Student Blog
Fieldwork

My Experience Shadowing at School-Based and Pediatric Outpatient Clinics ⟩
November 11, 2025, by Makayla

Externships Fieldwork Getting Involved

In continuation of my previous blog, My Guide for Finding Volunteering and Shadowing Opportunities, I wanted to share some of my experiences this past summer, where I volunteered at two different pediatric outpatient clinics and shadowed with a school-based Occupational Therapist. As an aspiring Occupational Therapist in the future, these experiences align with my innate desire to understand pediatric patients’ experiences and their application to broader implications on healthcare outcomes and treatment approaches in the field of Occupational Therapy.

Pediatric Outpatient Clinics

This summer, I volunteered at playSense and Kids in Motion Pediatric Therapy, where I gained invaluable exposure in considering a career working in pediatric outpatient clinics. I found these clinics via USC Chan’s OS/OT Volunteer Opportunities page , and I simply reached out to them through email. Since I am a planner, I reached out during the spring in order to start right away when summer started. I recommend planning ahead because programs and clinics can become bombarded with volunteering and shadowing requests. It is important to reach out and initiate getting involved early!

Here are some important takeaways that I learned!

1. Using play and intrinsic motivation to inform the patient’s session treatment and goals

In the pediatric outpatient clinics that I volunteered at, I found that Occupational Therapists would let patients play and pick out their games or activities right off the bat at the start of their session. Then, Occupational Therapists would use these influences to adapt and inform their sessions to empower patients to participate in meaningful occupations with greater independence, ease, and confidence. In doing so, occupations are used as both a means and an end goal to maintain independent skills or to find solutions to challenges that may make participation in daily living difficult. Whether it be through toys, board games, swings, or obstacle courses, kids are intrinsically motivated to engage in activities that they are personally drawn to or interested in. For example, to aid in the development of proper pencil grasp, an Occupational Therapist would have patients use tweezers to pick up small figurines hidden in a container full of rice. Using a spoon to scoop up kinetic sand or puff balls into a toy ice cream cone can also help patients work on their pencil grasp while also working on foundational bilateral skills as well. As a result, the interventions by the Occupational Therapists are made easier for patients in completing treatment goals and applying these skills for everyday use!

2. Therapy exhaustion is real

Oftentimes, I would see that the schedule of the Occupational Therapist was jam-packed, with back-to-back patients with only lunch as their break. It is not easy having to run from one session to another while having to debrief parents at the end of a session and then jump to introduce another patient at the start of their time. Additionally, patients may cancel or run late, or even sessions can go over time or run short if any difficulties arise. In order to alleviate some of these stressors, I line up the specific toys, materials, or adaptive tools ahead of time for the Occupational Therapist so that we are ready to go when each session starts. In addition, I have a new appreciation for the stillness and calm in between sessions, where Occupational Therapists are able to rest and recharge in whatever time they have left. I can only imagine the exhaustion after the end of a day’s work, so this serves as an important reminder to me to prioritize restorative occupations as well!

School-Based OT - Extended School Year (ESY)

This summer, I shadowed an Occupational Therapist during an Extended School Year (ESY) program. An Extended School Year (ESY) program provides special education services to students with intellectual disabilities extending beyond the regular school year. Many times, ESY programs have smaller class sizes and may be at no cost to parents as well.

I got connected with this opportunity through my involvement with the Asian Pacific Alumni Association’s (APAA) Scholar Program. Alongside receiving a scholarship from the program and participating in year-long service hour requirements, we are put into families with board members. Fortunately for me, my board member is an Occupational Therapist who also graduated from USC. I had simply reached out to talk with her, and she quickly connected me to an Occupational Therapist whom I could shadow in the school district that she worked in. Easy peasy; the connections in the Trojan Family are real! She has a breadth of knowledge and has since worked in schools as an Occupational Therapist, School Principal, and Director of Special Education. Now, she works at the County Office of Los Angeles, formulating plans to make inclusive college graduation requirements and integrate greater services for individuals with intellectual disabilities across the University of California System and USC. This is all good news!

Here are some important takeaways that I learned!

