Open Collections

UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Instructor competencies required for effective fieldwork supervision of occupational therapy and physical… Ryan, Susan Jennifer 1987

Your browser doesn't seem to have a PDF viewer, please download the PDF to view this item.

Item Metadata

Download

Media
831-UBC_1987_A8 R99.pdf [ 7.79MB ]
Metadata
JSON: 831-1.0097068.json
JSON-LD: 831-1.0097068-ld.json
RDF/XML (Pretty): 831-1.0097068-rdf.xml
RDF/JSON: 831-1.0097068-rdf.json
Turtle: 831-1.0097068-turtle.txt
N-Triples: 831-1.0097068-rdf-ntriples.txt
Original Record: 831-1.0097068-source.json
Full Text
831-1.0097068-fulltext.txt
Citation
831-1.0097068.ris

Full Text

INSTRUCTOR COMPETENCIES REQUIRED FOR EFFECTIVE FIELDWORK SUPERVISION OF OCCUPATIONAL THERAPY AND PHYSICAL THERAPY STUDENTS BY SUSAN JENNIFER RYAN B . S .R . (O .T . ) , The University of Brit ish Columbia, 1980 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Department of Math and Science Education) We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA September 1987 © Susan Jennifer Ryan, 1987 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of Math and Science Education The University of British Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 Date October 8, 1987 i i ABSTRACT The absence of clearly defined competencies to guide the development of educational programs for occupational therapy and physical therapy fieldwork instructors provided the impetus for this research. A primary objective of the study was to identify the competency categories and the competencies which occupational therapy and physical therapy fieldwork instructors, and occupational therapy and physical therapy students perceived to be important in determining the effectiveness of a student's fieldwork experience. A review of the l i terature in occupational therapy, physical therapy, and related health professions identif ied a pool of fieldwork instructor competencies from which 105 competencies were selected for the study questionnaire. The questionnaire was administered to 34 occupational therapy and 37 physical therapy students from the University of Brit ish Columbia, and to 59 occupational therapy and 76 physical therapy fieldwork instructors in Brit ish Columbia. A response rate of 87% was obtained. Respondents' ratings of importance of the competency categories and of the most important competencies were similar to previous research findings. Communication and supervisory behaviours were rated as most important in contributing to the effectiveness of a student's fieldwork experience. The majority of the competencies which were ranked as most important belonged to these two categories. Consistent with previous research, the professional competence category and the competencies which were assigned to i t were deemed least important in contributing to the effectiveness of a student's fieldwork experience. Group differences in ratings of importance were tested using a factorial design. The two-way and three-way analyses of variance, a multivariate analysis of variance and subsequent multiple comparison tests revealed only one significant main effect. Physical therapy students' ratings of importance differed signif icantly from the occupational therapy and physical therapy fieldwork instructors (p_ < .05). While this significant difference was identified from the analysis, examination of the mean ratings of the competencies showed a consistent pattern of low, moderate or high ratings among all of the groups. Participants in the study confirmed that the competencies included in the questionnaire were important in contributing to the effectiveness of a student's fieldwork experience. However, the l i terature suggests that the most important outcome will be the use of the competencies to guide the development of standardized educational programs for occupational therapy and physical therapy fieldwork instructors. i v Table of Contents Page LIST OF TABLES v i i LIST OF FIGURES ix ACKNOWLEDGEMENTS x Chapter 1. INTRODUCTION 1 The Problem 2 Purpose of the Study 4 Definition of Terms 9 Conceptual Framework 10 Significance of the Study 11 Research Design 13 Limitations of the Study 17 2. REVIEW OF THE LITERATURE 18 Program development 18 Competence 24 Competence and Program Development 26 The Process of Defining Competencies ' 28 Fieldwork Instructor Competencies: State of the Art 43 V 3. METHODOLOGY 68 .Research Design 68 Development of the Questionnaire 69 Subjects 77 Procedures 77 Data Analysis . 79 4. RESULTS 81 Characteristics of Respondents 82 Categories of Competence and Competencies: Perceptions of Importance 89 Response Profi le 89 Categories of Competence: Validation and Importance 90 Competencies Identified as Most Important 97 Group Differences in the Ratings of Importance . . . 102 The Relationship of Personal Variables to Ratings of Importance 113 5. DISCUSSION AND IMPLICATIONS 121 Characteristics of Respondents 122 Validation and Importance of the Categories 125 Important Competencies 127 Group Differences 131 vi The Relationship Between Personal Variables and Ratings of Importance 134 Implications 136 REFERENCES 139 APPENDICES 150 Appendix A: Questionnaire 151 Appendix B: Competencies Listed by Category 167 Appendix C: Mean Ratings of Importance for Each of the 105 Competencies by Group(s) 173 vi i L i s t of Tables Page 1. Distribution of Respondents by Group, Age, and Sex 82 2. Distribution of OTF and PTF Respondents by Level of Education 83 3. Distribution of OTF and PTF Respondents by Type of Practice Setting 84 4. Distribution of OTF and PTF Respondents by the Number of Fieldwork Students Instructed 85 5. Distribution of OTF and PTF Respondents by Type of Fieldwork Instructor Program Attended 87 6. Varimax Factors for the Pre-determined Categories of Competence 93 7. Proportion of the Top 10 Competency Rankings by Category and by Group 95 8. Means and SD by Category for a l l Subjects 96 9. Number of Competencies Perceived to be Most Important by Group(s) 97 10. The 10 Competencies Rated 4.5 or Higher which were Common to a l l Groups 98 11. The Top 10 Ranked Competencies for Al l Groups Combined, and the Means and SD for OTF, PTF, OTS and PTS Groups 99 12. Means and SD by Category for Al l Groups 104 13. Factorial Analysis of Variance of Core Groups and Categories 105 14. Factorial Analysis of Variance of Fieldwork Instructors, of Professions and of Categories 108 15. Analysis of Variance for Each Category 112 vi i i Page 16. T-test Comparing Ratings of Fieldwork Instructors who had and had not Participated in Workshops, by Category 117 17. T-test Comparing Ratings of Third and Fourth Year P.T. Students by Category 119 ix Lis t of Figures Page 1. A Model of the Program Development Process in Continuing Education 20 2. Differences in Mean Ratings for the Four Core Groups for Each Category 106 3. Differences in Mean Ratings for Fieldwork Instructors (OTF and PTF Combined) and Students (OTS and PTS Combined) for Each Category 109 4. Mean Ratings of Importance for Fieldwork Instructors (OTF and PTF) Students (OTS and PTS), and Professions (O.T. and P.T.) 110 X Acknowledgements I wish to thank my research advisor, Dr. Gordon Page for his encouragement and guidance in directing this study to completion. I am indebted to Dr. Robert C a r l i s l e , my committee member, for his suggestions and patience. I would l ike to thank al l of the occupational therapists, physical therapists, and occupational therapy and physical therapy students who participated in the study. Without their co-operation the study could not have been completed. I am most grateful for the advice and assistance of Mr. Wayne Jones in analysing the data. I also wish to thank Ms Jean Kwong for her s k i l l and endless patience in typing and revising this manuscript. I acknowledge with gratitude the continuing support of my family, friends, and the faculty members in the School of Rehabilitation Medicine. F ina l ly , I would l ike to thank my husband, Jef f . As my greatest advocate, his encouragement and forebearance fac i l i ta ted the completion of this study. 1 CHAPTER 1 Introduction Occupational therapy (O.T.) and physical therapy (P.T.) students registered in educational programs which have been approved by the World Federation of Occupational Therapists and the World Federation of Physical Therapists respectively, are required to complete a minimum of 1000 hours of fieldwork experience prior to graduation. An individual employed by the educational inst i tution typical ly administers the fieldwork program and l ia ises with fieldwork instructors or supervising therapists in a f f i l ia ted c l in ica l agencies. The therapists are normally assigned to the fieldwork instructor role in addition to regular c l in ica l duties. They also assume the responsibility for designing, implementing and evaluating the fieldwork experiences. Many educators consider that knowledge of educational processes, and s k i l l s in c l in ica l teaching, communication, supervision and evaluation, are essential for fieldwork instructors (Emery, 1984; Irby, 1978; May, 1983; Moore & Perry, 1976; Ramsden & Dervitz, 1972; Tompson, 1985, 1986). Studies of physical therapists (Moore and Perry) show that therapists lacked many of these s k i l l s . Recent research by May (1983) and Emery (1984) suggests that l i t t l e has changed in the last decade. 2 Information collected by Chris t ie , Joyce, and Moeller (1985b); Ryan (1981) and Tompson (1985, 1986) indicate that similar weaknesses have been found among occupational therapists. The Problem Participation of fieldwork instructors in educational programs to prepare them for their role is considered to be essential (Barker, 1986; Chris t ie , et a l . , 1985b; Greenburg, Goldberg, & Jewett, 1984; Jason, 1974; Sox, Morgan, Neufeld, Sheldon, & Tonesk, 1984; Tompson, 1986). However, the nature and extent of the programs available for O.T's and P.T's suggests that there has been only minimal progress towards this goal. Emery (1984), Peat (1985), and Tompson (1985) are consistent in their use of the term haphazard, to describe the co-ordination, content and avai labi l i ty of the programs designed to meet the needs of O.T. and P.T. fieldwork instructors. Sixty-six percent of physical therapists surveyed by May (1983) used t r ia l and error to develop competence in education. Her study supports the contention of Christ ie et a l . (1985b), Emery (1984) and Peat (1985) that education of fieldwork instructors consists largely of on-the-job training. Of the 25 physical therapy educational programs in the United States which responded to Moore and Perry's (1976) questionnaire, 16 offered meetings of 8 hours or longer duration, 3 at least once a year. Principles of teaching and learning, communication strategies and student evaluation procedures were included by only five educational programs. The primary purpose of the majority of the meetings was to exchange information about curriculum and other academic changes, and discuss problems of mutual concern. In a more recent survey of eight Canadian O.T. educational programs, Tompson (1985) reported that four offered formal workshops for fieldwork instructors on a regular basis. The remaining programs used a variety of methods such as providing inservice sessions on request, or used the Director of O.T. in the a f f i l i a t i n g agencies and students to orient fieldwork instructors. Although Tompson (1985) makes no reference to program content, an analysis of her recommendations for the future suggest that there is l i t t l e s imilarity between the workshops and inservice sessions which are currently available. Although the education of fieldwork instructors remains a "hit-and-miss affair", researchers agree that the solution l i es in the development of standardized educational programs for instructors (Christie et a l . , 1985b; Emery, 1984; Peat, 1985; Tompson, 1985, 1986). In order to implement standardized educational programs the competencies demanded of fieldwork instructors in O.T. and P.T. in al l settings, must be identified and clearly defined (Barker, 1986; Peat, 1985). Further, i f the competencies can be graded according to their degree of perceived 4 importance to a student's fieldwork experience, the task of developing standardized formats for the education of fieldwork instructors wil l be simplified. Purpose of the Study The objectives of this study are two-fold: (a) to derive a l i s t of fieldwork instructor competencies from the l i terature in the health professions; and (b) to determine which categories of the competencies, and which competencies are perceived by O.T. and P.T. fieldwork instructors and O.T. and P .T . students, to be important in contributing to the effectiveness of a student's fieldwork experience. The specific questions to be asked are: 1. What are the categories of fieldwork instructor competencies and how important is each in determining the effectiveness of a student's fieldwork experience? 1.1 What categories of competencies (for example, communication behaviours) can be identified by analysing the interrelationships between the ratings of importance of each competency? 1.2 To what extent do the categories identified empirically in 1.1 relate to the pre-determined categories of competence identified through a l i terature review? 5 1.3 Which of the categories are rated as most important in determining the effectiveness of a student's fieldwork experience? The l i terature on effective fieldwork instruction suggests that some factors (categories of interrelated competencies) are considered by respondents to be more important than others (Brown, 1981; Irby & Rakestraw, 1981; Moore & Perry, 1976; Romberg, 1984; Shellenberger & Mahan, 1982; S tr i t t er , Hain & Grimes, 1975). Factor analysis wi l l assist in identifying those competencies which are associated with the underlying dimensions of effective fieldwork instruction in O.T. and P.T. (Irby & Rakestraw, 1981; Romberg, 1984). If pre-determined competency categories are validated in this study, the assignment of the competencies to categories wil l also.be veri f ied. The matching of competencies to categories will have direct use for program planners. It will guide the assessment of the educational needs of fieldwork instructors relative to the underlying dimensions of effective instruction, and will be useful in planning educational programs for fieldwork instructors. 2. Which of the selected competencies do O.T. and P.T. fieldwork instructors, and O.T. and P .T . students perceive to be most important in determining the effectiveness of students' fieldwork experiences? 6 Although a number of studies of effective c l in i ca l teaching have been conducted in the health professions, none have clearly delineated the specific behaviours or competencies required for effective fieldwork instruction in occupational therapy and physical therapy. Studies completed are either too broad to provide specific direction for educational planners (Christie et a l . , 1985b) or have identif ied specific behaviours perceived to be important from only one relevant population (Emery, 1984). One of the tasks of this study then, is to ascertain which of the competencies derived from the l i terature are perceived to contribute most to effective fieldwork instruction in O.T. and P .T . Researchers have suggested that many of the fieldwork instructor competencies associated with effective fieldwork experiences can be improved through educational programs (Cassie, 1977; Greenburg et a l . 1984; Petzel, Harris & Masler, 1982). In Brit ish Columbia, such programs frequently take second place to those which focus on upgrading the c l in i ca l s k i l l s of O.T's and P.T's because they are given a lower prior i ty by employers. When employment contracts typical ly a l lot only 4 days per year to each therapist for educational leave, programs for fieldwork instructors must be limited to 1-2 day workshops. If such workshops are to focus 7 on the fieldwork instructor competencies which are most important, these must f i r s t be identif ied. 3. .To what extent do the ratings of importance of the selected competencies differ among the groups? 3.1 What are the differences between the ratings of importance of each of four groups (O.T. and P.T. fieldwork instructors and O.T. and P.T. students)? 3.2 What are the differences between ratings of importance of fieldwork instructors (O.T. and P.T.) and students (O.T. and P.T.)? 3.3 What are the differences between the ratings of importance of each profession (O.T. fieldwork instructors and students, and P.T. fieldwork instructors and students)? The findings related to this question will provide further guidance to planners of educational programs for fieldwork instructors. Although there appears to be some evidence of congruence in the beliefs about effective c l in i ca l teaching behaviours among various health professions (Christie et a l . , 1985b), O.T. and P.T. are separate professions with different theoretical bases and different undergraduate curr icula . It would be reasonable to expect that differences may exist in O.T. and P.T. assessments of the degree of importance of the selected competencies. 8 Although fieldwork instructors and students are both participants in the fieldwork experience, i t is conceivable, that their perspectives on the importance of the fieldwork instructor competencies may di f fer . Ratings by both groups, in each of O.T. and P . T . , should provide a balanced assessment of the importance of each competency. 4. To what extent are personal variables related to the O.T. and P .T . fieldwork instructors' and O.T. and P.T. students' ratings of importance of the competencies? It is possible that respondent characteristics may account for their ratings of the competencies. Christ ie et a l . (1985b) showed that experienced fieldwork instructors view the fieldwork instructor role differently from novice instructors. In another study, O'Shea and Parsons (1979) recommended that other variables such as age, sex, c l in i ca l experience of instructors and educational preparation (both level of education and attendance at fieldwork instructor preparation workshops) should be considered in future research. The areas of c l in i ca l practice of the fieldwork instructors, for example, psychiatry and physical dysfunction, and the type of setting in which they practice may also be related to differences in the respondents' ratings. 9 Definition of terms 1. Competency: a description of knowledge, a sk i l l or an attitude expected to be demonstrated by an effective fieldwork instructor. Competencies can be divided into traits and behaviours. Traits represent personal characteristics whereas behaviours refer to tasks, act iv i t ies or ways of acting. This study wil l only include trai ts and behaviours which have been identified in the l i terature as having a relationship to the effectiveness of a students' fieldwork experience. 2. Occupational Therapist: an individual who has met the requirements for registration as an O . T . , in his/her country; and has graduated from an educational program which is accredited by the World Federation of Occupational Therapists. 3. Physical Therapist: an individual who has met the requirements for registration as a P.T. in his/her country of residence; and who has graduated from an educational program which is approved by the World Federation of Physical Therapists. 4. Fieldwork instructors: a male or female O.T. or P .T. who has instructed at least one student on a full-t ime fieldwork experience of 4 weeks or longer duration, since May 1986; in 10 an agency which is a f f i l ia ted with the School of Rehabilitation Medicine at the University of Bri t i sh Columbia. 5. O.T. and P.T. students: al l males or females who are registered as third or fourth year students in the B.Sc.(O.T.) or B.Sc. (P.T.) programs at the University of Brit i sh Columbia in January, 1987. 6. Fieldwork experience: the period of time O.T. and P.T. students spend in an accredited c l in ica l agency, learning and applying their theoretical knowledge to c l ient assessment and treatment. Conceptual Framework Whether an educational program is based on a mastery learning or competency-based approach, or more general principles of instructional design, the formulation of objectives for the program is a c r i t i c a l element in the i n i t i a l phases of design (Guskey, 1985; Houle, 1978; Roberts, Cordova & Saxe, 1978). Guskey (1985) states that "objectives describe the sk i l l s and ab i l i t i e s students are to acquire as a result of our teaching" (p.18). This view that an objective is formulated from the program planner's perception of what "should be" is reinforced by Houle (1978) when he suggests that objectives include a bel ief 11 about "a desired perfection or excellence based on an ideal" (p.139). The belief that what should be can be identified by defining the competencies required for a particular role is common among educators (e.g Gale & Pol , 1975; Hutchison, 1974; Jason, 1974; Knowles, 1980; Laxdal, 1982). Once specified, the competencies can form the basis for an assessment of the need for educational programs. That i s , fieldwork instructors and others can determine the degree to which they display these behaviours, thus assessing their level of competence. The difference between the actual and desired level of competence of the fieldwork instructors can guide the selection of program objectives and content. Subsequently, instructional and evaluation plans for the program can be developed from the program objectives. This program development sequence is recognised in the l i terature (Boyle, 1981; Houle, 1972; Knowles, 1980). If educational programs for fieldwork instructors are to be further developed in O.T. and P . T . , i t is essential to f i r s t determine the competencies required of fieldwork instructors. Significance of the Study This research will add information about the competencies required by O.T. and P.T. fieldwork instructors. Specification of fieldwork instructor competencies and their importance in 12 determining the effectiveness of a student's fieldwork experience has implications for the development of educational programs for fieldwork instructors. Educational programs designed to prepare therapists for their fieldwork instructor role should focus on their needs. However, specification of the requirements for a role (that i s , the competencies) must be available to provide the basis for the needs assessment. Identification of relevant competencies and their level of importance in fieldwork instruction, should reveal which competencies are essential to the role. If this occurs, educational planners could use the information to determine content pr ior i t i es in developing educational programs to prepare fieldwork instructors for their role . Uniform inclusion of the essential content in programs in Canada and elsewhere, would in effect, standardize the content of programs for O.T. and P.T. fieldwork instructors. The wide variation in the content of the workshops and inservice sessions offered to date (Christie et a l . , 1985b; Emery, 1984; Peat, 1985; Tompson, 1985) diminishes the cred ib i l i ty of the courses outside the province or state in which they are offered. Continuing education courses designed to update c l in i ca l s k i l l s usually offer content which is standardized and thus more transferable to other provinces or states. Given the plethora of available courses, i t is 13 reasonable to assume that i f content in courses for fieldwork instructors is applicable "worldwide", participation in such courses could be enhanced. If the educational preparation of fieldwork instructors is related to the quality of fieldwork experiences, as the l i terature suggests (Greenberg et a l . , 1984; Sox et a l . , 1984; Lawson & H a r v i l l , 1980; Tompson, 1986), then this could be considered a positive development from this study. There are several other ways in which fieldwork instructor competencies will be useful for the professions. Identification of the competencies and their relative importance wil l assist Directors of Occupational Therapy and Physical Therapy Departments in selecting therapists for fieldwork instruction. The l i s t of competencies required for effective fieldwork instruction will provide a useful checklist for therapists to identify the act iv i t ies which encompass the role and guide their act iv i t ies during a fieldwork experience. Use of the competencies to develop a self-evaluation tool for fieldwork instructors, and develop a rel iable and valid form for the students' evaluation of fieldwork experiences are additional benefits from this research. Research Design A cross-sectional survey design was used to determine O.T. and P.T. fieldwork instructors' and O.T. and P.T. students' 14 perceptions of the importance of each fieldwork instructor competency selected from the l i terature . A questionnaire was used to col lect data from the subjects. Subjects Fieldwork instructors Subjects included al l male and female O.T . ' s or P . T . ' s who had instructed at least one student on full-time fieldwork experiences of 4 weeks or longer duration since May 1986, in agencies a f f i l ia ted with the School of Rehabilitation Medicine at the University of Brit i sh Columbia. Therapists were identified from the students' fieldwork performance reports f i l ed in the School of Rehabilitation Medicine. Since May 1986, the 71 third and fourth year students who comprised the student population in the study had completed a total of 355 fieldwork experiences. It was anticipated that some of the fieldwork instructors could have supervised more than one of these students during this period. However, a population of at least 50-60 therapists was expected for each profession. The demographic characteristics of therapists considered were age, sex, level of education, number of students supervised since graduation, type of practice setting, the type of c l ient problems encountered in practice, years of c l in ica l experience, and number of fieldwork instructor workshops attended. 15 Students Al l third and fourth year students registered in the B.Sc.(O.T.) and B.Sc. (P.T.) programs at The University of Br i t i sh Columbia in January, 1987 were included. Their names were obtained from the School of Rehabilitation Medicine. The population included 34 occupational therapy students and 37 physical therapy students. Age and sex of the respondents and student year were the only demographic data requested. The third year and fourth year O.T. students had completed 8 and 26 weeks of full-t ime fieldwork experience respectively; the third year and fourth year P.T. students had completed 10 and 26 weeks of full-t ime fieldwork experience. Data collection A profi le of the competencies hypothesized to be required of O.T. and P.T. fieldwork instructors, prepared from past research in c l in ica l teaching in the health professions, provided the framework for the questionnaire. If the items had been labelled as competencies, this may have suggested to the respondents that each was already required for O.T. and P.T. fieldwork instructors. Since this had not been established, and was one of the purposes of this study, the proposed competencies were presented to subjects in the form of traits and behaviours. The l i terature on scaling guided the selection of the rating scale(s) 16 considered to be most effective in meeting the objectives of this study. A pre-test of the questionnaire was conducted prior to the study. Subjects included three occupational therapists, three physical therapists, three occupational therapy new graduates (1986) and three physical therapy new graduates (1986). The therapists selected had supervised students in the past, but did not meet the cr i t er ia for inclusion in the study. Al l new graduates had completed their studies in the O.T. or P.T. programs at the School of Rehabilitation Medicine, University of Bri t i sh Columbia. Neither the subjects nor the data from the pre-test were used in the study. The final questionnaire was mailed or distributed by hand to a l l subjects concurrently. A letter of introduction outlined the purpose of the study and completion of the questionnaire was voluntary. A decision not to participate did not affect the subject's standing i n , or relationship with the School of Rehabilitation Medicine. The return of a completed questionnaire was considered as consent to participate. A stamped, self-addressed envelope for return of the questionnaire was included. Approximately 2 weeks after the f i r s t mailing, a thank-you letter which asked each non-respondent to complete and return the questionnaire was mailed. The confidentiality of respondents was assured at a l l times. 17 Data analysis Data was analysed on a group basis using descriptive s tat is t ics together with the appropriate inferential s tat i s t ics to study between group differences. Limitations of the Study 1. The response rate to the questionnaire determined the avai labi l i ty of data for analysis, and affected the generalizabil ity of the results. 2. The generalizabil ity of the findings was limited to occupational therapy and physical therapy fieldwork instructors, in Brit i sh Columbia. 18 CHAPTER 2 Review of the Literature A major assumption underlying this research is that the delineation of the competencies required of fieldwork instructors in occupational therapy and physical therapy will provide a necessary foundation for the development of educational programs to prepare fieldwork instructors for their role. In order to provide a rationale for this claim, approaches to program development and definitions of competence will be reviewed and the relationship between competency definition and program development will be demonstrated. Means for defining competencies wil l be derived from the l i terature to give direction and support to the chosen methodology. The contribution of past occupational therapy and physical therapy research to the definition of fieldwork instructor competencies will be compared to research in related health professions to provide a foundation for the study. Program Development The process of program development has been viewed as a mechanism through which theory and research related to adult development and learning, management, instructional design and evaluation, and marketing can be applied (Sork, 1981). Numerous 19 models for program development have been proposed (Sork & Buskey, 1981a, 1981b), and although descriptors di f fer , the elements are very similar (e.g. Boyle, 1981; Bergevin, Morris, & Smith, 1963; Brown & Uhl, 1970; Charters & Blakely, 1974; Chernoff, Lindsay, & Kris-Etherton, 1983; Houle, 1972; Knowles, 1980; Perry, 1978; Roberts, Cordova, & Saxe, 1978; Tyler, 1949). The model developed by Charters and Blakely (1974) has been selected for i l lus trat ion in Figure 1 because of its relationship to continuing education in the health professions. It represents a systematic planning effort in which each step is dependent on the information gathered from the steps that precede i t . The notion of the interdependence of the steps in program development is captured by Houle (1972) when he states that the steps "are to be understood as a complex of interacting elements" (p. 46). Although there are nine steps in Charter's and Blakely's model (1974), there appears to be agreement among planners that Step One, Determine Needs, is the most crucial to effective program development (Boyle, 1981; Hutchison, 1974; Knowles, 1980; Knox, 1974). The Concept of Need The l i terature abounds with articles which propose and debate definitions of need (e.g. Boyle, 1981; Bergevin et a l . 