressors and needed options that met their individual needs. “It was important to me personally to give students a choice. Whether they wanted to wait a year to have a Level II in an acute setting or had people depending on them to get licensed and make a dollar, I was going to work with them to make it happen. As a Program, we needed to make sure our students could graduate on time; not only for them, but for the profession as well. We didn’t want to contribute to the nationwide bottleneck in certification, licensing or in the job market.”

There are plans to continue offering students the Community Wellness option as the high number of fieldwork cancellations continues. Looking ahead, Bricker sees the experience expanding as a permanent addition to Level I and Level II Fieldwork opportunities. “This experience aligns with our curricular design and the Program’s commitment to creating equitable and valuable learning experiences for a diverse student body, while bringing to life our vision for occupational therapy to be engaged in community health. By partnering with a variety of community-based organizations, we have the opportunity to actively demonstrate the unique value of our profession.”

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