Entry-Level Occupational Therapy Capstone A Framew... - (Part I Development)

CHAPTER 4
Capstone Site Development and Communication
Julie A. Bednarski, OTD, MHS, OTR Rebecca Barton,

DHS, OTR, FAOTA
Human-Centered Design Mindsets for the Doctoral Students

Human-centered design mindset concepts of learning from failure and continuing to
embrace ambiguity are important for doctoral students to embrace as they embark on
planning for a site and finding a site mentor for the capstone experience and project.
Learning From Failure: It takes time to determine a potential site for your experience
and project, and not all initial ideas will be successful. Do not give up! Keep on
communicating and reaching out to sites with your ideas, and you will find a site that
Copyright © 2019. SLACK, Incorporated. All rights reserved.
needs help solving a problem. The first site you meet with may not be a good fit, but
learn from the first site meeting and continue on to find another site, which may end up
being the perfect fit. By meeting with people, you will continue to grow your doctoral
capstone experience and project.
Embrace Ambiguity: Remember ambiguity allows you to be creative, and new ideas
are formed from embracing ambiguity. You do not know the answers before you begin
communicating with sites, and that is okay. You want the sites to communicate to you
their specific needs and problems for you to assist in seeking solutions.
DeIuliis, E. D., & Bednarski, J. (Eds.). (2019). Entry-level occupational therapy capstone : A framework for the experience and project. SLACK, Incorporated.
Created from vermontdana-ebooks on 2024-01-16 15:22:15.
INTRODUCTION
The final phase in the development of the doctoral capstone experience (DCE) and project
is site development. Development of sites for the capstone student is important and involves
exceptional communication and education. Capstone placements tend to have more
ambiguity than fieldwork placements because the DCE is a newer concept—not only to
occupational therapy programs but also to fieldwork sites and community partners. Many
occupational therapy programs are now developing their DCE frameworks while
simultaneously educating and communicating with current sites while developing new sites
(Evenson & Connor, 2015). Developing the DCE requires communication and collaboration
with the occupational therapy student and potential sitessite mentor and is often a process of
communication different from that of fieldwork. The differences between fieldwork and
capstone experience placements are explored in this chapter. The DCE and project process is
unknown to many sites, and there are often misconceptions about what the capstone is and
what it is not. As the capstone development and inspiration continues, it is important to
establish communication with both traditional and role-emerging areas of practice sites. This
chapter assists the reader in exploring potential capstone sites, relationship development, and
the importance of initial communication.
Capstone Student Reflective Questions

During the final steps of the development phase of the doctoral capstone, the occupational
therapy student may find it helpful to reflect on the following questions:
1. What potential sites or populations do you have in mind for your DCE?
2. Think about your surrounding (or home) community. Are there unmet needs? If so,
what are they?
3. Are you familiar with a specific site through Level I and Level II fieldwork or other
means that might be of interest to you? If so, what are the sites?
4. What is your occupational therapy program’s policy and expectations regarding
communication with potential capstone sites?
Chapter Objectives
By the end of this chapter and completing the learning activities, the reader should be able
to:
1. Compare and contrast site procurement for the fieldwork experience and the DCE.
2. Articulate a flow of communication to the DCE sites.
3. Determine a plan for site development in both the traditional roles and role-
emerging areas of practice.
4. Assess how different rules and regulations may influence the DCE plan.
ROLES OVERVIEW
Chapter 1 explored the similarities and differences in the overall definitions of fieldwork
Level I, Level II, and the DCE and project. This chapter begins by broadly exploring the roles
of the academic fieldwork coordinator vs the capstone coordinator to give a foundation for
the discussion of site communication and procurement. The academic fieldwork coordinator
is responsible for the fieldwork curriculum and must ensure that fieldwork not only meets the
Accreditation Council for Occupational Therapy Education (ACOTE) requirements but also
is integrated within the academic program curricular threads and goals. The doctoral
capstone coordinator is responsible for the capstone experience and project and also must
adhere to the ACOTE requirements and “ensure that the doctoral capstone is designed
through collaboration of the faculty and student, and provided in setting(s) consistent with
the program’s curriculum design” (ACOTE, 2018, p. 44). Both the doctoral capstone
coordinator and the academic fieldwork coordinator have multifaceted responsibilities,
including education to faculty and administration, student education and preparation, and
site development and oversight. Table 4-1 gives the reader a comparison of the roles and
responsibilities of the academic fieldwork coordinator and the capstone coordinator.
Education to Faculty and Administration