1963; Bullard, 1983; Koonz, 1978; Monette, 1977). The 20 CONTEXT of practice and of co-operative planning and regional arrangements 9. Next steps If satisfied > and Provide to maintain improved results If not satisfied Re-examine and reconsider: 1. Determine needs 2 . Within pr ior i t i es --> select a need 3. Analyse need and --> define the problem or or 4. If i t is a learning --> problem, diagnose cause and cure 5. From alternatives --> select a corrective learning experience or or Plan and prepare the learning experience 8. Assess outcome (Evaluate) 7. Implement corrective learning experience Figure 1. A model of the program development process in continuing education. 21 definitions which appear consistently in the l i terature on education and are deemed relevant to adult and continuing education, describe many different types and sources of needs. Terms such as real needs and educational needs describe types of needs, whereas fe l t needs, normative needs, comparative needs, motivational and prescriptive needs describe sources of needs. A real need is one which indicates an objectively determined deficiency or gap in the knowledge, attitudes or sk i l l s of an individual (Bullard, 1983; Monette, 1977). Real needs are based on validated data (Bullard, 1983). Labelling a need as educational implies that the deficiency identified can be reduced or eliminated through a learning experience which provides the required knowledge, sk i l l s or attitudes (Bergevin et a l . , 1963; Boyle, 1981; Monette, 1977). A fe l t need in contrast, is thought to represent an individual's wants or desires for learning (Boyle, 1981; Bergevin et a l . , 1963). Monette (1977) states that "a fe l t need alone is an inadequate measure of real need in that i t is limited by the perceptions of individuals, that i s , their awareness of the services available, their own self-awareness, and their willingness to depend on services" (p.118). Dickinson and Verner (1974) state that when individuals are asked they are rarely able to identify their own needs. Beatty (1976) and Sork (1981) use the term motivational needs to label fe l t needs. 22 When a condition of deficiency exists relative to a social ly accepted standard or norm the deficiency is thought to describe a prescriptive need (Beatty, 1976). An individual or group fa l l ing short of the desirable standard is considered to have a normative need (Boyle, 1981; Monette, 1977). If the characteristics of two groups, one which is receiving a service and one which is not, are compared and found to be the same, the latter group is said to have a comparative need (Monette, 1977). This need, i f determined from outside the group can also be c lass i f ied as a prescriptive need. Although these definitions of need vary, the term always implies, more or less direct ly , a standard or a more desirable condition against which need is assessed (Monette, 1977). Boyle's (1981) generic definition that need "represents an imbalance, a lack of adjustment, or a gap between a present situation or state of being and a new or changed set of conditions assumed to be desirable" (p. 155) is typical of the summative definitions of need evident in the l i terature (Bullard, 1983; Chernoff et a l . , 1983; Fleisher, 1974; Hutchison, 1974; Knowles, 1980; Knox, 1974; Laxdal, 1982; Lessinger, 1974). Determining needs in the context of program development It is from the generic definition of need that the elements of Step One in the process of program development, Determine 23 Needs, are identified (Charters & Blakely, 1974). Three elements can be described as c r i t i c a l to this step: a) definition of the cr i t er ia and standards for performance; that i s , the more desirable condition, b) measurement of the potential learners' actual level of performance, and c) comparison of the descriptions of actual and desired performance to ascertain the gaps or needs (Boyle, 1981; Davis & McCallon, 1974; Dickinson & Verner, 1974; Jason, 1974; Laxdal, 1982; Lessinger, 1974). The f i r s t of these three elements, definition of the standards or c r i t e r i a for effective performance, provides the framework for completing Step One and the remaining steps in the process of program development (Gale & Pol , 1975; Jason, 1974; Laxdal, 1982; Macpherson, Davey, & Simpson, 1985; Young, Weser, McBride, Page, & L i t t l e f i e l d , 1983). The standards provide information for Step Two, setting pr ior i t i e s (Boyle, 1981; Charters & Blakely, 1974). When standards are defined clearly , they guide decision-making about the nature of the problem or def ic i t (Step Three) and aid the diagnosis of its cause and cure (Step Four). Each standard can be analysed to identify the domain(s) of learning (cognitive, psychomotor or affective) to which i t relates (Gronlund, 1978; Knox, 1974). This type of analysis provides direction for the selection of appropriate learning experiences (Step Five) and for planning the experiences (Step Six) (Boyle, 1981). One of the preliminary elements in 24 Step Six is formulating program objectives. Objectives reflect the desired outcomes of a program, and are a transformation of the standards for performance (Boyle, 1981; Knox, 1974). The objectives guide the instructor who is implementing the program (Step Seven) and become one of the standards against which program value can be judged. As such, they are c r i t i c a l to Step Eight, assessing the outcome of a program (Boyle, 1981; Charters & Blakely, 1974; Laxdal, 1982; Stake, 1983; Steinmetz, 1983; Stufflebeam, 1983; Tyler , 1983). Competence The definition of competence goes beyond the "art of being capable" as described in the Webster's Third New International Dictionary (1976). Gale and Pol (1975) have adopted a definition which is consistent with the meanings assigned to the term in education and the health professions. They state: Competence, by def init ion, is tied to a position or role . The ligatures binding the two are a b i l i t i e s , knowledge, s k i l l s , judgement, attitudes and values required for successful functioning in the position or role. That i s , possession of the c r i t i c a l l y required a b i l i t i e s , knowledge, judgement, s k i l l s , attitudes and values - and proficient use of the same - is what yields competence, (p. 20) Three core ingredients are evident: the role, the behaviours associated with functioning in that role, and success. In the l i terature there is consistent use of the terms role and successful or proficient performance in relation to competence 25 (Lewis, 1974; Schalock, 1981). However, the label l ing of the third ingredient, the behaviours or ac t iv i t i e s , is more commonly described as knowledge, s k i l l s , and attitudes (Boyle, 1981; Knowles, 1980; Knox, 1974; Laxdal, 1982). Knox (1974) indicates that "the term 'behaviour' refers to knowledge, s k i l l , attitude and also the combination of a l l three in the form of performance" (p. 77). Competence, l ike performance, represents a whole of interrelated parts (Gale & Pol , 1975; Rubin, 1981; Schalock, 1981). Schalock (1981) cautions that competence should "not be defined as the set of knowledges, s k i l l s , and attitudes that make up competence or, more accurately, that are needed for competent performance" (p. 154). He suggests that they should only be considered enablers or indicators of competence. Chicken'ng & Claxton (1981) also acknowledge that competence is a macroconcept which is larger that any collection of behavioural statements believed to represent the knowledge, s k i l l s , and attitudes related to performance in a particular role. However, they recognize that to operationalize the term, the definition of competence must be reduced to manageable terms and broken into recognizable units. To do this , the term competency [competencies (plural)] has been coined to label the parts or enablers of competence. Gale and Pol (1975) have indicated that use of these words is just as 26 i l l og i ca l as cal l ing in te l l igences parts of intell igence. Despite their objections these words have been found to be useful (e.g. Bridle , 1981; Chickering & Claxton, 1981; Davis et a l . , 1979; McClure & Leigh, 1981; Moncur, 1985; Roberts et a l . , 1978), and now appear in contemporary dictionaries (Halsey, 1979; Woolf, 1979). Competencies are considered to be the significant behaviours (knowledge, s k i l l s , and attitudes) which are performed in a particular role and/or setting, to a specified standard (Davis et a l . , 1979; Roberts et a l . , 1978). Competence and Program Development It is apparent that the definitions of the terms used to define competencies in a health professions context, and the terms c r i t e r i a and standards of performance in an educational context, are s imilar. The phrases effective performance, and knowledge, sk i l l s and attitudes, are central to both definitions. Indeed, in some definitions of need the terms competence or competencies are used as a substitute for desirable standards of performance or what should be (Gale & Pol , 1975; Hutchison, 1974; Jason, 1974; Knowles, 1980; Laxdal, 1982). Hutchison (1974) states that in the world of work the learning or educational needs can be stated as the difference between the present level of competency and desired competency. In discussing needs assessment in continuing medical education Laxdal (1982) defines 27 need simply as "a gap between current and optimal competence" (p. 828). This use of the terms competence and competency in relation to educational need appear more frequently in the references to the continuing education of professionals (Boyle, 1981; Young et a l . , 1983). If the definition of competencies represents the f i r s t element of Step One in the process of program development (see Figure 1) as supported by Gale and Pol (1975), then competencies can be directly related to program development. Past use of definitions of competence or competencies to guide the development of educational programs at graduate, post graduate and continuing education levels in the health professions, is evidence that this relationship exists (American Physical Therapy Association, 1981; Aston-McCrimmon, 1986; Bridle , 1981; Brintnell & Skakun, 1986; Caney, 1983; Davis, Anderson, & Jagger, 1979; G i l l , 1987; Meleca, Schimpfhauser, Witteman & Sachs, 1983; MacPherson, Davey, & Simpson, 1985; Roberts et a l . , 1978; Young et a l . , 1983). The use of competency definitions in providing the basis for a self-assessment to assist in determining educational needs, is an additional outcome of relevance to this study (Dunn et a l . , 1985; Knox, 1974; Laxdal, 1982; Shellenberger & Mahan, 1982). These uses provide the rationale for what Dunn, Hamilton, & Harden (1985) have described as the symbiotic link between competence and continuing education. 28 The Process of Defining Competencies The framework The three major ingredients in the definition of competence provide a framework for defining competence. Issues to be considered in the process wil l be examined in relation to the three ingredients of competence: the role or position, the behaviours which represent the knowledge, sk i l l s and attitudes related to the role, and the delineation of the standards required for effective performance of the behaviours (Davis et a l . , 1979; Gale & Pol , 1975; Schalock, 1981). Role There are several preliminary decisions to be made at the time the role or position for review is selected (Schalock, 1981). Within the health professions, the profession or professions must be selected, the role — c l i n i c i a n , administrator, educator, researcher - - must be chosen, and the setting must be identif ied. For example, occupational therapists and physical therapists may instruct students in a university or in a c l in ica l setting. The behaviours related to being an effective instructor in these two different settings will vary considerably. 29 Specifying the behaviours Identification of the behaviours to be performed relative to a particular role is a c r i t i c a l step in competency def init ion. The behaviours to be performed define the parameters of a role or position, and as indicators of competence, become the competencies to be demonstrated (Schalock, 1981). Components of the task. Due to the d i f f i c u l t nature of this task, i t can be divided into two steps: 1) identifying categories of behaviours (or areas of competence), and 2) specifying the essential behaviours (or elements of competence) within each category (Gale & Pol , 1975). This process appears to be a common practice within the health professions (e.g. American Physical Therapy Association, 1981; American Speech-Language-Hearing Association, 1982; Aston-McCrimmon, 1986; Bridle , 1981; Emery, 1984; Hercules, Kneedler, & Roth, 1986; MacPherson et a l . , 1985; Meleca, Schimpfhauser, Witteman, & Sachs, 1981; Moncur, 1985; Romberg, 1984; Shellenberger & Mahan, 1982). Categories or areas of competence serve as organizers for the task of competency definition by identifying major components of a role or job, whereas the elements or behaviours constitute the competencies for the role. A sample of competencies defined for entry-level pharmacists which was reported by McClure and Leigh 30 (1981) included eight categories (e.g. maintain drug information) for which 34 competencies were formulated. Limiting the scope of the task. The number of competencies identified for a particular role can be inf ini te (Gale & Pol , 1975). Pottinger (1975) emphasizes that competencies cannot be meaningfully defined by seemingly endless l i s t s of behaviors, which ultimately fa l l short of real world requirements for effective performance. Similarly , Gale and Pol (1975) warn that a l l elements of competence will never be identified and will not need to be, and others will only be vaguely defineable. Some elements wil l appear to be extremely simple, even mundane, while others are so complex they are considered to be impractical for use. The c r i t e r i a of importance and meaningfulness are commonly used to delimit the task (Chernoff et a l . , 1983; Emery, 1984; Fleisher, 1974; Gale & Po l , 1975; Schalock, 1981). Competency definitions should be readily recognizable as important, those who are to use them should perceive them to be meaningful and useful, and they should not be so numerous that they are overwhelming. Ideally, the behaviours considered to be important to a role wil l be common to many settings (Schalock, 1981). Standards Once the important and meaningful behaviours have been identif ied, standards for successful performance must be 31 formulated. Standards may be incorporated into the competency definitions (MacPherson et a l . , 1985; Young et a l . , 1983) or l i s ted separately (e.g. Bridle , 1981; Davis et a l . , 1979). General versus specif ic . The standards may be stated in general or specific terms. McAshan (1979) suggests that the level of specif ic i ty chosen should be the most functional within the context of the content and in the setting in which the competencies wil l be used. However, he indicates that there is an inverse relationship between the level of abstraction at which a competency is stated and the val idity of the measurement used to evaluate the degree to which i t is demonstrated. Clearly, broad or general competencies are amenable to general evaluation, whereas specific competencies are amenable to specific evaluation. Thus, the uses intended for the competencies will dictate the amount of specif icity required. Determining the level of performance. When decisions about the need for general or specific descriptions of standards have been made, the level of performance required must be determined (Gale & Pol , 1975). Pottinger (1975) indicates that this is one of the most d i f f i c u l t and troublesome tasks of competency def init ion. Regretably, the l i terature provides l i t t l e guidance (Schalock, 1981). Much of the di f f icul ty of the task l ies in deciding how high the standards for performance should be, and 32 how the chosen level of performance should be expressed in the competency def init ion. Selection of a level of performance which reflects what an individual should know or be able to do, or can r e a l i s t i c a l l y achieve is a common recommendation (Fleisher, 1974; Health and Welfare Canada, and Canadian Association of Occupational Therapists' Task Force, 1986; Roberts et a l . , 1978; Schalock, 1981; Young et a l . , 1983). Often, the level of performance represents the minimally acceptable level for success (Schalock, 1981). Opponents of this approach argue that standards may be set too low to challenge excellence (Chickering & Claxton, 1981). Regardless of the approach used, the terms minimally acceptable levels or excellence, must be defined. Unquestionably, there will always be tension between required minimums and desirable maximums in the process of standard setting (Spady, 1977). The competence of an individual may be determined by the degree to which an overall standard of performance is achieved (e.g. reaching the standards set for 75% of the competencies) or by successful performance in al l of the competencies. The overall standard method may be more desirable because i t has the capacity to challenge individuals to reach the standard or to attain a higher standard of performance. Given that competence has been described as a whole of interrelated parts (Gale & Pol , 1975) such an approach appears warranted. Schalock (1981) stresses 33 that establishing standards for each competency as well as for performance in a job or role as a whole is c r i t i c a l in the standard setting process. The next step in the process of defining competencies is to select the most appropriate methods to accomplish the task. Methods Although program development models emphasize the importance of defining the more desirable future level of performance or competencies, the l i terature provides only limited guidance on how this should be accomplished. The methods thought to be most appropriate for gathering information which will contribute to competency definition fa l l largely into three groups: a) past research, b) those which document expert opinion and c) those which identify the opinions of the individuals who function in the role under review (Boyle, 1981; Bridle , 1981; Davis et a l . , 1979; Young et a l . , 1983). Group c) wil l be hereafter referred to as the potential learners. Experts may include individuals who are recognized for their competence and experience in the role , individuals who are knowledgeable about the role due to their close association with those who function in the role , consumers of the service, and professional organisations, institutions and agencies. 34 Past Research An analysis of past research is a necessary and desirable exercise. It may y ie ld complete definitions of competencies related to the investigator's area of interest, may identify additional sources of information and/or may offer recommendations to guide competency def init ion. Sources include published research, and published and unpublished reports from government agencies, institutions and organisations. Findings may be based on opinions of experts and/or potential learners. Opinions of experts Four methods for involving experts in the process of competency definition are job analysis (Boyle, 1981; Dunn et a l . , 1985, Hutchison, 1974; Knowles, 1980; Lewis, 1974; Schalock, 1981), group decision-making (Boyle, 1981; Davis et a l . , 1979; Knowles, 1980; Knox, 1974), interviews (Dunn et a l . , 1985), and the Delphi technique (Dunn et a l . , 1985; Farrell & Scherer, 1983; MacPherson et a l . , 1985). Job analysis. Job analysis refers to the process of documenting through observation, interview and research, the significant behaviours which comprise performance in a given role, together with the responsibil it ies required for successful role performance (Lewis, 1974). Lewis (1974) divides job 35 analysis into two broad categories. The f i r s t category isolates the whole tasks of a job. In the second category each (whole) task is dissected to reveal its components; that i s , the knowledge, sk i l l s and attitudes necessary to perform the task successfully. These processes are comparable to the steps identifying areas and elements of competence which were discussed in relation to competency definit ion. Job descriptions, job specifications, task l i s t s or inventories, time and motion studies, work diaries or journals, behavioural event interviews, c r i t i c a l incident studies and work sampling are among the many techniques associated with this process (Boyle, 1981; Dunn et a l . , 1985; Hutchison, 1974; Knowles, 1980; Lewis, 1974). While job analysis can y ie ld specific and precise information about role requirements i t demands excellent observation and interviewing s k i l l s , accurate documentation, and is extremely time consuming (Lewis, 1974). The findings do not complete the process of competency definit ion. The detailed descriptions of performance in a role represent a bank from which the most important behaviours must be selected and the standards for performance of each must be established. Due to the funds, sk i l l s and time required job analysis can only be just i f i ed when l i t t l e or no research data is available. Group decision-making. When past research is lacking or l imited, and a job analysis is not considered to be viable 36 proposition, a group of experts may be convened to formulate an i n i t i a l l i s t of competencies (Boyle, 1981; Davis et a l . , 1979; Dunn et a l . , 1985; Gale & Pol , 1975; Knowles, 1980; Knox, 1974; Young et a l . , 1983). If information is available from past research and/or a job analysis, the group can organise the information into the desired format as a pre-requisite to confirmation by an expanded group of experts and potential learners. The size of the group and the procedures used to define competencies can vary with group membership and the extent of the task (Bridle, 1981; Davis et a l . , 1979; Young et a l . , 1983). Use of this method permits synthesis of different viewpoints, builds support for continuing education programs, and promotes understanding and agreement (Boyle, 1981; Knowles, 1980). Pottinger (1979) states that while this is the most popular method of defining competence i t is also the most dangerous technique. He believes that selective perception, beliefs and value systems can contaminate object ivity . For this reason i t is preferable to use group decision making in conjunction with other techniques. Two further limitations of this method are that success is usually dependent on effective leadership, and that the time required to complete the task may be excessive. Interviews. An interview can include open or closed questions which are directed to the subject in a face-to-face 37 situation (Borg & G a l l , 1983; Brink & Wood, 1978; Issac & Michaels, 1971). The advantages of the interview compared to the written questionnaire as described by Brink and Wood (1978), Coldeway and Delisa (1983), Knowles (1980), and Issac and Michaels (1971) include: 1. It permits greater depth in questioning. 2. A high response rate is more assured although this is dependent on the s k i l l of the interviewer. 3. The interviewee and the interviewer may seek c lar i f i ca t ion on questions or responses. 4. It is possible to establish and maintain rapport with the respondent or determine when rapport has not been established. The primary disadvantages of the interview is that i t can be costly, time consuming and inconvenient (Coldeway & Delisa, 1983). Accuracy of the results is highly dependent on the interviewer's s k i l l , and the problem of subjectivity and personal bias is more l ike ly to influence the results (Issac & Michaels, 1971). Coding and class i f icat ion of the responses may be d i f f i c u l t due to the var iabi l i ty in format and in the subjects responses (Bullard, 1983; Sowell & Casey, 1982). Due to the time needed a serious weakness in using interviews for research is the usual necessity of using small samples (Borg & G a l l , 1983). In the process of defining competencies, interviews may be used as a 38 job analysis method (Lewis, 1974), or to obtain information from consultants and consumers of the service in which the role is evident (Dunn et a l . , 1985; Knox, 1974). The interview is not identif ied in the l i terature as an major method for the definition of competencies. The Delphi Technique. This technique engages respondents in an anonymous debate to reach a concensus on specific issues. Although mailed questionnaires are used, one group of respondents (usually recognized experts in a field) contribute information up to four times to develop, refine or revise goals, statements or competencies (Dunn et a l . , 1985). With each administration of the questionnaire feedback can be given, issues c lar i f i ed and subsequent questionnaire content revised. A major drawback in the use of the Delphi technique is that i t requires a considerable amount of time to administer and places heavy demand on the respondents' time. Consequently, loss of subjects can be dramatic by the fourth stage. When this arises sampling bias may occur seriously questioning the value of the technique as a research tool (Borg & G a l l , 1983). The modification of the technique from a four-phase to a two-phase process by Farrel l and Scherer (1983) and MacPherson et a l . (1985), and unspecified modification by Meleca et a l . (1981, 1983), suggests that administration of the technique in i ts original form may not be necessary or desirable. Although the 39 var iabi l i ty of the responses does decrease between phase one and phase four, the mean responses appear to shift minimally (Borg & G a l l , 1983). In the study by Farrel l and Scherer (1983) only minimal change occurred between mailings and there was no change in negative group opinion. Use of the technique by Sweeney and Regan (1982) neither produced changes nor concensus. The Delphi technique may be just i f iable when empirical data is lacking (Farrell & Scherer, 1983). However, where this is not the case, a single administration of a questionnaire may be equally effective (Borg & G a l l , 1983). Opinions of potential learners While opinions of this group may also be obtained through interviews, or by participation in group decision making or a Delphi study, the most common way of receiving input from this group is through a questionnaire. Questionnaires. Use of written questionnaires to gather information which can contribute to the ident i f icat ion, definition and validation of competencies is a common practice in health professions education (e.g. Aston-McCrimmon, 1986; Bridle , 1981; Brown, 1981;^  Irby & Rakestraw, 1981; Meleca et a l . , 1981, 1983; Moncur, 1985; Shellenberger & Mahan, 1982; Str i t ter et a l . , 1975; S tr i t t er , Baker, & McGaghie, 1983). The questionnaire method has several advantages (Borg & G a l l , 1983; Boyle, 1981; 40 Brink & Wood, 1978; Knowles, 1980): 1. It is possible to cover wide geographic areas and to question large numbers of people without significant expense. 2. Anonymity and privacy of subjects can be maintained. 3. The written questions can be presented in the same way al l subjects and are not susceptible to the changes in tone or emphasis which can occur in verbal questioning. 4. Subjects have ample time to consider their responses. 5. Questions may be presented in open or closed form. 6. Systematic administration of the questionnaire aids tabulation and analysis of the data. 7. Opinions of experts and potential learners can be obtained at the same time. While sk i l l in questionnaire design is important in constructing a questionnaire there is always a possibi l i ty that respondents wil l interpret the questions differently (Brink & Wood, 1978; Schuman & Presser, 1981). Pre-testing the questionnaire minimizes this p i t f a l l (Borg & G a l l , 1983; Issac & Michaels, 1971). One of the major disadvantages of questionnaires is the problem of non-respondents (Coldeway & Delisa, 1983; Borg & G a l l , 1983). Butts (1983) states that when response rates are less than 75%, the results must be seriously questioned. When this occurs the respondents may differ substantially from non-respondents thus biasing the sample. 