Level II Fieldwork Diaries: Outpatient Pediatrics Week 12

I can’t believe my first level II fieldwork placement is already over! This week, I had to say goodbye to all of the wonderful OTs, COTAs, children, and families that I worked with throughout the summer, and it was really bittersweet. I’m happy because I had such a fun, formative experience at this clinic, but sad because I will miss all of my kiddos so much! One of my clients told me that he won’t forget me, and another asked if I’ll come back next year — it was so sweet.

What I Learned

  • How to be flexible and follow a child’s lead. They won’t always want to do what you have planned!
  • How to set limits and handle difficult situations. This is something that I am still working on, and was especially hard on telehealth. I learned how to co-regulate with kids and bring them back to the “green” zone.
  • The importance of connecting with a child and their family, and using motivating activities so the child will enjoy therapy. Sometimes your session is a lot of parent education, answering questions and giving suggestions for home.
  • How to interpret my clinical observations and assessment results during an evaluation. This is something that I found really challenging, but I think I have improved a lot! Actually assessing what I saw and putting it into words that a family or other providers will understand isn’t easy.
  • That running a private practice clinic is way harder than I thought! So much goes into it behind the scenes, and my supervisor had to deal with insurance a lot.
  • So much more!
The OT Gym – posted with permission by the clinic owner.

My Self-Care Strategies

I can’t stress enough how important it is to take care of yourself during fieldwork. I had some “easy” days, and some days where I saw 9 kids in a row or documented until 10pm. It was important for me to find occupational balance through these activities:

  • Daily exercise
  • Quality time with loved ones
  • “Signing off” (almost) every day by dinnertime
  • Setting aside time for hobbies (e.g. reading, needlepoint) every night
  • Getting outdoors often
  • Putting my phone on “Do Not Disturb” every day during fieldwork

My Final Project

For my final project, I created a packet filled with tips and strategies for caregivers to implement this fall during virtual, at-home learning. A common theme among nearly all of my clients and their families was the stress of virtual learning, or going back to school in a hybrid model. This packet has tips for how to set up your space at home, sensory tools, body break ideas, and more that caregivers can use with their kiddos this fall. All suggestions made in this packet are made by me, an occupational therapy student, and should be addressed with a licensed occupational therapist. Here is a glimpse of the packet; you are welcome to download it for free below!

Q & A

You guys had lots of questions about this fieldwork experience that you asked on my Instagram page. Here are the answers!

Q: People say that you learn the most in level II fieldwork. Has that been true?

A: Yes, definitely. This is not to downplay how much I learned in my program, but fieldwork is all about putting it together. I learn best by doing, which is exactly what I did in fieldwork. Specifically, I learned so much about communication, collaboration, intervention planning, evaluating, interpreting, being client-centered and occupation-based, and how to work with kids in general.

Q: How has telehealth impacted your ability to build rapport? What has your experience with telehealth been like?

A: I feel really lucky to have had the opportunity to provide both in-person and virtual OT services during fieldwork! Telehealth is really unique in that you see the client in their home, and can really dive deep into what their home environment is like and what might be supporting or hindering their occupational performance. It has actually helped me to build even stronger rapport in some cases, as I have had lots of parents asking questions and looking for guidance on telehealth. On the flip side, I have had some parents who are not quite as involved with telehealth, which does limit the ability to build rapport. It really just depends, but I certainly LOVED getting to move from telehealth to in-person services with some kiddos. It was so much fun to finally meet them in person!

Q: How should I prepare for a pediatrics fieldwork experience? Virtual vs. in-person?

A: The most beneficial things that I did to prepare include brushing up on some assessments, reviewing developmental milestones, and taking a Handwriting Without Tears workshop. Learning the HWT lingo was extremely helpful during this placement, and I think it will be during my fall placement at a school as well. I recommend asking your CI if there is anything they recommend studying before you arrive. I also posted a blog about how I prepared for fieldwork.

Q: Are there any websites you recommend for activities for teletherapy?

A: Yes! Check these out

Q: What do I do if a child throws a tantrum?

A: When working with kids, this is going to happen. Try co-regulating with the kiddo by demonstrating deep breathing, counting backwards from 10, providing deep pressure proprioceptive input, provide linear vestibular input, playing music, or putting on a preferred video. These things all worked for me!

Q: Did you feel holistically supported by your CI? Did you feel comfortable making mistakes or trying new things?

A: Yes! My CI was wonderful. I was actually lucky enough to have 1 main supervisor and 2-3 other OTs who I worked with regularly. I felt very supported by each of them, and they had a good balance of letting me try things and steeping in when I needed help.

Q: What kind of communication did you have with your CI?

A: At this fieldwork, we had informal meetings almost every day. Meetings were more formal in the beginning, but as we moved into the clinic and I became more comfortable with treating kids, the level of supervision decreased and I was given more freedom. I was free to call, email, or text all of my supervisors as needed!

*Side note: My supervisors found my blog! So if you’re reading this, hi!

Q: What is the fieldwork/coursework set-up like in your program?

A: We had level I fieldwork placements that lined up with our courses (e.g. ped’s fieldwork during ped’s semester; in-patient rehab/acute care fieldwork during physical dysfunction semester; etc.). We identified our preferences for level II fieldwork, and then we were placed by our school’s fieldwork team. During my first level II fieldwork, I was not enrolled in any additional courses. During my second level II fieldwork, I will have a 1-credit course to prepare for the advanced doctoral experience and board exam.

Q: What population/setting are you hoping to work with?

A: I am definitely a fan of pediatrics, but I am pretty open! I determined during level I fieldwork placements that my heart just wasn’t in hospital-based OT. However, who knows where I will end up! I am really excited to be in a school this fall.

Q: Are you getting your CI a gift? Ideas?

A: I had only planned on getting each of my supervisors a thank you card, until I received this question. Many of you guys said that you got your CI something small, like a candle, plant, cookies, book, office supplies, stationary, gift card, etc. I decided to write a thank you card for each of the OTs that I worked with, and then I got them each a small fall candle and a Starbucks gift card to show my appreciation. I also got my main supervisor a book, since we talked about how much we both love reading.

My gifts for my supervisors

Thanks for reading! Next stop: the schools!

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