1. Sitting in on Individualized Education Program (IEP) Evaluation session

While sitting in on an IEP meeting, I learned how comprehensive this process can be in order to determine if special education eligibility is required to fit the educational needs and curriculum of a student. One student’s file contains multiple documented evaluations over time, and different parties are involved in the meeting to consider the intervention plans for a student. This includes Occupational Therapists, Speech-Language Pathologists, parents, case workers, teachers, school administrators, and even lawyers/attorneys. I watched how emotionally laborious these meetings can be, especially for the parents when there is a legal presence and school administration in the room discussing their child. Nonetheless, it is nice to know that these teams of professionals are comprehensive and thorough when formulating educational plans for each student.

2. Career change is normal and encouraged!

The Occupational Therapist that I shadowed had started working in the biology field out of college, working in a genetics lab. However, she sought out a job that had a greater work-life balance when starting a family and decided to change her career to Occupational Therapy when she was 27 years old. If it weren’t for her biology background or her life’s circumstances, she would not have these experiences to inform her direction into the field of Occupational Therapy. Now, as an Occupational Therapist, she has greater meaning and purpose in her career, as well as in the current occupations she participates in.

3. Picking a field in occupational therapy: Personal experiences shape preferences

The Occupational Therapist that I shadowed shared that she had a greater inclination and cause toward working in younger populations because they are sponges for knowledge and have so much life ahead of them. She wasn’t attracted to older populations as much because they reminded her of her father, who dealt with Parkinson’s Disease, and this deeply affected her. She had been around hospice care and hospitals for a good while, and she knew that this field was not for her. On the other hand, her colleague, who is also an Occupational Therapist, enjoys working with older populations within geriatric care. The motivation for this person was working with people who were able to live out their whole lives and have extensive knowledge from their lived experiences. As a result, personal experiences can shape personal preferences, leading to greater motivations to serve specific populations.

4. Teacher, Occupational Therapist, and Speech-Language Pathologist - Same team, different roles

I found that balancing the needs of the teacher, Occupational Therapist, and Speech-Language Pathologist can be challenging when disrupting the student’s educational flow; however, maintaining a careful balance and encouraging intersectional collaboration between them all is crucial for worthwhile results. Sometimes the same student may need the services of both the Occupational Therapist and the Speech-Language Pathologist, so careful planning of classroom activities and schedules can help maximize the student’s time in these services. Additionally, The Occupational Therapist that I worked with utilized the push-in method, where they provide support directly with the student in the classroom. This intervention supplements the classroom instruction, instead of pulling the student out of the classroom for separate instruction.

Check out Student Ambassador Cara’s blog about the differences between Occupational Therapists and Physical Therapists

5. Sensory Integration in a school setting can be hard, but worthwhile

Sensory integration is a therapeutic framework aimed at aiding individuals in organizing and responding to sensory information from their bodies in relation to their environment. While volunteering at the pediatric outpatient clinics, sensory integration was everywhere; however, in a school, these interventions can be hard to do within the confines of the school’s resources, funding for equipment, and school schedules. However, if sensory integration can be supported in school-based occupational therapy practice, it can have a wide range of benefits in supporting student participation, inclusion, and regulation in schools. Learn more about Ayres Sensory Integration (ASI) here:

Check out more about Ayres Sensory Integration (developed here at USC Chan!)

6. Caseload vs. Workload

Caseload is the total number of students that the Occupational Therapist is responsible for supporting; however, the workload encompasses the amount of time and effort to support a student directly, and indirectly, through additional tasks and responsibilities that go into advocating for a student’s support towards their goals. Yet, in many school districts, only their caseload is recognized, which can invisibilize the extensive labor in additional responsibilities and can lead to burnout. School-Based Occupational Therapists are responsible for more than just treatment of students; Ongoing evaluations, IEP meetings, consultations with school administrators, and traveling between schools are just a short list of items that a School-Based Occupational Therapist covers.

Additionally, based on the school district, there could be one Occupational Therapist servicing multiple schools, leading to extensive travel time and careful planning to mitigate conflicts in scheduling. The work that School-Based Occupational Therapists do is invaluable to student success; however, it is difficult sometimes to quantify the depth and impact that they make in students’ lives. As a result, it is important to recognize setting healthy boundaries with the responsibilities that one manages, as well as advocate for greater school resources to supplement and support one’s role as an Occupational Therapist.

