Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Education (EdD)


Abraham S. Fischler College of Education


Kathleen Kardaras

Committee Member

James Miller


Bridge Program, Competency, Fieldwork Shortage, Level I Fieldwork, NBCOT Pass Rate, Virtual Simulation


This applied dissertation was designed to investigate student responses to three different instructional strategies used to fulfill level I fieldwork requirements: traditional in-clinic rotation, a combination of virtual simulation and traditional in-clinic rotations, and virtual simulation. A multi-decade occupational therapy (OT) fieldwork shortage was exacerbated by the COVID-19 pandemic, in which OT education programs struggled to provide accreditation-required clinical education. Virtual simulation programs were utilized to fulfill some requirements, particularly more introductory-level fieldwork. Several cohorts of a Masters of Science in Occupational Therapy “bridge” program for licensed, practicing Certified Occupational Therapy Assistants and Physical Therapist Assistants were the subjects of this study. Very little research exists about this group of occupational therapy students.

Students who graduated prior to the pandemic fulfilled level I fieldwork requirements with brief (4-day) traditional in-clinic fieldwork rotations. Students in the program in 2020 completed two brief traditional in-clinic rotations and one virtual simulation rotation. Students in the program from 2020 on completed only virtual simulation to fulfill the level I fieldwork requirement. This study utilized National Board for Certification in Occupational Therapy (NBCOT) first time pass rate exam data and Fieldwork Performance Evaluation scores for each cohort between 2016-2022 as outcome measures. Using a situated learning theoretical framework to design the study, the researcher hypothesized the null: there would be no statistically significant differences of the NBCOT exam score means or in the Fieldwork Performance Evaluation Form (FWPE) scores between groups that experienced the three instructional methods used to fulfill level I graduation requirements: Virtual Simulation, (very brief) traditional in-clinic fieldwork rotations, or a combination of both traditional in-clinic rotation and virtual simulation. This study also investigated potential associations between the amount of virtual simulation a student experienced and FWPE scores as well as NBCOT first-time pass rates. This study will provide more information about instructional methods for fulfilling level I requirements that may be especially supportive of “bridge” students’ learning needs while taking into account their work experience and the additional life demands of this population of nontraditional adult learners.