description of occupational therapy fieldwork supervision, at the university of the free state

258 Pages·2014·6.59 MB·English

DESCRIPTION OF OCCUPATIONAL
THERAPY FIELDWORK SUPERVISION, AT
THE UNIVERSITY OF THE FREE STATE
Submitted by

Rialda Hattingh

in accordance with the requirements for the degree
Magister Occupational Therapy
in the Faculty of Health Sciences
Department of Occupational Therapy
at the University of the Free State

Study leader: Ms R Hough
Co-study leader: Dr S van Vuuren
Biostatistician: Ms M Nel
January 2014
Declaration of own work
I hereby declare that the dissertation which I am submitting to the University of the Free State
for the degree Magister Occupational Therapy is my own independent work and has not been
submitted by me to any other university for degree purposes.

I furthermore waive copyright of the dissertation in favour of the University of the Free State.

SIGNATURE:
  Ms
 Rialda
 Hattingh
 (nee
 Van
 Aswegen)
  DATE:
  January
 2014
Dedication
This dissertation is dedicated to the loving memory of my mother, Marlene,
who passed away during the completion of this dissertation and
who sincerely believed in the riches of learning.
Acknowledgements
While this dissertation reflects my own work, its completion would not have been possible
without the valued contribution from others. I herewith wish to express my sincere gratitude to
the following people for their on-going guidance, support and encouragement throughout this
journey:

o My main supervisor, Ms Ronette Hough, lecturer at the Occupational Therapy
Department at the UFS and my co-supervisor, Dr Santie van Vuuren, Head of the
School of Allied Health Professions at the UFS for their wisdom, passion and energy.
o The supervisors and students who willingly offered their time and shared their
fieldwork education experiences for the sake of this study.
o Ms Riette Nel, Biostatistician at the Biostatistics Department at the UFS, for her
guidance in the methodology of this research and assistance with the quantitative data
analysis.
o Prof G J van Jaarveld for his guidance and attention to detail especially for the
linguistic revision of the dissertation.
o The Post-graduate School of the UFS for their academic knowledge and constructive
criticism.
o Fellow friends and colleagues at the Department of Occupational Therapy at the UFS.
Heartfelt gratitude to Monique and Juanita for supporting and motivating me
throughout this study.
o Family and friends for their patience, love and encouragement. Special thanks to my
sister Lizel for her support.
o My parents Barné and Marlene, for their constant support and love.
o My two beautiful children, Aidan and Larezé, thank you for your selflessness and
sacrifices. Your smiles inspired me to work hard and finish this study.
o My husband, Gerrit, whose continual support, wisdom and unwavering faith in me
became an essential part of my life.
o God, who makes all things possible.
Table of Contents
DECLARATION OF OWN WORK ............................................................................................................................

DEDICATION .................................................................................................................................................................

ACKNOWLEDGEMENTS ...........................................................................................................................................

TABLE OF CONTENTS .............................................................................................................................................. I

LIST OF TABLES ...................................................................................................................................................... III

LIST OF FIGURES .................................................................................................................................................... IV

CHAPTER 1 INTRODUCTION AND ORIENTATION ........................................................................................ 1

1.1 INTRODUCTION ............................................................................................................................................... 3

1.2 STATEMENT OF PROBLEM ............................................................................................................................ 5

1.3 RESEARCH AIM ................................................................................................................................................ 7

1.4 SCOPE OF THIS RESEARCH ............................................................................................................................ 7

1.5 METHODOLOGY ............................................................................................................................................... 8

1.6 ETHICAL CONSIDERATIONS ....................................................................................................................... 10

1.7 IMPORTANCE AND VALUE OF THE STUDY ............................................................................................ 10

1.8 OUTLINE OF CHAPTERS ............................................................................................................................... 11

1.8.1 Chapter 1: Introduction and Orientation .................................................................................................. 11

1.8.2 Chapter 2: Literature Perspectives ........................................................................................................... 11

1.8.3 Chapter 3: Research Approach and Methodology ................................................................................... 12

1.8.4 Chapter 4: Results ...................................................................................................................................... 12

1.8.5 Chapter 5: Discussion of the Results ......................................................................................................... 12

1.8.6 Chapter 6: Conclusion and Recommendations ......................................................................................... 12

1.9 SUMMARY OF CHAPTER 1 ........................................................................................................................... 13

CHAPTER 2 LITERATURE PERSPECTIVES .................................................................................................... 14

