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A Pre-OT's Guide to Observation Hours

by Beth Kramer

So, you’ve decided you want to become an occupational therapist, and have begun applying for programs. But somewhere between typing your transcript into OTCAS and crafting that perfect personal statement, you’ve stumbled upon the phrase “observation hours.” If you’ve come across those words and found yourself stuck there, I have written a guide based on my own experiences as a future occupational therapist hard at work on accumulating her own observation hours.

Lay a Strong Foundation

Many Master’s and Doctoral programs in occupational therapy require that prospective students observe a practicing occupational therapist for at least 40 hours. Some programs recommend that these hours come from at least two settings and populations.

While not always directly stated in programs’ application materials, programs and students alike interpret these numbers as minimum thresholds rather than absolute guidelines. Perusing threads on Student Doctor Network and Occupational Therapy’s Subreddit, you will find prospective students who have racked up as many as 300 hours in a total of four or more settings.

These numbers look intimidating. The time it takes to get them may seem overwhelming. Especially when, like all of us, you are already pressed for time due to your job, significant other, family, friends, pets, among other commitments. To make the process of accruing observation hours feel more attainable, I have specific advice. I also recommend reframing the process of acquiring observation hours not as a challenge but as an opportunity. To quote Hamilton, I recommend that you lay a strong foundation.

This glimpse at our future career is a gift. I’ve relished seeing how therapists apply interventions, interact with patients and their families, manage time on the job, and engage with their coworkers and supervisors. We are observing what, in a few years, will be our typical workday. This makes the present a time to learn what settings and populations appeal to us. This knowledge about ourselves will set us up for greater success as we begin school and set off toward our future careers.

Look Around, Look Around

Your local hospitals, nursing homes, rehabilitation facilities, and VA Medical Centers have volunteer programs. These programs may be willing to accommodate prospective occupational therapists who wish to observe licensed staff. For example, Medstar National Rehabilitation Network, located in Washington, DC, Maryland, and Virginia, has a Career Exposure Program in which individuals interested in healthcare careers can observe professionals in their department of interest.

National nonprofits that support people with developmental disabilities, such as The Arc, Easter Seals, and United Cerebral Palsy (UCP), have affiliated organizations located throughout the country. Many of these organizations offer direct services to their clients that include occupational, physical, and speech therapy. These nonprofit organizations nearly always need volunteers.

Check to see if your local affiliated chapter has opportunities that would enable you to volunteer while observing an occupational therapist. This example comes from my own experience as a former employee of the national office of The Arc, the United States’ largest nonprofit federation dedicated to advancing the full inclusion of people with intellectual and developmental disabilities (I/DD).

Don’t forget to mine your own personal and professional networks. You may be surprised to discover unexpected connections to the field because people from all backgrounds may need occupational therapy at some point in their lives. Since deciding to pursue occupational therapy as a career, I have discovered that a high school classmate has married into a family of occupational therapists spanning two generations. Also, I learned that the best friend of my mother’s neighbor is the now-retired dean of an occupational therapy program, and still has an independent equine-assisted occupational therapy practice.

Even if these links feel vague at best, and like you are playing an occupational therapy version of “Six Degrees of Kevin Bacon,” don’t be afraid to reach out to these contacts (or contacts of contacts). We are lucky to be entering a helping profession, one that encourages people to achieve their goals. The very mission of occupational therapy makes occupational therapists inclined to reach a hand back to support you, a future colleague.

Wait for It

Before you start observing, there are many procedures you will need to complete. Since these procedures involve some lag time, I recommend reaching out to organizations and/or facilities where you would like to observe an occupational therapist as soon as possible.

In addition to completing a volunteer application, you can expect an interview, and to provide paperwork confirming you have undergone medical tests and vaccinations, which at a minimum will include a flu shot and TB test. If you are planning to observe at a VA Medical Center or at a facility that provides services to children, there will also be a background check, which will take at least a week to clear.

This entire process may take up to several weeks, so I recommend being patient, but don’t be afraid to also be persistent by emailing and/or calling to get a timeline for when you can expect to start observing. Staff at hospitals, rehab facilities, and nonprofits are constantly busy and juggling multiple priorities. Reminding them of who you are, and your enthusiasm to observe an occupational therapist, will drive this process forward, and help them as well as you.

I also recommend making the most of this lag time by looking ahead to additional sites where you can observe occupational therapists. It may be tempting to focus on depth by accumulating a lot of hours in a single setting. However, achieving breadth by observing occupational therapy with a variety of populations will give you greater insight into your chosen profession. Reaching out to multiple sites simultaneously will also reduce the lag time on successive placements. It’s never too early to line up your next observation opportunity.

The Room Where It Happens

So your paperwork has been reviewed and processed, and now it’s time to observe. Basic rules of etiquette on how to conduct yourself in a professional setting apply:

The occupational therapists I’ve observed to date have encouraged me to ask questions about their work. I have appreciated being able to ask how and why a specific intervention is being used—be it how splinting can help a child with Spinal Muscular Atrophy (SMA), or why a certified hand therapist (CHT) has immersed a patient’s hand in a vial of water to measure its swelling.

I have also learned that observation doesn’t mean you are stuck on the sidelines. I’ve enjoyed getting to chat with patients. I have also been pleasantly surprised at how many opportunities I have had to assist occupational therapists, albeit in an appropriately limited capacity. I have held a patient’s shoulder steady while a therapist has wrapped that forearm in a cast, moved a toy to help test a toddler’s range of motion, and packaged theraputty, just to name three activities.

What Comes Next?

Once you’ve fulfilled your observation hours at your site, what comes next? Before setting off on your next opportunity, close the loop at your current one. It may seem obvious to thank the occupational therapist you have observed for their time and guidance, but don’t let the rapport you have built end on your last day.

Be sure to get their contact information so that you can keep in touch with them. This therapist may be your first mentor and career advocate. I have been very touched that all the OTs I have observed have offered to make themselves available to me to answer any questions I may have about the field.

If you have formed a strong connection with any of the therapists you’ve observed, you could ask them to write a letter of recommendation on your behalf for OT school. Don’t be too shy to make this request. If you have any lingering feelings of hesitation, keep in mind that you are asking a professional, someone dedicated to helping people fulfill their roles, help you fulfill your intended role of becoming their future colleague. They will likely be happy to support you.

After all, the OT you have just observed was once where you are now. This means that you, in turn, can look forward to the time when you are an experienced and confident therapist with an aspiring student observer of your own.

Do you have any advice from your own observation experiences? Please share it with us in the comments!

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