7. Occupational Therapy advocacy in the state legislature

The Occupational Therapist that I shadowed expressed challenges in explaining Occupational Therapy services and advocacy, especially in schools and state legislatures. She expressed that there are so many nuances and subtleties that come with the job that she did not know before entering the profession. Fortunately, since shadowing her, there have been great leaps in Occupational Therapy advocacy in the state legislature. California’s governor, Gavin Newsom, has since passed the California Bill AB 1009 law as of October 11, 2025, which modifies the current law to increase professional equity for Occupational Therapists and Physical Therapists to earn school-based administrative services credentials. In doing so, this is a huge stepping stone in giving state-licensed and highly educated professionals a pathway to pursue administrative leadership, opening doors for greater Occupational Therapy impacts on schools for generations to come.

When volunteering or shadowing, I’ll leave you with some parting advice:

• Take the pressure off
  Remember that this is your experience, so you get to ultimately decide what you want to get out of volunteering or shadowing experiences. Keep an open mind and flexible when entering a practice because you never know what you may encounter or find interesting.
• Be real with your commitment
  Although certain programs may have a specific schedule, be sure to block specific times to attend to this commitment. Changes in your schedule may happen, however be conscious of your time and their time as well. Sometimes you may be more available during the summer than during the school year. It is all up to you, however, keeping a consistent routine in your schedule is beneficial in establishing these relationships long-term.
• Ask questions
  No question is too dumb to answer. It is your experience at the end of the day, so the squeaky wheel gets the grease! A great question to ask is “In what ways do your professional and personal endeavors empower you to support the growth and development of the clients and students you work with?”
• Have a notebook in hand
  For me, I keep a small notepad to jot down notes during volunteering or shadowing sessions, where I write down observations or any questions I may have for an Occupational Therapist. For me, when I am shadowing a session, my main focus is observation, so as to keep the session as natural as possible and so as not to disturb the session. However, sometimes an Occupational Therapist may call upon me to participate with the patient as well, such as with a game or interactive activity. After a session, I will debrief with the Occupational Therapists on any questions I may have. Later, I add these notes to my own database of Occupational Therapy experiences!
• Adhere to their dress code
  Dress for success! Many times, volunteering or shadowing programs have a dress code, and it is for specific reasons. Having appropriate attire, especially when dealing with different populations, is crucial for stepping into a practice. For example, do not wear any dangly jewelry because it can be a safety issue in many settings that can potentially injure you. Don’t forget to wear your volunteer badge for easy identification in a clinic, if your program issues one as well!
• Remember to get any medical clearances!
  Many times, this may be proof of vaccinations or TB (Tuberculosis) tests in order to clear you to start at a practice. Try to do so early, and plan ahead so that you can get to volunteering or shadowing quicker!

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Grad School in LA… WITHOUT A CAR?!?! ⟩
September 19, 2025, by Trinity

Fieldwork Living in LA

Hello all!

New fieldwork assignments are about to begin, and with that in mind, I wanted to write about navigating the program without a car.

One thing about me is that I HATE driving, especially in Los Angeles. Beyond the actual driving part, paying for parking, finding an affordable gas station, and dealing with car insurance are extra stressors that I have chosen not to take on for the four years I have lived here.

Being able to make this choice is an incredible privilege! While the public transit in Los Angeles does have a bit of a negative reputation, I know I am lucky that this is even an option for me since a car is essential in most American cities. That being said, it does take flexibility, time management, and willingness to make things work to rely on this option for everything.

Here in Los Angeles, most of the public transit does connect to major attractions. For example, I can take the light rail right to famous museums, restaurants, and Union Station. The light rail as well as the Metro buses are covered by USC’s UPASS program, so students can ride for free. Students also get a discount on Metrolink tickets, which connects all of southern California.

Because I have been here for four years, I have gotten fairly used to public transportation and USC shuttles as my main means of getting around. Since most of my life exists on a college campus, this has not been too bad.

