Q: I am trying to decide if I should take a student this year considering the pandemic. What are some of the things I need to consider before making this decision?

A: As the regulator of occupational therapists in Ontario, our focus is on the safe, competent, and ethical practice of our registrants as this is one of the ways we achieve our mandate of public protection.  The College is aware of the challenge faced by students and academic providers in finding suitable placements. We recognize that fieldwork is a requirement of graduation, and thus College registration.  Our renewal information tells us that over 2000 therapists plan on taking a student this upcoming year, so this question is very topical to our registrant base.


We know many OTs may be wondering if providing a student placement during a pandemic is achievable.  The Standards for the Supervision of Students clearly outline a preceptor’s responsibilities. None of these expectations have changed with the current pandemic, but some additional considerations for preceptors might include:

Safety
The safety of clients, therapists and students is always the highest priority.  As such, the same general safety protocols you always applied to students should remain, plus any pandemic considerations. We would expect that preceptors educate and train their students on required safety protocols, and the students would adhere to these as well.

Preceptors and students are directed to the College’s COVID-19 webpage, the Ministry of Health, and employer-specific instructions  to begin their orientation to safety and other pandemic expectations including: screening of self and client, proper hand hygiene, protective equipment, distance needs during sessions, decisions about virtual or in-person care, sanitization of tools and workspaces, and adapting services to accommodate risks are all valuable learning experiences. As a preceptor, your demonstration of clinical judgement during these difficult times is important for a student to experience and will help them to elevate their own decision-making skills when they enter practice. 

Competency with Virtual Services and Virtual Supervision
For some hospital-based therapists, in-person services remain unchanged and the decision to have students onsite may be at the discretion of the organization.  However, for therapists in the community, adapting to virtual service delivery does not take away from the competence you have in your area of practice.  For those still getting comfortable with virtual service, this would not preclude a student from benefiting from the skills, knowledge, and judgement that you apply daily in your role.

Virtual service with a student and virtual precepting can take many forms, and always involves client consent. The Standards for the Supervision of Students states that this includes making sure the client or SDM has consented to the services and is clear what components of occupational therapy may be provided by the student.
Some examples may include having a student be present online during virtual sessions, or supervising a virtual session that your student is leading. Perhaps the student can observe the services you provide from a distance, or you can include the student in in-person sessions by computer or phone. While the student is listening or watching an in-person session, they can be note- taking, perhaps invited to ask questions if appropriate, and the two of you can debrief after about any follow-up or next steps that the student may be able to complete. If therapy volumes have reduced as clients decide to delay services until in-person resumes, perhaps the indirect client time needed of you as the preceptor could be filled by the student doing projects, building resources, or researching clinical areas of interest.
Of course, all of this precepting innovation will depend on the service area, the risks to all involved, and a review of organizational processes, but again the decision making around the options and possibilities may present great learning experiences. Supervising your student virtually, and/or with virtual services will require some thoughtful planning, adaptability, and regular communication.  Involve the school early as well to ensure all risks and benefits are discussed and resolved.

Ethical Considerations
Consent is always paramount with any student/preceptor/client interaction.  If consent to student involvement is a challenge in the COVID world, or if having a student present poses additional risks, our Code of Ethics, especially around transparency, autonomy, collaboration, and communication suggests preceptors develop student alternatives.
Further, the Standards for the Supervision of Students instruct the preceptor to “ensure that risks are managed to minimize any potential risk of harm to the client, the student, the supervisor and others in the provision of occupational therapy service.” In the current climate, this is where precepting might need to be creative.  For example, if a student cannot experience or learn something directly, can this be simulated, or taught differently?  Perhaps projects can fill in the knowledge or experience gaps?  Being nimble and adaptable (aka practicing in a pandemic!) are great skills to advance for both practicing therapists and the students they supervise.

Remember, our Practice team is here to help. Contact the Practice Resource Service at 416.214.1177 ext. 240 or email practice@coto.org.


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