Using ATRA Guidelines to Facilitate Student Internships

1. Using ATRA Guidelines to Facilitate Student Internships Teresa M. Beck, PhD, CTRS ILRTA Conference October 28, 2013

2. GUIDELINES FOR INTERNSHIPS IN THERAPEUTIC RECREATIONKaren Grote, MS, CTRSMichael Hasl, CTRS2003 Second EditionATRA

3. Purposes of an Internship • To apply academic knowledge of TR in a practice setting • To develop clinical practice skills and abilities under the guidance of a professionally certified practitioner of TR • To assess and expand the student’s competencies in TR • To acquire in-depth understanding ofhow TR fits into health and human services • To develop and practice ethical and professional behaviors in a work setting • To develop an understanding of critical issues related to the practice to TR

4. Definition of Terms • Academic Supervisor • The person at the academic institution responsible for advising, monitoring, and evaluating the student in an internship for academic credit. • NCTRC requires this person to be NCTRC certified and employed the academic institution giving credit for the internship • Fieldwork • The field experience that precedes the student’s final internship. ATRA recommends that the student complete 120 hours of fieldwork for three credits prior to completing an internship

5. Terms Continued • Internship • Means by which a student translates knowledge into clinical skills and abilities in structured, supervised setting • Student interns under a CTRS. NCTRC requires the internship to be a minimum of 560 hours • Minimum of 14 consecutive weeks • No less than 20 hours per week and no more than 45 hours per week • Must be completed at one agency

6. Terms Continued • Site Supervisor • The person at the agency who directs, supervises, and evaluates the student in the completion of an internship in an agency to satisfy academic requirements and NCTRC Standards • NCTRC requires that the CTRS be certified one full year prior to supervising an intern and be considered a full time employee working a minimum of 32 hours per week • Others in the profession recommend that a CTRS is eligible to be a site supervisor who has successfully 2 or 3 years of employment in TR and has been the at the present agency 6 months to a year

7. The Academic Supervisor • Prepare the student for the internship experience • Adequate coursework and learning experiences to satisfy the NCTRC coursework requirements and compliance with ATRA Standards of Practice • Assist in the selection of the appropriate agency site • Match students’ level of interest/competence with agencies • Make sure student is aware they must be registered to receive credit • Consult with the agency supervisor • Does the agency provide exposure to all areas required by NCTRC • Provide agency with Internship Manual from the University • Complete an affiliation agreement

8. The Academic Supervisor • Advise the student throughout the experience • Consult with the students regarding the “special project’ if required for academic credit • Maintain regular communication • Evaluate the student’s reports and assignments • Make at least one visit to the agency unless it is geographically impossible to visit • Support the site supervisor with emerging knowledge • Collect evaluations form the site supervisor • Grade paper and assign a final grade • Maintain a record of students’ internship • Send thank you letter

9. The Intern • Before the Internship • Determine the desired population and type of setting • Work with university internship supervisor and other resources to locate sties • Review NCTRC Standards • Complete self-assessment • Guidelines for Competency Assessment and Curriculum Planning in TR: A Tool for Self-Evaluation • Prepare resume and cover letter with list of references • Make application for internship • Phone interview/onsite interview • Portfolio review/Work Samples

10. The Intern • Agency pre-requisites for Internships • Liability Insurance • CPR/First Aid/Immunizations • Health Insurance • Driver’s License • Confidentiality Agreement • Inquire about agency’s dress code • Prepare a personal budget to make certain there is adequate financing for the duration of the placement • Verify CTRS certification via NCTRC.org

11. The Intern • During the Internship • Develop professional relationships • Follow agency schedule; complete all assignments on time • Acquire knowledge, skills, and abilities • End of Internship • Complete a self-evaluation • Evaluate placement/supervisor • Turn in final reports, evaluations etc.

12. Site Supervisor • Site Supervisor Responsibility • Be competent and ethical in practice • Enter into an affiliation agreement with the academic program • Have the time and ability to provide clinical supervision and mentoring to the intern • Provide a structured, sequential learning experience • Fairly evaluate the intern’s knowledge, competence and performance and share with the academic supervisor • Treat the intern with respect as a professional-in-training • Communicate with the academic supervisor • Write a letter of reference for the student upon request

13. Site Supervisor • Develop a Comprehensive Plan – prior to Internship • Goals and Objectives • Agency expectations • Affiliation agreement/Student Agreement • Assistance if any provided • Student’s schedule • Intern selection criteria • Policies and Procedures • Internship termination procedures • Performance schedule of responsibilities • Position description /Application procedures • Strategy for Marketing Internship

14. Site Supervisor • During the Internship • Provide an orientation to the intern • Agency identification badges and keys • Assist students in developing goals and completing self-assessment • Provide clinical supervision • Provide midterm and final evaluations • Assist intern in networking within agency and in community • Consult with academic supervisor regarding intern’s performance

15. Site Supervisor • End of the Internship • Complete all paperwork • Provide letter of reference if requested by intern • Recover agency property • Complete evaluation on internship experience including supervisor • Maintain confidential file of intern – employment reference/NCTRC certification

16. Sample Performance Schedule • Week One – Orientation to Agency and Work Environment • Week Two – Orientation to TR Program • Week Three • Caseload of 1 Client • Complete Assessment • Develop Treatment Plan • Write Progress Note • Continue to observe treatment interventions • Attend treatment team meetings

17. Sample Performance Schedule • Week Four • Adopt a caseload of up to 2 clients • Complete all documentation on assigned clients • Co-plan and Co-lead two assigned treatment groups or individual interventions • Review treatment outcomes with supervisor • Plan a recreation event or outing

18. Sample Performance Schedule • Week Five • Adopt a caseload of up to three clients • Arrange site visits to other TR programs • Observe available medical procedures • Co-lead three assigned groups or individual interventions • Review agency and department quality performance improvement philosophy and plan • Develop a plan for a special project

19. Sample Student Performance Schedule • By the end of Week Seven • Adopt a caseload of up to 5 patients • Lead one assigned group per day and individual interventions as necessary • Meet with site supervisor to complete midterm evaluation • By the end of Week Ten • Adopt a caseload of up to 8 clients • Conduct family meeting or intervention to assess client progress or family patterns or to discuss discharge planning • Develop a new treatment group of at lest 6 session, write a program protocol and evaluation procedure

20. Sample Student Performance Schedule • By the end of week 12 • Adopt a caseload of a maximum of 10 clients • Complete all sessions of the new group and evaluate outcomes • By the end of week 14 • Complete and present the special project • Present a case study at the TR staff meeting

21. Sample Student Performance Schedule • Week Fifteen • Complete all documentation/final evaluation • Accomplish closure with staff and clients • Turn in all Agency property • Obtain copy of site supervisor’s certification • Clarify procedure for securing reference • Turn in all required paperwork

22. Common Assignments • Resource Scavenger Hunt • Reading from journals, manuals, books • Visits to other area TR programs • Case Study Presentation • Write a diagnostic or program protocol • Meet/Interview other members of the interdisciplinary team • Attend professional meetings • Place an order for TR Supplies

23. Examples of Special Projects • Developing a Game • Assemble resource manual for future interns • Develop a community resource manual for clients • Design public relations brochure • Write a manual for volunteers • Develop National TR Month materials • Prepare a grant to solicit funding • Develop an interest survey • Complete SOP evaluation for the program • Participate in CQI • Evaluate the TR departments documentation procedures

24. Marketing the TR Program • Develop Promotional Packet • Newsletter Marketing • Telephone Communication • Internet • Email • Face Book • Websites • Personal/Face to Face

25. GUIDELINES FOR COMPETENCY ASSESSMENT AND CURRICULUM PLANNNING FOR RECREATIONAL THERAPY PRACTICERay West, MS, LRT/CTRSTerry Kinney, PhD, LRT/CTRSJeff Witman, EdD, CTRS2008ATRA

26. Knowledge, Skills and Abilities • Knowledge • Information that is basic to the understanding of concepts and constructs and consists largely of factual information • Typically occurs in didactic or classroom settings • Skill • Represents the level of education that results in application or performance of psychomotor skills within a particular context • Occurs when knowledge is applied to performance of a task or tasks in a lab, service learning, clinical education or fieldwork/internship

27. Knowledge, Skills and Abilities • Ability • Represents the highest and most complex demonstration of competence as it requires a higher level of integration and comparison between elements to achieve an intended outcome. • Development of abilities is facilitated when the knowledge and skill is used along with clinical judgment to reach a determination of a course of action or an outcome • The responsibility for learning knowledge and developing skills and abilities overlaps between the educational programs, practice, career-long education and professional development

28. Steps to Competent Practice SKILLS KNOWLEDGE Universities Practice Continuing Education

29. Value of Self-Assessment • Having students complete a self-assessment, the student may be better prepared to match personal competence with employment requirements • Can provide direction for clinical supervision and continuing professional development

30. Competency Self Assessment • Foundations of Professional Practice • Individualized Patient/Client Assessment • Planning Treatment/Programs • Implementing Treatment/Programs • Modalities and Facilitation Techniques • Evaluating Treatment/Programs • Managing Recreational Therapy Practice

31. Competency Self-Assessment • Support Content • Functional Aspects of the Human Body • Human Growth and Development • Psychology • Cognitive/Educational • Abnormal • Human Growth and Development • Counseling, Group Dynamics and Leadership • First Aid and Safety • Disabling Conditions • Pharmacology • Understanding Health Care Services and Systems • Recreation and Leisure

32. ATRA Standards of Practice and Self-Assessment GuideRevised 2013

33. Clinical Performance Appraisal Summary and Reference Form • Intern Performance Assessment • Individualized Patient Assessments • Plans Treatment Interventions • Implementation of Treatment • Evaluates Patient’s Progress • Develops Discharge Plan • Recreation Opportunities are Available to Patients • Practices Professional Ethics • Quality Improvement • Safety and Risk Management • Research

34. Group Work • Who currently uses one or all of these guidelines • If use, what is beneficial and how are they used • Which one of these do you think you would incorporate into your internships? How? • What other activities are being used in placements that could benefit others to know about

35. LET’S SHARE

36. Ordering Information • Standards for the Practice of Therapeutic Recreation (Revised) 2008 • Non-Member $40.00 • Member $28.00 • Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice (Revised 2008) • Non-Member $45.00 • Member $35.00 • Guidelines for Internships in Therapeutic Recreation 2003 (2nd Edition) • Non-Member $25.00 • Member $15.00 http://www.atra-online.com/storeindex.cfm

37. QUESTIONS?