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Keuka College News

Beyond the Hospital Walls

In the world of higher education, the niche Keuka has carved with its occupational sciences program is virtually unparalleled for a small, private, liberal arts college.

Studying anatomy of the body is part of Keuka's OT program.

In 2010, three state-of-the-art occupational therapy (OT) labs opened where students are taught cutting-edge OT techniques. Keuka boasts a pediatric play lab, a clinical care lab and a community living skills lab, set up much like a small apartment, where some 95 upperclass and graduate students take classes in occupational science. Nearly all students in Keuka’s OT program go on to a fifth year of study at the graduate level, in order to qualify for the certification exam that must be passed to obtain a permanent license as an occupational therapist.

A unique change to the program is that while Keuka’s OT students are building diverse, hands-on skills, it’s not all happening inside the walls of hospitals or schools. Traditional placements like a hospital are now supplemented by non-traditional placements, said Jean Wannall, Ph.D., who coordinates field work placements for OT students and is a full professor in the program.

“We’re seeing fewer jobs in traditional settings because of the changes in Medicare and Medicaid,” said Wannall.”A lot of agencies are downsizing and letting therapists go, so we are training therapists to be entrepreneurs, to go out and seek places where there could be a niche. At hospitals, the length of stay is shorter and shorter these days as people are being pushed out into the community quicker and quicker. More care is happening out in the community.”

Toys are part of therapy for children in the OT program.

In addition, OTs may find more work with assisted living communities or home health care as more members of the aging population try to stay in their own homes as long as possible, Wannall said. Keuka lies in Yates County, one of the poorest counties in the state, and other opportunities for non-traditional OT support may lie in areas with migrant workers, those who are illiterate, or other needy individuals, she said.
“As OTs, we’re trying to get out in the community more and do placements where an organization doesn’t have an OT right now. It’s a job opportunity. It’s expanding your [options], taking initiative. What could you do? What could you offer to this clientele?” Wannall described, noting this is Keuka’s second year of placing OT students in non-traditional therapy settings for a 70-hour assignment.

Keuka OT students are now working with organizations such as Literacy Volunteers of Ontario or Yates Counties, Syracuse Rescue Mission, Keuka Comfort Care, and the  D.R.I.V.E. program, a partnership between the Yates ARC, Penn Yan Central Schools and the College that provides on-campus learning and life training skills to area students with special needs, ages 18-21. Wannall said she is placing Keuka OT students “all over, from Maine to New York.”

Senior Jessica Van derPoel of Horseheads completed a Level 1 field work placement with the D.R.I.V.E. program in the fall, teaching a class on community mobility to six D.R.I.V.E. students. Under her tutelage, students used maps, planned transportation for trips, and learned basic safety skills and rules of the road.

“I didn’t have a lot of students with physical disabilities–there were more intellectual disabilities, which usually meant explaining things in a different way, or doing more hands-on learning activities, for them to better understand it,” she said.

One of those activities was use of the life-like driving simulator machine in the pediatrics lab that creates a virtual reality where students can sit in a unit with seat belts, pedals, a wheel and experience the feel of an ignition starting at the turn of a key, braking to slow down and other common vehicle operations. The machine can be a valuable teaching tool for those D.R.I.V.E. students able to test for a learner’s permit.

Van derPoel said that the machine can test reaction time and she was able to discuss how it can slow when a driver is distracted by loud music, active friends in the car, or alcohol impairments.

According to Wannall, another senior taught a healthy living and cooking skills class to 10 D.R.I.V.E. students who used the community skills lab kitchenette to prepare meals and snacks, practice how to save money with coupons, read labels for nutritional information, and learn portion equivalencies. In addition, the students also used pedometers to track daily walking logs, and practiced exercise with a Wii entertainment machine, to support the healthy lifestyle practices they were learning.

The D.R.I.V.E. Thanksgiving dinner, 2011

“At the end of the fall semester, we had the two classes combine and they cooked up a big Thanksgiving dinner,” Wannall said. “One class did the long-term preparation, and the other class did the last-minute prep for it.”