Education to faculty and administration at the academic institution on the overall
program, whether fieldwork or capstone, is often the first task of both the academic fieldwork
coordinator and the doctoral capstone coordinator. Once faculty and administration have an
understanding of each program, moving on to educating potential sites and site personnel is
important. Throughout this educational process, the academic fieldwork coordinator and
doctoral capstone coordinator are ensuring compliance of ACOTE Standards and
establishing the legal agreements between the site and the academic institution.
Student Education and Preparation

Student education and preparation is another important role taken on by both the
academic fieldwork educator and capstone coordinator. In preparation for both fieldwork
and the DCE, professionalism is important to address with students. The academic fieldwork
coordinator and doctoral capstone coordinator are educators and role models to the doctoral
students for professional behaviors needed for fieldwork and the DCE (DeIuliis, 2017).
Professional (practice-ready) behaviors and the importance of professional communications

for the capstone student is an area addressed in Chapter 5. Determining fieldwork sites vs
capstone sites is a different process, and students need to be aware of this early in their
academic program. Education to students on the processes and expectations of fieldwork and
DCEs is a role of both the academic fieldwork educator and doctoral capstone coordinator.
This leads into the role of site development and oversight, which is another responsibility of
the academic fieldwork coordinator and doctoral capstone coordinator.
Establishing and Developing New Sites
The academic fieldwork coordinator and doctoral capstone coordinator each have a
significant role in establishing and developing fieldwork and DCE sites that will serve as an
educational experience for students. From a fieldwork perspective, initiation of new sites
often occurs when students are wanting to complete Level I or Level II fieldwork at a location
where the fieldwork program does not have a current relationship. This same process will
occur for initiation of a DCE site. Both the academic fieldwork coordinator and doctoral
capstone coordinator are responsible for developing relationships with new sites that will
meet the needs of the fieldwork and DCE programs. Both programs should be congruent
with the academic program and with accreditation standards (ACOTE, 2018).
Table 4-1. Role Comparison Between Academic Fieldwork and

Doctoral Capstone Coordinators
ACADEMIC FIELDWORK DOCTORAL CAPSTONE
COORDINATOR COORDINATOR
Faculty and Administrative Education
Education of faculty and Overall education to faculty and
administration on the FW administration on the capstone
program experience and project
Assurance of compliance of Assurance of compliance of ACOTE
ACOTE FW standards DCE standards
Facilitation of legal agreements Facilitation of legal agreements with
with FW sites DCE sites
Education to students, sites, FW Education to faculty mentors, site
educators on all aspects of FW mentors, and students
Student Education and Preparation
Model and reinforce professional
behaviors Model and reinforce professional
Provide guidance to student in behaviors
order to best match the student Collaborate with student on site
to the FW site identification

