Bridging the Gap: A Structured Curriculum for Occupational Therapy Students on Level II Fieldwork in Acute Care

Introduction: Students achieve entry-level competence through didactic education and fieldwork (Accreditation Council for Occupational Therapy Education [ACOTE], 2023). However, transitioning from student to practitioner can be challenging (Mason et al., 2020). Research has identified challenging areas globally across fieldwork settings environment (Knecht-Sabres et al., 2013; Mason et al., 2020) and specifically in the acute care. These challenges indicate a compelling need to cultivate lacking skills and close the gap between students' didactic curriculum and clinical placement in acute care, where supervisors have the highest expectations for students (Kemp & Crabtree, 2018). Objectives: This project aimed to develop an educational program for entry-level OT students completing Level II fieldwork in an adult acute care setting at an urban hospital. Following curriculum development, a formative evaluation was conducted to: ensure alignment between curriculum components, the Fieldwork Performance Evaluation (FWPE), and the Accreditation Council for Occupational Therapy Education (ACOTE) standards, assess acute care fieldwork educators’ perspectives on the program’s effectiveness, and gather feedback to refine the curriculum before implementation. Methods: Using Kern’s Six Steps of Curriculum Development, a needs assessment was conducted, followed by goals and educational content creation. The curriculum underwent formative evaluation using a Likert-scale survey targeting academic educators and a focus group with fieldwork educators in a large urban teaching hospital. Quantitative survey data was evaluated using descriptive statistics. Qualitative data underwent Inductive Content Analysis (ICA) to identify key content categories. Results: A ten-module curriculum, including instructors' guides, evaluation methods, and supplementary materials, was created. An academic educator confirmed strong alignment between the curriculum’s learning activities and national standards. Fieldwork educators noted that the program was comprehensive and valuable, while suggesting modifications to implementation that would strengthen the fieldwork program. Conclusion: The curriculum provides a structured approach to address student needs during Level II fieldwork in acute care. Positive feedback from educators supports its potential impact, though logistical considerations must be addressed. Future research should focus on implementation and summative evaluation. References: Accreditation Council for Occupational Therapy Education. (2023). 2023 Accreditation Council for Occupational Therapy Education (ACOTE) standards and interpretive guide (effective July 31, 2025). https://acoteonline.org/accreditation-explained/standards Kemp, E. L. & Crabtree, J. C. (2018). Differentiating fieldwork settings: Matching student characteristics to demands. Occupational Therapy in Health Care, 32(3), 216-229, https://doi.org/10.1080/07380577.2018.1491084 Knecht-Sabres, L. J., Kovic, M., Wallingford, M., & St.Amand, L. E. (2013). Preparing occupational therapy students for the complexities of clinical practice. The Open Journal of Occupational Therapy, 1(3), 1-14. https://doi.org/10.15453/2168-6408.1047 Mason, J., Hayden, C. L., & Causey-Upton, R. (2020). Fieldwork educators’ expectations of level II occupational therapy students’ professional and technical skills. The Open Journal of Occupational Therapy, 8(3), 1-16. https://doi.org/10.15453/2168-6408.1649