41 Use of multiple methods Program development experts agree that use of methods which involve experts as well as the potential learners is essential (Boyle, 1981; Fleisher, 1974; Hutchison, 1974; Knowles, 1980; Laxdal, 1982). In the context of determining needs, the views of experts represent prescriptive needs, whereas the views of the potential learners represent motivational needs (Beatty 1976; Sork, 1981). Involvement of both groups provides balance, sets the climate for participative program development, and increases the l ikelihood of program success (Boyle, 1981; Hutchison, 1974; Knox, 1974). Fleisher (1974) stresses that the more the individuals whose future performances are to be measured by the competencies accept the val idity of the standards and their application, the greater authority the standards wil l carry and the stronger their commitment to reach them will be. When these individuals have participated in the formulation of competencies they wil l have a greater stake in the success of continuing education programs which may be developed to assist them to meet and/or maintain the performance standards. Consequently, the l ikelihood that behavioural change wil l result , is enhanced (Hutchison, 1974). The review of the l i terature shows that those responsible for competency definition recognize that completion of the task demands the use of more than one method. Typical ly , the process 42 begins with the use of past research, job analysis techniques and/or group decision-making, to formulate an i n i t i a l l i s t of competencies. Experts and potential learners then verify or validate the competencies through interviews, and through the use of a questionnaire or the Delphi technique. Selection of methods for this study The major determinants in selecting the method for this study were the research objectives, the effectiveness of the method in contributing to competency definitions in past research, the degree to which competencies have been defined for fieldwork instructors, and the extent to which involvement of both potential learners and experts was possible. After consideration of al l of these factors the questionnaire was selected as the best method for this study. It permits inclusion of a large number of subjects in each of the four groups (O.T. fieldwork instructors, P.T. fieldwork instructors, O.T. students and P.T. students) regardless of their geographic location in the province. Perspectives from potential learners (O.T. & P.T. fieldwork instructors) and two expert groups (O.T. and P.T. students as consumers) can be obtained as recommended in the l i terature . Use of the large sample sizes anticipated with the questionnaire method can provide credible units for s tat is t ical analysis (Hopkins & Glass, 1978; Issac & 43 Michael, 1971). S tr i t t er et a l . (1983), in discussing research in c l in ica l teaching suggested that future studies should build on previous work rather than "re-inventing the wheel". Given that a body of research has been developed in the area of c l in ica l teaching i t seemed wise to use that knowledge to formulate a questionnaire for this study. A number of researchers in the health professions have indeed done this , to research competencies in c l in ica l teaching (Brown, 1981; Emery, 1984; Irby, 1978; Meleca et a l . , 1981, 1983; O'Shea & Parsons,, 1979; Shellenberger & Mahan, 1982; S tr i t ter et a l . , 1975, 1983). A once-administered questionnaire with an ordered categories scale was the most common type of questionnaire used. This pattern is also evident in other studies in which formulation of competencies was the research goal (Aston-McCrimmon, 1986; Bridle , 1981; Moncur, 1985). Fieldwork Instructor Competencies: State of the Art If the development of a questionnaire is to be based on past research, the research findings related to both the categories or areas of competence and elements of competence (referred to as competencies) must be examined. The research findings in occupational therapy and physical therapy will be compared to 44 those in related health professions. Categories of Competence Occupational Therapy and Physical Therapy Studies Research directed at identifying categories of competence or categories of behaviours, and their importance to the effectiveness of a student's fieldwork experience is extremely limited in occupational therapy and physical therapy. Christ ie et a l . (1985a) found that there were three categories of behaviours most frequently identified as c r i t i c a l to a fieldwork experience by O.T. fieldwork instructors and O.T. students. They were in order of importance: a) supervision, b) communication and interpersonal relationships, and c) the attitudinal environment. Research conducted by Emery (1984), and Moore & Perry (1976) in physical therapy revealed similar findings. One purpose of Emery's study (1984) was to determine which of 43 fieldwork instructor behaviours were considered by students to be most important in contributing to an effective fieldwork experience. Communication behaviours were thought to be most important, followed by interpersonal s k i l l s , teaching behaviours and, of least importance, professional sk i l l s behaviours. An analysis of fieldwork instructor behaviours noted by Moore and Perry (1976) identified six categories of 45 performance: a) ab i l i ty as a physical therapist, that is professional competence, b) supervision, c) instruction of students, d) student evaluation, e) interpersonal relationships/communication and f) personal characterist ics . In a subsequent study, behaviours which fe l l into the categories of supervision, communication, and personal characteristics were most linked to effective fieldwork instructors. Studies in Related Health Professions Research in medicine, nursing and dentistry provide additional information about the categories of behaviours/competence which are most often associated with effective fieldwork instructors. A variety of methods were used to obtain the data. These studies examined student and instructor perceptions of instructor effectiveness, and the results of students' evaluations of their fieldwork instructors. Nursing studies Results of a nursing study by Brown (1981) showed that the categories of behaviours believed to be important differed between faculty and students. Both groups rated personal attributes to be least important ( third) . However, their rankings of the categories, professional competence and relationship with students, were reversed. Students ranked 46 relationship with students as most important, whereas professional competence was thought to be most important by the instructors. The behaviours c lass i f ied as evaluative by O'Shea and Parsons (1979) were most frequently linked to instructor effectiveness by nursing instructors and students. Instruct!ve/assistive behaviours were ranked second, and personal characteristics th ird . Brown (1981), and O'Shea and Parsons (1979) both l i s ted personal attributes or characteristics as least important. The categories which were ranked f i r s t and second are too different to permit comparison. In both studies no additional s tat i s t ica l analyses were conducted. Meleca et a l . (1981) conducted a multi-faceted study in nursing. Two phases of their project are relevant to this study. They f i r s t used trained observers to record the behaviours of fieldwork instructors, and compiled c r i t i c a l incident reports from students to supplement the information collected by the raters. Using the l i s t of 72 nursing instructor behaviours, they developed a questionnaire. Instructors in nursing were then asked to note the frequency with which actual instructors and ideal instructors have or should demonstrate the behaviours l i s t ed . The parallel factor analyses and orthogonal rotations conducted on actual and ideal scales yielded no clear-cut solution. Most behaviours loaded highly on a one-factor solution. No patterns relative to the four categories of 47 behaviours, presentation and providing s k i l l s , attending s k i l l s , questioning s k i l l s and teaching styles/attitudes emerged. This may have been due to the apparent s imilarity of these categories. Studies in medicine In a study of 340 medical students and their instructors Irby (1978) found that the categories demonstrating the greatest difference between best and worst instructors were enthusiasm/stimulation and organisation/clarity. Group instructional s k i l l s and c l in ica l supervision were ranked second, c l in ica l competence and role modelling were ranked th ird , and the combination of role modelling and instructor knowledge was ranked fourth. Six of the seven categories were confirmed using a principal component solution to orthogonal factors, and these accounted for 49.7 percent of the variance. Modelling was subsumed with group instructional s k i l l and was not found to be orthogonal. S tr i t t er et a l . (1975) identified six categories or factors in their research on the contribution of student behaviours to student learning. In descending order of importance based on mean values, these were: a) provides a personal environment in which the student is an active participant, b) reflects a positive attitude toward teaching and students, c) concentrates 48 on the problem-solving process rather than on factual content alone, d) uses a student-centred instructional approach, e) displays a humanistic orientation, and f) emphasizes his personal research and the research of others. These six factors were obtained from a centroid factor analysis of the intercorrelation matrix followed by a maxplane rotation of factors having an eigenvalue greater than 1.0. Irby and Rakestraw (1981) used Irby's earl ier work (1978) as a foundation for the development of an instructor evaluation instrument. In the factor analysis which they used to determine whether hypothesized factors of instructor effectiveness corresponded with students' assumptions about c l in ica l teaching, four factors emerged. They accounted for 86.7 percent of the variance. In order of importance they were: a) supervisory s k i l l s , b) knowledge and c l a r i t y , c) interpersonal relations, and d) demonstration of c l in ica l s k i l l s . Further evaluations of instructors by medical students yielded six factors following a principal component factor analysis and subsequent varimax rotation (Shellenberger & Mahan, 1982). The six factors accounted for 58 percent of the variance. Wording of the factors were similar to the categories described by Irby (1978) and S tr i t t er et a l . (1975). The relative importance of each factor was not discussed by the authors. 49 Meleca et a l . (1983) conducted the only comprehensive investigation of the behaviours which constitute the role of a fieldwork instructor in medicine. The procedures used were indistinguishable from those used in the nursing study (Meleca et a l . , 1981). Seventy-six instructor behaviours were identi f ied. There were no substantial differences in the findings for medicine and nursing, related to the categories of behaviours which were studied. Due to the fact that the labell ing of the categories is not identical and the research methods differ in these studies, comparison of the findings is d i f f i cu l t (Irby, 1978, Str i t ter et a l . , 1975). In the studies by Irby (1978), and Irby and Rakestraw (1981) c l in ica l competence appears to be less important to instructor effectiveness than supervisory s k i l l s . S tr i t t er et a l . (1975) uses some categories which in other studies, stand alone as behaviours or competencies. For example, the factors b), c) and d) are l i s ted as behaviours by Christie et a l . , (1985b), Hughes (1985), and Shellenberger and Mahan (1982). Dentistry Romberg (1984) used student evaluations of teaching to identify the behaviours most frequently related to instructor effectiveness in dentistry. A principal component factor analysis with a varimax rotation revealed four factors which 50 accounted for 92.1 percent of the variance. The four factors in descending order of importance were a) an instructor meeting teaching responsibi l i t ies , b) an instructor behaving in a manner conducive to c l in ica l learning, c) an instructor being technically competent, and d) an instructor enjoying his/her job. The descriptions used by Romberg (1984) also make comparison with other research d i f f i c u l t . While the technical competence (Romberg, 1984), and the c l in ica l competence (Irby, 1978) of an instructor may be compared, interpretation of "behaving in a manner conducive to c l in ica l learning" is v ir tual ly impossible. Analysis of findings The review of research findings related to categories of competence (or behaviours) has shown that the label l ing of categories is inconsistent. Categories were defined earl ier in this Chapter as the major components of a role. Within each category a number of behaviours or competencies may be specified. Not al l of the researchers reviewed have used this def init ion. The categories or factors identified by Romberg (1984), Shellenberger and Mahan (1982), and Str i t ter et a l . (1975) are either too specific or are so poorly defined that the intended meaning is not clear. For this reason comparison of the findings is problematic. In spite of these d i f f i cu l t i es a pattern is apparent in the research. The categories of supervisory and/or 51 communication and interpersonal relations behaviours appear to be ranked as highly important by Brown (1981), Christie et a l . (1985a), Emery (1984), Irby and Rakestraw (1981), and Moore and Perry (1976). In contrast, personal characteristics and/or c l in i ca l competence appear to be less important in describing an effective fieldwork instructor (Brown, 1981; Emery, 1984; Irby & Rakestraw, 1981; Moore & Perry, 1976; O'Shea & Parsons, 1979; Romberg, 1984). The rankings of teaching or instructive behaviours vary from moderate to high importance. Further research is necessary to verify these trends. Selection of categories for this study The category labels and definitions identified by Moore and Perry (1976) have been adopted with sl ight modification for use in this study. They incorporate the categories in which research trends are evident, they are meaningful to occupational therapy and physical therapy fieldwork experiences, they are more discrete than many of the categories identified in the l i terature , and with the exception of personal characteristics or t ra i t s , they represent units of instruction which would be helpful in subsequent program development. The categories and their descriptions are as follows: 1. Professional competence incorporates al l entry-level competencies which therapists must demonstrate to provide 52 up-to-date, and effective patient/cl ient care. These include the act iv i t ies therapists must carry out regardless of their fieldwork instructor role . Teaching/instruction-related behaviours include those behaviours related to planning and implementing instruction, and making program/changes. Application of knowledge of educational theory and practices is required to perform these ac t iv i t i e s . Supervisory behaviours are those act iv i t ies related to directing the fieldwork experience and ensuring that the student's performance is effectively monitored. The type, amount and quality of feedback, and the avai labi l i ty of the instructor are samples of the behaviours included in this category. Communication behaviours include non-verbal and verbal interactions between therapist and student, openness of communication, exchange of ideas, and l istening s k i l l s . Evaluation behaviours include those act iv i t ies related to formative and summative evaluation; evaluating student performance, evaluating the fieldwork program, and applying educational theory and knowledge of evaluation to the evaluation process. 53 6. Personal characteris t ics / trai ts refers to the aspects of the fieldwork instructor's values or belief system which have an impact on the fieldwork experience. This category includes desirable personal qua!ities of the fieldwork instructor (e.g. f l e x i b i l i t y and enthusiasm for teaching). Competencies In comparison to the information available on categories of competence, the l i terature provides a significant amount of information related to the definition of competencies for fieldwork instructors. A total of 32 reports in occupational therapy, physical therapy, nursing, medicine, speech pathology, dentistry and pharmacy are evident. They include descriptions of effective fieldwork instructors, effective fieldwork instructor behaviours which have been identified from research, and some fieldwork instructor competencies which are entry-level (new graduate) requirements for occupational therapists and physical therapists. The competencies and the methods used to determine them are discussed under the following headings: (a) Competencies: Occupational therapy and physical therapy, and (b) Competencies: Related health professions. An analysis of these findings and their significance to this study completes the Chapter. 54 Competencies: Occupational therapy and physical therapy Nine sources of information in O.T. and P .T . l i terature were identif ied. Of these, four related to O . T . , and five to P.T. Research contributed to the definition or validation of the competencies in seven of the nine cases. The content of the remaining two art ic les was derived from the l i terature and the experience of the authors. Occupational therapy. In 1981, Bridle conducted a survey of Canadian occupational therapists to ascertain their perceptions about the competencies required of entry-level therapists. Seventeen of the 177 competencies identified are relevant to the role of the fieldwork instructor. The categories teaching behaviours and supervisory behaviours are represented. One competency is an administrative function that is more l ike ly to be within the domain of the Department Director than that of the fieldwork instructor. Barker (1986) reviewed the l i terature to summarize desirable fieldwork instructor behaviours. The importance of negotiating a learning contract with the student, working with the student to fac i l i ta te goal achievement, and providing regular feedback are emphasized. A five-year evaluation of a regional fieldwork program in Australia produced two clusters of recommendations regarding fieldwork instructor behaviours (Mocellin, 1984). The 55 following five fieldwork instructor attributes were perceived to be most important by the 105 occupational therapy students who participated: gives feedback, is an effective role model and teacher, encourages students, and is open to discussion. Two preferred methods of receiving feedback were: being told when mistakes were made, and evaluating their own performance with the instructor acting as a monitor. Christ ie et a l . (1985b) used open-ended questionnaires to ask fieldwork instructors (n = 188) and students (n = 127) to define the respective roles of the student and instructor, to l i s t the primary responsibi l i t ies of each and to identify the characteristics of the effective and ineffective instructor. The effective instructor was an active l istener, was open, honest and f lex ible , provided feedback which was timely, constructive, consistent and growth-promoting; adapted his/her supervisory approach to meet the student's needs, was supportive and empathic, and was a competent c l in ic ian and educator. Physical therapy. The entry-level competencies for physical therapists in the United States also includes some fieldwork instructor competencies (American Physical Therapy Association, 1981). Seventeen competencies are given, and each includes one to four sub-competencies or objectives. In a pattern similar to the O.T. entry-level competencies, three of the competencies would normally be carried out by the Director of 56 the Department. Of the remaining competencies, nine can be categorized as teaching behaviours and five as evaluation behaviours. Some aspects of communication and supervision are l i s ted as sub-competencies. Moore & Perry (1976) investigated the characteristics of effective fieldwork instructors, as one aspect of a substantial physical therapy study. The top three behaviours were: a) gives regular feedback to students, b) demonstrates a positive attitude toward teaching, and c) confers 1:1 with students. In a subsequent report Perry (1978) mentioned six fieldwork instructor teaching behaviours and two evaluation behaviours, as components of the curriculum design process in fieldwork education. Emery (1984) l i s ted 43 important fieldwork instructor behaviours which were assessed by 102 physical therapy students. The results were similar to the occupational therapy findings by Christie et a l . (1985b). Communication behaviours such as active l i s tening, communicating in a non-threatening manner, providing useful and positive feedback and openness were ranked highly. The behaviours of least importance were those in the category of professional competence. Physical therapists (n = 296) ranked the order of importance of the same 43 fieldwork instructor behaviours in a study by Biediger and Larson (1987). The top three behaviours were: a) relate academic knowledge to c l in ica l practice, b) plan effective learning experiences and c) question 57 or coach in a way that fac i l i tates student learning. Demonstrating leadership among peers, being perceived as a consistent extension of the academic program and clearly explaining the physiological basis of treatment were identified as the three least important behaviours. Students ranked communication behaviours as most important Emery (1984), whereas therapists believed that teaching behaviours were most important (Biediger & Larson, 1987). The differences in rankings may be due to different perceptions of importance, or may be a reflection of the different scales and procedures used in each study. Competencies: Related Health Professions Although there are a total of 23 reports from the professions of nursing, medicine, speech pathology, dentistry and pharmacy, no single source provides competency definitions which can be adopted en masse for occupational therapy and physical therapy. The majority of the reports (n = 16) focussed on the 10-30 behaviours which have been most frequently linked to effective fieldwork instructors in the profession being studied. Four reports addressed one specific behaviour or category of behaviours related to the fieldwork instructor role (Craig, 1981; Ende, 1983; Farquhar & Holdman, 1982; Hughes, 1985). Meleca et a l . (1981, 1983) were the only authors to compile a l i s t of al l 58 of the important behaviours of fieldwork instructors in medicine and nursing. Nursing. Of the nine reports in the nursing l i terature five include l i terature reviews and/or the authors' opinions of the most important fieldwork instructor behaviours (Gri f f i th & Bakanauskas, 1983; Hughes, 1983; McCabe, 1985; Shamian & Inhaber, 1985; Wong & Wong, 1980). While the recommendations are similar to those which have emerged from the O.T. and P.T. l i terature , thirty additional competencies were l i s t ed . Al l of the six categories chosen for this study were represented by the competencies. Hughes (1983) described competencies which were categorized as supervisory behaviours. She was the only one of these authors to focus on one aspect of the fieldwork instructor role. Two hundred and five students and 24 nursing faculty were asked to l i s t fieldwork instructor behaviours which fac i l i ta ted and interferred with learning in a study by O'Shea and Parsons (1979). The 28 fac i l i ta t ive behaviours- identified were categorized by the authors as personal characterist ics , evaluation, or instructive/assist ive behaviours. Behaviours included in their evaluation category — positive feedback, honest feedback, constructive cr i t ic i sm and clearly defined expectations - - were rated as most important by students and faculty. Personal characteristics (e.g. supportive) were seen to 59 be less important to learning. These findings contributed to the development of a questionnaire which Brown (1981) used to ask 82 nursing students and 42 faculty members to rank the importance of fieldwork instructor behaviours. The provision of useful feedback on performance, and fairness and objectivity in student evaluation were the two behaviours ranked as most important by both groups. The low ranking given to personal characteristics in the O'Shea and Parsons (1979) study, was duplicated by Brown (1981). Craig (1981) investigated the questioning sk i l l s of nursing instructors. Her findings supported the need for fieldwork instructors to ask questions in a manner that fosters the development of problem-solving s k i l l s . Meleca et a l . (1981) conducted an extensive study to determine the competencies required of fieldwork instructors in nursing. Almost 700 nurses participated in the United States study. A pool of 72 competencies were identif ied. The usefulness of the competency definitions to O.T. and P.T. appears to be limited because the language used is specific to the nursing profession. Medicine. One of the ten reports in medicine is descriptive; the remaining nine document research into various aspects of the fieldwork instructor role. Ende (1983) describes the nature and importance of feedback in medical education. The guidelines he provides for giving 60 feedback to students parallel the important dimensions of feedback which have been noted by Brown (1981), Christ ie et a l . (1985b), Emery (1984), and O'Shea and Parsons (1979). S tr i t t er et a l . (1975), Irby (1978), S t r i t t er , Baker, and McGaghie (1983), Meleca et a l . (1981), and McLeod (1986) conducted research to identify the behaviours which were most frequently linked to effectiveness of an instructor. In a study which asked 265, 3rd and 4th year medical students to rate the contribution of 77 instructor behaviours to student learning, 16 behaviours emerged as most helpful (Str i t ter et a l . , 1975). The most effective c l in ica l instructor approached teaching with enthusiasm, set student objectives, summarized major points, focussed on comprehension and problem solving rather than factual r eca l l , encouraged student questions, answered questions precisely, provided opportunities to practice a variety of s k i l l s , and provided constructive feedback on performance. Characteristic of al l of the behaviours was evidence of the instructor's geniune interest in students and access ibi l i ty to students (Stri t ter et a l . , 1975). S tr i t t er et a l . (1983) investigated the degree to which effective medical instructors were perceived to demonstrate each of 48 teaching behaviours and the degree to which each behaviour should be demonstrated. Sixty-three instructors and 116 students participated in the study. There was no significant 61 difference between instructor and student ratings of the behaviours an "ideal" instructor should demonstrate. Students reported that the best instructors provided more role modelling and more evaluation of performance. Congruence between the content emphasized by the instructor and the students learning needs, and the instructor's teaching style and the student's learning style were recommended by the authors. A total of 61 instructor behaviours derived from the l i terature provided the basis for a futher study of instructor effectiveness in medicine by Irby (1978). Medical faculty, students and residents (n = 268) were asked to select the characteristics which described the best and worst c l in ica l instructors. The best instructors were described as enthusiastic, clear and well organised, and adept at interacting with students and residents. An analysis of the responses to open-ended questions identified the following additional important behaviours: breadth of medical knowledge, c l in i ca l competence, access ibi l i ty , friendliness; and interest in students, residents and patients. McLeod (1986) asked each of 62 medical students to identify at least five instructors who they perceived to be most capable of conducting ward rounds that were conducive to learning and to appropriate patient care. The nine instructors who were most frequently mentioned were asked to report on how they conducted 62 rounds. Analysis of the reports showed that empathy to the needs of medical students, interest in being with and fac i l i ta t ing the learning of students, and being available to provide advice were common recommendations of the instructors. The most comprehensive study of the behaviours which constitute the role of c l in ica l instructor in medicine was carried out by Meleca et a l . (1983). A total of 76 competencies were identified by the 256 c l in i ca l instructors who participated. The findings were similar to the national nursing study (Meleca et a l . , 1981). The competency definitions related to the content and context of fieldwork education in medicine. Consequently, their usefulness to O.T. and P.T. is minimal. Irby and Rakestraw (1981), and Shellenberger and Mahan (1982) both obtained information about the behaviours of effective instructors through students' evaluations of c l in i ca l teaching. The evaluation form used by Irby and Rakestraw included eight instructor behaviours. While al l eight behaviours have been identified in previous research, the three highest mean ratings were: is clear and organised, is knowledgeable and analyt ica l , and establishes rapport. The form used by Shellenberger and Mahan included 34 items which represented the broad categories of behaviours identified by Str i t ter et a l . (1975). It appears that only three of the eight items included by Irby and Rakestraw were incorporated in the form used by 63 Shellenberger and Mahan. The different contexts within which the forms were used (obstetrics and gynaecology versus general practice clerkships), and the variation in the number of items on the forms may account for the lack of similarity in the content of the items. Both of the forms appeared to be valid measures of instructor effectiveness. Petzel , Harris , and Masler (1982) attempted to validate empirically the effectiveness of certain c l in ica l instructor behaviours in an introductory c l in ica l medicine course. Students' assessments of their f irst-year tutors' teaching s k i l l s were correlated with the same students' c l in ica l performance as rated by their second year tutors. Setting clear goals, providing adequate supervision, and providing regular feedback al l correlated with the students' ab i l i ty to pursue symptoms, overall abi l i ty to take a medical history, and use of instruments when conducting a physical examination (p_ < .05). There was l i t t l e or no correlation between student competency ratings and the following tutor characteristics or s k i l l s : was f lexible to meet needs, maintained reasonable expectations, was accessible, encouraged questions, provided clear and succinct explanations, was a positive role model, and excelled as a teacher. The authors' suggested that the ratings may be different in studies of senior students. 64 A study by Farquhar and Holdman (1982) revealed that even though students may desire to have active involvement in their learning, c l in i ca l instructors in medicine tend to choose instructional techniques which l imit active student involvement. These findings have significance for this study in that they confirm the importance of this instructor behaviour. Speech pathology. There are only two recent references to fieldwork instructor competencies in speech pathology l i terature . The fieldwork instructor competencies defined by the American Speech-Language-Hearing Association (1982) included 70 competencies. However, many of the definitions appear to focus more on the level of professional competence of the speech pathology instructor or on the behaviours of the student rather than the education-related behaviours of the instructor. Pletts (1981) in reviewing the l i terature on c l in ica l teaching, included l i s t s of behaviours desired of a speech pathology fieldwork instructor. Although the wording differs from competencies or behaviours which have been cited already, the pattern is s imilar. Dentistry. Romberg (1984) examined instructor effectiveness from students' evaluations of their instructors. The behaviours found to be most important were instructor ava i lab i l i ty , instructor responsiveness to questions, grading throughout the 65 fieldwork experience and promptness in grading. Meleca et a l . (1981, 1983) refers to a dentistry study which was identical to the comprehensive studies in medicine and nursing. However, a report of the findings does not appear in the l i terature . Pharmacy. The need for fieldwork instructors to model role-making an professional negotiation behaviours in addition to c l in i ca l sk i l l s is emphasized by Broadhead and Facchinetti (1985). Nine responsibil i t ies of a fieldwork instructor are l i s ted in a descriptive art ic le by C i l i a (1986). The f i r s t five responsibi l i t ies outline some of the steps of curriculum design (e.g. set clear learning objectives) as reported by Perry (1978). The remaining four responsibil i t ies are similar to behaviours identified by other authors (e.g. provide positive corrective feedback during the learning process). Analysis of findings The review of the l i terature revealed 13 research studies from which fieldwork instructor competencies could be identi f ied. An analysis of these competencies showed that there were eight competencies which four or more of the researchers had c lass i f ied as most important to a student's fieldwork experience. These were: 1. Provides (regular, positive, consistent) feedback 66 2. Is open in discussing issues with student and others 3. Is available/accessible to students 4. Demonstrates positive regard for the student 5. Sets clear (and real i s t ic ) goals and responsibil i t ies 6. Demonstrates the s k i l l s to be learned 7. Shows enthusiasm for teaching 8. Is sensitive to students' needs. The content of the research reports did not always include the competencies which were perceived to be least important. Where these were presented, the information provided suggests that the competencies which are related to the professional competence of the health professional, appear to be less c r i t i c a l in influencing the outcome of a fieldwork experience. Although the amount of information in the l i terature may suggest that fieldwork instructor competency definition should be complete, the findings are disappointing. No single source of information provides competency definitions which are sufficient to eliminate the need for this study. The majority of the reports (n = 28) focus on the 10-30 behaviours which have been most frequently associated with an effective fieldwork instructor in the profession being studied. In each of these reports, the definitions do not encompass al l of the important behaviours which constitute the role of a fieldwork instructor. 