Since the inception of the profession, The American Occupational Therapy Association has required fieldwork internships as part of the comprehensive educational preparation for occupational therapy/occupational therapy assistant students. Fieldwork is provided through contracted partnerships between OT/OTA academic programs and fieldwork sites in medical and community practice settings serving clients across the life span. These educational partnerships are based on a shared commitment to the next generation of entry-level practitioners to support the values and beliefs of the profession and create a diverse workforce to meet the health needs of society. The benefits of fieldwork partnerships extend to students, practitioners, employers and clients. Fieldwork bridges academic and professional practice by developing students’ clinical skills, professional reasoning, professional behavior, theory and evidence-based practice. And, by being continually engaged with student questions, practitioners engage in active clinical reasoning, which might otherwise become habitual. Fieldwork also strengthens the professional competence and continuing education of the fieldwork educator through academic faculty partnerships in practice and scholarship. Fieldwork increases therapist recruitment and clinical productivity for many sites. Therefore, fieldwork is perceived as a professional responsibility and service whereby experienced practitioners contribute to the ongoing development of their profession.
Charging fees for fieldwork threaten the historical values and beliefs of the educational partnership between academic programs and fieldwork sites, including the professional responsibility to promote continuation of the profession through educating upcoming practitioners. Further, charging fees introduces a risk of students expecting favorable outcomes with the exchange of money for fieldwork, an educational service. There are equity issues for students whose economic status presents barriers for the means to fund the fieldwork fee. Fieldwork fees create an elitist exception for those students who cannot afford fees, creating an environment of education at a price. Thus, not all students enrolled in the same program are eligible for a particular site, and not because of a perceived mismatch between the skills of a student and the needs of a facility. Rather, some students are able to access sites charging fees only because of personal economic resources. Fees are not value added, but only add burden to the student. There should be a level playing ground to give access to all students for fieldwork opportunities, not just for a few students who can “afford” the experience. Students should not have to fundraise or take out more loans to pay for foundational educational, clinical experiences and requirements for the degree. Most of all, it negates the educational partnerships supporting the mutual benefit of the student, fieldwork educators, and academic faculty who thrive with a lively professional discourse about evidence-based practice, clinical reasoning, and scholarly endeavors.
There is the possibility that sites expect academic programs to assume the financial responsibility to pay for students to do fieldwork, which is unrealistic and impossible given the sheer numbers of students in academic programs and financial hardship it entails.
Recipients of service, vested stakeholders in the fieldwork education process, also lose opportunities to influence and guide future OT practitioners. Many clients value the opportunity to work with energetic students who bring fresh ideas and new ways of doing into the traditional practice environment. Students motivate and invigorate clients in the therapeutic context with mutually valuable learning and service provision.
The CSU OT Department renounces and discourages fieldwork sites from charging fees for placements by not paying fees charged for fieldwork placements. The CSU OT Department neither supports nor endorses fieldwork sites charging fees for student placements. We stand united, alongside other fieldwork education consortiums (e.g., California OT Fieldwork Council, New England OT Education Consortium), against this threat to the fieldwork education partnerships in occupational therapy. Asking for payment from OT students, whose earning power will never even approach that of other professionals who have traditionally paid for internships is a travesty.