However, the fieldwork component of the occupational therapy program has made relying on public transit a bit more challenging (but not impossible). Fieldwork placements can be anywhere within the vicinity of USC, which can mean up to a 2 hour commute away depending on where you stay. Most people get placements that are near their homes, which makes it a better commute.

Still, most people have cars in the program because of the commute and the potential distance to the fieldwork sites. I have gotten really lucky, and I still have not had to bring a car for fieldwork or any other obligations I have here. This is because of my willingness to put location of site as my number one priority as I make my fieldwork wishlists, as well as the generosity of my friends in the program.

My first fieldwork location was a mental health site in Long Beach, California. I was going to take the train, but my lovely fieldwork partner, Angela, picked me up every week. I will be forever grateful that she helped me get to fieldwork, and I definitely owe her one for life! Carpooling is one option that has saved me from getting a car in the program.

Next, I had my pediatric fieldwork in a children’s mental and behavioral health clinic. This location was within walking distance, and I was able to get there with ease every week. It was a huge blessing. Of course, this is not very common. I am not sure anyone else ever had a site as close as mine was to me.

This semester I am doing my geriatrics fieldwork at an assisted living facility in Sierra Madre. I will be taking a combination of public transportation options to get there. I was paired with one of my good friends, Joseph, in the program for this rotation, and we are going to take public transit together.

I still know several other people in the program who do not have cars, so it is definitely possible! There, of course, are elements of compromise. Sometimes, you won’t get your first choice of a site or it may take a while to get there. For me though, it is worth it financially and emotionally to not have a car. This might change with my next rotation, but I am so grateful this has been an option for me thus far. My biggest piece of advice is to make the most out of every fieldwork experience, even if it was not your first choice or if the commute is long. There is always something to learn at every place. Truly, I have been so incredibly lucky in this program!

TLDR: While it can present challenges, it is absolutely possible not to have a car in the program, especially if you are willing to be flexible and lean on others for support.

 

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For the Adult Rehab Immersion, I Recommend Max Assist ⟩
June 24, 2025, by Katelyn

Classes Fieldwork School/Life Balance

Within the USC Chan E-OTD program, each year is divided into 4 different groups (A, B, C, and D). After a gentle Fall first semester to understand foundations, each cohort transitions into one of four immersions: Adult Physical Rehabilitation, Mental Health, Pediatrics, or Productive Aging and Geriatrics. At the start of our second semester, each cohort participates in a different practice immersion simultaneously.

My cohort, Cohort A, started with Adult Physical Rehabilitation, a class known to be intellectually stimulating and engaging. It was difficult. As the title states, I recommend Maximum Assistance. For those unfamiliar, in Adult Rehab, there are functional levels of assistance that determine the level of assistance a client requires. I required maximum assistance from my community to flourish in the class. It is clear that Adult Rehab is a team endeavour, and now that I have succeeded and have had the opportunity to reflect on my time within the Adult Rehab immersion, I am thankful. The Adult Rehab immersion, while stressful, was invigorating. The material was dense, but applicable. The practicums, while nerve-wracking, shaped us to be better future clinicians. It was fulfilling.

50-plus pages of weekly textbook reading, wading through dense articles, and weekly quizzes that felt like exams — I thought I was in a fever dream going 100 miles an hour in my Adult Rehab Immersion. I could never have gotten through the class without my amazing table group. Shout-out to Angie, Maya, Nicole, Noah, and Taylor. I could not have asked for a better group, and I was so grateful to have been able to work with all of you and divvy up each week’s work for our weekly IRATS (more on this in a second). Similarly, I am so grateful to have been taught by phenomenal professors Dr. Carly Roberts, Dr. Samia Rafeedie, and Jane Baumgarten.

So let’s get down to the nitty gritty. The Adult Rehab immersion, like all other immersions, is broken into three parts. One day of fieldwork and three 3-hour classes each week: two lectures and one lab. To deepen our understanding of Adult Rehab and promote collaboration, this class uses a Team-Based Learning method. Every student takes a weekly quiz, an Individual Readiness Assurance Test (IRAT), before immediately taking a Group Readiness Assurance Test (GRAT). These quizzes focus on collaboration. My group worked as a team, holding each other accountable and enriching our learning. This ultimately helped us hone our teamwork skills, skills we will later employ as practicing occupational therapists working within a healthcare team.