67 While the l i terature does not y ie ld competency definitions which can be transplanted directly on to an occupational therapy and physical therapy questionnaire, i t does provide a rich data base from which a questionnaire can be developed. When al l of the competencies relevant to occupational therapy and physical therapy were l i s ted regardless of their s imilar ity, 199 competencies were ident i f ied. All of the categories of competence chosen for this study were represented. 68 CHAPTER 3 Methodology This chapter provides an explanation of and a rationale for the methods used to gather the information needed to answer the research questions in this study. It includes sections on the research design, questionnaire development, subjects, and the procedures used for data collection and analysis. Research Design A cross-sectional survey design was used to obtain O.T. and P.T. fieldwork instructors' , and O.T. and P.T. students' perceptions of the importance of selected fieldwork instructor trai ts and behaviours (competencies) in determining the effectiveness of a student's fieldwork experience. In this type of survey, standard information is gathered from a pre-determined population, at the same point in time (Borg & G a l l , 1983). It is considered to be a viable method to explore the relationships between two or more variables; in this case, the relationship between fieldwork instructor traits and behaviours and the effectiveness of a student's fieldwork experience. The nature of the apparent relationship can be described, but additional research with appropriate controls is necessary to determine the extent to which the relationship is causal (Mann, 1985). 69 Development of the Questionnaire The steps taken in developing the questionnaire are described in this section of the Chapter. An outline of the content and format of the questionnaire is included. In addition, a discussion of question format, specif ic ity and sequence; and of scale type, length and sequence provide a rationale for the chosen format. The summary of the pre-test procedures and a description of the modifications made to the questionnaire based on the pre-test results complete the section. Questionnaire content The questionnaire comprised of two sections: Section A -Demographic information and Section B - Fieldwork instructor tra i t s and behaviours. Section A included questions related to the personal characteristics of the therapist and student respondents. Age, sex, the number of students supervised since graduation, years of c l in ica l experience, the type of practice setting, the type of cl ient problems encountered in c l in ica l practice, the number and type of fieldwork instructor workshops attended, and the level of education were considered for each group of therapists (O.T. and P.T. fieldwork instructors). For the O.T. and P.T. students only age, sex and student year were included. These characteristics had been incorporated into 70 similar studies by other professions or were suggested for inclusion in future research (Christie et a l . , 1985b; O'Shea & Parsons, 1979). The l i terature in the area of fieldwork instruction was the primary source for the content in Section B. An i n i t i a l l i s t of 199 competencies was derived from the l i terature . A l l of the competencies located in the l i terature were included at this stage regardless of apparent duplication or s imi lar i ty . Using the experience of the researcher and expert advisors, the i n i t i a l l i s t of competencies was reduced. Competencies which were eliminated included (a) those which were so specific that they were unrelated to occupational therapy or physical therapy, and (b) those which were a duplication of content. The consolidation of the competencies yielded 99 competencies for the pretest of the questionnaire. Format of the questionnaire The l i terature on questionnaire design and scaling guided the choice of question format and scale in both sections of the questionnaire. In Section A, respondents were asked to give direct responses to questions (e.g. state their age) or to select the best response from a check-l ist . This format is typical of that used for demographic information (Sudman & Bradburn, 1982). In Section B, decisions about question format (open versus 71 closed), question specif ic ity and sequence; and scale type, length and sequence were necessary. Question format A questionnaire may include open or closed questions, or combination of the two. In open questions, the respondent is free to answer as he or she chooses; in closed questions, a forced-choice format is used ( i . e . , the respondent must select one of several given answers). Schuman and Presser (1981) indicate that most contemporary questionnaires are more l ikely to use closed rather than open questions because they are signif icantly easier to code and analyse. Further, they cite numerous problems in the use of open questions, and suggest that many of the d i f f i cu l t i e s can be "avoided in closed questions, where respondents are in essence asked to code themselves, with minimal intervention by third parties" (p.104). The data from their research indicate that differences in responses to open and closed questions appear to be smaller for more-educated, in comparison to less-educated subjects. If i t is accepted that the subjects in this study are generally more-educated than the populace at large, a questionnaire which ut i l izes a closed question format can be jus t i f i ed . In addition, research on open versus closed questions suggest that both formats produce similar information (Borg & G a l l , 1983). 72 Question specif icity and sequence In Section B of the questionnaire, subjects were asked to indicate their perceptions of the degree of importance of certain fieldwork instructor competencies in determining the effectiveness of a student's fieldwork experience. By asking for subjects' perceptions of the degree of importance, their perceptions about the strength of the relationship between the competency and effective student experience is being ascertained. The subjects' ab i l i ty to respond draws on their personal experience in a particular situation; that i s , their experience as a fieldwork instructor, or as a student who has participated in a fieldwork experience. The research undertaken by Schuman and Presser (1981) shows that the level of specif ic ity in questionnaire items is c r i t i c a l in enabling subjects to respond appropriately. For this reason, the competency statements were written as specif ical ly as possible. In addition to being preferable in terms of the questionnaire design, other studies in which development of competencies was the goal (e.g. MacPherson et a l . , 1985; Young et a l . , 1983), and the l i terature on the process and objectives of competency formulation (McAshan, 1979; Nickse & McClure, 1981) advise that specific competency statements are more useful than general statements. This is consistent with the need for clear definitions of competencies 73 for O.T. and P.T. fieldwork instructors (e.g. Peat, 1985; Tompson, 1985). Although the findings are inconclusive, research suggests that question order may bias respondents, particularly when similar questions are logical ly clustered together (Schuman & Presser, 1981). To diminish to risk of response-order bias a table of random numbers was used to randomize the questions. Scale type, length and sequence An ordered categories scale was selected for this study. This method asks participants to select their responses to questions from a fixed number of categories, commonly 2, 3, 4, 5, 7, 9 or 11 (Dunn-Rankin, 1983). The categories may be represented by numbers, descriptive statements, or a combination of the two. A Likert scale (1932) in which 1 represents strongly disagree, 2 - disagree, 3 - undecided, 4 - agree, and 5 -strongly agree is an example of an ordered categories scale which combines numbers and descriptive statements. Studies which have examined the characteristics or behaviours of effective c l in i ca l teachers are consistent in their use of this type of ordered categories scale (Emery, 1984; Irby, 1978; MacPherson et a l . , 1985; Meleca et a l . , 1983; Romberg, 1984; Shellenberger & Mahan, 1982; Str i t ter et a l . , 1975). When descriptive statements are used together with numbers 74 for a l l points on a scale i t is not always clear to a respondent how each label is d is t inct . For example, in a scale which asks whether a behaviour contributes s ignif icantly , moderately, somewhat or not at al l to student learning, the difference between moderately and somewhat, may not be clear to the respondent. In this situation respondents may arbi trar i ly choose a response because the meaning is not clear. Even when statements are described clearly there can be no assurance that each term wil l be interpreted similarly by a l l respondents. To minimize such d i f f i c u l t i e s , a scale which used bipolar descriptive statements, of low importance and of extreme importance, together with a 7-point numerical scale was chosen. Sudman and Bradburn (1982) suggest that a numerical scale should always use an odd number of points. The 7-point scale was selected to provide participants with a range of response options and increase the likelihood of dispersion of responses. In accordance with the recommendations from the l i terature the scale was sequenced from 1 - of low importance to 7 - of extreme importance (Schuman & Presser, 1981; Sudman & Bradburn, 1982). Pretesting the questionnaire The questionnaires were mailed to a convenience sample of 12 subjects to pretest face va l id i ty , to determine the time required to complete the questionnaire, and to obtain respondents' 75 opinions about comprehensiveness, format and c lar i ty of instructions. Subjects comprised 6 O.T. ' s and 6 P . T . ' s . Three of the O.T. ' s and 3 of the P .T . ' s had supervised students in the past but did not meet the cr i t er ia for inclusion in the study. The remaining therapists were recent graduates (1986) from the School of Rehabilitation Medicine, at the University of Brit i sh Columbia who had never supervised students. Completed questionnaires were returned from 10 (83.3%) of the subjects; they included 5 O.T. ' s and 5 P . T . ' s . The mean age of the pretest respondents was 29 years, they were a l l female, and the number of years of experience of the fieldwork supervisors was 13.5 years. The average time taken to complete the questionnaire was 27 minutes, with a range from 15-50 minutes. Aside from the identif ication of one typing error in Section A no changes of wording, instructions or format were recommended. In Section B, two changes were suggested: a) reduction of the scale length from 7 to 5 points and b) revisions to the wording of some items. Many of the pre-test respondents stated that the long 7-point scale made the scale seem "fuzzy" in the middle. The fact that many of their ratings were at 6 or 7 on the scale caused them to believe that they were completing the questionnaire incorrectly. The mean ratings for the items, which 76 ranged from 5.1 - 6.9 (with the exception of one item which had a mean of 3.1), indicated a skewed pattern. Analysis of the top 15 and the bottom 15 competencies based on the mean ratings of importance indicated that the 7-point scale did not appear to be as effective as anticipated in distinguishing between the most and least important competencies. In order to address these concerns, three changes were made. The scale length was changed to 5-points. Research by Jones (1978) provided no evidence to question the effectiveness of a 5-point compared to a 7-point scale. Instructions in Section B were revised because both the pattern of responses and respondents' comments indicated that re-phrasing might increase the dispersion of the ratings. F ina l ly , additional distractor competencies (that i s , those expected to be of low importance) were added to the questionnaire. The revised Section B, included 105 competencies. While revisions were suggested to c lar i fy the wording of some of the trai ts and behaviours none were considered to be irrelevant to the role of fieldwork instructor. Even though the questionnaire was long, the majority of respondents found the task interesting. I met with six of the respondents to discuss their comments, and the revised items were critiqued by two pretest respondents and one advisor. The final versions of the questionnaire are presented in Appendix A. 77 Subjects Four groups of subjects were included in the study: a) O.T. fieldwork instructors, b) P.T. fieldwork instructors, c) O.T. students and d) P.T. students. Fieldwork instructors were therapists (male or female) who had instructed at least one student from School of Rehabilitation Medicine at the University of Bri t i sh Columbia (UBC) on a full-time fieldwork experience of 4 weeks or longer duration, between May 1986 and March 1987. The therapists, in O.T. and P . T . , were identified from a review of the students' fieldwork performance reports which were located in the School of Rehabilitation Medicine. The fieldwork instructor population included 59 O.T. ' s and 76 P . T . ' s . Al l students who were registered in the third or fourth year of the B.Sc.(O.T.) and B.Sc. (P.T.) programs at U.B.C. were included. The student population comprised of 34 O.T. students and 37 P.T. students; of these 13 were male. The third year O.T. and P.T. students had completed 8 and 10 weeks of full-t ime fieldwork experience respectively; and the fourth year students had completed 26 weeks of full-time fieldwork experience. Procedures The questionnaires were mailed or distributed to al l subjects in the same week. The accompanying letters of introduction were signed by the researcher and the O.T. or P .T. 78 fieldwork co-ordinator from the School of Rehabilitation Medicine at the University of Bri t i sh Columbia. A stamped, self-addressed envelope for returning the questionnaire was included for therapists. The students were requested to leave the questionnaire in the School of Rehabilitation Medicine office prior to leaving the University of Brit i sh Columbia for the summer months. Two weeks after the i n i t i a l mailing, a follow-up letter and an additional questionnaire was sent to a l l of the non-respondents. An overall response rate of 87% was obtained from the i n i t i a l and follow-up mailings. The response rates for each of the four core groups were 88% for O.T. fieldwork instructors, 80% for P.T. fieldwork instructors, 97% for O.T. students, and 89% for P.T. students. One questionnaire was excluded from the analysis because more than 5% of the data were missing. Exclusion of eight additional questionnaires due to their late return, yielded a final study sample of 171 persons. Prior to data analysis, each competency was assigned to one of the six pre-determined categories. The researcher and two advisors independently assigned the competencies to categories using the category definitions which were described in Chapter 2. When there was not ful l agreement about the assignment to categories, the majority rule was applied. For several of the competencies there was no agreement. In these situations, 79 discussion ensued and the researcher made a final decision about the appropriate category for the competency. The number of competencies assigned to each category ranged from 8 to 39. Appendix B l i s t s the competencies by category. Data Analysis Each respondent was assigned an identif ication code, and al l of the data were transferred to coding forms. Descriptive s ta t i s t i c s , that is means, medians, standard deviations, frequencies, percentages and ranks were used to compare respondents on each of the demographic variables. The mean scores and standard deviations were also calculated for the ratings of importance for the O.T. fieldwork instructors, P.T. fieldwork instructors, O.T. students, P.T. students, and for the different combinations of these groups. Inferential s tat i s t ics were used to complete the data analysis. A factor analysis and subsequent varimax rotation with eigenvalues greater than 1.0 was used to examine the underlying dimensions of fieldwork instruction, and the pre-determined categories of competence. Two-way and three-way analyses of variance, followed by a multivariate analysis of variance were employed to assess between group differences in the ratings of importance of the competencies, by category. Tukey's multiple comparison tests and multiple t-tests were used to determine 80 which means differed significantly from each other. Pearson Product Moment Correlation Coefficients were used to examine the relationship of age and years of experience to ratings of importance. F ina l ly , t-tests were used to determine the significance of differences in ratings of importance by groups of respondents categorized on the basis of demographic variables. The data were analysed on the University of Bri t i sh Columbia MTS system using the Midas Stat is t ical Package. 81 CHAPTER 4 Results The analysis of the l i terature indicates that there are s imi lari t ies between O.T. and P.T. fieldwork instructors' , and O.T. and P.T. students' beliefs about the behaviours which characterize an effective fieldwork instructor (Barker, 1986; Biedeger & Larson, 1987; Christie et a l . , 1985b; Emery, 1984; Moore & Perry, 1976). The degree to which this trend is evident in Bri t i sh Columbia is reported in this chapter. Findings from this study are presented in two parts: (a) characteristics of respondents, and (b) categories of competence and competencies: perceptions of importance. In part one, the demographic characteristics of the respondents which have been summarized from Section A of the study questionnaire (see Appendix 1, Section A) are presented. Descriptions of the general characteristics of the respondents (group c lass i f i cat ion , age and sex) are followed by descriptions of the characteristics which are relevant to a l l students, or al l instructors. One of the questions, the category of cl ient problems encountered by O.T. and P.T. fieldwork instructors, differed for each profession. For this reason, these data are discussed separately. In part two, the analyses of the data from Section B of the questionnaire (see Appendix A) are reported in relation to 82 the four research questions which were identified in Chapter one. Of the 171 respondents, 55 were O.T. fieldwork instructors (OTF), 50 were P.T. fieldwork instructors (PTF), 33 were O.T. students (OTS), and 33 were P.T. students (PTS). Twenty-one (12.28%) were men and 150 (87.72%) were women. The average age of respondents was 30.67 years (SD = 8.18) with a range from 20 years to 60 years. The sex and age of respondents by group is presented in Table 1. Table 1 Distribution of Respondents by Group, Age, and Sex Group OTF PTF OTS PTS No. of Respondents Male 3 5 4 9 Female 47 50 29 24 Characteristics of the Respondents Age M SD Medi an Range 35.54 8.65 33.00 24-59 33.33 7.29 31.00 23-60 24.42 4.09 22.67 21-37 25.18 3.72 24.20 20-35 83 In the OTS group 18 (54.55%) were third year students and 15 (45.45%) were fourth year students. A similar analysis of the PTS group showed that 16 (48.48%) were third year students and 17 (51.52%) were fourth year students. The level of education of OTF and PTF respondents is presented in Table 2. A majority of the respondents in both groups reported that their highest level of education was a baccalaureate degree (72% and 72.73% respectively). Table 2 Distribution of OTF and PTF Respondents by Level of Education OTF PTF Qualifications No. of 1 respondents of OTF group No. of respondents % of PTF Group Diploma in OT or PT 14 28.00 14 25.45 Diploma in OT and PT Bachelors degree in OT or PT 21 42.00 23 41.82 Bachelors degree in OT and PT 13 26.00 17 30.91 Masters degree 1 1.82 Other 2 a 4.00 Note. a = 1 has a B .A. ; 1 has a B.Sc. and a Post-graduate diploma. 84 Al l of the fieldwork instructors were asked to identify the type of setting in which they had practised most frequently in 1987. Their responses are reported in Table 3. Table 3 Distribution of OTF and PTF Respondents by Type of Practice  Setting OTF PTF Type of setting No. of % respondents of OTF group No. of respondents % of PTF Group Inpatient program -acute care or rehabil i tat ion 23 46.00 31 56.36 Inpatient program -long term care 3 6.00 - -Outpatient program, day program or community service 21 42.00 22 40.00 Other 3a 6.00 2 b 3.64 Note. a = 1, outpatient - acute care; 1, Child Development program; 1, unstated. o = l , Workers' Compensation Board; 1, combination of inpatient and outpatient, acute care and rehabil i tat ion. The average number of years that OTF respondents had practised O.T. since graduation was 11.21 years (SD = 7.64) with a range from 2 years to 34 years. In the PTF group, respondents 85 had practised an average of 10.18 years (SD = 7.29) ranging from 1 year to 36 years. The median number of years of practice for the OTF and PTF groups were 9.50 years and 7.88 years respectively. The number of fieldwork students instructed by respondents in each group since graduation is presented in Table 4. Table 4 Distribution of OTF and PTF Respondents by the Number of Fieldwork Students Instructed OTF PTF Number of students instructed No. of % respondents of OTF group No. of respondents % of PTF Group 0 - 5 11 22 24 43.64 6 - 1 0 14 28 12 21.82 11 - 15 10 20 5 9.09 16+ 15 30 14 25.45 Similar proportions of OTF respondents were represented in each of the four groups. Fifty percent of the O.T. ' s had instructed 10 or fewer students, and 50% had instructed 11 or more students. In contrast, 65.46% of PTF respondents had instructed 10 or fewer 86 students, and only 34.54% had instructed 11 or more students. These data show that OTF respondents have had more experience instructing students than the PTF respondents. Further analysis of the number of students instructed by the older and more experienced OTF and PTF respondents provided more information about the differences between the groups. The proportion of PTF respondents who were above the P.T. median for years of experience, and who had instructed five or fewer students was 28.57% (n = 8). Occupational therapy fieldwork instructors who had instructed five or fewer students represented only 4% (n = 1) of the instructors who were above the O.T. median for years of experience. A similar analysis of OTF and PTF respondents who were above the median for age and who had instructed five or fewer students yielded proportions of 12% (n = 3) and 24% (n = 6) respectively. These data reveal that fewer of the older and more experienced respondents in the PTF group instruct students than do older and more experienced OTF respondents. The proportion of older, more experienced O.T. and P.T. fieldwork instructors who had instructed 16 or more students in each group was similar. In the PTF group 40% (n = 10) of the older instructors and 40% (n = 12) of the more experienced respondents had instructed 16 or more students. The proportions of older and more experienced OTF respondents who had instructed 16 or more students were 48% and 52% respectively. 87 Thirty of the OTF respondents (60%) reported attending a fieldwork instructor preparation program within the last five years, compared to 10 (18.18%) of the PTF group. The type of programs attended by these respondents is displayed in Table 5. Table 5 Distribution of OTF and PTF Respondents by Type of Fieldwork  Instructor Program Attended 0TF a PTFD Program attended No. of respondents % of OTF group No. of 5 respondents I of PTF Group 1 day, or 2 1/2 day workshops offered by the School of Rehabilitation Medicine (SRM) 23 76.67 3 30.00 6 week course offered by the SRM (OTF only) 2 6.67 1-2 hour inservice session offered by the SRM 1 3.33 2 20.00 Inservice series offered by the SRM 3 10.00 - -Other 0 1 3.33 5 50.00 Note. a £ = 30. br^ = 10. c = Seminars, workshops and inservice sessions offered by the University of Alberta, Dalhousie University, Queens University, University of Saskatoon, University of Toronto and the University of Western Ontario. 88 The response options for the question on the most common category of c l ient problems encountered in the respondents' practice in 1987 differed for each of the therapist groups. Nineteen (38%) of the OTF respondents practiced in adult psychiatry, 22 (44%) in adult, physical dysfunction, 5 (10%) in paediatric, physical dysfunction, and 4 (8%) reported working with types of c l ient problems which they did not perceive to be incorporated in the previous categories. In the PTF group, the highest proportion of therapists (n = 25; 45.45%) worked with adults who had orthopaedic or musculo-skeletal problems. Of the remainder, 11 (20%) treated adults with cardio-respiratory problems, 8 (14.55%) treated adult neurology c l ients , 3 (5.45%) treated children with neurological problems, 3 (5.45%) treated children with orthopaedic disorders and 5 (9.09%) treated clients who had problems which were not included in these categories. In general, the OTS and PTS respondents, can be described as young, mainly female, third and fourth year students registered the O.T. and P .T . undergraduate programs at the University of Bri t i sh Columbia. The OTF and PTF respondents are young to middle-aged adults, the majority of whom are female, with education to the baccalaureate level . 89 Categories of Competence and Competencies: Perceptions of Importance A profi le of the pattern of responses to Section B of the questionnaire, and the presentation of the findings for each of the four study questions are incorporated in the next part of this chapter. The data pertaining to the study questions are reported under the following headings: (a) categories of competencies: validation and importance, b) competencies identified as most important, c) group differences in the ratings of importance, and d) the relationship of personal variables to the ratings of importance. Response Profi le The mean rating of each competency for the four core groups (OTF, PTF, OTS and PTS), and for combinations of these groups are presented in Appendix C. Analysis of the mean ratings of the competencies for al l groups combined (see Appendix C, Section 3), showed that the ratings ranged from a low of 1.70 (Chair staff meetings) to a high of 4.85 (Provide constructive feedback). Nineteen percent of the OTF and PTF ratings of importance, and 26% and 36% of OTS and PTS ratings of importance respectively, were below 4.00 (see Appendix C, Section 1). Although the ratings of importance for the majority of the competencies ranged from 1:00 to 5:00 the response pattern indicated that the data 90 were negatively skewed (Ferguson, 1981). Examination of the mean ratings of importance across the groups showed that while there were differences in ratings between the groups the direction of the ratings were the same. That i s , a l l groups tended towards higher or lower ratings of each competency rather than one or more groups giving low ratings (less than 3.00) and others giving high ratings (more than 3.00). The variance between groups on the each competency did not differ markedly. Nine competencies were included in the questionnaire as distractors; that i s , competencies which were shown to be less important in previous research. The mean ratings of these competencies ranged from 1.70 to 3.72. Only one of the nine mean ratings exceeded 3.50. Seven of the nine distractors were included in the 10 lowest ranked mean ratings when the data from a l l groups were combined. Categories of Competence: Validation and Importance Typical ly , educational programs are divided into units of instruction in which similar or related dimensions of a topic are introduced at the same time, or in a logical sequence (Gronlund, 1978; Tyler, 1949). Since the outcomes of this study wil l provide a basis for planning educational programs for fieldwork instructors, the division of the competencies required for 91 effective instruction of students' fieldwork experiences into categories of competence was considered to be desirable. In order to guide the development of preparatory programs for O.T. and P .T . fieldwork instructors, six categories were pre-determined for this study. These categories were professional competence behaviours, teaching behaviours, supervisory behaviours, communication behaviours, evaluation behaviours, and personal characteristics or t r a i t s . The f i r s t research question was comprised of three parts: (a) what categories of competencies ( i . e . factors) can be identified by analysing the interrelationships between ratings of importance, (b) to what extent do the categories [ identif ied in (a)] relate to the six pre-determined categories of competence, and (c) which of the categories are rated as most important in determining the effectiveness of students' fieldwork experiences. Questions (a) and (b) are reported under the heading, validation of categories; question (c) is addressed in the most important categories section. Validation of Categories A principal component factor analysis followed by a varimax rotation of the factors with eigenvalues greater than 1.0 was employed to determine what factors emerged from the data and to validate the six pre-determined categories of competence. 