Development of student self-efficacy in innovative fieldwork placements: A qualitative study.
Mackenzie Cheng, Felicity Niles-Williams, Andrea Duncan and 1 others
PMID 42186605WHAT IT FOUND
Sixteen OT students described how non-traditional placements in early 2020 affected their confidence.
It went up with clear roles, supportive preceptors, and matching interests; down with ambiguity and limited clinical practice. These are perceptions, not measured change.
Key findings
01Four themes shaped students' self-efficacy during LEAP placements: being on my own, preceptor perception and support, perceived learning, and fieldwork environment.
02Lack of clarity about the student's role in the placement negatively affected confidence, while the ability to direct one's own learning positively supported it. Students who could not identify where they fit or who had no one to ask felt uncertain about whether what they were doing was even occupational therapy.
03Students reported that virtual LEAP placements limited their opportunity to develop hard clinical skills such as transfers, mobility aid use, hand hygiene, and one-on-one client work, which they felt they needed for practice. A hybrid model combining in-person and online time was described as a good compromise.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This is a secondary analysis: the interviews were collected for a different research question (fieldwork innovations during the pandemic), and the self-efficacy angle was identified after the fact by the analysis team. There is no baseline measure of self-efficacy before the placement, so the study captures students' retrospective perceptions rather than actual change. All 16 participants completed their LEAP placement in a six-month window during the first year of the pandemic, a period of unusual uncertainty that the authors acknowledge was not separately captured in the analysis. The sample is small (16) and drawn from a single university program (University of Toronto MScOT), so the findings reflect one program's approach to LEAP placements. The authors were faculty at the same university that runs the LEAP placements and describe the program as a 'champion' of these placements, which they acknowledge as a potential influence on interpretation.
Declared interests
The authors declared no conflicts of interest and no financial support for the research, authorship, or publication.
The easy way to misread this
Do not read this as evidence that LEAP placements are good or bad for student development. The 16 students' accounts are mixed and highly context-dependent: the same type of placement was described as confidence-building by one student and confidence-eroding by another, depending on role clarity, preceptor availability, and personal fit. The data are retrospective perceptions collected during the first year of the pandemic, analysed secondarily for a question the original study did not ask, and there is no pre-placement baseline to show that self-efficacy actually changed rather than was merely described.