Exploring Career Pathways of the Occupational Therapy AFWC Role: A Review of Push, Pull, and Stay Factors

Academic Fieldwork Coordinators (AFWCs) are essential to occupational therapy (OT) education, yet little is known about the career pathways, retention, and attrition associated with this role. With increasing faculty turnover, understanding the factors that influence AFWC career decisions is critical. This mixed-methods study surveyed 187 OT educators across the US, including current, former, and never-serving AFWCs. A researcher-designed Qualtrics survey gathered demographic, quantitative, and open-ended qualitative data. Quantitative data were analyzed using chi-square tests; qualitative responses underwent thematic analysis. Respondents reported psychological (e.g., burnout, satisfaction), job (e.g., mentoring, administrative burden), organizational (e.g., support, workload), and leadership/team (e.g., recognition, collaboration) factors that influenced their decisions to pursue, remain in, or leave the AFWC role. While mentoring students was consistently ranked most valuable and enjoyable, administrative duties were least favorable. Nearly one-third of current AFWCs reported intent to leave their role within 2 years, often citing workload and lack of support. AFWC roles often serve as a pathway into academia but suffer from limited support, unclear preparation, and high attrition. Findings highlight the need for structured onboarding, supportive leadership, and retention strategies to sustain the OT fieldwork education workforce.