92 Analysis of the scaled factor loadings on all of the 105 competencies revealed that most of the competencies loaded rather highly on a one-factor solution. Beyond the f i r s t unrotated factor, which accounted for 20.90% of the variance, none of the factors explained more than 4.60% of the variance. Although the proportion of variance accounted for by the f i r s t factor was transferred to other factors following the varimax rotation, the pattern was similar. Inspection of the competencies with loadings greater than 0.50 on the f i r s t factor showed that competencies from al l of the pre-determined categories of competence were included. Thus, the pre-determined categories were not shown to represent independent sets of competencies in the factor analysis. Competency intercorrelations were moderate; 80% of the correlations ranged from 0.10 to 0.39. Of the pairs of competencies with correlations of 0.50 or higher, 60% belonged to the same category. These data support the val idity of the pre-determined categories of competence. When a principal component factor analysis and a subsequent varimax rotation was conducted on the mean ratings for the six pre-determined competency categories rather than the 105 competencies, further evidence of a trend towards independence of the categories emerged (see Table 6). Each factor showed a high loading on one category of competency. 93 Table 6 Varimax Factors for the Pre-determined Categories of Competence Factor Category 1 2 3 4 5 6 Professional competence .275 .215 .839 a .318 .176 .200 Teaching behaviours .449 .237 .381 .247 .317 .658 a Supervisory behaviours .291 .320 .185 .286 • 810a .197 Communication behaviours .166 .903 a .167 .227 .242 .132 Evaluation behaviours .884 a .173 .233 .208 .232 .189 Personal trai ts .158 .248 .306 .854 a .253 .155 % Variance 20.0 18.5 17.7 17.8 16.1 9.9 Note. a = highest loadings for each factor, and represent each of the six categories of competence. Most Important Categories While the presentation of the competencies which were identif ied as most important is related to the second research question, analysis of the categories to which the most important competencies belong is pertinent to the f i r s t research question. 94 Three steps were taken to identify the most important competencies: (a) the top 10 ranked competencies for each group were sorted by category (see Table 7), (b) the average ratings of the competencies in each category were compared (see Table 8), and (c) competencies which received a mean rating of 4.50 or higher by each group or combination of groups (see Tables 9 and 10) were identi f ied. Table 7 depicts the distribution of the top 10 ranked competencies by category for each of the nine groups. Due to the fact that some of the competencies were given equal ranking by some groups, the number of competencies which were ranked in the top 10, ranged from 10 to 16. As indicated in Table 7, when the pre-determined categories for each of the top 10 ranked competencies were examined, the competencies in the categories of supervisory behaviours and communication behaviours appeared to be most important. The OTF group rated communication behaviours as most important, whereas the PTF group gave supervisory behaviours and communication behaviours equal rating. In the OTS group and the PTS group, twice as many supervisory behaviours were ranked in the top 10 as were communication behaviours. This is the reverse of the OTF group pattern, where communication behaviours were ranked in the top 10 twice as often as supervisory behaviours. 95 Table 7 Proportion of the Top 10 Competency Rankings by Category and by  Group Category 3 Category 1 2 3 4 5 6 OTF 9.09 - 18.18 36.36 9.09 27.27 PTF - 10.00 40.00 40.00 - 10.00 OTS 18.75 43.75 25.00 6.25 6.25 PTS 18.18 54.55 18.18 - -OTF and PTF 9.09 27.27 36.36 - 18.18 OTS and PTS 20.00 50.00 30.00 - -OTF and OTS 16.67 25.00 33.33 8.33 16.67 PTF and PTS 9.09 36.36 45.45 - 9.09 OTF, PTF, OTS & PTS - 10.00 40.00 40.00 - 10.00 Note. a l = professional competence; 2 = teaching behaviours; 3 = supervisory behaviours; 4 = communication behaviours; 5 = evaluation behaviours; 6 = personal t r a i t s . Further information about the relative importance of the six categories is provided in Table 8. This table displays the mean ratings and standard deviations of the ratings of the competencies within the six categories for al l groups combined. An analysis of variance revealed significant differences among the mean ratings 96 of the categories ( £ < .0001). Tukey's multiple comparison test was used to determine which means were different from each other. Table 8 Means and SD by Category for al l Subjects 9 Category M SD Professional competence 3.81 0.50 Teaching behaviours 4.04 0.41 Supervisory behaviours 4.47 0.32 Communication behaviours 4.58 0.32 Evaluation behaviours 4.13 0.52 Personal tra i t s 4.38 0.42 Note. a n = 171. A l l of the means differed significantly from each other at p_ < .05. The category of Communication behaviours was perceived to be the most important category, and the category of professional competence behaviours was deemed the least important in contributing to the effectiveness of a student's fieldwork experience. These findings are consistent with the pattern which was apparent in the analysis of the top 10 rankings by category and by group (see Table 7). 97 Competencies Identified as Most Important Identification of the competencies which the O.T. and P.T. fieldwork instructors' and the O.T. and P.T. students' perceived as most important in determining the effectiveness of students' fieldwork experiences was the objective of the second research question. A mean rating of 4.50 or higher has been specified as the cri terion for identifying the most' important competencies ( traits and behaviours). The number of competencies meeting this cr i ter ion in each of the nine groups or combinations of groups is displayed in Table 9. Table 9 Number of Competencies Perceived to be Most Important by Group(s) Group(s) Items Perceived to be Most Important No. of Items % of total items OTF 42 40.00 PTF 33 31.43 OTS 41 39.05 PTS 15 14.29 OTF and PTF 37 35.24 OTS and PTS 28 26.67 OTF and OTS 39 37.14 PTF and PTS 23 21.90 OTF, PTF, OTS and PTS 32 30.48 Fifty-three of the 105 competencies (50.48%) were c lass i f ied 98 as most important in one or more of the nine groups. Ten of the 53 competencies (19%) received a mean rating of 4.50 or higher by al l nine groups. In addition, these same 10 competencies were the only competencies rated 4.50 or higher which were common to the four core groups (OTF, PTF, OTS and PTS). The 10 competencies are presented in Table 10. Table 10 The Top 10 Competencies Rated 4.5 or Higher which were Common to  a l l Groups Rank Competency 1 Provide constructive feedback 2 Provide feedback without be l i t t l ing the student 3 = Allow the student progressive independence 3 = Provide opportunities for supervised and unsupervised practice appropriate to the students' level of fieldwork experience. 5 = Make specific suggestions for improvement of performance 5 = Discuss issues openly with students 7 Communicate with student(s) in a non-threatening manner 8 Explain c learly , basis for own actions 9 Provide time for discussion and questions on a regular basis 10 Observe students' performance in such a way as not to intimidate the student 99 A second approach to identifying the 10 most important competencies was to combine the ratings of all groups, and to select the competencies with the highest mean ratings. Table 11 l i s t s these competencies, their ranking of importance, and the means and standard deviations of the ratings of the competencies by the four core groups. The proportion of the 10 competencies l i s ted in Table 11 which were included in the top 10 rankings of the remaining eight groups, ranged from a low of 45.45% (PTS) to a high of 81.82% (PTF and PTS; OTF and PTF). Table 11 The Top 10 Ranked Competencies for al l Groups Combined, and the  Means and SD for OTF, PTF, OTS and PTS Groups Rank Competency OTF PTF OTS PTS Provide constructive feedback M SD Provide feedback without be l i t t l ing the student M SD Provide opportunities for supervised and unsupervised practice appropriate to the students' level of fieldwork experience M SD 4.94 4.84 0.24 0.42 4.94 0.24 4.80 0.56 4.82 0.39 4.91 0.38 4.79 0.42 4.52 d 0.62 4.66 a 4.69 b 4.89 4.85 0.52 0.54 0.33 0.36 100 Rank Competency OTF PTF OTS PTS 3 = Allow the student progressive independence M SD 4.70 a 0.54 4.75 0.44 4.82 0.39 4.79 0.42 5 = Discuss issues with the student openly M SD 4.78 0.46 4.78 0.50 4.70 0.53 4.64 0.65 5 = Make specific suggestions for improvement of performance M SD 4.78 0.46 4.76 0.51 4.76 0.50 4.60 0.66 7 Demonstrate positive regard for the student M SD 4.84 0.42 4.73 0.56 4.73 0.52 4.45 d 0.56 8 Encourage student questions, opinions and requests for assistance M SD 4.80 0.45 4.75 0.48 4.67 c 0.54 4.42 d 0.71 9 Communicate with the student in a non-threatening manner M SD 4.74 0.44 4.69 b 0.47 4.70 0.47 4.52 d 0.67 10 Provide positive feedback on performance M SD 4.70 a 0.54 4.69 b 0.47 4.70 0.53 4.45 d 0.56 Note. a = item not included in top 10 items for OTF. b = item not included in top 10 items for PTF. c = item not included in top 10 items for OTS. d = item not included in top 10 items for PTS. 101 For the combined rankings only the items provide constructive  feedback, discuss issues with the student openly, and make  specific suggestions for improvement of performance were included in the top 10 rankings of the four core groups. While inferential analysis of the differences in ratings of importance for a l l of the competencies among the groups was judged to be inappropriate, some additional observations were possible from the review of the descriptive data. Of the 53 competencies c lass i f ied as most important by one or more groups, 26 (49%) were ranked in the top 10 by one or more of the OTF, PTF, OTS and PTS groups. Although overlap in the top rankings of the competencies was evident among the groups, a higher proportion of the students' top ratings pertained to supervisory behaviours, particularly those which focussed on feedback regarding student performance. In contrast, competencies related to communication behaviours were rated higher by the fieldwork instructors. These differences emerged when the top 10 competencies were isolated for each of the core groups, and for the different combinations of groups (see Table 7), but the differences were less apparent when the mean ratings for the competencies were compared (see Table 11). For example, the competency which was ranked 10th, provide positive feedback on  performance, was not included in the top 10 ranked competencies for the OTF, PTF and PTS groups. However, the mean ratings for 102 this competency ranged from 4.45 to 4.70 for the four core groups, and the variance ranged from 0.22 to 0.31. Of the 53 competencies which were ranked in the top 10 by one or more groups there were only eight competencies for which the difference between the lowest and highest mean ratings of the four core groups exceeded 0.50. The difference was 0.70 or higher for three of these competencies. For two of the three, request feedback from the student regarding the fieldwork program and take responsibility for own actions, the OTF and PTF groups gave higher ratings than the students. The differences between the fieldwork instructors' ratings (OTF and PTF combined) and the students' ratings (OTS and PTS combined) of these two competencies were 0.47 and 0.24 respectively. The students' rated the competency, point out weaknesses in student performance 0.45 higher than the fieldwork instructors. In general, the differences between the group ratings of the majority of the 53 competencies which were rated as most important were low, and the variances in the competency ratings were similar across the groups. However, i t is notable that the mean ratings of importance of the PTS group were lower than the other three core groups on 43 of the 53 competencies. Group Differences in the Ratings of Importance The third research question sought to determine to what 103 extent the mean ratings of importance of the competency categories differed between the OTF, PTF, OTS and PTS groups, between professions (OTF and OTS groups compared to PTF and PTS groups), and between fieldwork instructors (OTF and PTF groups) and students (OTS and PTS groups). In order to identify any main and/or interaction effects between the ratings.of importance and these various combinations of groups a two-way analysis of variance (ANOVA) and a three-way ANOVA were employed (Borg & G a l l , 1983). The two-way ANOVA explored the main and interaction effects for the core groups (OTF, PTF, OTS and PTS) and the ratings of importance for a l l six competency categories. In the three-way ANOVA, the main and interaction effects for fieldwork instructors (OTF and PTF) and students (OTS and PTS), and O.T. (OTF and OTS) and P.T. (PTF and PTS), and ratings of importance in each of the six categories were assessed. The means and standard deviations for each of the groups or combinations of groups provided the raw data for the s tat i s t ica l analyses and are displayed in Table 12. The findings are presented under the following headings: (a) differences between core groups, (b) differences between fieldwork instructors and students, and between professions, (c) multivariate analysis of variance results. The multivariate analysis of variance (MANOVA) was used to confirm any differences that were identified in the mean ratings of importance for the six competency categories for 104 each of the four core groups. Table 12 Means and SD by Category for al l Groups Category Group OTF M 3.86 4.13 4.46 4.62 4.24 4.51 SD 0.47 0.41 0.30 0.29 0.48 0.29 PTF M 3.88 4.10 4.52 4.64 4.24 4.38 SD 0.56 0.45 0.35 0.27 0.52 0.43 OTS M 3.76 4.05 4.54 4.54 4.06 4.37 SD 0.40 0.26 0.25 0.33 0.45 0.43 PTS M 3.65 3.79 4.35 4.47 3.81 4.17 SD 0.52 0.41 0.32 0.37 0.52 0.49 OTF and PTF M 3.87 4.12 4.49 4.63 4.24 4.44 SD 0.52 0.43 0.33 0.28 0.50 0.37 OTS and PTS M 3.71 3.92 4.44 4.50 3.94 4.27 SD 0.46 0.36 0.30 0.35 0.49 0.47 OTF and OTS M 3.82 4.10 4.49 4.59 4.17 4.46 SD 0.44 0.35 0.28 0.31 0.47 0.36 PTF and PTS M 3.79 3.99 4.47 4.58 4.08 4.30 SD 0.56 0.45 0.35 0.32 0.56 0.46 105 Differences between Core Groups and Ratings of Importance The results of the two-way factorial ANOVA for core groups is presented in Table 13. Table 13 Factorial Analysis of Variance of Core Groups and Categories Source df MS F P Core groups 3 3.342 4.98 0.003* Error 167 0.671 9.79 0.000 Categories 5 14.639 213.76 0.000** Core groups x categories 15 0.164 2.39 0.002* Error 835 0.068 Note. * £ < .01. **p < .0001. Administration of Tukey's multiple comparison test for the Core groups x Categories interaction effects revealed significant differences between groups in four of the six categories. A plot of the Core groups x Categories interaction is shown in Figure 2. 106 0> O _ to +-> _ o C L _ •i— +-> <V OC (Z ra 0 1 Categories Figure 2. Differences in mean ratings for the four core groups for each category. There were no significant differences in the categories of supervisory and communication behaviours (categories three and four respectively). In category one, professional competence, the PTS ratings differed significantly from the PTF group (p_ < .05). The PTS ratings were lower than the OTF, PTF and OTS groups in category two, teaching behaviours and in category f ive, evaluation behaviours (p < .05). Analysis of the differences 107 between the OTS and PTS mean ratings of the competencies in the teaching and evaluation behaviours categories showed that there were nine teaching behaviours and one evaluation behaviour in which the differences between the groups exceeded 0.50. Al l of the teaching behaviours in which the OTS group was 0.50 or higher (n = 6) than the PTS group included content related to objectives for fieldwork experiences. For the one evaluation behaviour (document evaluation accurately) the mean rating of the OTS group was 0.67 higher than the mean rating of the PTS group. In the personal tra i t s category (category six) the PTS group was significantly lower ( £ < .05) than the O.T. and P.T. fieldwork instructors. Differences between the overall mean scores for each category of competence were significant to the p_ < .05 l eve l . Analysis of the differences between the core groups indicated that the ratings of importance of the PTS group were signif icantly lower than the OTF and the PTF groups (p_ < .05). The two-way ANOVA demonstrated significant main effects for the core groups and the categories, and significant interaction effects in the Core groups x Categories analysis. Differences between Fieldwork Instructors and Students,-and  between Professions The s tat i s t ica l data from the three-way ANOVA for fieldwork 108 instructors and students, and professions are displayed in Table 14. Table 14 Factorial Analysis of Variance of Fieldwork Instructors and  Students, of Professions and of Categories Source df MS F P Fieldwork instructors and students 1 6.879 23.96 0.005** O.T. and P.T. 1 1.278 9.54 0.027* Categories 5 14.639 213.76 0.000**** Fieldwork instructors and students x O.T. and P.T. 1 1.868 26.49 0.004** Fieldwork instructors and students x categories 5 0.287 4.19 0.001*** O.T. and P .T . x categories 5 0.134 1.96 0.082 Fieldwork instructors and students x O.T. and P.T. x categories 5 0.071 1.03 0.399 Error 835 0.068 Note. *p < .05. **p < .01. ***p < .001. ****p < .0001. Subsequent multiple comparison tests confirmed that there were no significant interaction effects for O.T. and P.T. x Categories, or for Fieldwork Instructors and Students x O.T. and P.T. x 109 Categories. In the Fieldwork instructors and Students x Categories analysis, the students' mean ratings were s igni f ic iant ly lower than the fieldwork instructors' (p_ < .05) except in categories three and four, the categories of supervisory and communication behaviours respectively (see Figure 3). CD O c (O -)-> S-O C L +-> OC rO CU 4.8-4.6-4.4 4.2 -4.0 " 3.8 -3.6-J 3 ~r 4 • OTF and PTF A OTS and PTS 5 i 6 Categories Figure 3. Differences in mean ratings for fieldwork instructors (OTF and PTF combined) and students (OTS and PTS combined) for each category. 110 The differences between fieldwork instructors and students, and professions (O.T. and P . T . ) , were both significant to the p_ < .05 l eve l . However, when the interaction between these four groups is considered (that i s , O.T. and P.T. are collapsed over fieldwork instructors and students) this result is c lar i f i ed (see Figure 4) . The only significant main effect continues to be that o c (B +J S-o Q . in or ro CD 4.8 4.6 4.4 4.2 4.0 3.8 3.6 • OTF • PTF • OTS 0 PTS 1 OT 1 ' PT Profession Figure 4. Mean ratings of importance for fieldwork instructors (OTF and PTF) and students (OTS and PTS), and professions (OT and PT). I l l the ratings of the PTS group are lower than the OTF and PTF groups (p_ < .05). The OTS group ratings did not differ s ignif icantly from either the PTS or OTF and PTF groups. Multivariate Analysis of Variance Results A multivariate analysis of variance (MANOVA) was used to further examine the main finding that emerged from the two-way ANOVA and the three-way ANOVA - - that the PTS group was signif icantly lower in their ratings of importance than the OTF and PTF groups. The analysis which tested for differences between the core groups and the mean ratings of importance for the six competency categories revealed s i g n i f i c a n t differences (Wilks Lambda 0.71; df = 6, 3, 167; p < .0001). Administration of a one-way ANOVA and subsequent multiple comparison tests confirmed the pattern of the previous findings. The ANOVA findings are presented in Table 15. 112 Table 15 Analysis of Variance for Each Category Category Source df MS F P Professional Group 3 0.444 1.779 0.151 competence Error 167 0.250 Teaching Group 3 0.977 6.176 0.001*** behaviours Error 167 0.158 Supervisory Group 3 0.294 ' 3.023 0.031* behaviours Error 167 0.097 Communication Group 3 0.247 2.574 0.055 behaviours Error 167 0.096 Evaluation Group 3 1.630 6.611 0.000*** behaviours Error 167 0.247 Personal Group 3 0.816 4.927 0.003** tra i ts Error 167 0.166 Note. *p < .05. **p < .01. ***p < .001. The PTS group was significantly different from the other three groups (OTF, PTF and OTS) in category six, the teaching behaviours category (p_ < .05). In the evaluation behaviours category (category f ive) , the PTS group differed signif icantly from the OTF and PTF groups [p_ < .05). F ina l ly , the PTS group was significantly different from the OTF group in category six, so the personal trai ts category (p < .05). 113 A comparison between these results and those of the Core Group x Categories analysis revealed some differences. In the two-way ANOVA the PTS group were also significantly different from the PTF group in the category of professional competence(category one). This difference was not evident in the one-way ANOVA. Although the PTS group differed signif icantly from other groups in the categories of evaluation behaviours and personal trai ts (categories five and six respectively), the differences were evident between fewer groups in the one-way ANOVA. The findings from al l of the analyses are relatively consistent in demonstrating the trend towards significant differences between the PTS group and other groups, in three to four of the competency categories. The Relationship of Personal Variables to  Ratings of Importance Part A of the questionnaire requested demographic information from al l of the respondents in each of the OTF, PTF, OTS and PTS groups (see Appendix 1, Part A). Assessing the extent to which the personal variables, which were e l i c i ted from this part of the questionnaire, were related to the respondents ratings of importance for the competency categories, was the goal of the fourth research question. The descriptive data (means and standard deviations) for the six categories rather than the 105 114 competencies provided the basis for these s tat i s t ica l analyses. The respondent characteristics analysed for the fieldwork instructors were age, years of experience, number of students . supervised, type of setting in which the respondents were employed, the type of c l ient problems addressed by respondents, and attendance of respondents at fieldwork instructor preparation programs. For the students, the relationships between age, student year, and mean ratings of importance were analysed. Two variables, sex (fieldwork instructors and students) and educational qualifications (fieldwork instructors), were not included in this analysis due to the small cell sizes of some of the response categories (see Tables 1 and 2). Fieldwork Instructors In order to determine the extent to which OTF and PTF respondents' ages, and number of years of practice were related to the mean ratings for the six competency categories, Pearson Product Moment Correlation Coefficients were calculated. No significant correlations were found for age. The number of years in which a fieldwork instructor had practised as an O.T. or a P.T. was s ignif icantly correlated to the mean ratings for the categories of professional competence behaviours (r = 0.25; p < .01), teaching behaviours (r = 0.22; p < .05) and evaluation behaviours (r = 0.20; p < .05). While these correlations are 115 significant they are low. A post-hoc t-test showed that there were no significant differences between ratings of importance of OTF and PTF respondents who had less than 10 years experience (n = 55) and those who had more than 10 years experience (n = 48). The responses of the fieldwork instructors to the question on the number of students supervised, fe l l into four groups: (a) 0-5, (b) 6-10, (c) 11-15 and (d) 16 or more students. The OTF and PTF populations consisted only of instructors who had supervised one or more UBC students. Thus, al l of the group (a) respondents had supervised at least one student. Inclusion of a zero in this item can be considered to be an error in the questionnaire. In order to determine i f differences were evident when OTF and PTF data were combined and analysed across each of these four groups for each of the six categories, an analysis of variance was used. No significant differences were found. T-tests were used to examine all of the remaining fieldwork instructor variables. Table 3 indicated that the majority of OTF and PTF respondents worked in inpatient settings (acute and rehabilitation) and outpatient settings. The low number of respondents who worked in inpatient, long term settings (n = 3) and other settings (n = 5) did not permit s tat i s t ica l comparison. Therapists who worked in inpatient settings (n = 54) were compared to therapists who worked in outpatient settings (n = 43) 116 using a t-test . The findings were not s ignif icant. Due to differences in the types of c l ient problems addressed by OTF and PTF subjects these data could not be compared. However, in the OTF group the extent of the differences between OTF respondents who selected the categories of adult psychiatry (n = 19) and adult, physical dysfunction (n = 27) were analysed. In the PTF group, the ratings of PTF respondents who chose adult orthopaedics (n = 25) were compared to those who chose other categories (n = 30). None of the findings were signif icant. The type of c l ient problems addressed by the respondents in these groups appear to be unrelated to their ratings of importance. Of all of the s tat is t ical tests conducted on the relationship of personal variables to the fieldwork instructors' ratings of importance only one other significant finding appears to be meaningful. There was a significant difference ( £ < .01) between OTF and PTF respondents who had participated in a fieldwork instructor preparation program compared to those who had not, in the category of evaluation behaviours (see Table 16). 117 Table 16 T-test Comparing Ratings of Fieldwork Instructors who had and had not Participated in Workshops by Category Category Yes a Nob t df P Professional competence M SD 3.88 0.50 3.87 0.53 0.12 103 0.905 Teaching behaviours M SD 4.22 0.40 4.06 0.44 1.91 103 0.058 Supervisory behaviours M SD 4.50 0.35 4.49 0.30 0.12 103 0.903 Communication behaviours M SD 4.63 0.30 4.63 0.26 -0.08 103 0.939 Evaluation behaviours M SD 4.39 0.47 4.15 0.50 2.49 103 0.014* Personal trai ts M SD 4.52 0.35 4.40 0.39 1.62 103 0.108 Note. a n = 40. b n = 65. * p < .01. 118 Students The relationship between the age of the students and their ratings of importance for the six categories was explored using the Pearson Product Moment Correlation Coefficient. No significant effects for age were found. The results of the analysis of between group differences in ratings of importance presented in the previous section showed that the PTS group was s ignif icantly different from the OTF, PTF and PTS groups. In an effort to seek an explanation for this difference a t-test was employed to compare the ratings of importance of third and fourth year P.T. students (see Table 17). The analysis of the results revealed significant differences between third and fourth year students in their ratings of the competencies in the teaching behaviours category (p_ < .01) and in the evaluation behaviours category ( £ < .01). In both categories the fourth year P.T. students had lower mean ratings than the third year P .T. students. While no other significant differences were found, the mean ratings of the fourth year P .T . students were lower for al l of the categories except for the personal traits category, for which the fourth year students gave higher ratings. The ratings of importance by category for the third and fourth year OTS group revealed no significant differences. In contrast to the PTS group, the fourth year O.T. students rated the supervisory 119 Table 17 T-test Comparing Ratings of Third and Fourth Year P.T. Students by  Category Category Third year 9 Fourth year b t df p Professional competence M 3.75 3.56 1.01 31 0.320 SD 0.61 0.42 Teaching behaviours M 3.98 3.61 2.90 31 0.007* SD 0.34 0.38 Supervisory behaviours M 4.36 4.34 0.19 31 0.849 SD 0.38 0.27 Communication behaviours M 4.48 4.47 0.10 31 0.918 SD 0.43 0.31 Evaluation behaviours M 4.05 3.60 2.81 31 0.009* SD 0.42 0.50 Personal t r a i t s M 4.08 4.25 -0.97 31 0.340 SD 0.62 0.35 Note. a n = 16. b n = 17. *p < .01 120 behaviours, communication behaviours, evaluation behaviours and the personal trai ts categories higher than third year O.T. students. Fieldwork Instructors and Students While there were no significant correlations between age and ratings of importance for the six categories when fieldwork instructors (n = 104) and students (n = 66) were analysed separately, s ignificant correlations were evident in three of the categories when the data were combined (n = 170). The categories were: (a) professional competence (r = 0.21; p < .01), (b) teaching behaviours (r = 0.22; p < .01), and (c) evaluation behaviours (r = 0.27; p < .01). Although the correlations are low, there appears to be a significant relationship between age and ratings of importance for the categories. 121 CHAPTER 5 Discussion and Implications The purposes of this study were two-fold: (a) to derive a l i s t of fieldwork instructor competencies from the l i terature in the health professions, and (b) to determine which competency categories and which competencies were perceived by O.T. and P.T. fieldwork instructors, and by O.T. and P.T. students to be important in contributing to the effectiveness of a student's fieldwork experience. A review of the l i terature suggested that i f the respondents' ratings of the importance of the categories and the competencies were similar for al l groups, they could be used to guide the development of educational programs to prepare fieldwork instructors in each profession for their role. Central to this belief is the assumption that a relationship exists between the concepts of competence and competencies, and program development. The postulates which link these concepts were examined in Chapter 2. Discussion of the results is centred around the important competency categories and competencies identified in this research, their relationship to previous research, and their usefulness in guiding the future development of educational programs for fieldwork instructors. The headings used to provide a framework for the discussion are similar to those which guided the presentation of the results. They are: (a) characteristics 122 of the respondents, (b) validation and importance of the categories, (c) important competencies, (d) group differences, and (e) the relationship between personal variables and ratings of importance. Differences between the groups which are evident from the descriptive data wil l be discussed in (b) and (c), while differences which emerge from the inferential analyses will be examined in (d). Implications of the results follow the discussion. Characteristics of Respondents The descriptive s tat is t ics on the age and sex of the respondents in a l l groups produced no unexpected results. The ratio of male to female fieldwork instructors parallels the ratio of males to females in each profession. A higher proportion of males in each of the student groups reflects the increases in the number of men entering the University of Brit ish Columbia programs in O.T. and P.T. It is apparent from the wide range in the ages of the fieldwork instructors that therapists instruct students from graduation to retirement. The age ranges of the students is indicative of the higher numbers of mature students entering these professions. Third year and fourth year students in O.T. and P.T. were equally well represented among the respondents. 