Lectures were insightful. We learned about case applications, how to write SOAP notes, and how to go about applying our knowledge on amputations, lymphedema, and durable medical equipment, and more at our Fieldwork (FW) Level I sites. I had an amazing experience at USC Verdugo Hills’ outpatient hand therapy clinic. I was able to follow my FW educator and apply the knowledge I learned in class to my time at Verdugo Hills. My FW focused mainly on patients with carpal tunnel, pain in the upper extremity, and also patients who were diagnosed with breast cancer. My FW educator was certified in lymphatic drainage and saw many patients to prevent or decrease lymphedema, typically secondary to breast cancer.

And labs. I loved labs. We had the ability to have hands-on experience on the very things we were learning in lecture. Each class focused on a different aspect within the Adult Rehab curriculum. Some of my favorites were: Standardized Patients: Bed Mobility, Wheelchair Mobility lab with Juan Angulo, and Orthotic Selection, Design, and Fabrication. Each had their own difficulties. The standardized patients helped scaffold our learning. They provided lots of feedback and provided us a safe environment to make mistakes (even though those mistakes felt traumatic at the time!), and subsequently learn from them. While the wheelchair mobility lab was fun, it was also eye-opening. From turning around a corner to propelling yourself forward up a hill, each was difficult and had its nuances. While Juan made it look easy, he made it clear that it came with time and practice.

Finally, fabricating orthotics. This might have been my favorite lab, as I have always loved hands-on crafting. I enjoyed the act of refining my orthotic, focusing on minute details in an attempt to prevent blisters or rubbing against the skin. I felt useful applying my creative side to the profession I love.

Ultimately, one key takeaway from reflecting on my time in my Adult Rehab immersion was the importance of balance. While it is important to learn about spinal cord injuries, wheelchairs, and other things of the like, it was equally important to do meaningful activities. Being completely honest, I found it difficult to find that balance. There were weeks when I felt I was swamped by Adult Rehab and struggled. However, there were other weeks I did better! I took up running and ran two 5Ks in the month of March, I had good food and yap sessions with friends, and I even went to Six Flags!

Run With All Your Heart Annual 5k hosted by Keck Medicine Students for #CuringKidsCancer

Six Flags with Az, Shanan, and Diego right after CraZanity!

In the end, I loved my time in Adult Rehab. I am forever grateful for such an amazing cohort and program. I feel like my blog post is only the tip of the iceberg in regards to what Adult Rehab truly entails. Regardless, just remember… take breaks and find balance, even in the hardest of semesters.

Ta-ta for now!

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Grad School: Growth, Gratitude, and Group C ⟩
May 1, 2025, by Dana

Beginnings and Endings Community Fieldwork

From foundational courses, to Pediatrics, to Geriatrics, to Adult Physical Rehabilitation, and lastly Mental Health, I have gone through all didactic courses and the 4 immersions of the E-OTD Program! Throughout the last 1.5 years, I have gained so much knowledge and hands-on experience that prepared me to take on the next part of my OT journey. The interactions that I have had the privilege to make in my Level I Fieldwork experiences with individuals from across the lifespan were so inspirational because not a single encounter was the same. I learned from their stories and how they make meaning from it. As OTs, we actively listen to our clients’ needs when other healthcare professionals don’t have the time to, which makes this profession more meaningful in the sense that we get a full scope of people’s narratives. The fieldwork sites, immersions, and classes not only focus on what to do with clients, but they really encompass how we develop our time with the clients that is meaningful and worthwhile to their goals and overall quality of life.

So, from the jitters of heading into my first Level I Fieldwork to now about to start a full-time Level II Fieldwork experience with my own caseload by the end of it, it’s been a whole whirlwind of emotions, but the amount of support and guidance from professors, teaching aides, and other students have been immeasurable. When there were times of doubt and disappointment, the community at USC Chan provided one another reassurance and motivation to continue because we believe in each other’s successes. As I look ahead to my Level II Fieldwork, I carry with me the lessons, values, and unwavering support that shaped this journey so far. The E-OTD program has not only equipped me with the clinical skills needed to be an effective occupational therapist—it has also deepened my empathy, strengthened my resilience, and affirmed my commitment to advocating for and empowering others. I’m incredibly grateful for every challenge, every connection, and every moment that has brought me to this point.

