Becoming a Clinical Instructor

At some point in our careers, we may decide to pass on our knowledge by mentoring others. There are several ways we can do this, including writing articles for publication, mentoring new COTAs or OTRs, or even becoming a fieldwork clinical supervisor or instructor (CI).

There are many benefits to becoming a fieldwork CI. We can pass on our acquired knowledge and practice experience to the next generation of therapists; we are exposed to new theories or ideas the therapy students are currently learning in school; we may even have them work on independent projects which can benefit the facility or rehab center. Also, there is opportunity to provide "on the job training" to the fieldwork student and potentially recruit the student as a therapist after he or she passes the certification exam.

After more than 25 years in acute, rehab, outpatient, home health and SNF settings, I wanted a bigger challenge and a way to stretch myself, so I decided to become a clinical instructor. In preparation, I took the AOTA fieldwork educator certification course, and then started with one COTA student. I was blessed and had a wonderful experience with my first fieldwork student.

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Columnist Jackie Thrash, left, with Annacess, her first fieldwork student. ADVANCE thanks Jackie Thrash

I reflected on my own experiences (nearly 30 years ago), and approached the experience as if I was writing a treatment plan for my student. I let her know my expectations regarding communication, timeliness, treatment and documentation, and also asked her what she wanted to accomplish. This idea of active learning and accountability helps the student to be responsible for his/her own learning. I checked with her each week to see how it was going, and made suggestions for treatment approaches, ideas, and what to do in the event of a problem.

The facilities where I currently work (two within three blocks of each other) are technically SNF facilities; however, they are both are locked psych facilities for ambulatory residents, and therefore are considered more of a psych affiliation. I also have the opportunity to bring students to traditional SNF facilities to experience hands on for transfers and working with those who are more physically challenged.

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Annaccess brought activities she learned in school to her fieldwork affiliation, such as creating tissue-paper flowers.

My first OTA student, Annacess, provided activities she learned in school such as paper weaving and tissue-paper flower folding. I taught her to use cooking as an activity. I had her plan and schedule a month of activities, and then to reflect on their effectiveness and have back-up activities ready. She worked on a translation activity for me (Tagalog) and she did a case study. Her goals were to learn treatment skills, and learn about patient problems and diagnoses.

My second OTA student, Krystle, who was a classmate of Annacess's, did two case studies, an activity analysis of a variety of activities, and a cultural "cheat sheet" for three cultures (Filipino, Japanese and Chinese) as well as self-care and IADL treatments. Krystle had particular goals for herself: to improve documentation, and to be ready to jump in and work as a COTA as soon as she finished fieldwork and passed the certification exam.

Resources I provided included access to the text Psychosocial Occupational Therapy: A Clinical Practice by Elizabeth Cara and Anne MacRae, previous student projects, and a booklet I authored about occupation and activities.

The benefit for me, in addition to sharing my knowledge, is that I was able to experience the freshness that comes with being a student, as well as the curiosity and thirst for knowledge. I was able to revamp my list of activities to be used, and keep myself from becoming stale. I was also able to be more in a mentor mode than a treating-clinician mode, which was beneficial for me because it is more cognitive and less physically demanding. The OTA students did most of the treatments.

I would highly recommend this experience to therapists who feel they are ready or want a challenge. I was blessed to have two energetic, interested and motivated fieldwork students. I hope you do as well!

Jacqueline Thrash, OTR, has nearly 20 years of clinical experience in California and Arizona, in acute care and outpatient rehab, SNF, adult day treatment, and home health. Reach her online at or by email at

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