Integrate classroom learning with Integrate classroom learning for
application to the FW setting application to DCE setting
Provide education about the FW Provide education on self-directed
settings and expectations learning and expectations of the DCE
Provide feedback on FW Provide feedback on DCE performance
performance
Site Development and Oversite
Establish and develop new DCE sites
Develop new FW sites and build relationships
Provide education regarding FW Mentor and collaborate with current
best practice DCE sites
Mentor existing FW educators Determine which current FW sites may
Complete ongoing program be appropriate DCE sites
evaluation Complete ongoing program
evaluation
FW = fieldwork.
Once a site is established, it is important to continue to build on the relationship and keep
fieldwork/DCE site personnel up to date on new policies or ACOTE Standard changes, as
well as occupational therapy curriculum information. For example, if students are completing
Level I fieldwork, it is important that the fieldwork site and personnel understand the
curriculum sequence and courses the students have completed. Students are encouraged to
share their current knowledge of best practice learned within the classroom. Students can
share with the fieldwork educators their course content and learning activities that they have
completed before fieldwork or what they will be doing in future coursework. This reciprocal
education between the fieldwork educator and the fieldwork students can be a rich
experience. In addition, the role of the academic fieldwork coordinator can be “professionally
rewarding and (involves) factors contributing to perceptions of professional reward” (Stutz-
Tanenbaum, Greene, Hanson, & Koski, 2017, p. 20).
As sites are developed and relationships are established, students begin their site
exploration for both fieldwork and the capstone experience. These are different processes and
require different communication.
FIELDWORK SITE EXPLORATION

When first exploring fieldwork sites, students should consider the various settings in
which practice occurs and the populations that would benefit from the distinct value of
occupational therapy. This process may actually start informally before students enter the
academic program through exploration of the occupational therapy profession as a possible

career. As students continue this exploration during their courses, the exploration process
deepens as they start to think about what lies ahead with their fieldwork placements.
Investigating the fieldwork sites with whom the academic program has a relationship is a first
step in exploring where the student would like to go for Level I and Level II fieldwork. The
American Occupational Therapy Association (AOTA) Fieldwork Data Form (FDF) is one
tool that can facilitate student exploration of potential sites (AOTA, 2017). Occupational
therapy faculty should have access to the AOTA FDF if this information has been provided to
the academic fieldwork coordinator by the site.
In addition, students should be encouraged to research areas of practice and specific
practice sites and settings used by the academic program to have a better understanding of
the occupational therapy generalist. Students often come to the academic program with ideas
for occupational therapy fieldwork placements based on previous shadowing experiences.
More ideas will surface as the students continue to learn about the practice of occupational
therapy in their didactic courses. The academic fieldwork coordinator will also facilitate this
exploration during the education and planning phase and the fieldwork selection process.
Exploration of potential doctoral capstone sites begins in the development stage of the
capstone as students are exposed to potential sites through in-class site presentations,
previous doctoral student experiences, student contacts within their community, fieldwork
placements, and community contacts through the school. Exploration of capstone sites is
discussed later in this chapter.
FIELDWORK COMMUNICATION
The role of the academic fieldwork coordinator is to facilitate communication with the
various fieldwork sites via fieldwork educators and, when applicable, the clinical coordinator
of fieldwork (Hanson & DeIuliis, 2015). It is essential that there is congruence between the
fieldwork site and the academic program (ACOTE, 2018). Does the fieldwork site embrace
and exemplify the goals and objectives of the academic curriculum? Is best practice at the
fieldwork site current with regard to evidence and accreditation standards? Do both the
students and the fieldwork educators know what is expected of them?
It is important for students and their fieldwork educators to understand the policies and
procedures of fieldwork and the importance of professional communication. With regard to
fieldwork, most academic settings have procedures regarding communication between
potential fieldwork sites and fieldwork educators. Traditionally, the academic fieldwork
coordinator will be the point person in developing appropriate fieldwork sites including
making initial contact with the fieldwork site regarding a student placement for Level I or
Level II fieldwork. In addition, the academic fieldwork coordinator may be interviewing the
fieldwork site clinical coordinator or potential individual fieldwork educators. The following
are potential questions an academic fieldwork coordinator may ask when meeting with a
potential fieldwork site.
TEXT BOX 4-1

