SIGNIFICANCE: In this study, we sought to determine the connection between students’ perceptions of occupational therapy academic preparation and clinical experiences, particularly Level I experiences. By exploring education and clinical practice, we can better sync didactic, lab, and fieldwork experiences for improved student outcomes.

INNOVATION: Accreditation Council for Occupational Therapy Education (ACOTE) Standard C.1.1 focuses on ensuring that fieldwork and curricular content are compatible with one another. For occupational therapy educators to appropriately address ACOTE Standard C.1.1, it is imperative to identify students’ perceptions of fieldwork experiences and how these experiences are similar or different from classroom education.

APPROACH : Research questions include the following: (1) What factors associated with Level I fieldwork positively influence students’ perceptions of occupational therapy? (2) What factors associated with Level I fieldwork negatively influence students’ perceptions of occupational therapy? (3) Do Level I fieldwork experiences alter students’ perceptions of occupational therapy that were developed in their prior academic curricula?

RATIONALE: Educators must be aware of all aspects of the education process, whether in the classroom or in the field. Gaining an understanding of students’ perceptions of the connection between fieldwork and classwork will help to enhance education and to increase student satisfaction.

METHOD: In this quantitative study, we utilized an online survey to gather and describe data. A virtual setting was used as students completed an online survey. A recruitment letter was e-mailed to fieldwork coordinators (FCs) in 18 occupational therapy programs in New York, asking whether they would be willing to forward the survey link to all of their occupational therapy students who had completed at least two Level I fieldworks. Of the 18 programs, 9 FCs responded positively and forwarded the recruitment to students. The resulting sample was 120 occupational therapy students from New York who had completed at least two Level I fieldworks (total students recruited = 298; response rate = 40.27%).

An online survey was used to gather data. The survey was broken into four sections as follows: (1) perceptions prior to Level I fieldwork (Likert-type scale), (2) perceptions of clinical experiences (ranking of most/least positive), (3) perceptions following Level I fieldwork (Likert-type scale), and (4) demographic data. Descriptive statistics were calculated and were used to identify frequencies and percentages related to most/least positive factors associates with fieldwork. We used t tests for means comparison from prefieldwork to postfieldwork.

RESULTS: Students identified that characteristics of the fieldwork supervisor had the greatest impact on student outcomes. Students also perceived hands-on experiences to be better than observation. Perceptions of occupational therapy changed significantly from before Level I to after Level I. Most notably, significant changes in a negative direction were identified regarding students’ perceptions that occupational therapists used occupation-based treatment (t = −6.18, p = .00), used individualized activities for all clients (t = −6.00, p = .00), graded activities appropriately to meet client needs (t = −5.76, p = .00), and used a holistic approach to treatment (t = −5.56, p = .00).

CONCLUSION: There does seem to be a disconnect between what is taught in class and what students see in Level I fieldwork. This mismatch can be frustrating for students. Therapists and educators need to work more closely toward our common goal: creating therapists that are compassionate and competent.