Hurry up and wait

Health sciences students navigate tricky world of certification, clinical training and job-seeking in the middle of a pandemic

In a way, Alyana Simpron is lucky.

As one of the 40-plus Master of Occupational Therapy (MOT) students at the UND School of Medicine & Health Sciences (SMHS) whose clinical training — and thus graduation — has been upended due to COVID-19, Simpron had been stuck in a strange limbo where she was neither a student nor a certified therapist.

And then she remembered her other job.

“I’m actually competing for the title of Miss North Dakota in July — so I’m busy with that,” said the third-year Master of Occupational Therapy student from her parents’ home in Bismarck. “So I can’t commit to a job yet anyway.”

Occupied therapy

Simpron’s story is familiar for most locked-down health sciences students at UND — including those in occupational and physical therapy, athletic training, medical laboratory science, and physician assistant studies — who are mostly sort of just waiting.

“I spent three weeks at home before getting information about how to proceed,” sighed Simpron’s classmate Karen Jaspers. “This ‘unknown’ was frustrating, and it was difficult feeling useless and having to just wait.”

Both Jaspers and Simpron were waiting on direction not from the School’s Department of Occupational Therapy, but the Accreditation Council on Occupational Therapy Education (ACOTE), one of several organizations stuck with the difficult task of determining how to keep the pipeline of fresh health providers flowing despite a global pandemic.

“I’ll be working on a couple projects for my supervisor that will benefit the facility I was at,” Jaspers explained. “I’m creating a group curriculum using evidence from the Substance Abuse and Mental Health Services Administration and compiling some hands-on activities for one of the occupational therapy groups. Many of my classmates are doing other site-specific program development to fulfill their fieldwork requirements.”

“But I am for sure on track to graduate in May,” she added. “Some of my classmates may have to delay graduation if they hadn’t gotten as far in their fieldwork experiences.”

Serving as the mediator between ACOTE and the students is Janet Jedlicka, professor and chair of the OT Department, who sees both sides of the conundrum.

“We are working with sites and students, and have identified possible options,” Jedlicka explained. “We have shifted level-one fieldwork placements to virtual simulations. And we’re working with the UND Registrar and Financial Aid office to see if it would be possible for our year-two students to flip fall and summer semesters.”

Jedlicka admits, though, that clinics that would typically accept OT students are in a tough spot too.

“Given the current status of the pandemic, many sites are not wanting to take on students, which we understand,” she said. “We are looking into the possibility of having the fall didactic sessions taught this summer — hopefully with a longer semester — and trying to get our students out for their fieldwork in the fall and spring.”

But none of this is crystal clear yet, which is why answers to these questions — will fieldwork sites accept students? will ACOTE waive certain requirements during an unprecedented pandemic? will students even be able to graduate? — have been slow in coming for some students.

Physical therapy while physical distancing

In the School’s Department of Physical Therapy, things are much the same. Just ask Tyler Trumble.

“The pandemic resulted in me and my classmates being pulled from our final clinical rotation,” wrote Trumble in an email to North Dakota Medicine. “While I am still able to get my degree, COVID-19 has prevented me from gaining valuable clinical experience.”

According to Trumble, while the need for physician and nurses has dominated headlines, therapists too are working on the front lines to help those affected by COVID-19, and are suffering themselves as a result.

Acute care notwithstanding, many outpatient physical therapy clinics are taking in much less revenue and are having to lay off therapists. Consequently, without therapy many clients are experiencing limitations and even declines in their function, Trumble said.

“Some outpatient clinics have implemented telehealth services to help patients progress in their rehabilitation, provide education and answer any questions patients may have,” he said. “A number of insurance companies have made changes to cover such telehealth visits with certain stipulations. This has been beneficial; however, telehealth services have their limitations and aren’t appropriate for everybody.”

Like Jedlicka, PT Department Chair Dave Relling is navigating the delicate path of maintaining standards, helping students graduate and enabling faculty to perform for the University despite quarantine.

“From my perspective, it has been challenging as students, faculty, and staff ride a roller coaster of hope and concern during this unprecedented time,” Relling said. “We continue to plan and respond to the shifting expectations and realities that this situation presents. Thankfully we have excellent faculty, staff, students, clinical partners, and SMHS leadership to assure that educational needs are strongly supported. The American Physical Therapy Association has used the #bettertogether hashtag for some time, and that sentiment seems to fit now for how things are working in the Department of Physical Therapy.”

Making it up as they go

All of which is to say: everyone is sort of making this up as they go.

“My classmates and I would normally take our boards on specific dates in April or July,” Trumble continued. “Unfortunately, due to COVID-19, the April test was canceled and has not been rescheduled yet. Having planned to take my exam in April, this uncertainty of when I might get to sit for my boards has caused some anxiety.”

Likewise, both Simpron and Jaspers admit to studying as best they can for their board exam, the passing of which is required for students to become certified occupational therapists and which can be taken before students have officially graduated from an accredited OT program school.

“I will have to take my certification exam at least a month or two later than I had originally planned,” Jaspers said.

Of course, tests can be rescheduled and passed. What can’t be recovered is the hands-on clinical time each of these students has lost.

But like Jaspers, Simpron was fortunate to hear recently that she, too, has been approved to complete her remaining 56 hours of fieldwork at home in Bismarck.

This news will both allow her to keep up her skills and “make sure that I’m on track to graduate in May.”

In any case, a job search still has to wait because the Miss North Dakota Pageant is calling.

About the author

Brian James Schill is the assistant director of the Office of Alumni and Community Relations at the University of North Dakota School of Medicine & Health Sciences.