The interview may consist of inquiring about what type of practice settings are
available:
Is this site a large hospital with many areas of practice?
What is the age range of clients, and what type of occupational therapy
programming is currently being used? Does the site currently host students
from other schools for fieldwork?
Are there existing goals and objectives for fieldwork from the site perspective?
What is the supervision process at the fieldwork setting, and does this process
meet ACOTE accreditation standards?
Have the occupational therapy practitioners been provided with resources
and training for their role as fieldwork educators?
Does this potential fieldwork site have the resources and desire to provide an
appropriate educational experience for Level I or Level II fieldwork?
What is the supervision model for students?
In planning formal fieldwork experiences, most academic programs and traditional
fieldwork sites prefer that the initial contact from the school come from the academic
fieldwork coordinator rather than from individual students because of the administrative and
educational questions noted in the preceding text box. In addition, some sites receive
numerous requests and have organizational guidelines that are best addressed first by the
academic fieldwork coordinator and the clinical coordinator at the fieldwork site. That being
said, some sites require a face-to-face or phone interview, and those that do not may still
appreciate the personal outreach.
In some areas of practice, students must shadow for a day to ascertain whether this is a
good match for the student, the fieldwork educator, and the population. For instance, if a
student wants to complete a fieldwork rotation in an area such as burns and wound care, it
may be a fieldwork site requirement for that student to spend time with an occupational
therapy practitioner working in this area of practice before being considered for placement.
FIELDWORK GOALS AND OBJECTIVES

Through guided learning, students will inevitably experience emotions and some
ambiguity, especially at the beginning of the fieldwork rotation. For that matter, fieldwork
educators may experience the same thing as they embark on training students. It is important
to have clearly established goals and objectives for the student to reduce ambiguity (AOTA,
2009; Dickerson, 2006). Establishing goals and objectives is also needed for the DCE;
however, it is a different process and is discussed later in this chapter. In contrast to the DCE
site, the fieldwork site develops goals and objectives specific to that site before taking
students. To facilitate this process, it is necessary for supervising personnel to have good
interpersonal skills that can be modeled for students during fieldwork. These behavioral goals
are developed in collaboration with the site and the academic fieldwork coordinator based on
entry-level expectations for that specific site so that students are clear on what is expected of
them (ACOTE, 2018). Even with these established goals and objectives, there will be times of
ambiguity, and there are many multifaceted factors to consider in fieldwork, including the
client’s areas of concern, the family, the other disciplines involved, different approaches to
practice, and many more. Learning to negotiate and analyze these factors that do not always
follow the “protocol” or “what I learned in a textbook” creates ambiguity and may ultimately
disrupt the student’s plan. Some might call this a failure, but really, it is an opportunity for
growth and improvement as noted in human-centered design.
DOCTORAL CAPSTONE SITE COMMUNICATION

Collaboration between the academic fieldwork coordinator and the doctoral capstone
coordinator is a key aspect of developing capstone sites. At the start, it is important for the
academic fieldwork coordinator and the doctoral capstone coordinator to educate the current
fieldwork sites and community sites to the capstone experience and process. This preemptive
communication will allow questions to be asked and misconceptions eliminated. The earlier
in the process these educational meetings can take place, the better. The goals of these
meetings reach beyond education and information gathering. These meetings often lead to
discussion of site needs and how a capstone student may be able to assist in filling a need at
the site. During the meetings, the capstone coordinator can also be determining congruence
between the capstone experience site and the academic program.
TEACHING TIP 1: If the occupational therapy doctoral (OTD) program is new or has
transitioned from a master’s to a doctoral program, it is recommended that meetings
with the doctoral capstone coordinator and the academic fieldwork coordinator are set
up with fieldwork sites, especially larger hospitals, to discuss how the DCE is different
from fieldwork. The goal of these meetings should be to educate the sites on the new
ACOTE Standards for the capstone experience and project, discuss your school’s
process of the doctoral capstone, and describe the differences between fieldwork and
the capstone. These meetings can also lead to brainstorming ideas for projects at the
sites.
TEACHING TIP 2: In my role as the capstone coordinator at the University of Indianapolis, I

