Can an Occupational Therapy Student Find Their Own Fieldwork Setting? And Other Fieldwork Issues in Occupational Therapy School

One question that students commonly asked is if they can find their own fieldwork opportunities in occupational therapy school. The answer is it depends. There’s is a continuum of possible answer actually and this depends on the school that you attend.

On one end of the spectrum, as shown by this response from ACOTE, some students are unable to find their own fieldwork placements and this responsibility and capacity fall on the role of the Fieldwork Coordinator.

“Good morning and thank you for reaching out. The student very well may be correct that their program does not allow for the student to reach out to potential sites at all. The 2018 Standards require that institutions have an academic fieldwork coordinator (AFWC) who is responsible for all of the C Standards, which are the fieldwork Standards. The AFWC has to ensure the site meets the needs, has an educator who has met the minimum requirements, review the FW objectives, etc.” – ACOTE

Then somewhere in the middle is the experience of some of the peers of my cohort. For various reasons that there may be (see below for an example), my classmate ended up not going with the prospective fieldwork site that was assigned for their Level II. This student was able to find one on their own, coordinate it with the site and the OT (this is for OTR), and then touch base with the existing Fieldwork Coordinator to get the final okay. This worked out for my classmate and they were able to use the fieldwork site that they found themself.

Then on the other extreme some schools may actually even expect the student to find one on their own and put the responsibility on them. This has its pros and cons. Pros being that if you have a site already in mind that agrees, then this is a great opportunity to learn and grow as an OT student. The con of course is it can come with stress and anxiety being that the responsibility is put on the student to find it on their own. I personally am not sure how many schools use this approach in OT, so if someone knows please write me so I can include this in this post as factual information.

So the question is, well if a student has an existing Fieldwork Coordinator whose job it is to do this very thing of finding fieldwork sites and doing all of the leg work, why would a student be incentivized to find one on their outside of this? There are many reasons but a recent example is if there is something unethical going on in which the site may not meet the standards of a fieldwork (either Level I or II). A fieldwork site is after all, its own entity and there may be red flags in which may not meet requirements for the standards for a Level I or a Level II fieldwork placement, or something unethical is going on in general, e.g., fraud, illegal activity, etc.

You can reference some of these guidelines and standards on the ACOTE website. If you have specific questions, I found that contacting ACOTE is the best way to get a more specific answer. If they cannot help, they likely would be able to point you in the right direction.

As an example, one Reddit post outlined a situation in which this student has been overwhelmingly advised by other commentators to find a different fieldwork site.

[Post was removed to protect privacy, but you can still get an idea based on the context below.]

Based on this description, this example of a fieldwork site appears to fail certain requirements found in an ACOTE document:

  • “The fieldwork educator and student should have access to current professional information, publications, texts, and Internet resources related to occupational therapy education and practice.” – No phone policy as described by OP.
  • “Client records should be available to the staff and students for intervention planning and practice.” – Likely not to be the case based on the description provided in the post.
  • “The educational value of the student fieldwork experience should be of primary importance, and the placement should not be used to extend services offered by the fieldwork agency.” – Many commentators in this post hypothesize this to be highly possible and there may be conflict of interest, e.g., FW coordinator doing a favor for the FW site or OT [assumption].

Source: COE Guidelines for an Occupational Therapy Fieldwork Experience – Level II 

So as you can see, based on this example, many students may want to seek another fieldwork placement as this perspective one raises many red flags. I personally would not proceed if I was this student. I am all for non-traditional sites, but this example looks more like free-labor than an OT student learning opportunity, especially for a Level II.

Some advocacy for you students out there:

Students should be treated like adults. There are some situations where students should stand up for themselves and advocate for their own best interests, especially if they do not feel safe and listened to. Yes, this may mean deferring or delaying graduation. But you only get one opportunity to do your fieldwork and you should get the most out of this. It affects your future. And what you do can go on your resume. I am not saying to be like super choosy. But in some situations, you shouldn’t settle for a site that just does not sit right.

Again, choosing not to proceed with a setting like this is not ‘being picky’, this example flat out fails many standards for a Level II fieldwork site based on my preliminary research. If the OT on site does not document, they are not doing real OT. They are holding a position in which they just happen to be an OT, but they are not doing real OT.

In these situations, there is no easy answer. The FW advisor might even have some unconscious or conscious opinions of the student. Heck, they might even give unfavorable treatment to some students and not others. This is unfortunate, but the nature of things.

Ideas and Solutions:

Every situation and circumstance is unique and each school has different policy and student resources available.

If you are in this situation, seek advice from peers and those who you trust. Ultimately, you should try to come up with a solution with the FW coordinator first in a professional manner. If you have evidence that the site is not suitable (and it doesn’t just come down to preference, but other major issues) and no solution can be reached, consider escalating the situation because you should not be getting shortchanged, “just because you are a student”. This is gaslighting. If you discover something is not right in the middle of FW, you should also inform the Fieldwork Coordinator first.

If you do not trust or have confidence in the Fieldwork Coordinator, another option is to speak with the Program Director or with student services from the school.

Last, a complaint can be filed with ACOTE, even anonymously. A student should consider this (you may choose to not do so right away), but it is important that you do that another future student (or students) is/are not put in the exact situation that could even have serious consequences if a FW is not safe or ethical. Timing is still important because this process may take time and other students may potentially end up in your situation. To learn more about the complaint process, do a Google search for “ACOTE VB Complaints” for the most up to date guide on how to get started or reach out to ACOTE directly. Do not contact AOTA or NBCOT.

Good luck everyone!