2.1 INTRODUCTION ............................................................................................................................................. 14

2.2 RATIONALE OF FIELDWORK IN OCCUPATIONAL THERAPY ............................................................ 15

2.2.1 Changes and challenges influencing fieldwork education ........................................................................ 19

2.3 STUDENT LEARNING IN FIELDWORK ...................................................................................................... 22

2.4 SUPERVISION .................................................................................................................................................. 26

2.4.1 Models of supervision ................................................................................................................................ 29

2.4.2 Feedback in supervision ............................................................................................................................ 31

2.5 THE FIELDWORK ENVIRONMENT ............................................................................................................. 33

2.6 FIELDWORK SUPERVISORS ........................................................................................................................ 35

2.6.1 Effective fieldwork supervision and supervisors ....................................................................................... 37

2.6.2 Ineffective fieldwork supervision and supervisors .................................................................................... 41

2.7 CONCLUSION .................................................................................................................................................. 43

CHAPTER 3 RESEARCH APPROACH AND METHODOLOGY ................................................................... 44

3.1 INTRODUCTION ............................................................................................................................................. 44

3.2 RESEARCH AIM .............................................................................................................................................. 44

3.3 RESEARCH DESIGN ....................................................................................................................................... 44

3.4 RESEARCH POPULATION ............................................................................................................................. 46

3.5 RESEARCH SAMPLE ...................................................................................................................................... 47

3.5.1 Inclusion criteria ........................................................................................................................................ 47

3.5.2 Exclusion criteria ....................................................................................................................................... 47

3.6 DATA COLLECTION ....................................................................................................................................... 47

3.6.1 Data collection instrument: Self-report questionnaire ............................................................................. 48

3.6.2 Data collection process .............................................................................................................................. 51

3.7 MEASUREMENT ERRORS ............................................................................................................................ 53

3.8 PILOT STUDY .................................................................................................................................................. 55

3.9 DATA ANALYSIS ............................................................................................................................................ 57

3.10 DATA QUALITY CONTROL ........................................................................................................................ 57

3.10.1 Reliability of the study ............................................................................................................................. 57

3.10.2 Validity of the study .................................................................................................................................. 59

3.11 ETHICAL CONSIDERATIONS ..................................................................................................................... 60

3.11.1 Approval ................................................................................................................................................... 60

3.11.2 Informed consent ...................................................................................................................................... 61

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3.11.3 Confidentiality and anonymity ................................................................................................................. 61

3.11.4 Right to privacy ........................................................................................................................................ 61

3.11.5 Risks .......................................................................................................................................................... 62

3.11.6 Compensation ........................................................................................................................................... 62

3.11.7 Competence of researcher ....................................................................................................................... 62

3.11.8 Publication of findings ............................................................................................................................. 62

3.12 SUMMARY ..................................................................................................................................................... 63

CHAPTER 4 RESULTS ............................................................................................................................................ 64

4.1 INTRODUCTION ............................................................................................................................................. 64

4.2 SECTION A: STUDENT QUESTIONNAIRE ................................................................................................. 64

4.2.1 Demographic description of the students .................................................................................................. 64

4.2.2 Information about the fieldwork areas ...................................................................................................... 65

4.2.3 Information about the supervisors in the fieldwork areas ........................................................................ 66

4.2.4 Students’ perspective on effective and ineffective characteristics of supervision .................................... 67

4.2.5 Students’ perspective on what had a positive and negative influence on the supervision received ........ 69

4.2.6 Students’ perspectives of what was descriptive of the supervisor and the supervision they received ..... 70

4.2.7 Interrelationship between various supervision characteristics from students’ response ........................ 91

4.3 SECTION B: SUPERVISOR QUESTIONNAIRE ........................................................................................... 95

4.3.1 Demographic description of the supervisors ............................................................................................. 95

4.3.2 Information about the fieldwork placement area ...................................................................................... 95

4.3.3 Information about the supervisors in the fieldwork areas ........................................................................ 97

4.3.4 Supervisors’ perspective on effective and ineffective characteristics of supervision ............................... 99

4.3.5 Supervisors’ perspectives on what had a positive and negative influence on the supervision provided101

4.3.6 Supervisors’ perspectives of what was descriptive of the supervisor and the supervision they provided
........................................................................................................................................................................... 103

4.3.7 Interrelationship between various supervision characteristics .............................................................. 127

4.4 SUMMARY ..................................................................................................................................................... 131

CHAPTER 5 DISCUSSION OF RESULTS .......................................................................................................... 133