123 Of the remaining demographic findings related to the fieldwork instructors education, type of practice setting, type of c l ient problems encountered by respondents, years of experience since graduation, number of students supervised, and fieldwork preparation programs attended - - the majority of the findings were anticipated. The educational qualifications of the respondents, the types of settings in which they practice, and their years of experience since graduation reflect the educational and employment patterns of O.T. ' s and P .T . ' s in Bri t i sh Columbia (Brit ish Columbia Society of Occupational Therapists, 1987; Physiotherapy Association of Bri t i sh Columbia, 1986; Health Manpower Research Unit, 1985). Students in the O.T. and P.T. programs at the University of Bri t i sh Columbia are required to complete fieldwork experiences which focus on the variety of c l ient problems they wil l encounter following graduation. The population of fieldwork instructors included al l therapists who had instructed O.T. and P.T. students from the University of Bri t i sh Columbia between May 1986 and February 1987. The range of problems encountered by the fieldwork instructors parallels the assignment of students to fieldwork experience areas during this period. The numbers of students instructed by the OTF and PTF respondents in each of the four groups (0-5 students, 6-10 students, 11-15 students, and 16 or more students) was 124 disproportionate between the professions. The study findings show that the OTF respondents are more experienced fieldwork instructors than the PTF respondents. Physical therapists outnumber O.T. ' s in Brit i sh Columbia by a margin of 3:1 (Health Manpower Research Unit, 1985). The lower number of O.T. ' s may account for the higher numbers of students instructed by O . T . ' s . That i s , each O.T. may be required to instruct students more frequently than P . T . ' s to ensure that al l of the students receive the necessary fieldwork experience prior to graduation. When the number of students instructed by OTF and PTF respondents was compared to the age and years of experience of these respondents, the data indicated that P .T. students were more l ike ly to be assigned to fieldwork instructors who were younger and who had less experience. There are several possible reasons for this trend. The older and more experienced PTF respondents may have administrative responsibil it ies which l imit the time they have available to instruct students. However, when shortages of fieldwork experiences do occur, for example, in the summer months, they may feel more pressure to instruct students. Secondly, although the geographic location of respondents was not requested in this study, i t is possible that the eight more experienced P . T . ' s who had instructed five or fewer students worked in a centre or city to which a smaller number of students were assigned. Variations in the procedures for assigning 125 students to instructors may also be a factor. In some a f f i l i a t i n g agencies, policy may dictate that students are considered to be the responsibility of the younger, less experienced therapists. None of these hypotheses can be confirmed without further research. A higher proportion of OTF respondents had attended fieldwork instructor preparation workshops (see Table 5). While courses have been offered at least once annually for the last five years in O . T . , courses have not been available in P.T. for the last 2-3 years. Lack of access to workshops in Bri t i sh Columbia in recent years is l ike ly to be the primary reason for the discrepancy between the OTF and PTF groups. Validation and Importance of the Categories The data analysis related to the competency categories (see Table 6) supported the val idity of the pre-determined categories. This validation of the categories offers program designers some assurance that the competencies assigned to each category accurately represent the behaviours in the category. The high loading of most of the competencies on a one-factor solution, in the factor analysis and subsequent varimax rotation is consistent with the findings of Meleca et a l . (1981, 1983). The ratings of the importance of the categories of competence in this study appear to be related to previous 126 research findings in O.T. and P.T. (Christie et a l . , 1985a; Emery, 1984; Moore & Perry, 1976), and in medicine (Irby & Rakestraw, 1981). When al l data were combined the category of communication behaviours emerged as most important in this research (see Table 8). However, when the data was analysed for each group, a higher proportion of the top 10 ranked competencies for students were in the category of supervisory behaviours (see Table 7). In the study by Christie et a l . (1985a), supervisory behaviours were most frequently mentioned as the most c r i t i c a l components of a fieldwork experience, by O.T. fieldwork instructors and students. Communication behaviours were considered to be of secondary importance. The results of Moore and Perry's study (1976) of P.T. fieldwork instructors produced identical results . Emery's (1984) finding that P.T. students rated communication behaviours as most important, differed from the ratings of students in this study. However, the communication behaviours category which Emery used, included behaviours from the categories of communication and supervisory behaviours which were used in this research. Although the differences between instructor and student ratings of the most important category found in this study were not apparent in previous research, the categories of supervision and communication behaviours were consistently rated as highly 127 important to a student's fieldwork experience (see Figures 2 and 3). The low rating of importance of the professional competence category (see Tables 7 and 8) appears to confirm the findings of previous researchers (Emery, 1984; Irby & Rakestraw, 1981; Romberg, 1984). While professional competence behaviours are important in contributing to an effective fieldwork experience, i t is clear that they are perceived to be less important than the other competency categories by the respondents in this study. It is possible that respondents may place less importance on the competencies in the professional competence category because they assume that a l l fieldwork instructors meet basic professional competence requirements. The findings from this study regarding the most and least important categories of fieldwork instructor behaviours appear to support the trends identified in earl ier O.T. and P.T. studies. Important Competencies With the exception of the competencies which were c lass i f ied as distractors, the study results appear to confirm that the competencies which were derived from the l i terature were perceived by the respondents to be important in contributing to the effectiveness of a student's fieldwork experience. 128 Appendix C shows that the ratings of importance by each group followed a similar pattern. That i s , the ratings on each competency tended to be high, medium or low across al l groups. Although the ratings of the OTF group were closer to the PTF group, and the OTS group ratings were more similar to the PTS group on some competencies, i t was apparent that the PTS group ratings were generally lower than the OTF, PTF and OTS groups. It has been reported that there were ten competencies in which the differences between the OTS and PTS groups exceeded 0.50 and that six of these included content related to the objectives for the fieldwork experience. These competencies were c lass i f ied as teaching behaviours. The ratings of the OTF, PTF and OTS groups were higher than the PTS group on five of these six competencies. These five competencies stated that fieldwork objectives should be consistent with university goals for fieldwork, be able to be accomplished in the time available, be compatible with the student evaluation form; and should specify the knowledge, sk i l l s and attitudes to be acquired during the fieldwork experience. Although fieldwork instructors may rate these competencies more highly because they provide structure and organisation to the fieldwork experience, a l l of the students may not share this view. Fieldwork objectives have been developed and are used to guide the majority of O.T. fieldwork experiences (J . O'Callaghan, personal communication, April 8, 1987). In 129 P . T . , fieldwork objectives are being developed in many a f f i l i a t i n g agencies but as yet are not in frequent use (L. Botman, personal communication, Apri l 8, 1987). For this reason, i t is conceivable that the P.T. students' lack of experience in using objectives, may have contributed to their lower ratings of these competencies. Although the ratings of importance followed a similar pattern among the groups, the analysis of the competencies ranked in the top 10 by each group revealed some differences between fieldwork instructors and students. The competencies ranked highly by the fieldwork instructors, such as make specific  suggestions for improvement and encourage student questions  opinions and requests for assistance, seem to be more objective than subjective. That i s , they are the type of competencies which would be recommended as requirements of sound educational practice. In contrast, competencies ranked highly by students appear to be more subjective and relate to the interpersonal dynamics between the fieldwork instructor and the student. Observe students' performance in such a way as to not intimidate  the student, and supervise the student without taking over,  unless absolutely necessary, are examples of the competencies which i l lus trate this trend. The finding that the ratings of importance between fieldwork instructors and students, varies according to the content of the 130 competency is not surprising. Each of the groups can be expected to have different perspectives on the degree of importance of each competency in contributing to the effectiveness of a student's fieldwork experience. The instructors' examine the competencies from the perspective of service provider (where the service is fieldwork instruction) whereas the students' consider each competency from the perspective of the recipient or consumer of the service. Other factors such'as whether the respondents' experiences of fieldwork were negative or positive are l ike ly to have effected their ratings. The influence of other personal variables on ratings of importance is discussed in a later section of the Chapter. When the competencies which were ranked in the top 10 by the groups in this study are compared to those competencies which have been identified as most important in past research, s imi lar i t ies are evident. The inclusion of several competencies related to the provision of feedback is consistent with the majority of the previous research (Brown, 1981; Christie et a l . , 1985b; Emery, 1984; Moore & Perry, 1976; O'Shea & Parsons, 1979; Petzel et a l . , 1982; S tr i t ter et a l . , 1975). Other competencies which had been found to be highly important by four or more researchers — discussing issues openly with the student, being accessible to students and demonstrating positive regard for the student - - were also ranked in the top 10 in this study (Christie 131 et a l . , 1985b; Emery, 1984; McLeod, 1986; Moore & Perry, 1976; Romberg, 1984; S tr i t ter et a l . , 1975; Tompson, 1986). Group Differences The descriptive data related to the differences in group ratings of the importance of the competency categories and competencies has been discussed. This section will discuss the appropriateness of the chosen inferential s tat is t ics for the data, and the results which emerged from the analyses. The identif ication of any main and/or interaction effects between ratings of importance and the different combinations of groups used in this study, was determined by a two-way factorial ANOVA and a three-way factorial ANOVA, and a MANOVA. Use of these methods usually requires that the assumptions underlying the use of ANOVA - - homogeneity of variance and normality of the distribution - - are not violated. Examination of the data indicated that the variance between the groups on each of the categories were s imilar. No radical departures from homogeneity were evident for any of the samples. Although i t has been noted that the data were negatively skewed, Ferguson (1981) and Borg and Gall (1983) indicate that reasonable departures from the assumption of normality can occur without seriously affecting the val id i ty of the inferences drawn from the data. When the distribution of the data is not normal the data can be 132 transformed to meet this requirement (Ferguson, 1981). The raw data used for the two-way and three-way ANOVA's were the mean ratings for the six categories in each group. Due to the fact that the raw data were aggregated scores, further transformation of the scores to meet normality requirements was judged to be inappropriate. Furthermore, Jones (1978) found no evidence that the Type I error rate was higher for skewed distributions when scaled data (rather than continuous data) were analysed using ANOVA procedures. Although significant differences were found in the Core Groups x Categories ANOVA (see Table 13), and in the Fieldwork Instructors and Students x Professions x Categories ANOVA (see Table 14), the subsequent multiple comparison tests produced only two consistent and meaningful findings. The main effect from these analyses was that the ratings of the PTS group differed signif icantly from the OTF and PTF groups (p_ < .05). This finding was also supported by the MANOVA results. Differences between the core groups, and between fieldwork instructors and students were not apparent for the categories of supervisory and communication behaviours (categories three and four, respectively). The fact that competencies in these categories were perceived to be more important in contributing to the effectiveness of a student's fieldwork experience is l ike ly to have contributed to this result. 133 Some possible reasons for the PTS differences in ratings in the teaching behaviours category were offered in the preceding section of this Chapter. A further review of the differences between the PTS group and the other core groups in the categories of professional competence, evaluation behaviours and personal t r a i t s , provides only two possible explanations for the lower PTS ratings of the competencies in these categories. The lower PTS ratings may be due to the instructions on the questionnaire. Section B of the questionnaire (see Appendix A, Section B) asked respondents to attempt to use the ful l range of the scale in differentiating the degree of importance of each competency. The P.T. students may have taken more care to complete the questionnaire according to the instructions. If the PTS respondents were not influenced to a greater degree than other respondents by the instructions on the questionnaire, their perceptions of the importance of the competencies in these categories may actually be lower than those of the other core groups. Although there are significant differences between the PTS group ratings and one or more of the other core groups in four categories, the pattern of the responses is similar (see Figure 2 ) . The small differences in the mean ratings between the groups do not appear to effect the trend towards high, moderate or low ratings of the competencies among al l of the groups. 134 The Relationship between Personal Variables and Ratings of Importance The analyses revealed that four personal variables appeared to influence the ratings of importance for one or more of the respondent groups. Age, years of experience, attendance at fieldwork preparation workshops, and student year were the variables which showed a relationship to the ratings of importance. The ages of a l l respondents, and the years of experience of the fieldwork instructors correlated signif icantly with the ratings of importance by category. Although the correlations were a l l significant to the p_ < .01 level , the correlations were low (r = 0.20 to r = 0.27). The significant correlations for age and years of experience were in the categories of professional competence, teaching behaviours and evaluation behaviours. It is conceivable that as an instructor ages and acquires more experience, that perceptions of importance in these areas might change. While a correlation between age and ratings of importance is evident, i t may be due to the fact that the PTS group were younger and had lower ratings than other groups. The ratings of the competencies in the three most important categories (communication behaviours, supervisory behaviours, and personal traits) appear to be less affected by the age and experience of the respondents. 135 When the ratings of the OTF and PTF respondents who had and had not attended fieldwork preparation programs were compared a significant difference (p_ < .01) was found in the category of evaluation behaviours (see Table 16). Twenty-six of the 40 respondents who had attended a fieldwork preparation program, had attended the 1-day workshops offered by the School of Rehabilitation Medicine at the University of Brit i sh Columbia. These programs included content related to the teaching behaviours, supervisory behaviours, and evaluation behaviours categories. The higher ratings of the respondents who attended the programs in the teaching behaviours and evaluation behaviours categories may have been influenced by their participation in the programs. Further pre- and post-testing of the workshop participants would be necessary to confirm this trend. Although no significant differences were evident in the ratings of importance for third and fourth year O.T. students, the ratings of third and fourth year P.T. students differed signif icantly (p_ < 0.1) in the teaching behaviours and evaluation behaviours categories (see Table 17). The variance in the fourth year PTS ratings in a l l categories suggests that the lower ratings of the fourth year students represent a general trend among fourth year students. If "deviant" ratings of several students had contributed to this effect, the variance would be expected to be greater among the fourth year students. The 136 variances in the categories are similar to those of the third year PTS group. Fourth year PTS ratings in the teaching and evaluation behaviours categories are lower than those of the third year PTS group. Two possible explanations for this pattern are presented. The additional year of fieldwork experience may change students' perceptions of the importance of the competencies in these categories. Lower ratings by the fourth year students may be attributed to the experiences of this group of students, but may not be apparent in future fourth year PTS groups. Further research would be necessary to confirm or refute these findings, and to explore the reasons for the differences in the ratings. Implications The findings related to the validation and importance of the competency categories, and the degree of importance of the competencies in contributing to a student's fieldwork experience have several implications for fieldwork education in O.T. and P.T. Validation of the pre-determined categories provides a legitimate framework for the organisation of a standardized hierarchy of fieldwork instructor preparation programs. Although educational programs are offered by both professions to ensure the continuing professional competence of therapists, at least 137 four of the remaining five categories - - teaching behaviours, supervisory behaviours, communication behaviours and evaluation  behaviours - - provide dist inct content areas in which instructor workshops could be developed. The category of personal characteristics or trai ts includes competencies which are thought to be less responsive to change, and consequently less affected by educational programs (Petzel et a l . , 1982). The hierarchy of importance of the categories ( i . e . most important to least important) wil l also be useful in setting pr ior i t ies for fieldwork instructor preparation programs. Al l of the competencies except the nine distractors were perceived to be of moderate to high importance in contributing to the effectiveness of a student's fieldwork experience. The confirmation by O.T. and P.T. fieldwork instructors and students of the importance of the competencies which were derived from the l i terature , jus t i f i e s continued use of the competencies in O.T. and P.T. education. There are a variety of ways in which use of the competencies could benefit fieldwork instructors and/or students' fieldwork experiences. The competencies could form the basis of a questionnaire to assess the educational needs of fieldwork instructors. A clear description of the degree to which fieldwork instructors are competent in their role is necessary to guide educational planning. Development of a self-evaluation 138 tool based on the competencies would enable the fieldwork instructors to assess their own learning needs. In this form, the l i s t of competencies could be used by fieldwork instructors as a way of checking that they have carried out the tasks associated with their role . Use of the competencies to review and revise the forms used by students to evaluate fieldwork instructors is an additional benefit arising from this research. While a number of benefits of this research are evident, the l i terature suggests that the most important outcome will be the provision of clearly defined competencies to guide the development of standardized educational programs for fieldwork instructors in O.T. and P.T. 139 References American Physical Therapy Association. (1981). Competencies in  physical therapy: Analysis of practice (3rd ed.) . Washington, DC: Author. American Speech - Language - Hearing Association. (1982). Suggested competencies for effective c l in ica l supervision. Journal of the American Speech and Hearing Association, 24 (12), 1021-1023. Aston-McCrimmon, E. (1986). Analysis of the ratings of competencies used in physical therapy practice. Physical  Therapy, 66 (6), 954-960. Barker, J . (1986). Fieldwork supervision: Roles, tasks and responsibi l i t ies . Australian Occupational Therapy Journal, 33 (3), 108-113. ~ Beatty, P.T. (1976). A process model for the development of an  information base for community needs assessment: A guide for  practit ioners. Paper presented at the 17th Annual Adult Education Research Conference, Toronto, Ontario. Bergevin, P . , Morris, D . , & Smith, R.M. (1963). Adult education  procedures: A handbook of tested patterns for effective  part ic ipation. New York: Seabury. Biediger, K . , & Larson, T. (1987). Cl in ica l instructor's perspective of behavioral characteristics needed to be an effective c l in ica l instructor. Physical Therapy, 67 (5), 781. Borg, W.R., & G a l l , M.D. (1983). Educational research: An  introduction (4th ed.) . New York"! Longman. Boyle, P.G. (1981). Planning better programs. New York: McGraw H i l l . Bridle , M.J . (1981). Profi le of an occupational therapist revis i ted. Canadian Journal of Occupational Therapy, 48 (3), 107-113. — Brink, P . J . , & Wood, M.J. (1978). Basic steps in planning  nursing research: From question~to proposal. Belmont, Cal i form'a: Duxbury. 140 Brintne l l , E . S . , & Skakun, E . (1986). Educational standards and entry-level considerations. Canadian Journal of Occupational  Therapy, 53 (5), 255-256. Br i t i sh Columbia Society of Occupational Therapists. (1987). Occupational Therapy Manpower in Brit ish Columbia. Vancouver, B . C . : Author. Broadhead, R .S . , & Facchinett i , N .J . (1985). Cl in ica l clerkships in professional education: A study in pharmacy and other anc i l l iary professions. Social Science in Medicine, 20 (3), 231-240. Brown, J r , M.D. , & Uhl, H.S.M. (1970). Mandatory continuing education: Sense or nonsense? Journal of the American  Medical Association, 213 (10), 1660-1668. Brown, S.T. (1981). Faculty and student perceptions of effective c l in i ca l teachers. Journal of Nursing Education, 20 (9), 4-15. — Bullard, M. (1983). A needs assessment strategy for educational planning. American Journal of Occupational Therapy, 37 (9), 624-629. Butts, D.P. (1983). The survey: A research strategy rediscovered. Journal of Research in Science Teaching, 20 (3), 187-193. ~ ~ Canadian Association of Occupational Therapists. (1987). Position statement on continuing professional education. Toronto, Ontario: Author. Caney, D. (1983). Competence - Can i t be assessed? Physiotherapy, 69_ (9), 302-304. Charters, A . N . , & Blakely, R . J . (1974). The management of continuing learning: A model of continuing education as a problem-solving strategy for health manpower. In A.N. Charters and R . J . Blakely (Eds.) , Fostering the growing need  to learn: Monographs and annotated bibliography on continuing  education and health manpower (Contract No. HSM 110 71 147, pp. 1-63). Syracuse, New York: Syracuse University. 141 Chernoff, R., Lindsay, C . A . , & Kris-Etherton, P.M. (1983). Continuing education needs assessment and program development. Journal of the American Dietetics Association, 83 (6), 649-653. Chickering, A . , & Claxton, C. (1981). What is competence? In R. Nickse & L. McClure (Eds.) , Competency-based education:  Beyond minimum competency testing (pp. 5-41). New York: Teachers College. Chr i s t i e , B . A . , Joyce, P . C , & Moeller, P . L . (1985a). Fieldwork experience, Part I: Impact on practice preference. American  Journal of Occupational Therapy, 39 (10), 671-674. Chris t ie , B . A . , Joyce, P . C , & Moeller, P . L . (1985b). Fieldwork experience, Part II: The supervisor's dilemma. American  Journal of Occupational Therapy, 39 (10), 675-681. C i l i a , D.D. , & Manolakis, M.L. (1986). Making the most of an internship: A guide for interns and preceptors. American  Pharmacy, 26_ (3), 72-77. Coldeway, N.A. , & Delisa, J . A . (1983). Educational needs assessment in physical medicine and rehabil i tat ion: The foundation of continuing medical education. Archives of  Physical Medicine and Rehabilitation, 64 (9), 391-395. Craig, J . L . , & Page, G. (1981). The questioning sk i l l s of nursing instructors. Journal of Nursing Education, 20 (5), 18-23. ~ Davis, C M . , Anderson, M . J . , & Jagger, D. (1979). Competency: The what, why and how of i t . Physical Therapy, 59 (9), 1088-1094. Davis, L . N . , & McCallon, E. (1974). Planning, conducting and  evaluating workshops. U.S .A. : Learning Concepts. Dickinson, G . , & Verner, C. (1974). The provision of inservice education for health manpower. In A.N. Charters and R . J . Blakely (Eds.) , Fostering the growing need to learn:  Monographs and annotated bibliography on continuing education  and health manpower (Contract No. HSM 110 71 147, pp. 175-198). Syracuse, New York: Syracuse University. 142 Dunn, W.R., Hamilton, D.D. , & Harden, R.M. (1985). Techniques of identifying competencies needed of doctors. Medical Teacher, M l ) , 15-25. Dunn-Rankin, P. (1983). Scaling methods. New Jersey: Lawrence Erlbaum. Emery, M.J. (1984). Effectiveness of the c l in ica l instructor. Physical Therapy, 64 (7), 1079-1083. Ende, J . (1983). Feedback in c l in ica l medical education. Journal of the American Medical Association, 250 (6), 777-781. Farquhar, L . J . , & Holdman, H. (1982). Preferred styles of c l in i ca l teaching: Measuring physician control over students in patient care encounters. Medical Teacher, 4_ (3), 104-109. F a r r e l l , P . , & Scherer, K. (1983). The Delphi technique as a method for selecting cr i t er ia to evaluate nursing care. Nursing Papers - Perspectives in Nursing, 15 (1), 51-60. Ferguson, G.A. (1981). Stat is t ical analysis . in psychology and  education (5th ed.). New York: McGraw-Hil1. Fleisher, D.S. (1974). Pr ior i t ies and data bases: Their relationship to continuing education. In A.N. Charters and R . J . Blakely (Eds.) , Fostering the growing need to learn:  Monographs and annotated bibliography on continuing education  and health manpower (Contract No. HSM 110 71 147, pp. 199-224). Syracuse, New York: Syracuse University. Gale, L . E . , & Pol, G. (1975). Competence: A definition and conceptual scheme. Educational technology, 15 (6), 19-25. G i l l , T . (1984). Professional cert i f icat ion procedures: A developmental forecast for the year 2000. Canadian Journal of  Occupational Therapy, 51 (1), 31-36. G i l l , T. (1987). Standards for practice in occupational therapy: We do need them. Canadian Journal of Occupational Therapy, 54 (1), 7-9. Greenburg, L.W., Goldberg, R.M. & Jewett, L . S . (1984). Teaching in the c l in ica l setting: Factors influencing residents' perceptions, confidence and behaviour. Medical Education, 18 (5), 360-365. 143 G r i f f i t h , J .W. , & Bakanauskas, A . J . (1983). Student-instructor relationships in nursing education. Journal of Nursing  Education, 22_ (3), 104-107. Gronlund, N.E. (1978). Stating objectives for classroom  instruction (2nd ed.)"! New York: Macmillan. Guskey, T.R. (1985). Implementing mastery learning. Cal i fornia: Wadsworth. Halsey, W.D. (Ed.) . (1979). MacMillan Contemporary Dictionary. New York: MacMillan. Health Manpower Research Unit. (1985). Roll ca l l 85: A status  report of health personnel in the province of Brit i sh Columbia (Report R: 28). Vancouver, BC: University of Brit i sh Columbia, Division of Health Services Research and Development. Health and Welfare Canada and the Canadian Association of Occupational Therapists' Task Force. (1986). Intervention  guidelines for the client-centred practice of "occupational  therapy. Ottawa, Ontario: Health and Welfare Canada TR1-TTJ0/1986E). Hopkins, K . D . , & Glass, G.V. (1978). Basic s tat is t ics for the  behavioral sciences. Englewood C l i f f s , NJ: Prentice-Hall . Houle, C O . (1972). The design of education. San Francisco, Cal i fornia: Jossey-Bass. Hughes, C M . (1985). Supervising c l in ica l practice in psychosocial nursing. Journal of Psychosocial Nursing, 23 (2), 27-32. ~ ~ Hutchison, D .J . (1974). The process of planning programs of continuing education for health manpower. In A.N. Charters and R . J . Blakely (Eds.) , Fostering the growing need to learn:  Monographs and annotated bibliography on continuing education  and health manpower (Contract No. HSM 110 71 147, pp. 133-173). Syracuse, New York: Syracuse University. Irby, D. (1978). Cl in ical teacher effectiveness in medicine. Journal of Medical Education, 53 (10), 808-815. Irby, D . , & Rakestraw, P. (1981). Evaluating c l in ica l teaching in medicine. Journal of Medical Education, 56 (3), 181-186. 