Lastly, getting through all these immersions and classes was thanks to the best group I could ask for. Because USC is a larger program, when we start the E-OTD, we are split into 4 groups - A, B, C, and D. We still have the larger network, but we really get to know our smaller group. So to my group, Group C, throughout our time together, we have gone through the highs and lows of each course, and despite all of it, we were there to support one another, making the process less lonely. We tried to understand each other and bounced ideas that added to our learning and humility. We voiced our opinions and advocate for each other as well as the profession as a whole because at the core of it, we unanimously want to spread what OT is and provide meaningful services to all populations. Because of this group and everyone’s unique experiences, I gained so much more than knowledge. I learned what it’s like to work as a team and how collaboration plays a strong role in building meaningful relationships, not just between colleagues, but also to my future clients. Additionally, I learned how developing friendships as an adult is not as daunting as I initially thought it was. Grateful is an understatement, but thank you, Group C. Let’s rock in our Level IIs!

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First 4 Fieldwork Sites Done! ⟩
March 24, 2025, by Patricia

Beginnings and Endings Fieldwork

Level one fieldwork is a clinical hands-on opportunity where you get to observe and apply the knowledge you’ve learned within the four immersions: adult rehab, mental health, pediatrics, and productive aging and geriatrics. As the level one fieldwork experience comes to an end I can’t help but reflect back at my experiences - especially day one! I remember waking up super early to get ready, arriving at my destination 30 minutes early, standing outside the facility and feeling nervous to enter. Honestly, this is something I did for every fieldwork site I was placed at, so let’s get started. 

On the first day of each fieldwork experience I never really knew what to expect so I entered each space with an open mind. I started off my first fieldwork experience at a community-based mental health site with no OT on site and the staff themselves did not know what OT was. I realized the need for OT in mental health settings and I walked away building rapport with the clients and staff by sharing how OT can support individuals with mental health challenges. And I won’t lie, it wasn’t easy creating that experience for myself. I definitely remember going back to class and having discussions with the professors and sharing during our debrief groups in the lab to get feedback and suggestions on what I could do. There was another student from my cohort group at this site and we both created group sessions which were a major success. I enjoyed my experience at the mental health site and I wish I had more time because it wasn’t until near the end of my fieldwork experience that I felt confident in practicing the strategies we learned in class.

My second fieldwork experience was at a pediatric outpatient clinic. The structure of this setting was much different than mental health because there were OTs on site. What I really loved about the site was that my fieldwork educator (OT) involved me during the treatment session and supported my learning during my time there by answering my questions. They shared with me what the child’s goals were, what type of interventions they were using, and asked for my input on what therapeutic activities could be done in order to meet the child’s goal. I will say what was new and interesting to observe was the approach of sensory integration and sensory strategies used during sessions. I enjoyed my experience as there was definitely a lot to learn about and observe that nine weeks was not enough.

My third fieldwork experience was at a continuing care retirement community (CCRC) that provides four levels of care: independent living, assisted living, memory care, and skilled nursing facility. In this setting most of the interactions were with elder individuals in the independent living and assisted living level of care and there was no OT on site. At this site there were three other students from my cohort group and we created activities for the residents while keeping in mind their abilities and limitations. This experience has a special place in my heart as the residents were so welcoming, shared their life experiences, and allowed us to share what OT is about.

Lastly, this semester I am in an outpatient setting for adult rehabilitation. Patients with different diagnoses are seen in this setting for the following reasons: a referral for an OT evaluation, continuing clients attending their treatment sessions, and/or wheelchair evaluations. I truly appreciate my fieldwork educator (OT) as they facilitate my learning when they explain what and why they are doing a screen test and/or assessments for an evaluation. Similarly, during treatment sessions they explain what the client’s goals are and will ask me what therapeutic activities can be done to help meet the client’s goal.

Overall, the level one fieldwork experiences for me have been such eye opening experiences filled with memorable moments. I hope my sharing of experiences serves a glimpse into the fieldwork experience and that you get to create these experiences for yourself. Until next time, Fight On!

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