Wannall’s two student course leaders “actually created the syllabus, developed the course descriptions, came up with course goals and objectives and came up with a weekly log of activities [to go with] what was going to take place each week with a weekly class session,” she said. “It was a challenge for our students right from the get-go.”

Van derPoel said other OT students placed in the literacy or home care organizations mentioned that they, too, were not teaching just physical skills of daily living, but reading skills or coping skills.

“You hear ‘reading’ and automatically think ‘teachers,’ but this shows how OT can supplement other areas out there. It just gives a broader perspective on the role of OTs in the future. We’re not just in hospitals — we can be seen across the community helping others in all different ways,” Van derPoel said, adding she has a personal interest in autism spectrum disorders.

In another non-traditional placement, senior Jessica Ingutti of Rochester completed a Level 1 field work placement with Bridges for Brain Injuries, a group serving those who sustained traumatic brain injuries (TBI’s). A primary part of that organization’s outreach is a program known as the Wildlife Defenders, which enables clients with TBI  to teach presentations about wild animals.

Boomer the wallaby, one of the animals used in the Wildlife Defenders program (Courtesy Bridges for Brain Injury).

Ingutti said she observed about 10 clients – some young adults, but most middle-aged – coming in to the Canandaigua center, who would research animals on the computer to discover what they could share in presentations to the public. The Canandaigua group featured a porcupine, two tortoises, a few lizards, a couple exotic birds, stink bugs, an opossum, a wolf and a fox, she said.

“The handlers would determine what was safe for clients to do,” she said. “The handlers would bring the animal out, walk it around and hold it, while the clients would be reading scripts they had written up about each animal – what they were, where they came from, what their diet was, how they care for them and taking questions. ”

“I definitely learned that there’s a place for OT in these unique settings,” Ingutti said. “It would be something interesting and relevant to the profession to explore and expand options.”

Senior Alicia Masloski of Lodi in Seneca County, spent a portion of her fall semester on assignment at Keuka Comfort Care, a small community-run facility that hosts no more than two residents at a time for end-of-life care in a family-style setting. As most residents are too weak to move from their beds, much of Masloski’s work involved personal care such as changing sheets around a resident, assisting them with meals if they were eating, and calming family members who might be fearful of leaving a loved one’s bedside.

Masloski said her clinical training enabled her to offer insights to the volunteers providing non-medical care, such as suggesting a one-way “valve” straw that could help a patient sip without exhaustion, or a headset attachment for a patient to make a telephone call without requiring a volunteer to hold a phone against the patient’s head.

“It helped me with my interpersonal skills. It’s kind of like jumping into the pool without your floaties to learn how to swim. You’re not just going into a hospital to help someone put on a gown. You’re helping someone at the end of their life and it’s a big deal, and it’s not just a client you’re working with but a family as well, in a critical moment of time in their lives. It’s also being creative, based on volunteers and donations, so as to not be wasteful and figure things out like that.”

Keuka's clinical skills OT lab, where proper therapy techniques are learned.

Masloski was so struck by how rare it was for a community-built and run facility such as Keuka Comfort Care to succeed at its mission that she stayed on as a volunteer.

“They’re not asking for help from the government or anything and they’re succeeding. It’s a beautiful place. It’s not just the residents but the volunteers there that are good people to work with,” she said.

According to Wannall, the objective of Keuka’s OT program is to best prepare students for the certification exam, but that is a challenge in itself because “you graduate with a B.S. in occupational science and yet you can’t become a therapist. You go out for the first Level II experience for three months, come back in the fall and start a graduate project, then leave campus again, January – March, to do a second Level II [placement].

“The exciting thing is these agencies are open to having students and excited about the possibility. Our objective is to expose the students to these agencies and give them an opportunity to find out what it’s all about.”

Therapy training also happens in the Pediatrics lab.

And according to Van derPoel, “OT is all about education. Whether we’ll be in traditional settings or non-traditional settings, we’ll always be teaching our clients something, whether it has to do with dressing or how to get around the community. Working in these areas is newfound territory for OT.”

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