How to Survive Hand Therapy Fieldwork
An OT student recently asked me if I had any advice on surviving hand therapy fieldwork. They confided in me that they were only two weeks into their Level II Fieldwork placement in an outpatient hand therapy clinic, and that the sheer amount of information and learning all of the diagnoses and surgical protocols had felt so overwhelming that they were already feeling “burned out.”
This question was so relatable, and made me reflect on my time as a hand therapy OT student in my Level II Fieldwork, including the stress I felt. I remember working all day, studying through lunch, and then spending hours a night studying from the Indiana Hand to Shoulder Center Diagnosis & Treatment Manual. I still have the notebook that I wrote down all my post-op protocols, notes, and research (10 years into my hand therapy practice, I can’t quite stand the thought of throwing it away!).
There’s a huge knowledge gap between OT/PT school and entering the field of hand therapy; while I can’t solve that problem in one article, I do think that as Certified Hand Therapist (CHT) myself, I can provide some valuable advice to surviving in a Level II Fieldwork hand therapy placement.
1. Talk with your Clinical Instructor
Have an open and honest discussion about their expectations, your concerns, and their preferences on when you can ask questions (are they okay receiving questions while they are with a patient, or do they prefer questions at a designated time, for example).
Some fieldwork placements will have a set structure or weekly expectations for your time in the clinic, while others may not.
But I think it’s reasonable to discuss a plan with your clinical instructor (CI). Together, you can come up with a set of realistic expectations of diagnoses, assessment, and intervention techniques that you can be expected to know each week. Be honest with them about any problems you are facing, and you can likely come up with a system that works for both of you.
2. Set a study schedule
Because most PT and OT schools don’t have much hand therapy-focused education, you are likely going to need to study outside of your work day to feel confident as an entry level clinician.
Plan a schedule each week that includes time for studying (as well as time for hobbies, exercise, and fun things!), and stick to it.
For example, you could spend one hour studying each night after your work day. Once the hour is up, step away and take a break! There’s no need to overwork yourself; you are not expected to know everything nor be an expert clinician at this stage in your career. But studying and learning is going to make you feel more competent, confident, and less stressed each day in your fieldwork.
3. Find time for fun
Being a student in fieldwork is challenging, and your mental and physical health are important!
You need to make time for movement, hobbies, socializing with friends, and other fun activities. Find a balance in your week, just like we encourage our clients or patients to do! Keep up those meaningful occupations, the things that are important to you and keep you mentally and physically well.
4. Find resources that are helpful
There are lots of good resources to help you learn! Some that I have personally used and/or recommend:
Indiana Hand to Shoulder Center Diagnostic and Treatment Manual for Therapists and Physicians
This is kind of what I consider the “Hand Therapy Bible.”
Many clinics will likely have a copy of this text in their clinic. It is a really excellent collection of common diagnoses and surgical procedures, and an evidence based protocol for rehabilitation guidelines that you can start with. As you learn more, you will find yourself using clinical reasoning to expand beyond these guidelines, but as a student or new clinician it is a very helpful starting point.
Hand Therapy Facebook Groups
if you are on Facebook, there are a lot of hand therapy groups with active membership where you can post clinical questions and receive advice from other hand therapists!
Hand Nerds is a group I’m a part of that I recommend, though I know there are lots of others out there. I actually still use this resource from time to time, when I have a particularly difficult patient or diagnosis that I’m not familiar with! It’s a great way to connect with other therapists and get support.
(You can search “Hand Therapy Groups” like I did in this search, as well as “Occupational Therapy Hand Therapy Groups”, etc. to find active groups that will work for you)
Fundamentals of Hand Therapy by Cynthia Cooper
This textbook was part of my OT program curriculum, and I used it heavily for the first 2 years of my hand therapy career. It’s a great starting text for hand therapists and students who are learning.
Connect with Hand Therapists
There are lots of us out there! You can find us on YouTube, LinkedIn, Facebook, Instagram, Tik Tok, etc.
You can also rely on your CI and other hand therapists working at your fieldwork location. Start building your network and open yourself up to learning from others! There are lots of good clinical pearls to be found from other clinicians.
Feel free to ask questions or start a discussion!
5. Be patient with yourself
Hand therapy can be a hard setting, and you are not going to know everything right now. You will likely have moments where you feel completely overwhelmed, or where you have no idea what is going on with a patient, and that’s okay.
Ask for help! Your CI is there to help you learn, and to support you. And if it makes you feel better, they don’t know everything, either! I promise.
The cool thing about hand therapy is that you will continue learning for your entire career. That’s been my experience so far, at least. I am continually learning, and I love that about the field! It keeps things exciting.
Be patient with yourself, and find some way to be ok with the fact that you aren’t going to be perfect at this yet.
It’s okay. Allow yourself the space to grow!
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I hope this advice is helpful for any of you amazing students out there reading it. Take comfort in the knowledge that you are doing something incredible, and think of all the patients you will be able to help.
Hand therapy is a truly special practice setting, and while it can feel overwhelming or stressful at times, it is also incredibly meaningful and rewarding. Remember that fieldwork is a temporary experience, and that you can get through it because you are capable of hard things.
Learn everything that you can, and don’t forget to take time for yourself to do activities you enjoy. And try to enjoy your time as a student, because it doesn’t last forever!
Go forth and survive thrive.
If you have any tips to survive hand therapy fieldwork, please leave them in the comments below!
Additional Hand Therapy Resources from My OT Spot:
