Collaboration At Camp Tenaha

Growing a partnership program between OT and OTA students

By Terrie King, Cheri Lambert, Cindy Murray and Laura Shaffer

It started innocently among four friends one afternoon in 2003. As faculty members in the Panola College OTA program in Carthage, Texas, and the OT program at Louisiana State University Health Sciences Center (LSUHSC) in Shreveport, we said, "Let's bring our students together and do something with Camp [Tenaha]."

We put our heads together and got busy implementing a collaborative learning project that built upon previously established aspects of our respective educational programs.

Students from both programs are given the opportunity to "try out" the collaborative and supervisory roles found between OT and OTA by working together to implement intervention services at Camp Tenaha, a summer camp in Tenaha, Texas, for children with special needs held every Saturday in June. This project seemed to fit well with the educational curricula standards for both programs, which require learning about:

• the roles of OT and OTA;

• the principles of the teaching-learning process;

• demonstrating skills in supervision and collaboration; and

• identifying, explaining and justifying the need and importance of supervisory roles, responsibilities and collaborative professional relationships. (Accreditation Council for Occupational Therapy Education Standards and Interpretive Guidelines, 2007)

A Perfect Setting for Collaboration

Camp Tenaha was initially developed as a level-II fieldwork project in 1999 by an OTA student at Panola College. It is sponsored by New Destinations Inc., a local non-profit organization. This project is a testament to the power of community networking and service learning: through the generous support of both community and professional resources, the camp is 100-percent community supported, and the children are able to receive all the benefits of camp at no cost.

Today, Camp Tenaha's design and implementation are fully integrated into the Panola College OTA curriculum. The camp's intent is to provide a milieu for students to apply and integrate multiple levels of classroom instruction as they participate in this service-learning project. Adding the OT/OTA collaboration piece seemed to be the next stage of evolution for the students' educational process; our new goal was to find a way to integrate the LSUHSC-S OT students into the camp process.

The summer semester, which is when camp is held, coincided with LSUHSC-S OT students' enrollment in the Clinical Reasoning II course. This course brought together previous coursework in Therapeutic Occupations and Activities, Occupational Performance Across the Lifespan, Pediatric Occupation-based Practice and Application, Clinical Reasoning I and level-I fieldwork experiences.

The focus of the Clinical Reasoning II course is implementation and documentation of the OT process. It seemed the logical meeting point of the two curricula, as the OTA students were using the camp to employ course content related to Therapeutic Use of Occupations and Activities I and II for the first-year students, and OT Management and level-II fieldwork for the second-year OTA students. Specific assignments for each respective student group are required as part of the project.

Camp Tenaha started as a one-day, four-hour experience for ten children. Through this collaborative project, the camp has now expanded into a four-day, sensory-motor extravaganza for up to thirty children.

Working the Kinks Out

Our initial collaborative efforts involved creating OTS and OTAS partnerships, which work with one camper throughout the four sessions of camp. The OTS was present for the first and second sessions of camp, creating an occupational profile on the camper as well as discussing, creating and implementing the intervention plan in collaboration with the OTAS.

Camp sessions three and four provided the opportunity for the OTAS to implement the intervention plan independently, followed by written and verbal communication with the OTS regarding the outcome of the camp day. Together, the OT partners collaborated on any changes that needed to be made to the intervention plan for the next camp session.

The first collaboration year, camp was a success, as it had always been: the campers caught fish, painted horses and rode four wheelers, and everyone had a great time. However, the student collaboration project had some growing and modifying to do. Although the students in both curricula gave feedback that they enjoyed working together, they expressed confusion over the educational assignments. The faculty was also unclear as to whether our goals of teaching/learning about the collaborative process through actual collaboration between OTA and OT students had been met.

We decided to set revised objectives, to clarify each educational program responsibility, emphasize the strengths of the collaborative process and focus on the OT/OTA student relationship. Over the next few years, the Camp Tenaha project objectives fell into four categories: rapport building, documentation, communication and collaboration.

Rapport building. The logistics of rapport building between the two student groups, given that the educational programs are located approximately one hour apart, created multiple challenges for both programs. Over the years, we've tried several strategies to best create rapport between the two levels of students: telephone interviews, a classroom teaching experience to explain the educational programs to each group, supervision guidelines for OT and OTA partnerships, and group interaction activities. All of the aforementioned strategies had benefits; however, we did not think our collaborative goals were being met, nor were students developing partnerships.

Last year, both sets of students met at the camp location prior to the first day of camp for a face-to-face meeting. Students were able to meet their collaborative partner, gain a little more personal information about each other by completing a personality profile called True Colors© and discuss their assigned camper intake application.

This format seemed to work best, and the OTS and OTAS partners began to establish a working relationship prior to the first day of camp. It also appeared to decrease fear of the "unknown" about camp and increase the enthusiasm and cooperation between the student partners.

Documentation. Challenges continued in regard to the documentation aspects of the collaboration. The documentation process for the OT students involved completing a phone interview with the parent(s) of the campers, completion of an Occupational Profile on the first day of camp in conjunction with the OTA student, development of a very specific intervention plan using the activities that the OTA students had planned and collaborative completion of a SOAP note following the camp day.

All of these aspects of documentation worked well, with the exception of the SOAP notes. The solution for this component was to have the OTA student complete the SOAP note for each camp day and e-mail the note to the OT student. This then became the path for discussion between the partners and possible changes to the intervention plan. The OT students do not grade the OTA SOAP note, but do give feedback about its clarity and usefulness.

Communication. One would think in this day and age, and with incredibly techno-savvy students, that communication would be the easiest aspect of this project. However, challenges presented themselves in this area as well.

The OT students were asked to communicate once a week for five weeks (discussing the Occupational Profile, the intervention plan and the individual camp sessions/SOAP note feedback). Several levels of technology were implemented, including WebCT, personal and school e-mail, and telephone.

Every type of communication seemed to have some glitch, and the solution was to let the student partners decide the most effective means of establishing a reliable method of communication. The only criterion given for assignment completion was for there to be one printed e-mail communication between them per week. This is a mandatory "graded" requirement for both programs.

Although awareness of how communication between OT/OTA partners can improve the therapeutic outcome for the client is explained in this collaborative process assignment, it appears that often at this level, students continue to require an external motivator, a "grade," to consistently implement this critical aspect of professional collaboration.

Collaboration. The collaboration piece of the project—our major intention—truly only required definition and clarity rather than modification through the years. Having the students meet each other ahead of time and form their partnerships allowed the initial focus to be on relationship development. Once the partners established a relationship, they could turn their focus toward the needs of the camper, the intervention plan, plan implementation and desired outcomes for the camper. Didactic course work related to the importance of verbal, non-verbal and written communication was readily applicable in every phase of the collaborative process.

In keeping with the "OT way," post-camp processing is an aspect of the camp day. Once the last camper is seat-belted in and the final goodbyes said, the faculty and students—though hot, sweaty, and mentally and physically tired—gather under a shade tree to share the coldest cold drinks and their camp experiences.

The students' experience is the focus for this first moment of "down" time. The general flow of the process is sharing what worked and what didn't, problem solving for the next session and, with guidance, recognition of the incredible level of collaboration they have achieved. Camp Tenaha works because the students work together.

Surveying Effectiveness

Around year three of our collaboration, we thought we had worked out most of the kinks in the implementation of our mutual student-learning project. We decided to do research to determine if this type of educational experience was having the impact on the students that we had hoped. Students from both professional programs completed a pre and post survey identifying changes in understanding of their specialized roles and responsibilities, as well as any personal growth in the area of collaboration and supervision.

Results of the survey showed an overall enhanced understanding of the knowledge base provided by each respective educational program. A Likert scale determined a positive shift in all students' comfort levels regarding their understanding of collaboration, effective communication skills and confidence to administer and/or receive supervision. Perception of abilities addressed included: educational knowledge; verbal, written and non-verbal communication; problem-solving abilities; giving/receiving constructive feedback; and comfort with a supervisory relationship.

In addition, OT students are required to complete a written assignment describing their entire camp and collaboration experience. On the whole, students report through this assignment that they considered the camp experience helpful in many ways, including facilitating a collaborative relationship with OTA students.

One student wrote, "Learning how to exchange information and collaborate with the OTA to increase the therapeutic qualities of the activities was exceedingly satisfying."

Another student wrote, "The message I took home was definitely that the OT and OTA must be in constant communication and must be respectful toward each other's ideas and suggestions. I think that when each therapist feels respected, they are able to work more effectively together to improve clients' lives."

Where Do We Go from Here?

Since the students completed the survey, we have continued to modify this project in many ways. Though faculty do question at times whether the educational gains are worth the energy required to create this student experience, we feel more confident each year about the benefits of the collaborative process in spite of all the challenges.

Perhaps what seals our decision is the overwhelmingly positive feedback from students, campers and parents. It is this feedback which prevents our complacency and facilitates our collective growth and development, reminding us to choose the road less traveled in the academic arena.

We have learned that we greatly value occupation-based education, that the collaborative process has a positive impact on our students, and that students' confidence levels increase through the application of the collaborative and supervisory relationship.

Future goals for our educational programs in this project include:

• intensify the collaboration experience;

• improve students' ability to give and receive constructive feedback;

• enhance students' written and verbal communication skills;

• increase students' knowledge of the OT and OTA educational programs;

• continue to find ways to apply classroom knowledge to community practice; and

• measure student learning and development through the project.

So, you might ask, after all the trials and errors, are we four still friends? You bet! This whole project has brought us together not only in the summer, but also to present posters and short courses about our collaborative learning project. We enjoy the balance of personalities and skills our group has developed, and we always look forward to camp starting again.

References available at www.advanceweb.com/OT or upon request.

Terrie King, MA, LOT, and Cheri Lambert, OTR, are faculty members in the OTA program at Panola College in Carthage, TX. Cindy Murray, MHS, LOTR, and Laura Shaffer, MS, LOTR, are faculty members in the OT program at Louisiana State University Health Sciences Center in Shreveport, LA.