144 Issac, S. , & Michael, W.B. (1971). Handbook in research and  evaluation. San Diego, Cal i fornia! Edits . Jason, H. (1974). The health-care practitioner as instructor. In A.N. Charters and R . J . Blakely (Eds.) , Fostering the  growing need to learn: Monographs and annotated bibliography  on continuing education and health manpower (Contract No. HSM 110 71 147, pp. 225-277). Syracuse, New York: Syracuse University. Jones, W. (1978). The analysis of variance with scaled data: A  simulation study" Unpublished master's thesis, University of Toronto, Toronto, Ont. Karuhije, H.F. (1986). Educational preparation for c l in ica l teaching: Perceptions of the nurse educator. Journal of  Nursing Education, 25_ (4), 137-144. Knowles, M.S. (1980). The modern practice of adult education: From pedagogy to andragogy. Chicago: Association. Koonz, F . P . (1978). Identification of Learning needs. Journal  of Continuing Education in Nursing, 9_ (3), 6-11. Lawson, B . K . , & H a r v i l l , L..M. (1980). The evaluation of a training program for improving residents' teaching s k i l l s . Journal of Medical Education, 55_ (12), 1000-1005. Laxdal, O .E . (1982). Needs assessment in continuing medical education: A practical guide. Journal of Medical Education, 57_ (11), 827-834. Lessinger, L.M. (1974). Effective caring: An approach to a rational scheme for financing continuing education for health manpower. In A.N. Charters and R . J . Blakely (Eds.) , Fostering  the growing need to learn: Monographs and annotated  bibliography on continuing education and health manpower (Contract No. HSM 110 71 147, pp. 279-312). Syracuse, New York: Syracuse University. Lewis, A. (1974). The use of analytical techniques to determine health manpower requirements for educational planning - or how do I find out what sk i l l s and knowledges to teach? In A.N. Charters and R . J . Blakely (Eds.), Fostering the growing need  to learn: Monographs and annotated bibliography^on continuing  education and health manpower (Contract No. HSM 110 71 147, pp. 313-368). Syracuse, New York: Syracuse University. 145 Likert , R.A. (1932). A technique for the measurement of attitudes. Archives of Psychology, 140, 5-53. Madi l l , H.M. (1984). Lifelong education in an occupational therapy context. Canadian Journal of Occupational Therapy, 51 (2), 68-72. McAshan, H.H. (1979). Competency-based education and behavioural  objectives. Englewood C l i f f s , New Jersey: Educational Technology. McCabe, B.W. (1985). The improvement of instruction in the c l in ica l area: A challenge waiting to be met. Journal of  Nursing Education. 24 (6), 255-257. McClure, L . , & Leigh, J . (1981). A sampler of competency-based education at i ts best. In R. Nickse & L . McClure, (Eds.) , Competency-based education: Beyond minimum competency testing (pp. 81-147). New York: Teachers College. McLeod, P . J . , & Harden, R.M. (1985). Cl in ica l teaching strategies for physicians. Medical Teacher, 7_ (2), 173-189. McLeod, P . J . (1986). A successful formula for ward rounds. Canadian Medical Association Journal, 134 (8), 902-904. MacPherson, C .R . , Davey, R . J . , & Simpson, M.B. (1985). Results of a del phi poll to describe the necessary competencies of blood bank physicians. Transfusion, 25 (5), 429-432. Mann, W.C. (1985). Survey methods. American Journal of  Occupational Therapy, 39_ (10), 640-468. May, B . J . (1983). Teaching - A sk i l l in practice. Physical  Therapy, 63 (10), 1627-1633. Meleca, C . B . , Schimpfhauser, F . T . , Witteman, J . K . , & Sachs, L. (1981). Cl in ica l instruction in nursing. Journal of Nursing  Education, 2 £ (8), 32-40. Meleca, C . B . , Schimpfhauser, F . T . , Witteman, J . K . , & Sachs, L .A. (1983). Cl in ica l instruction in medicine: A national survey. Journal of Medical Education, 58 (5), 395-403. 146 Mocellin, G. (1984). Some aspects of a c l in ica l education programme for occupational therapy students af f i l ia ted at a psychiatric hospital: 1979-1983. Australian Occupational  Therapy Journal, 31_ (3), 106-118. Moncur, C. (1985). Physical therapy competencies in rheumatology. Physical Therapy, 65_ (9), 1365-1372. Monette, M.L. (1977). The concept of educational need: An analysis of selected l i terature. Adult Education, 27 (2), 116-127. — Moore, M . L . , & Perry, J . F . (1976). Cl in ical education in P??ysl'f:a1..!*-^ raPy.:. P r e s e n t statusTTuture needs. (Contract No. NOl-AH-44112). Washington, DC: American Physical Therapy Association. O'Shea, H .S . , & Parsons, M.K. (1979). Cl in ica l instruction: Effective and ineffective teacher behaviours. Nursing  Outlook, 27 (6), 411-415. Peat, M. (1985). Enid Graham memorial lecture: Cl in ica l education of health professionals. Physiotherapy Canada, 37 (5), 301-307. ~ Perry, J . F . (1978). Handbook of c l in ica l curriculum develIopment. North Carolina: Division of Physical Therapy, University of North Carolina at Chapel H i l l . Petzel, R .A . , Harris, I . B . , & Masler, D.S. (1982). The empirical validation of c l in ica l teaching strategies. Evaluation and  the Health Professions, 5_ (4), 499-508. Pletts , M. (1981). Principles and practice of c l in ica l teaching - A need for structure. Br i t i sh Journal of Disorders of  Communication, 1 M 2 ) , 129-134. Physiotherapy Association of Brit i sh Columbia. (1986). Physiotherapy Manpower in Brit i sh Columbia. Vancouver, BC: Author. Pottinger, P.S. (1975). Comments and guidelines for research in  competency ident i f icat ion, definition and measurement (National Institute of Education, Contract No. 400 75 0036). Syracuse, NY: Educational Policy Research Centre, Syracuse University Research Corp. 147 Pottinger, P.S. (1979). Competence assessment: Comments on current practices. In P.S. Pottinger and J . Goldsmith (Eds.), New Directions for Experiential Learning #3: Defining and  measuring competence pp. 25-39. San Francisco: Jossey-Bass. Ramsden, E . L . , & Dervitz, H.L. (1972). Cl in ica l education: Interpersonal foundations. Physical Therapy, 52 (10), 1060-1066. Roberts, M.D., Cordova, D . , & Saxe, E. (1978). A process model for competency-based education. American Journal of  Occupational Therapy, 32_ (6), 369-374. Romberg, E . (1984). A factor analysis of student's ratings of c l in i ca l teaching. Journal of Dental Education, 48 (5), 258-262. Rubin, L. (1981). How can competencies be taught? Some observations and suggestions. In R. Nickse & L. McClure (Eds.) , Competency-based education: Beyond minimum  competency testing (pp. 6"2-80). New York: Teachers Col 1 ege. Ryan, S . J . (1981). Identification of the needs of occupational  therapy c l in ica l faculty in Brit i sh Columbia. Unpublished manuscript. Schalock, H.D. (1981). How can competencies be assessed? In R. Nickse & L . McClure (Eds.) , Competency-based education (pp 148-175). New York: Teachers College Press. Schuman, H . , & Presser, S. (1981). Questions and answers in  attitude surveys. New York: Academic Press. Shamian, J . , & Inhaber, R. (1985). The concept and practice of preceptorship in contemporary nursing: A review of pertinent l i terature . International Journal of Nursing Studies, 22 (2), 79-88. ~ ~ Shellenburger, S. , & Mahan, J . M . (1982). A factor analytic study of teaching in off-campus general practice clerkships. Medical Education, 16 (3), 151-155. Sork, T . J . (1981). ACE 821 Program development and evaluation in  adult and continuing education. Unpublished manuscript, University of Nebraska-Lincoln. 148 Sork, T . J . , & Buskey, J . H . (1981). Bibliography of program  planning models. Lincoln, NE: University of Nebraska-Lincoln. Sork, T . J . , & Buskey, J . H . (1981, October). The practical art of  program planning. Paper presented at the National Adult Education Conference,.Anaheim, Cal i fornia . Sowell, E . , & Casey, R. (1982). Research methods in education. Belmont, CA: Wadsworth. Spady, W.G. (1977). Competency based education: A bandwagon in search of def init ion. Educational Researcher, 6_ (1), 9-14. Sox, H . C . , Morgan, W.L. , Neufeld, V.R. Sheldon, G . F . , & Tonesk, X. (1984). Association of American medical colleges, Sub-group report on c l in ica l s k i l l s . Journal of Medical  Education, 59_ (11), 139-147. Stake, R.E. (1983). Program evaluation, particularly responsive evaluation. In G.F. Madaus, M. Scriven, & D.L. Stufflebeam (Eds.) , Evaluation models: Viewpoints on educational and  human services evaluation (pp. 287-310). Boston: Kluwer-Nijhoff. Steinmetz, A. (1983). The discrepancy evaluation model. In G.F. Madaus, M. Scriven, & D.L. Stufflebeam (Eds.). Evaluation  models: Viewpoints on educational and human services  evaluation (pp. 79-99). Boston: Kluwer-Nijhoff. S tr i t t er , F . T . , & Bowles, L . T . (1972). The teacher as manager: A strategy for medical education. Journal of Medical  Education, 47, 93-101. S t r i t t e r , F . T . , Hain, J . D . , & Grimes, D.A. (1975). Cl in ica l teaching reexamined. Journal of Medical Education, 50, 876-882. S t r i t t e r , F . T . , Baker, R.M. , & McGaghie, W.C. (1983). Congruence between residents' and c l in ica l instructors perceptions of teaching in outpatient care centres. Medical Education, 17 (6), 385-389. ~ 149 Stufflebeam, D .L . (1983). The CIPP model for program evaluation. In G.F . Madaus, M. Scriven, & D.L . Stufflebeam (Eds.), Evaluation models: Viewpoints on educational and human  services evaluation (pp. 117-141). Boston: Kluwer-Nijhoff. Sudman, S., & Bradburn, N.B. (1982). Asking questions: A  practical guide to questionnaire design. London: Jossey-Bass. Sweeney, M.A. , & Regan, P.A. (1982). Educators, employees, and new graduates define essential sk i l l s for baccalaureate graduates. Journal of Nursing Administration, 12 (9), 36-42. : Tompson, M. (1985). Fieldwork in occupational therapy in Canada  (excluding Quebec)" Unpublished manuscript. Tompson, M. (1986). Factors affecting Saskatchewan occupational  therapists' involvement in fieldworRT Unpublished master's thesis, University of Saskatchewan, Saskatoon, Sask. Tyler , R.W. (1949). Basic principles of curriculum and  instruction. Chicago: University of Chicago. Tyler, R.W. (1983). A rationale for program evaluation. In G.F. Madaus, M. Scriven, & D . L . Stufflebeam (Eds.). Evaluation  models: Viewpoints on educational and human services  evaluation (pp. 67-78). Boston: Kluwer-Nijhoff. Van der Ven, A.H.G.S. (1980). Introduction to scaling. New York: John Wiley. Wong, S., & Wong, J . (1980). The effectiveness of c l in ica l teaching: A model for self-evaluation. Journal of Advanced  Nursing, 5_ (5), 531-537. Woolf, H.B. (Ed. ) . (1979). Webster's New Collegiate Dictionary. Springfield, Mass: G. & C. Merriam. Young, E . A . , Weser, E . , McBride, H.M., Page, C P . , & L i t t l e f i e l d , J . H . (1983). Development of core competencies in c l in i ca l nutr i t ion. American Journal of Cl in ical Nutrit ion, 38 (5), 800-810. — 150 APPENDICES APPENDIX A. Questionnaire Page 151 APPENDIX B. Competencies Listed by Category Page 167 APPENDIX C. Mean Ratings of Importance for Each of the 105 Competencies by Group(s) Page 173 151 APPENDIX A QUESTIONNAIRE ON FIELDWORK INSTRUCTOR TRAITS AND BEHAVIOURS Section Page A Demographic Information - OTF Respondents 152 - PTF Respondents 154 - OTS and PTS Respondents 156 B Fieldwork Instructor Traits and Behaviours: Al l Respondents 157 152 A p p e n d i x A : S e c t i o n A - OTF R e s p o n d e n t s FIELDWORK INSTRUCTOR TRAITS AMD BEHAVIOURS INSTRUCTIONS: P l e a s e r e a d a l l I n f o r m a t i o n p r o v i d e d b e f o r e a n s w e r i n g t h e q u e s t i o n s In e a c h s e c t i o n . D e f i n i t i o n s : Fieldwork Instructor - an o c c u p a t i o n a l t h e r a p i s t o r p h y s i c a l t h e r a p i s t who i s a s s i g n e d r e s p o n s i b i l i t y f o r t e a c h i n g , s u p e r v i s i n g and e v a l u a t i n g a s t u d e n t In a d d i t i o n t o p a t i ent/c11ent c a r e a c t Iv111es. Fieldwork - t h e t i m e s t u d e n t s spend i n an a c c r e d i t e d c l i n i c a l s e t t i n g / f a c i l i t y a p p l y i n g t h e i r t h e o r e t i c a l k n o w l e d g e t o p a t i e n t / c l i e n t a s s e s s m e n t and I n t e r v e n t i o n . SECTION A : DEMOGRAPHIC INFORMATION  INSTRUCTIONS: P l e a s e check t h e most s u i t a b l e an swer t o e a c h q u e s t i o n . 1. Age - p l e a s e s t a t e i n y e a r s : 2. Sex M a l e Fema l e 3 . H i g h e s t l e v e l o f e d u c a t i o n a t t a i n e d : D i p l o m a In O . T . o r P . T . D i p l o m a i n O . T . & P . T . B a c h e l o r ' s d e g r e e In O . T . or P . T . B a c h e l o r ' s d e g r e e i n O . T . & P . T . M a s t e r ' s d e g r e e O t h e r , p l e a s e s t a t e 4 . Type o f s e t t i n g In w h i c h you have p r a c t i s e d most f r e q u e n t l y t h i s y e a r ( c h e c k o n l y o n e ) : I n p a t i e n t p r og r am - a c u t e c a r e o r r e h a b i I i t a t Ion I n p a t i e n t p rog ram - l o n g t e r m c a r e O u t p a t i e n t , day p rog r am o r communi ty s e r v i c e O t h e r , p l e a s e s t a t e 1.53 SECTION A: DEMOGRAPHIC INFORMATION 5 . Mo s t common c a t e g o r y o f p a t i e n t / c l i e n t p r o b l e m s i n y o u r p r a c t i c e t h i s y e a r ( check o n l y o n e ) : A d u l t p s y c h i a t r y P a e d l a t r l c p s y c h i a t r y A d u l t - p h y s i c a l d y s f u n c t i o n P a e d l a t r l c - p h y s i c a l d y s f u n c t i o n O t h e r , P l e a s e s t a t e 6 . Number o f y e a r s you have p r a c t i s e d o c c u p a t i o n a l t h e r a p y s i n c e g r a d u a t i o n ( s t a t e number o f y e a r s ) : 7 . Number o f f i e l d w o r k s t u d e n t s you have I n s t r u c t e d s i n c e g r a d u a t i o n : 0 - 5 s t u d e n t s 6 - 10 s t u d e n t s 11 - 15 s t u d e n t s 16 + s t u d e n t s 8 . a) Have you a t t e n d e d f i e l d w o r k I n s t r u c t o r p r e p a r a t i o n p r og r ams In t h e l a s t f i v e y e a r s ? Yes > P l e a s e c o m p l e t e q u e s t i o n 8 ( b ) No > P l e a s e p r o c e e d t o S e c t i o n B, o f t h e q u e s t i o n n a i r e b) F i e l d w o r k I n s t r u c t o r p r e p a r a t i o n p rog rams a t t e n d e d In t h e l a s t f i v e y e a r s ( c h e c k t h o s e w h i c h a p p l y ) : A 1-day ( o r a 2 , 1/2 day ) work shop o f f e r e d by t h e S c h o o l o f R e h a b i l i t a t i o n M e d i c i n e (SRM) t a t t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a (UBC) , In V i c t o r i a o r In P e n t i c t o n ! A 6 week c o u r s e o f f e r e d by t h e SRM, a t UBC (1983) A 1-2 hour I n s e r v i c e s e s s i o n o f f e r e d by t h e SRM A S e r i e s o f 2 o r 3 I n s e r v i c e s e s s i o n s o f f e r e d by t h e SRM O t h e r , p l e a s e s t a t e 154 A p p e n d i x A : S e c t i o n A - PTF R e s p o n d e n t s FIELDWORK INSTRUCTOR TRAITS AND BEHAVIOURS INSTRUCTIONS: P l e a s e r e a d a l l I n f o r m a t i o n p r o v i d e d b e f o r e a n s w e r i n g t h e q u e s t i o n s In each s e c t i o n . D e f i n i t i o n s : F ie ldwork I n s t ruc to r - an o c c u p a t i o n a l t h e r a p i s t o r p h y s i c a l t h e r a p i s t who i s a s s i g n e d r e s p o n s i b i l i t y f o r t e a c h i n g , s u p e r v i s i n g and e v a l u a t i n g a s t u d e n t i n a d d i t i o n t o p a t i e n t / c l i e n t c a r e a c t i v i t i e s . Fie ldwork - t h e t i m e s t u d e n t s spend i n an a c c r e d i t e d c l i n i c a l s e t t i n g / f a c i l i t y a p p l y i n g t h e i r t h e o r e t i c a l k n o w l e d g e t o p a t l e n t / c l l e n t a s s e s s m e n t and I n t e r v e n t i o n . SECTION A: DEMOGRAPHIC INFORMATION INSTRUCTIONS: P l e a s e check t h e most s u i t a b l e answer t o each q u e s t i o n . 1. Age - p l e a s e s t a t e i n y e a r s : 2 . Sex M a l e FemaIe 3. H i g h e s t l e v e l o f e d u c a t i o n a t t a i n e d : D i p l o m a In O . T . o r P . T . D i p l o m a i n O . T . & P . T . B a c h e l o r ' s d e g r e e i n O . T . o r P . T . B a c h e l o r ' s d e g r e e In O . T . & P . T . M a s t e r ' s d e g r e e O t h e r , p l e a s e s t a t e 4 . Type o f s e t t i n g In wh i ch you have p r a c t i s e d most f r e q u e n t l y t h i s y e a r ( check o n l y o n e ) : I n p a t i e n t p r og r am - a c u t e c a r e o r r e h a b 111 t a t Ion I n p a t i e n t p r og r am - l o n g t e r m c a r e O u t p a t i e n t , day p r o g r a m o r communi ty s e r v i c e O t h e r , p l e a s e s t a t e 155 SECTION A: DEMOGRAPHIC INFORMATION 5 . Mo s t common c a t e g o r y o f p a t i e n t / c l l e n t p r o b l e m s In y o u r p r a c t i c e t h i s y e a r ( check o n l y o n e ) : O b s t e t r i c s A d u l t , n e u r o l o g y A d u l t , c a r d l o - r e s p i r a t o r y A d u l t , o r t h o p a e d l c s / m u s c u l o - s k e l e t a l P a e d l a t r l c , n e u r o l o g y P a e d l a t r l c , c a r d t o - r e s p i r a t o r y P a e d l a t r l c , o r t h o p a e d l c s / m u s c u l o - s k e l e t a l O t h e r , P l e a s e s t a t e 6 . Number o f y e a r s you have p r a c t i s e d p h y s i c a l t h e r a p y s i n c e g r a d u a t i o n ( s t a t e number o f y e a r s ) : 7 . Number o f f i e l d w o r k s t u d e n t s you have i n s t r u c t e d s i n c e g r a d u a t i o n : 0 - 5 s t u d e n t s 6 - 10 s t u d e n t s 11 - 15 s t u d e n t s 16 + s t u d e n t s 8. a) Have you a t t e n d e d f i e l d w o r k i n s t r u c t o r p r e p a r a t i o n p rog rams i n t h e l a s t f i v e y e a r s : Yes > P l e a s e c o m p l e t e q u e s t i o n 8 (b ) No > P l e a s e p r o c e e d t o S e c t i o n B, o f t h e q u e s t i o n n a i r e b) F i e l d w o r k I n s t r u c t o r p r e p a r a t i o n p rog rams a t t e n d e d i n t h e l a s t f i v e y e a r s ( c h e c k t h o s e w h i c h a p p l y ) : A 1-day ( o r a 2 , 1/2 day ) work shop o f f e r e d by t h e S c h o o l o f R e h a b i l i t a t i o n M e d i c i n e (SRM) t a t t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a (UBC) o r i n V i c t o r i a ! A 1 - 2 hou r i n s e r v l c e s e s s i o n o f f e r e d by t h e SRM A S e r i e s o f 2 o r 3 i n s e r v l c e s e s s i o n s o f f e r e d by t h e SRM O t h e r , p l e a s e s t a t e 156 A p p e n d i x A : S e c t i o n A - OTS and PTS R e s p o n d e n t s FIELDWORK INSTRUCTOR TRAITS AND BEHAVIOURS INSTRUCTIONS: P l e a s e r e a d a l l I n f o r m a t i o n p r o v i d e d b e f o r e a n s w e r i n g t h e q u e s t i o n s In each s e c t i o n . D e f i n i t i o n s : Fieldwork Instructor - an o c c u p a t i o n a l t h e r a p i s t o r p h y s i c a l t h e r a p i s t who Is a s s i g n e d r e s p o n s i b i l i t y f o r t e a c h i n g , s u p e r v i s i n g and e v a l u a t i n g a s t u d e n t In a d d i t i o n t o p a t l e n t / c l l e n t c a r e a c t i v i t i e s . Fieldwork - t h e t i m e s t u d e n t s spend In an a c c r e d i t e d c l i n i c a l s e t t i n g / f a c i l i t y a p p l y i n g t h e i r t h e o r e t i c a l k n o w l e d g e t o p a t l e n t / c l l e n t a s s e s s m e n t and i n t e r v e n t i o n . SECTION A : DEMOGRAPHIC INFORMATION  INSTRUCTIONS: P l e a s e check t h e most s u i t a b l e answer t o each q u e s t i o n . 1. Age - p l e a s e s t a t e In y e a r s : _ 2. Sex M a l e _ Fema le _ 3 . A t t h e p r e s e n t t i m e I am r e g i s t e r e d as a ( c h e c k one w h i c h a p p l i e s ) : 3 r d y e a r O . T . s t u d e n t _ 4 t h y e a r O.T. s t u d e n t _ 3 r d y e a r P . T . s t u d e n t _ 4 t h y e a r P . T . s t u d e n t _ PLEASE PROCEED TO SECTION B 157 A p p e n d i x A : S e c t i o n B - A l l R e s p o n d e n t s SECTION B: FIELDWORK INSTRUCTOR TRAITS AND BEHAVIOURS T h i s s e c t i o n o f t h e q u e s t i o n n a i r e l i s t s t r a i t s and b e h a v i o u r s w h i c h d e s c r i b e t h e b r o a d r o l e of t h e r a p i s t s as f i e l d w o r k I n s t r u c t o r s . You a r e a s k e d t o r a t e t h e d e g r e e t o w h i c h each t r a i t o r b e h a v i o u r c o n t r i b u t e s t o t h e e f f e c t i v e n e s s o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e . S p e c i f i c a l l y " T o what decree I s t h i s f i e l d w o r k i n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? EXAMPLE: • P r e s e n t f o r m a l l e c t u r e s on o f low o f e x t r e m e i m p o r t a n t c l i n i c a l t o p i c s ' I m p o r t a n c e 1 2 3 4 5 i m p o r t a n c e I f you gave t h i s b e h a v i o u r a r a t i n g o f 5, t h i s wou ld mean t h a t you p e r c e i v e t h a t i t i s extremely Important In c o n t r i b u t i n g t o t h e e f f e c t i v e n e s s o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e . I f you gave t h i s b e h a v i o u r a r a t i n g o f 1, t h i s wou l d mean t h a t you p e r c e i v e t h a t I t has low Importance In c o n t r i b u t i n g t o t h e e f f e c t i v e n e s s o f s t u d e n t ' s f i e l d w o r k e x p e r i e n c e . I f you b e l i e v e t h a t t h a t t h i s b e h a v i o u r i s n e i t h e r e x t r e m e l y I m p o r t a n t nor o f low I m p o r t a n c e you can s e l e c t t h e r a t i n g ( 2 , 3 o r 4) wh i ch b e s t r e f l e c t s y o u r o p i n i o n o f I t s degree of Importance In c o n t r i b u t i n g t o t h e e f f e c t i v e n e s s o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e . You s h o u l d a t t e m p t t o use t h e f u l l r a n g e o f t h e s c a l e i n d i f f e r e n t i a t i n g t h e d e g r e e o f i m p o r t a n c e o f e a c h t r a i t and b e h a v i o u r , In o r d e r t o c l e a r l y I d e n t i f y t h e t r a i t s and b e h a v i o u r s wh i ch you b e l i e v e a r e e x t r e m e l y I m p o r t a n t In c o n t r i b u t i n g t o t h e e f f e c t i v e n e s s o f s t u d e n t ' s f i e l d w o r k e x p e r i e n c e . Some t r a i t s o r b e h a v i o u r s l i s t e d on t h e f o rm a r e s i m i l a r t o each o t h e r , b u t t h e y a r e not I d e n t i c a l . Make y o u r r a t i n g o f each t r a i t o r b e h a v i o u r a s e p a r a t e and I ndependen t j u d g e m e n t . Your f i r s t I m p r e s s i o n s , o r y o u r Immed ia te " f e e l i n g s " a b o u t t h e r a t i n g f o r each t r a i t o r b e h a v i o u r w i l l be t h e b e s t g u i d e f o r y ou r r e s p o n s e s . P l e a s e p r o c e e d t o S e c t i o n B o f t h e q u e s t i o n n a i r e . 158 SECTION B: FIELDWORK INSTRUCTOR TRAITS AND BEHAVIOURS To what degree I s t h i s f i e l d w o r k I n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? ( C i r c l e t h e number w h i c h b e s t r e p r e s e n t s y o u r p e r c e p t i o n o f t h e d e g r e e o f i m p o r t a n c e )  TRA TS OR BEHAVIOURS 1 . Summar i ze m a j o r p o i n t s a t t h e end o f an i n s t r u c t i o n a l s e s s i o n o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 2 . E x p l a i n c l e a r l y , t h e b a s i s f o r own a c t i o n s o f low I m p o r t a n c e 1 2 3 4 5 of e x t r e m e I m p o r t a n c e 3 . D i s p l a y f l e x l b l 1 i t y and a d a p t a b l 1 i t y o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 4 . D e m o n s t r a t e l e a d e r s h i p among p e e r s o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 5 . R e l a t e s t u d e n t ' s a c a d e m i c knowledge t o c l i n i c a l p r a c t i c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 6 . A d m i t l i m i t a t i o n s and m i s t a k e s h o n e s t ) y o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 7 . Make s p e c i f i c s u g g e s t i o n s f o r improvement o f p e r f o r m a n c e o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 8 . A p p l y b a s i c t e s t i n g and e v a l u a t i o n p r i n c i p l e s when e v a l u a t i n g s t u d e n t s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 9 . F o r m u l a t e s p e c i f i c , c l e a r l y s t a t e d f i e l d w o r k o b j e c t i v e s w i t h a s s i s t a n c e f rom U n i v e r s i t y p rog ram o r o t h e r t h e r a p i s t s as n e c e s s a r y o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 1 0 . O r i e n t s t u d e n t t o c l i n i c a l s e t t t n g / f a c i 1 I t y o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 1 1 . E v a l u a t e t h e e f f e c t i v e n e s s o f t h e f i e l d w o r k p rog ram d u r i n g and a t the end o f each f i e l d w o r k e x p e r i e n c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 1 2 . Sequence i n s t r u c t i o n so t h a t o b s e r v a t i o n o f t h e r a p i s t p r e c e d e s s t u d e n t ' s s u p e r v i s e d p r a c t i c e o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 13 . P r o v i d e f e e d b a c k t o t h e s t u d e n t In p r i v a t e e x c e p t when Immed ia te f e e d b a c k i s c r i t i c a l t o p a t i e n t c a r e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 159 To what degree Is t h i s f i e l d w o r k I n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? ( C i r c l e t h e number w h i c h b e s t r e p r e s e n t s y o u r p e r c e p t i o n o f t h e d e g r e e o f I m p o r t a n c e )  TRA TS OR BEHAVIOURS 1 4 . R e q u e s t f e e d b a c k f rom t h e s t u d e n t r e g a r d i n g t h e f i e l d w o r k p rog ram o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 1 5 . Manage t i m e wel1 o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 1 6 . C i t e u p - t o - d a t e r e f e r e n c e s w h i c h a r e I m p o r t a n t t o a r e a o f p r a c t i c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 1 7 . E n c o u r a g e s t u d e n t t o a c c e p t r e s p o n s i b i l i t y f o r own l e a r n i n g o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 1 8 . O b s e r v e s t u d e n t ' s p e r f o r m a n c e In s u c h a way as no t t o i n t i m i d a t e the s t u d e n t o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 1 9 . C h a i r s t a f f m e e t i n g s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 2 0 . Use u p - t o - d a t e c l i e n t / p a t i e n t a s s e s s m e n t and I n t e r v e n t i o n p r o c e d u r e s o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 2 1 . P r o v i d e f e e d b a c k w i t h o u t b e l l t t l l n c s t u d e n t o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 2 2 . Remain r e a d i l y a c c e s s i b l e t o s t u d e n t ( s ) a n d / o r a s s i g n a l t e r n a t e r e s o u r c e p e r s o n o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 2 3 . A r r a n g e t i m e f o r I n t e r a c t i o n w i t h e a c h s t u d e n t d a l l y o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 2 4 . P r e s e n t I n f o r m a t i o n c l e a r l y and s u c c i n c t l y o f low I m p o r t a n c e 1 2 3 4- 5 o f e x t r e m e I m p o r t a n c e 2 5 . D e m o n s t r a t e s e n s i t i v i t y t o t h e needs o f o t h e r s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 2 6 . P r o v i d e o p p o r t u n i t i e s f o r s u p e r v i s e d and u n s u p e r v i s e d p r a c t i c e a p p r o p r i a t e t o t h e s t u d e n t ' s l e v e l o f f i e l d w o r k e x p e r 1 e n c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 2 7 . E n c o u r a g e a c t i v e p a r t i c i p a t i o n i n d i s c u s s i o n s / c l i e n t c o n f e r e n c e s o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 160 To what degree I s t h i s f i e l d w o r k I n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? ( C i r c l e t h e number w h i c h b e s t r e p r e s e n t s y o u r p e r c e p t i o n o f t h e d e g r e e o f I m p o r t a n c e )  TRAITS OR BEHAVIOURS 2 8 . B a s e a s s e s s m e n t o f s t u d e n t p e r f o r m a n c e on t h e d e g r e e t o w h i c h t h e f i e l d w o r k o b j e c t i v e s have been met 2 9 . P r o v i d e f r e q u e n t f e e d b a c k on s t u d e n t p e r f o r m a n c e 3 0 . Draw i n f o r m a t i o n f r om r e l a t e d f i e l d s e . g . s o c i o l o g y , p h y s i o l o g y . . . In c o n s i d e r i n g p a t l e n t / c l I e n t p r o b l e m s 3 1 . D e v e l o p l o g i c a l s t r a t e g i e s f o r r e s o l v i n g s t u d e n t d i f f i c u l t i e s 3 2 . D i s p l a y c r i t i c a l and a n a l y t i c a l t h i n k i n g 3 3 . P r e s e n t s t u d e n t as a ' p r o f e s s i o n a l ' t o c l i e n t s / p a t i e n t s , and a l l s t a f f 3 4 . G e a r I n s t r u c t i o n t o s t u d e n t ' s l e v e l o f k n o w l e d g e 3 5 . F r e q u e n t l y o b s e r v e s t u d e n t ' s p r o g r e s s t o w a r d o b j e c t i v e s 3 6 . Show empathy f o r o t h e r s 3 7 . R e v i s e f i e l d w o r k p r og r am ba sed on r e s u l t s o f e v a l u a t i o n 3 8 . F o r m u l a t e f i e l d w o r k o b j e c t i v e s w h i c h f o c u s on t h e I m p o r t a n t c l i n i c a l a c t i v i t i e s o f t h e f i e l d w o r k I n s t r u c t o r and match p r o f e s s i o n a l e n t r y - l e v e l r e q u i r e m e n t s o f t h e p r o f e s s i o n 3 9 . An swer q u e s t i o n s c a r e f u l l y and p r e c i s e l y 4 0 . P r o v i d e s f e e d b a c k r e l a t e d t o a l l I m p o r t a n t a r e a s o f p e r f o r m a n c e 4 1 . M a i n t a i n an o n g o i n g r e c o r d o f a s s e s s m e n t s o f s t u d e n t p e r f o r m a n c e o f low o f e x t r e m e i m p o r t a n c e 1 2 3 4 5 i m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 i m p o r t a n c e o f low o f e x t r e m e i m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e i m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e i m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 i m p o r t a n c e o f low . o f e x t r e m e i m p o r t a n c e 1 2 3 4 5 i m p o r t a n c e o f low o f e x t r e m e i m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e i m p o r t a n c e 1 2 3 4 5 i m p o r t a n c e 161 To what degree I s t h i s f i e l d w o r k I n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? ( C i r c l e t h e number w h i c h b e s t r e p r e s e n t s y o u r p e r c e p t i o n o f t h e d e g r e e o f I m p o r t a n c e )  TRA TS OR BEHAVIOURS 4 2 . Take r e s p o n s i b i l i t y f o r own a c t i o n s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 4 3 . I n t e r a c t c o n f i d e n t l y and e f f e c t i v e l y w i t h c o l l e a g u e s , s t u d e n t ( s ) and o t h e r members o f the h e a l t h team o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 4 4 . D e m o n s t r a t e p o s i t i v e r e g a r d f o r the s t u d e n t ( s ) o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 4 5 . A d o p t a p p r o p r i a t e p r o f e s s i o n a l r o l e ( a s a t h e r a p i s t ) on h e a l t h team o f low 1mpo r t ance 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 4 6 . D e s c r i b e t h e u s e f u l n e s s o f common a u d i o - v i s u a l e q u i p m e n t i n p a t i e n t e d u c a t i o n p r o g r a m s e . g . o v e r h e a d p r o j e c t o r , s l i d e s . . . . o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 4 7 . A d o p t a n o n - d e f e n s i v e s t a n c e i n r e c e i v i n g f e e d b a c k f rom o t h e r s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 4 8 . F o r m u l a t e f i e l d w o r k o b j e c t i v e s w h i c h a r e c o n s i s t e n t w i t h u n i v e r s i t y g o a l s f o r f i e l d w o r k o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 4 9 . D e m o n s t r a t e s e l f - c o n t r o l and p a t i e n c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 5 0 . S e l e c t a v a r i e t y o f s u i t a b l e c l i e n t s / p a t i e n t s f o r s t u d e n t ( s ) c o n t a c t o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 5 1 . P o i n t o u t weakne s s e s In s t u d e n t p e r f o r m a n c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 5 2 . S u p e r v i s e s t u d e n t ( s ) w i t h o u t t a k l n c o v e r , u n l e s s a b s o l u t e l y n e c e s s a r y o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 5 3 . Q u e s t i o n , s t u d e n t ( s ) t o e l i c i t r e a s o n s u n d e r l y i n g t h o u g h t s o r a c t i o n s o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 5 4 . R e v i e w e v a l u a t i o n f o rm f o r m a l l y w i t h t h e s t u d e n t ( s ) a t m i d - t e r m , and a t t h e end o f t h e f i e l d w o r k e x p e r i e n c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 5 5 . D e m o n s t r a t e c o n f i d e n c e as a p r o f e s s i o n a l o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 162 T o what degree i s t h i s f i e l d w o r k i n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? ( C i r c l e t h e number w h i c h b e s t r e p r e s e n t s y o u r p e r c e p t i o n o f t h e d e g r e e o f I m p o r t a n c e )  TRA ITS OR BEHAVIOURS 5 6 . D e m o n s t r a t e k n o w l e d g e , s k i l l s and a t t i t u d e s t h a t a r e t o be d e v e l o p e d by t h e s t u d e n t ( s ) 5 7 . P r e s e n t I n s e r v i c e p r o g r a m s t h a t arc we I I o r g a n i s e d 5 8 . D i s p l a y a s e n s e o f humor 5 9 . N e g o t i a t e a l e a r n i n g c o n t r a c t w i t h e a c h s t u d e n t , b a s e d on t h e w r i t t e n f i e l d w o r k o b j e c t i v e s and t h e s t u d e n t ' s p a s t e x p e r i e n c e . 