Importance: Level I fieldwork is an integral part of occupational therapy education, yet limited research exists on how it affects the development of critical thinking skills.

Objective: To compare the influence of a nontraditional Level I fieldwork experience with that of a traditional Level I fieldwork experience on the development of critical thinking.

Design: Nonrandomized, pretest–posttest design.

Setting: Traditional and nontraditional Level I fieldwork.

Participants: Seventy-three fourth-semester Master of Occupational Therapy students enrolled in a physical disabilities or psychosocial Level I fieldwork course. Each group completed the Health Sciences Reasoning Test (HSRT) at the beginning and end of each semester.

Intervention: Sixteen-week nontraditional fieldwork or two 1-wk traditional fieldworks.

Outcomes and Measures: HSRT.

Results: All students showed a significant increase in scores on the Analysis subtest of the HSRT (p = .004). Both Analysis (p = .001) and overall HSRT (p = .025) scores improved significantly for 55 students who completed nontraditional fieldwork. Students who completed nontraditional fieldwork and had taken multiple previous science classes (p = .014) and had a higher grade point average (p = .033) had a greater likelihood of improving their HSRT score.

Conclusion and Relevance: Although in this pilot study both Level I traditional and nontraditional fieldwork improved critical thinking, further development and examination of pedagogical approaches that facilitate critical thinking are needed.

What This Article Adds: Both traditional and nontraditional Level I fieldwork can improve occupational therapy students’ critical thinking skills.