5.1 INTRODUCTION ........................................................................................................................................... 133

5.1.1 Biographical information ........................................................................................................................ 134

5.1.2 Interpersonal supervision and supervisor characteristics ...................................................................... 137

5.1.3 Curriculum supervision and supervisor characteristics ......................................................................... 143

5.1.4 Clinical / Professional supervision and supervisor characteristics ....................................................... 149

5.1.5 Feedback supervision and supervisor characteristics ............................................................................ 152

5.1.6 Environment supervision characteristics ................................................................................................ 154

5.1.7 Student attributes in fieldwork ................................................................................................................. 156

5.2 LIMITATIONS OF THE RESEARCH ........................................................................................................... 159

5.3 SUMMARY ..................................................................................................................................................... 160

CHAPTER 6 CONCLUSION ................................................................................................................................. 162

6.1 INTRODUCTION ........................................................................................................................................... 162

6.2 CONCLUSIONS .............................................................................................................................................. 162

6.3 RECOMMENDATIONS ................................................................................................................................. 166

6.4 VALUE OF THE STUDY ............................................................................................................................... 172

6.5 TO CONCLUDE .............................................................................................................................................. 173

REFERENCE LIST .................................................................................................................................................. 174

APPENDIX A: PERMISSION LETTER .............................................................................................................. 181

APPENDIX B: INFORMATION DOCUMENT .................................................................................................. 182

APPENDIX C: STUDENT QUESTIONNAIRE ................................................................................................... 183

APPENDIX D: SUPERVISOR QUESTIONNAIRE ........................................................................................... 184

APPENDIX E: ETHICAL CLEARANCE ............................................................................................................ 185

APPENDIX F: EFFECTIVE AND INEFFECTIVE: DESCRIPTION OF SUPERVISION
CHARACTERISTICS ............................................................................................................................................. 186

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List of Tables
TABLE 4-1 DISTRIBUTION OF STUDENTS IN TYPE OF FIELDWORK AREAS 65