6 0 . F o r m u l a t e f i e l d w o r k o b j e c t i v e s w h i c h s p e c i f y t h e k n o w l e d g e , s k l l l j and a t t i t u d e s t o be a c q u i r e d d u r l n c t h e f i e l d w o r k e x p e r i e n c e 6 1 . P r e s e n t i n f o r m a t i o n i n an o r g a n l s e c manner 6 2 . F o r m u l a t e f i e l d w o r k o b j e c t i v e s w h i c h a r e r e a l i s t i c g i v e n t h e a c a d e m i c l e v e l and p a s t e x p e r i e n c e o f t h e s t u d e n t ( s ) 6 3 . A s s e s s s t u d e n t ( s ) k n o w l e d g e and a s s i g n l e a r n i n g t a s k s a c c o r d i n g l y 6 4 . G r a d e t h e f i e l d w o r k p r og r am t o b u l I d s t u d e n t ( s ) s k i I Is 6 5 . A d m i n i s t e r c l i e n t / p a t i e n t a s s e s s m e n t s and I n t e r v e n t i o n s c o m p e t e n t Iy 6 6 . F a c i l i t a t e I n dependen t l e a r n i n g ( f o r e x a m p l e , d i r e c t s t u d e n t t o u s e f u l r e f e r e n c e s , s u g g e s t commun i t y r e s o u r c e s f o r r e v i e w , r e f e r s t u d e n t t o p o l i c y m a n u a l s , . . . e t c . ) 6 7 . A p p r o a c h t e a c h i n g w i t h e n t h u s i a s m o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 i m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 i m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e o f low o f e x t r e m e I m p o r t a n c e 1 2 3 4 5 I m p o r t a n c e 163 To what degree i s t h i s f i e l d w o r k I n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? ( C i r c l e t h e number w h i c h b e s t r e p r e s e n t s y o u r p e r c e p t i o n o f t h e d e g r e e o f I m p o r t a n c e )  TRA TS OR BEHAVIOURS 6 8 . C o - o r d i n a t e c l t e n t / p a t i e n t , a d m i n i s t r a t i v e and s t u d e n t - r e l a t e d a c t i v i t i e s w i t h i n c l i n i c a l s e t t i n g / f a c l 1 I t y o f low I m p o r t a n c e 1 2 3 4 5 of e x t r e m e I m p o r t a n c e 6 9 . R e c o r d p a t l e n t / c l l e n t a t t e n d a n c e s t a t i s t i c s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 7 0 . D e m o n s t r a t e dynamism and e n e r g y i n t h e f i e l d w o r k i n s t r u c t o r r o l e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 7 1 . E n c o u r a g e s t u d e n t q u e s t i o n s , o p i n i o n s and r e q u e s t s f o r a s s 1 s t a n c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 7 2 . S t i m u l a t e s t u d e n t ' s I n t e r e s t i n , and e n t h u s i a s m f o r t h e p r o f e s s i o n o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 7 3 . P r o v i d e c o n s t r u c t i v e f e e d b a c k o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 7 4 . A c k n o w l e d g e s t u d e n t o u t s i d e work e n v i r o n m e n t o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 7 5 . C o u n s e l s t u d e n t ( s ) In d i f f i c u l t y o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 7 6 . L i s t e n a t t e n t i v e l y t o s t u d e n t ( s ) o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 7 7 . M o d i f y I n s t r u c t i o n a l p l a n i n r e s p o n s e t o s t u d e n t s ' c h a n g i n g needs ( a s t h e s e a r e p e r c e i v e d by f i e l d w o r k I n s t r u c t o r and s t u d e n t ) o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 7 8 . P r o v i d e l e c t u r e s on i m p o r t a n t c l i n i c a l t o p i c s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 7 9 . U t i l i z e a s u p e r v i s o r y a p p r o a c h w h i c h Is a p p r o p r i a t e t o t h e s t u d e n t ( s ) l e a r n i n g s t y l e o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 8 0 . P r o v i d e f e e d b a c k w h i c h Is c o n s 1 s t e n t o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 81 . A l l o w t h e s t u d e n t p r o g r e s s i v e I ndependence o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 164 To what degree I s t h i s f i e l d w o r k I n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? ( C i r c l e t h e number w h i c h b e s t r e p r e s e n t s y o u r p e r c e p t i o n o f t h e d e g r e e o f TRA TS OR BEHAVIOURS 8 2 . P r o v i d e p o s i t i v e f e e d b a c k on p e r f o r m a n c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 8 3 . S u g g e s t ways In w h i c h s t u d e n t can m o n i t o r own p r o g r e s s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 8 4 . Document e v a l u a t i o n a c c u r a t e l y o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 8 5 . Commun i ca te w i t h s t u d e n t ( s ) In a n o n - t h r e a t e n i n g manner o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 8 6 . P r o v i d e I n s t r u c t i o n r e l a t e d t o f i e l d w o r k o b j e c t i v e s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 8 7 . Ask q u e s t i o n s d e s i g n e d t o f o s t e r d e v e l o p m e n t o f p r o b l e m - s o l v i n g s k i 1 Is o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 8 8 . S e l e c t methods f o r a s s e s s i n g t h e d e g r e e t o w h i c h t h e f i e l d w o r k o b j e c t i v e s have been r e a c h e d o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 8 9 . O p e r a t e a u d i o - v i s u a l e q u i p m e n t c o r r e c t 1y o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 9 0 . F o r m u l a t e f i e l d w o r k o b j e c t i v e s w h i c h can be a c c o m p l i s h e d r e a l i s t i c a l l y ' In t h e t i m e a v a l l a b l e o f low i m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 91 . U t i l i z e a s u p e r v i s o r y a p p r o a c h w h i c h i s a p p r o p r i a t e t o t h e s t u d e n t ' s l e v e l o f f i e l d w o r k e x p e r i e n c e o f low 1mpo r t ance 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 9 2 . A s s i s t t h e s t u d e n t In p r e p a r i n g t o a d d r e s s new o r d i f f i c u l t p r a c t i c e p r o b lems o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 8 3 . P r o v i d e s u p p o r t and e n c o u r a g e m e n t f o r s t u d e n t t o r e a c h o p t i m a l l e v e l o f p e r f o r m a n c e o f low 1mpo r t ance 1 2 3 4 5 o f e x t r e m e i m p o r t a n c e 9 4 . P r o v i d e t i m e f o r d i s c u s s i o n and q u e s t i o n s on a r e g u l a r b a s i s o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e 165 To what degree I s t h i s f i e l d w o r k I n s t r u c t o r t r a i t o r b e h a v i o u r Important In c o n t r i b u t i n g t o t h e effectiveness o f a s t u d e n t ' s f i e l d w o r k e x p e r i e n c e ? ( C i r c l e t h e number wh i ch b e s t r e p r e s e n t s y o u r p e r c e p t i o n o f t h e d e g r e e o f I m p o r t a n c e )  TRA ITS OR BEHAVIOURS 9 5 . A r r a n g e l e a r n i n g a c t i v i t i e s w h i c h c h a l l e n g e s t u d e n t ( s ) w h i l e m a x i m i z i n g t h e i r c h a n c e s f o r s u c c e s s 9 6 . P r o v i d e f e e d b a c k I m m e d i a t e l y f o l l o w i n g s t u d e n t p e r f o r m a n c e , whe re p o s s i b l e 9 7 . D e v e l o p an I n s t r u c t i o n a l p l a n t o meet o b j e c t i v e s f o r t h e f i e l d w o r k e x p e r i e n c e 9 8 . R e l a t e t h e f i e l d w o r k o b j e c t i v e s c l e a r l y t o t h e U n i v e r s i t y e v a l u a t i o n f o rm 9 9 . A p p l y c u r r e n t t h e o r i e s t o p r a c t i c e 100 . P r e p a r e m a t e r i a l t o g u i d e t h e s t u d e n t d u r i n g t h e e x p e r i e n c e ( f o r e x a m p l e , f a c i l i t y map, s c h e d u l e s of m e e t i n g s , r o u n d s , l o c a t i o n o f r e f e r e n c e m a t e r i a l , . . . . e t c . ) 1 0 1 . F o l l o w f l e i d w o r k p r o c e d u r e s / p o l i c i e s e s t a b l i s h e d by t h e s t u d e n t ' s u n i v e r s i t y p rog ram 1 0 2 . D e v e l o p a p l a n f o r o r i e n t i n g t h e s t u d e n t ( s ) t o t h e c l i n i c a l s e t t i n g / f a c i l i t y 1 0 3 . E n s u r e t h a t t h e s t u d e n t ( s ) has amp le o p p o r t u n i t y t o p r a c t i c e a c t i v i t i e s w h i c h a r e t o be e v a l u a t e d 104 . E s t a b l i s h an e n v i r o n m e n t In w h i c h t h e s t u d e n t f e e l s c o m f o r t a b l e 1 0 5 . D i s c u s s I s s u e s w i t h t h e s t u d e n t o p e n l y o f low I m p o r t a n c e o f low I m p o r t a n c e o f low I m p o r t a n c e o f low I m p o r t a n c e o f low i m p o r t a n c e o f low I m p o r t a n c e o f low I m p o r t a n c e o f low I m p o r t a n c e o f low I m p o r t a n c e o f low I m p o r t a n c e o f low I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e o f e x t r e m e 1 2 3 4 5 i m p o r t a n c e of e x t r e m e 1 2 3 4 5 I m p o r t a n c e o f e x t r e m e 1 2 3 4 5 I m p o r t a n c e 1 2 3 4 5 o f e x t r e m e I m p o r t a n c e o f e x t r e m e 1 2 3 4 5 i m p o r t a n c e o f e x t r e m e 1 2 3 4 5 i m p o r t a n c e o f e x t r e m e 1 2 3 4 5 I m p o r t a n c e o f e x t r e m e 1 2 3 4 5 I m p o r t a n c e o f e x t r e m e 1 2 3 4 5 I m p o r t a n c e o f e x t r e m e 1 2 3 4 5 I m p o r t a n c e THANK YOU FOR YOUR CO-OPERATION IN COMPLETING THIS QUESTIONNAIRE. 166 APPENDIX B Competencies Listed by Category Page 167 167 APPENDIX B COMPETENCIES LISTED BY CATEGORY Professional Competence Demonstrate leadership among peers Manage time well Cite up-to-date references which are important to area of practice Chair staff meetings Use up-to-date cl ient/patient assessment and intervention procedures Draw information from related fields e.g. sociology, physiology. . . . in considering patient/cl ient problems Display c r i t i c a l and analytical thinking Interact confidently and effectively with colleagues, student(s) and other members of the health team Adopt appropriate professional role (as a therapist) on health team Demonstrate knowledge, sk i l l s and attitudes that are to be developed by the student(s) Administer cl ient/patient assessments and interventions competently Co-ordinate c l ient /pat ient , administrative and student-related act iv i t ies within c l in ica l se t t ing/ fac i l i ty Record patient/cl ient attendance stat is t ics Apply current theories to practice Teaching Behaviours Summarize major points at the end of an instructional session Relate student's academic knowledge to c l in ica l practice 168 Formulate specif ic , clearly stated fieldwork objectives with assistance from University program or other therapists as necessary Orient student to c l in ica l se t t ing/ fac i l i ty Sequence instruction so that observation of therapist precedes student's supervised practice Encourage student to accept responsibility for own learning Arrange time for interaction with each student daily Present information clearly and succinctly Provide opportunities for supervised and unsupervised practice appropriate to the student's level of fieldwork experience Encourage active participation in discussions/client conferences Gear instruction to student's level of knowledge Revise fieldwork program based on results of evaluation Formulate fieldwork objectives which focus on the important c l in ica l act iv i t ies of the fieldwork instructor and match professional entry-level requirements of the profession Describe the the usefulness of common audio-visual equipment in patient education programs e.g. overhead projector, slides Select a variety of suitable clients/patients for student(s) contact Assist the student in preparing to address new or d i f f i c u l t practice problems Formulate fieldwork objectives which are consistent with university goals for fieldwork Fac i l i ta te independent learning (for example, direct student to useful references, suggest community resources for review, refer student to policy manuals, . . . etc.) Negotiate a learning contract with each student, based on the written fieldwork objectives and the student's past experience Formulate fieldwork objectives which specify the knowledge, s k i l l s and attitudes to be acquired during the fieldwork experience 169 Present inservice programs that are well organised Present information in an organised manner Formulate fieldwork objectives which are rea l i s t i c given the academic level and past experience of the student(s) Assess student(s) knowledge and assign learning tasks accordingly Grade the fieldwork program to build student(s) sk i l l s Modify instructional plan in response to students' changing needs (as these are perceived by fieldwork instructor and student) Provide lectures on important c l in ica l topics Suggest ways in which student can monitor own progress Provide time for discussion and questions on a regular basis Provide instruction related to fieldwork objectives Operate audio-visual equipment correctly Formulate fieldwork objectives which can be accomplished rea l i s t i ca l l y in the time available Arrange learning act iv i t ies which challenge student(s) while maximizing their chances for success Relate the fieldwork objectives clearly to the University evaluation form Prepare material to guide the student during the experience (for example, f a c i l i t y map, schedules of meetings, rounds, location of reference material etc.) Follow fieldwork procedures/policies established by the student's university program Develop a plan for orienting the student(s) to the c l in ica l sett ing/ fac i l i ty Ensure that the student(s) has ample opportunity to practice act iv i t ies which are to be evaluated Develop an instructional plan to meet objectives for the fieldwork experience 170 Supervisory Behaviours Provide feedback to the student in private except when immediate feedback is c r i t i c a l to patient care Make specific suggestions for improvement of performance Observe student's performance in such as way as not to intimidate the student Remain readily accessible to student(s) and/or assign alternate resource person Develop logical strategies for resolving student d i f f i cu l t i e s Frequently observe student's progress toward objectives Provide feedback related to al l important areas of performance Provide frequent feedback on student performance Provide feedback immediately following student performance, where possible Point out weaknesses in student performance Supervise student(s) without taking over, unless absolutely necessary Ut i l i z e a supervisory approach which is appropriate to the student(s) learning style Provide feedback which is consistent Allow the student progressive independence Counsel student(s) in d i f f icul ty Provide constructive feedback Ut i l i ze a supervisory approach which is appropriate to the student's level of fieldwork experience Provide positive feedback on performance 171 Communication Behaviours Explain c learly , the basis for own actions Provide feedback without be l i t t l ing student Discuss issues with the student openly Answer questions carefully and precisely Question student(s) to e l i c i t reasons underlying thoughts or actions Listen attentively to* student(s) Communicate with student(s) in a non-threatening manner Ask questions designed to foster development of problem-solving sk i l l s Encourage student questions, opinions and requests for assistance Evaluation Behaviours Apply basic testing and evaluation principles when evaluating students Evaluate the effectiveness of the fieldwork program during and at the end of each fieldwork experience Request feedback from the student regarding the fieldwork program Maintain an ongoing record of assessments of student performance Select methods for assessing the degree to which the fieldwork objectives have been reached Base assessment of student performance on the degree to which the fieldwork objectives have been met Document evaluation accurately Review evaluation form formally with the student(s) at mid-term, and at the end of the fieldwork experience 172 Personal characterist ics/traits Admit limitations and mistakes honestly Display f l e x i b i l i t y and adaptability Demonstrate sensit ivity to the needs of others Show empathy for others Present student as a 'professional ' to cl ients/patients, and al l staff Approach teaching with enthusiasm Demonstrate confidence as a professional Adopt a non-defensive stance in receiving feedback from others Demonstrate self-control and patience Demonstrate positive regard for the student(s) Take responsibil ity for own actions Display a sense of humor Provide support and encouragement for student to reach optimal level of performance Establish an environment in which the student feels comfortable Demonstrate dynamism and energy in the fieldwork instructor role Acknowledge student outside work environment Stimulate student's interest in, and enthusiasm for the profession 173 APPENDIX C MEAN RATINGS OF IMPORTANCE FOR EACH OF THE 105 COMPETENCIES, BY GROUP(S) Section Page 1. OTF, PTF, OTS and PTS Groups 174 2. A l l in s t ructor s , A l l Students, A l l O.T.'s and A l l P.T.'s 177 3. A l l Subjects Combined 180 174 APPENDIX C Section 1: OTF, PTF, OTS AND PTS GROUPS GROUP OTF GROUP PTF GROUP OTS GROUP 1 PTS N MEAN N MEAN N MEAN N MEAN QI 49 4.3673 55 4.1636 33 4.0606 33 3.6970 Q2 49 4.5102 55 4.7091 33 4.6364 33 4.7273 Q3 50 4.5600 55 4.4909 33 4.4848 32 4.4063 Q4 49 3.1837 55 3.1455 33 3.2424 32 3 .0625 Q5 50 4.3400 55 4.5818 33 4.3030 33 4.5455 Q6 50 4.5800 55 4.5455 33 4.5758 33 4.2121 Q7 50 4.7800 55 4.7636 33 4.7576 33 4.6061 Q8 48 3.7708 54 4.0556 33 3.5152 32 3.7188 Q9 50 4.3800 54 4.1481 33 4.4848 33 3.7576 Q10 50 4.4200 55 4.3091 33 3.8485 33 3.8788 Q l l 49 4.4490 55 4.4182 33 4.5152 33 4.1212 Q12 49 4.2041 55 4.0909 33 4.4242 33 4.3333 Q13 49 4.4694 55 4.5455 33 4.3939 32 4.2500 Q14 50 4.5600 55 4.4727 33 4.2424 33 3.8485 Q15 50 4.2200 55 4.1636 33 3.9394 32 3.7188 016 50 3.4800 54 3.6481 33 3.0909 33 3.6667 Q17 50 4.4200 55 4.4727 33 4.2424 33 4.0606 Q18 50 4.5000 55 4.6545 33 4.7879 33 4.5758 Q19 49 1.9388 55 1.6182 33 1.7879 33 1.3939 Q20 50 4.2400 55 4.2182 33 4.4242 33 4.1515 Q21 50 4.9400 55 4.8000 33 4.9091 33 4.5152 Q22 50 4.5800 55 4.7091 33 4.7273 33 4.1818 Q23 50 4.2600 55 4.1636 33 4.0000 33 3.5455 Q24 50 4.5000 55 4.4364 33 4.2727 33 4.0606 Q25 50 4.5200 55 4.4364 33 4.2727 33 4.3030 Q26 50 4.6600 55 4.6909 33 4.8788 33 4.8485 Q27 50 4.3400 55 4.1818 33 4.3030 33 4.1212 Q28 49 4.0408 55 4.1091 33 3.5758 33 3.7879 Q29 50 4.6600 55 4.5273 33 4.6970 33 4.4242 Q3 0 50 3.7200 55 3.7455 33 3.6970 33 3.7273 Q31 50 4.2000 55 4.2545 33 4.0909 33 4.0303 Q32 50 3.7800 55 4.0727 33 4.0000 33 4.2424 Q33 50 4.4600 55 4.3091 33 4.3030 33 4.1818 Q34 50 4.6200 55 4.5273 33 4.5152 33 4.2727 Q35 49 4.3469 55 4.4000 33 4.1818 33 3.9091 Q36 50 4.3800 55 4.2727 33 4.4242 33 4.1212 Q37 50 4.1000 54 4.2222 33 4.3939 32 4.1250 Q38 47 3.9787 53 3.7925 33 4.0000 32 3.9688 Q39 50 4.2400 55 4.4182 33 3.9697 33 4.0909 Q40 50 4.6000 55 4.4909 33 4.6667 33 4.1818 175 Q41 50 3.9200 55 4.0000 33 3.5758 33 3.3636 Q42 50 4.8200 54 4.7037 33 4.3333 32 4.1250 Q43 50 4.7000 55 4.4000 33 4.5758 33 4.2424 Q44 50 4.8400 55 4.7273 33 4.7273 33 4.4545 Q45 49 4.7551 54 4.5741 33 4.6061 33 4.4242 Q46 50 2.7000 55 2.7818 33 2.3939 33 2.2727 Q47 49 4.5510 55 4.3455 33 4.4848 33 4.0303 Q48 50 4.2200 55 4.2182 33 4.3030 33 3.5758 Q49 50 4.2200 55 4.3455 33 4.2727 33 3.9091 Q50 50 4.4400 55 4.5273 33 4.6364 33 4.4242 Q51 50 3.9000 55 4.4000 33 4.6061 33 4.6061 Q52 50 4.5000 55 4.4909 33 4.6364 33 4.7273 Q53 50 4.3200 55 4.4727 33 4.0000 33 4.5152 Q54 50 4.7400 55 4.5455 33 4.6970 33 4.3939 Q55 50 4.7000 55 4.5455 33 4.5758 33 4.4545 Q56 50 4.3600 54 4.4444 33 4.6061 32 4.4375 Q57 50 3.1800 55 3.3818 33 2.6970 33 2.9697 Q58 50 4.2600 55 3.8182 33 3.9697 33 3.6970 Q59 50 3.4800 55 3.3273 33 4.0303 32 3.4063 Q6 0 50 4.4000 55 4.2909 33 4.4848 32 3.7500 Q61 50 4.2000 55 4.3091 33 4.2727 33 4.0303 Q62 50 4.6000 55 4.4545 33 4.9091 33 4.5152 Q63 50 4.2200 55 4.3273 33 4.4242 33 4.1212 Q64 50 4.4400 55 4.2909 33 4.5758 32 4.2813 Q65 50 4.6400 55 4.4545 33 4.4545 33 4.2727 Q66 50 4.3200 55 4.4727 33 3.9394 33 4.0606 Q67 50 4.8200 55 4.5455 33 4.5758 33 4.4545 Q68 48 3.8958 54 3.8333 33 3.6061 33 3.3333 Q69 50 3.0000 55 3.6182 33 2.6667 33 2.2121 Q70 50 4.2400 54 4.2037 33 4.0606 33 3.8788 Q71 50 4.8000 55 4.7455 33 4.6667 33 4.4242 Q72 50 4.6800 55 4.3636 33 4.4545 33 4.1818 Q73 50 4.9400 55 4.8364 33 4.8182 33 4.7879 Q74 50 3.6600 55 3.7091 33 3.5758 33 3.5455 Q75 50 4.0000 55 4.3273 33 3.9697 33 3.9091 Q76 50 4.7000 55 4.6545 33 4.6970 33 4.3636 Q77 50 4.6800 55 4.5273 33 4.6970 33 4.2121 Q78 50 2.7600 55 2.9273 33 2.3030 33 2.3636 Q79 50 4.0800 55 4.0909 33 4.0000 33 4.0303 Q80 50 4.6200 54 4.6111 33 4.6667 33 4.4242 Q81 50 4.7000 55 4.7455 33 4.8182 33 4.7879 Q82 50 4.7000 55 4.6909 33 4.6 97 0 33 4.4545 Q83 50 3.8400 55 3.9091 33 3.9394 33 3.7273 Q84 50 4.3800 55 4.4545 33 4.5758 33 3.9091 Q85 50 4.7400 55 4.6909 33 4.6970 33 4.5152 Q86 50 4.3200 55 4.3273 33 4.0606 33 3 .9091 Q87 50 4.5400 55 4.5091 33 4.5455 32 4.4688 Q88 50 4.0400 55 3.8909 32 3.7188 31 3.3548 Q89 50 2.1400 55 2.2182 33 1.6061 33 1.3636 Q90 50 4.6400 54 4.2407 33 4.6061 33 4.0000 176 Q91 50 4.3600 55 4.4909 33 4.5758 33 4.2121 Q92 50 4.5200 55 4.5273 33 4.3636 33 4.1818 Q93 50 4.7000 54 4.5741 33 4.6667 33 4.5455 Q94 49 4.6939 55 4.7091 33 4.5758 33 4.4545 Q95 50 4.2800 55 3.9818 33 4.3939 33 4.2121 Q96 50 4.3600 55 4.3455 33 4.6061 33 4.1818 Q97 50 3.9600 55 3.9455 33 3.7879 33 3.3939 Q98 50 3.7400 55 3.9818 33 3.5152 33 3.0000 Q99 50 4.1200 55 4.3818 33 4.0303 33 4.2424 Q100 50 4.0800 55 3.8364 33 3.8788 33 3.5152 Q101 50 4.0000 55 4.0182 33 3.7879 33 3.3333 Q102 50 4.2000 55. 4.1455 33 3 .5152 33 3 .2121 Q103 50 4.5400 55 4.5818 33 4.6667 33 4.4848 Q104 50 4.7000 55 4.5455 33 4.5455 33 4.3636 Q105 50 4.7800 55 4.7818 33 4.6970 33 4.6364 OTF: O.T. Fieldwork instructors PTF: P.T. Fieldwork instructors OTS: O.T. Students PTS: P.T. Students 177 SECTION 2: ALL INSTRUCTORS, ALL STUDENTS, ALL O.T.'s AND ALL P.T. 'S ALL INSTRUC. ALL STUDENTS ALL OT'S ALL PT'S N MEAN N MEAN N MEAN N MEAN QI 104 4.2596 66 3.8788 82 4.2439 88 3.9886 Q2 104 4.6154 66 4.6818 82 4.5610 88 4.7159 Q3 105 4.5238 65 4.4462 83 4.5301 87 4.4598 Q4 104 3.1635 65 3.1538 82 3 .2073 87 3.1149 Q5 105 4.4667 66 4.4242 83 4.3253 88 4.5682 Q6 105 4.5619 66 4.3939 83 4.5783 88 4.4205 Q7 105 4.7714 66 4.6818 83 4.7711 88 4.7045 Q8 102 3.9216 65 3.6154 81 3.6667 86 3.9302 Q9 104 4.2596 66 4.1212 83 4.4217 87 4.0000 Q10 105 4.3619 66 3.8636 83 4.1928 88 4.1477 Qll 104 4.4327 66 4.3182 82 4.4756 88 4.3068 Q12 104 4.1442 66 4.3788 82 4.2927 88 4.1818 Q13 104 4.5096 65 4.3231 82 4.4390 87 4.4368 Q14 105 4.5143 66 4.0455 83 4.4337 88 4.2386 Q15 105 4.1905 65 3.8308 83 4.1084 87 4.0000 Q16 104 3.5673 66 3.3788 83 3.3253 87 3.6552 Q17 105 4.4476 66 4.1515 83 4.3494 88 4.3182 Q18 105 4.5810 66 4.6818 83 4.6145 88 4.6250 Q19 104 1.7692 66 1.5909 82 1.8780 88 1.5341 Q20 105 4.2286 66 4.2879 83 4.3133 88 4.1932 Q21 105 4.8667 66 4.7121 83 4.9277 88 4.6932 Q22 105 4.6476 66 4.4545 83 4.6386 88 4.5114 Q23 105 4.2095 66 3.7727 83 4.1566 88 3.9318 Q24 105 4.4667 66 4.1667 83 4.4096 88 4.2955 Q25 105 4.4762 66 4.2879 83 4.4217 88 4.3864 Q26 105 4.6762 66 4.8636 83 4.7470 88 4.7500 Q27 105 4.2571 66 4.2121 83 4.3253 88 4.1591 Q28 104 4.0769 66 3.6818 82 3.8537 88 3 .9886 Q29 105 4.5905 66 4.5606 83 4.6747 88 4.4886 Q3 0 105 3.7333 66 3.7121 83 3.7108 88 3.7386 Q31 105 4.2286 66 4.0606 83 4.1566 88 4.1705 Q32 105 3.9333 66 4.1212 83 3.86 75 88 4.1364 Q33 105 4.3810 66 4.2424 83 4.3976 88 4.2614 Q34 105 4.5714 66 4.3939 83 4.5783 88 4.4318 Q35 104 4.3750 66 4.0455 82 4.2805 88 4.2159 Q36 105 4.3238 66 4.2727 83 4.3976 88 4.2159 Q37 104 4.1635 65 4.2615 83 4.2169 86 4.1860 Q38 100 3.8800 65 3.9846 80 3.9875 85 3.8588 Q39 105 4.3333 66 4.0303 83 4.1325 88 4.2955 Q40 105 4.5429 66 4.4242 83 4.6265 88 4.3750 Q41 105 3.9619 66 3.4697 83 3.7831 88 3.7614 Q42 104 4.7596 65 4.2308 83 4.6265 86 4.4884 178 Q43 105 4.5429 66 4.4091 83 4.6506 88 4.3409 Q44 105 4.7810 66 4.5909 83 4.7952 88 4.6250 Q45 103 4.6602 66 4.5152 82 4.6951 87 4.5172 Q46 105 2.7429 66 2.3333 83 2.5783 88 2.5909 Q47 104 4.4423 66 4.2576 82 4.5244 88 4.2273 Q48 105 4.2190 66 3.9394 83 4.2530 88 3.9773 Q49 105 4.2857 66 4.0909 83 4.2410 88 4.1818 Q50 105 4.4857 66 4.5303 83 4.5181 88 4.4886 Q51 105 4.1619 66 4.6061 83 4.1807 88 4.4773 Q52 105 4.4952 66 4.6818 83 4.5542 88 4.5795 Q53 105 4.4000 66 4.2576 83 4.1928 88 4.4886 Q54 105 4.6381 66 4.5455 83 4.7229 88 4.4886 Q55 105 4.6190 66 4.5152 83 4.6506 88 4.5114 Q56 104 4.4038 65 4.5231 83 4.4578 86 4.4419 Q57 105 3.2857 66 2.8333 83 2.9880 88 3.2273 Q58 105 4.0286 66 3.8333 83 4.1446 88 3.7727 Q59 105 3.4000 65 3.7231 83 3.6988 87 3.3563 Q6 0 105 4.3429 65 4.1231 83 4.4337 87 4.0920 Q61 105 4.2571 66 4.1515 83 4.2289 88 4.2045 Q62 105 4.5238 66 4.7121 83 4.7229 88 4.4773 Q63 105 4.2762 66 4.2727 83 4.3012 88 4.2500 Q64 105 4.3619 65 4.4308 83 4.4940 87 4.2874 Q65 105 4.5429 66 4.3636 83 4.5663 88 4.3864 Q66 105 4.4000 66 4.0000 83 4.1687 88 4.3182 Q67 105 4.6762 66 4.5152 83 4.7229 88 4.5114 Q68 102 3.8627 66 3.4697 81 3.7778 87 3.6437 Q69 105 3.3238 66 2.4394 83 2.8675 88 3.0909 Q70 104 4.2212 66 3.9697 83 4.1687 87 4.0805 Q71 105 4.7714 66 4.5455 83 4.7470 88 4.6250 Q72 105 4.5143 66 4.3182 83 4.5904 88 4.2955 Q73 105 4.8857 66 4.8030 83 4.8916 88 4.8182 Q74 105 3.6857 66 3.5606 83 3.6265 88 3.6477 Q75 105 4.1714 66 3.9394 83 3.9880 88 4.1705 Q76 105 4.6762 66 4.5303 83 4.6988 88 4.5455 Q77 105 4.6000 66 4.4545 83 4.6867 88 4.4091 Q78 105 2.8476 66 2.3333 83 2.5783 88 2.7159 Q79 105 4.0857 66 4.0152 83 4.0482 88 4.0682 Q80 104 4.6154 66 4.5455 83 4.6386 87 4.5402 Q81 105 4.7238 66 4.8030 83 4.7470 88 4.7614 Q82 105 4.6952 66 4.5758 83 4.6988 88 4.6023 Q83 105 3.8762 66 3.8333 83 3.8795 88 3.8409 Q84 105 4.4190 66 4.2424 83 4.4578 88 4.2500 Q85 105 4.7143 66 4.6061 83 4.7229 88 4.6250 Q86 105 4.3238 66 3.9848 83 4.2169 88 4.1705 Q87 105 4.5238 65 4.5077 83 4.5422 87 4.4943 Q88 105 3.9619 63 3.5397 82 3.9146 86 3.6977 Q89 105 2.1810 66 1.4848 83 1.9277 88 1.8977 Q90 104 4.4327 66 4.3030 83 4.6265 87 4.1494 Q91 105 4.4286 66 4.3939 83 4.4458 88 4.3864 179 Q92 105 4.5238 66 4.2727 83 4.4578 88 4.3977 Q93 104 4.6346 66 4.6061 83 4.6 86 7 87 4.5632 Q94 104 4.7019 66 4.5152 82 4.6463 88 4.6136 Q95 105 4.1238 66 4.3030 83 4.3253 88 4.0682 Q96 105 4.3524 66 4.3939 83 4.4578 88 4.2841 Q97 105 3.9524 66 3.5909 83 3.8916 88 3.7386 Q98 105 3.8667 66 3.2576 83 3.6506 88 3.6136 Q99 105 4.2571 66 4.1364 83 4.0843 88 4.3295 Q100 105 3.9524 66 3.6970 83 4.0000 88 3.7159 Q101 105 4.0095 66 3.5606 83 3.9157 88 3.7614 Q102 105 4.1714 66 3.3636 83 3.9277 88 3.7955 Q103 105 4.5619 66 4.5758 83 4.5904 88 4.5455 Q104 105 4.6190 66 4.4545 83 4.6386 88 4.4773 Q105 105 4.7810 66 4.6667 83 4.7470 88 4.7273 A l l Instructors: OTF and PTF A l l Students : OTS and PTS A l l O.T.'s : OTF and OTS A l l P.T.'s : PTF and PTS SECTION 3: ALL SUBJECTS COMBINED ALL SUBJECTS N MEAN QI 170 4.1118 Q2 170 4.6412 Q3 170 4.4941 Q4 169 3.1598 Q5 171 4.4503 Q6 171 4.4971 Q7 171 4.7368 Q8 167 3.8024 Q9 170 4.2059 Q10 171 4.1696 Qll 170 4.3882 Q12 170 4.2353 Q13 169 4.4379 Q14 171 4.3333 Q15 170 4.0529 Q16 170 3.4941 Q17 171 4.3333 Q18 171 4.6199 Q19 170 1.7000 Q20 171 4.2515 Q21 171 4.8070 Q22 171 4.5731 Q23 171 4.0409 Q24 171 4.3509 Q25 171 4.4035 Q26 171 4.7485 Q27 171 4.2398 Q28 170 3.9235 Q29 171 4.5789 Q3 0 171 3.7251 Q31 171 4.1637 Q32 171 4.0058 Q33 171 4.3275 Q34 171 4.5029 Q35 170 4.2471 Q36 171 4.3041 Q37 169 4.2012 Q38 165 3.9212 Q39 171 4.2164 Q40 171 4.4971 Q41 171 3.7719 Q42 169 4.5562 Q43 171 4.4912 Q44 171 Q45 169 Q46 171 Q47 170 Q48 171 Q49 171 Q50 171 Q51 171 Q52 171 Q53 171 Q54 171 Q55 171 Q56 169 Q57 171 Q58 171 Q59 170 Q60 170 Q61 171 Q62 171 Q63 171 Q64 170 Q65 171 Q66 171 Q67 171 Q68 168 Q69 171 Q70 170 Q71 171 Q72 171 Q73 171 Q74 171 Q75 171 Q76 171 Q77 171 Q78 171 Q79 171 Q80 170 Q81 171 Q82 171 Q83 171 Q84 171 Q85 171 Q86 171 Q87 170 Q88 168 Q89 171 Q90 170 Q91 171 Q92 171 Q93 170 4.7076 4.6036 2.5848 4.3706 4.1111 4.2105 4.5029 4.3333 4.5673 4.3450 4.6023 4.5789 4.4497 3.1111 3.9532 3.5235 4.2588 4.2164 4.5965 4.2749 4.3882 4.4737 4.2456 4.6140 3.7083 2.9825 4.1235 4.6842 4.4386 4.8538 3.6374 4.0819 4.6199 4.5439 2.6491 4.0585 4.5882 4.7544 4.6491 3.8596 4.3509 4.6725 4.1930 4.5176 3.8036 1.9123 4.3824 4.4152 4.4269 4.6235 Q94 170 Q95 171 Q96 171 Q97 171 Q98 171 Q99 171 Q100 171 Q101 171 Q102 171 Q103 171 Q104 171 Q105 171 4.6294 4.1930 4.3684 3.8129 3.6316 4.2105 3.8538 3.8363 3.8596 4.5673 4.5556 4.7368 A l l subjects: OTF, PTF, OTS, and PTS combined. 

Cite

Citation Scheme:

        

Citations by CSL (citeproc-js)

Usage Statistics

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
https://iiif.library.ubc.ca/presentation/dsp.831.1-0097068/manifest

Comment

Related Items