TABLE 4-2 SUPERVISORS RESPONSIBLE FOR SUPERVISION 65

TABLE 4-3 NUMBER OF STUDENTS PLACED IN A FIELDWORK AREA 66

TABLE 4-4 LEVEL OF QUALIFICATION OF SUPERVISORS 66

TABLE 4-5 EFFECTIVE SUPERVISION CHARACTERISTICS AS INDICATED BY STUDENTS 67

TABLE 4-6 INEFFECTIVE SUPERVISION CHARACTERISTICS AS INDICATED BY STUDENTS 68

TABLE 4-7 FACTORS THAT POSITIVELY INFLUENCED THE SUPERVISION RECEIVED AS IDENTIFIED BY STUDENTS 69

TABLE 4-8 FACTORS THAT NEGATIVELY INFLUENCED THE SUPERVISION RECEIVED AS IDENTIFIED BY STUDENTS 70

TABLE 4-9 DESCRIPTION OF INTERPERSONAL CHARACTERISTICS AS INDICATED BY STUDENTS 72

TABLE 4-10 DESCRIPTION OF CURRICULUM CHARACTERISTICS AS INDICATED BY STUDENTS 76

TABLE 4-11 DESCRIPTION OF CLINICAL AND PROFESSIONAL CHARACTERISTICS AS INDICATED BY STUDENTS 83

TABLE 4-12 DESCRIPTIONS OF FEEDBACK CHARACTERISTICS AS INDICATED BY STUDENTS 86

TABLE 4-13 DESCRIPTION OF ENVIRONMENT CHARACTERISTICS 89

TABLE 4-14 CLASSIFICATION OF TYPE OF FIELDWORK AREA 95

TABLE 4-15 SUPERVISORS RESPONSIBLE FOR SUPERVISION 96

TABLE 4-16 NUMBER OF STUDENTS PLACED IN FIELDWORK PLACEMENT AREA 97

TABLE 4-17 YEARS OF SUPERVISION EXPERIENCE 98

TABLE 4-18 EFFECTIVE SUPERVISION CHARACTERISTICS AS INDICATED BY SUPERVISORS 99

TABLE 4-19 INEFFECTIVE SUPERVISION CHARACTERISTICS AS INDICATED BY SUPERVISORS 100

TABLE 4-20 FACTORS THAT POSITIVELY INFLUENCED THE SUPERVISION PROVIDED AS IDENTIFIED BY SUPERVISORS 101

TABLE 4-21 FACTORS THAT NEGATIVELY INFLUENCED THE SUPERVISION PROVIDED AS IDENTIFIED BY SUPERVISORS 102

TABLE 4-22 DESCRIPTION OF INTERPERSONAL CHARACTERISTICS AS INDICATED BY SUPERVISORS 104

TABLE 4-23 DESCRIPTION OF CURRICULUM CHARACTERISTICS AS INDICATED BY SUPERVISORS 109

TABLE 4-24 DESCRIPTION OF CLINICAL/PROFESSIONAL CHARACTERISTICS AS INDICATED BY SUPERVISORS 117

TABLE 4-25 DESCRIPTION OF FEEDBACK CHARACTERISTICS AS INDICATED BY SUPERVISORS 120

TABLE 4-26 DESCRIPTION OF ENVIRONMENT CHARACTERISTICS AS INDICATED BY SUPERVISORS 124

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List of Figures
FIGURE 2-1 PROGRESSION OF LITERATURE PERSPECTIVE 15

FIGURE 3-1 RESEARCH PROCESS FOLLOWED IN THIS STUDY 46

FIGURE 6-1 SUMMARY OF DESCRIPTION OF INTERPERSONAL CHARACTERISTICS 187

FIGURE 6-2 SUMMARY OF DESCRIPTION OF CURRICULUM CHARACTERISTICS 188

FIGURE 6-3 SUMMARY OF DESCRIPTIONS OF CLINICAL/PROFESSIONAL CHARACTERISTICS 189

FIGURE 6-4 SUMMARY OF DESCRIPTION OF FEEDBACK CHARACTERISTICS 190

FIGURE 6-5 SUMMARY OF DESCRIPTION OF ENVIRONMENT CHARACTERISTICS 191

FIGURE 6-6 SUMMARY OF DESCRIPTION OF INTERPERSONAL CHARACTERISTICS 192

FIGURE 6-7 SUMMARY OF DESCRIPTION OF CURRICULUM CHARACTERISTICS 193

FIGURE 6-8 SUMMARY OF DESCRIPTION OF CLINICAL/PROFESSIONAL CHARACTERISTICS 194

FIGURE 6-9 SUMMARY OF DESCRIPTION OF FEEDBACK CHARACTERISTICS 195

FIGURE 6-10 SUMMARY OF DESCRIPTION OF ENVIRONMENT CHARACTERISTICS 196

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Clarification of Terms
Fieldwork
During fieldwork, Occupational Therapy students are provided with the opportunity to
incorporate theory into practice. Students are expected to apply the knowledge they
have learned at the Tertiary institution practically in a clinical setting (S. Mulholland &
Derdall, 2007, p. 162). Fieldwork is the practical component of undergraduate
Occupational Therapy education (Kirke, Layton, & Sim, 2007, p. s13).

Supervision
Supervision is the interactive process in which a supervisor (qualified occupational
therapist) is assigned to assist with and give direction to the work and growth of an
Occupational Therapy student (Smith, 2003, p. 7). Tasks include teaching, guidance
and feedback to students on personal, professional and educational development
with regard to clinical work (Kilminster, Cottrell, Grant, & Jolly, 2007, p. 3).

Supervisors
Supervisors are occupational therapists, whose main role is to be facilitators of
student learning (Hummel, 1997: 155). Supervisors are also clinical occupational
therapists and involved in educating prospective occupational therapists (Thomas et
al., 2007, p. s3).

Students
Occupational Therapy students are individuals who are actively enrolled in a
programme seeking accreditation from an Occupational Therapy department at a
tertiary institution and a relevant Health Professional Council (Smith, 2003, p. 8).

Characteristics
A characteristic can be defined as a quality typical of a person or thing (Soanes,
Spooner, & Hawker, 2001, p. 138). Supervision characteristics are interpersonal
skills, preparedness for students, knowledge about the curriculum, clinical and
professional knowledge and skills, providing feedback and creating a learning
environment (Susan Mulholland, Derdall, & Roy, 2006, p. 569; Rodger, Fitzgerald,
Davila, Millar, & Allison, 2011, p. 200). For the purpose of this study the word
characteristics will refer to qualities of supervisors and supervision as it relates to
effective and ineffective supervision in Occupational Therapy fieldwork training.
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List of Acronyms
OT: Occupational Therapy
UFS: University of the Free State
WFOT: World Federation of Occupational Therapy
HPCSA: Health Professional Council of South Africa

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