was able to meet with the therapy managers of a large local hospital to explain our
program’s transition to the OTD degree and the addition of the DCE and project. During this
educational meeting, the managers identified potential program development needs,
clinical skills areas, leadership areas, and research opportunities for the students. This led to
one of the managers visiting class and describing to the students her ideas for potential
capstone experiences and projects at the hospital as they were in the development phase.
This in turn led to three students completing their capstones at that hospital system in 2018.
—Julie A. Bednarski, OTD, MHS, OTR
Clinical Associate Professor
Associate Program Director
School of Health & Human Sciences
Department of Occupational Therapy
Indiana University
Indianapolis, Indiana
When meeting with sites to discuss the doctoral capstone process, the questions that are
asked may be different from those that are asked to potential fieldwork sites. Plan ahead for
these meetings and prepare questions. Table 4-2 identifies potential questions a doctoral
capstone coordinator may ask when meeting with a potential capstone experience sites that
are community or role-emerging sites.
Throughout the conversation at the site, think about your program’s curricular threads
(e.g., evidence based, occupation based, professionalism) and design. Determine if there is a
link between the site and your program. For example, the site may be an adult day center and
use a person-centered approach. The site director states that the “person” is central to all
aspects of care and provides training to all staff on the person-centered approach. The site
director is involved in the community and stays up to date on literature and legislation
related to older adults and adult day centers. This philosophy is in congruence with the
school’s philosophy and this site appears to be a good fit.
TEXT BOX 4-2

In my role as the capstone coordinator at the University of Indianapolis, I found myself
meeting with all types of people from a variety of organizations. Oftentimes I was reaching
out and meeting with personal or professional connections I had, or people my colleagues,
friends, and/or family members connected me with.
I love going out to sites to explain the doctoral capstone process and finding a link with an
organization—finding the win-win connection. I have been meeting some wonderful
people doing amazing things to improve the lives of others. Seeing the “light bulb” moment
when they realize how occupational therapy can contribute to their mission is the start of a
great partnership and how capstone projects begin.
—Julie A. Bednarski, OTD, MHS, OTR
Clinical Associate Professor
Associate Program Director
School of Health & Human Sciences
Department of Occupational Therapy
Indiana University
Table 4-2. Questions for Potential Community and/or Role-

Emerging Sites
What is the mission of your organization? (This will allow the doctoral capstone
coordinator to determine whether there is a link between the organization and
your program’s mission.)
Who are the clients you serve?
What is the organizational structure?
What types of professionals serve the clients, and are there any occupational
therapists within the organization?
Do you have personnel whom you feel may want to be a site mentors, and what
are their educational backgrounds?
Do you have students from other disciplines that serve your organization?
What are your funding sources?
What types of services do you provide?
Questions that the doctoral capstone coordinator may ask when visiting traditional sites
or that already have an established relationship with the program through fieldwork will be
different from those discussed in Table 4-2. Table 4-3 give examples of potential questions for
traditional sites or those with an established relationship through fieldwork.
Again, throughout the conversation, think about the link of the site to your program’s
curriculum design. Is there a link, and if so, what is it? Does the site provide services to an
underserved, marginalized population? Does it practice an evidence-based approach to care?
If social justice or occupational justice are central to your program design and the site is a
public, urban hospital that serves all regardless of payer source, this may be a good
collaboration.
There may be times the capstone student is making the first contact with a site, and the
capstone coordinator may become involved in education after the initial communication. An
example of when a capstone student may meet with a new site before the capstone
coordinator is if the student already has a well-established relationship with the site. It is
important, however, to discuss how site communication and exploration will take place
within your individual programs. Establishing a policy for communication will be helpful and
is discussed later in the chapter. One-on-one meetings between the capstone coordinator and
capstone student is important as site exploration begins. Some students may have well-
established community connections and ideas for a site and project secondary to prior
experiences.
TEXT BOX 4-3

From elementary to high school, I was a competitive cheerleader and always had a
passion to start a cheerleading team for those with special needs in my hometown. As I
went through school to one day become an occupational therapist, I thought those dreams
would be put on the back burner. Little did I know the opportunities that the DCE would
bring me. I am bringing my past passions into my future schooling, allowing the process to
be easier and allowing my passion to guide me. In 2020, with the opportunity given by the
doctoral capstone class, I will be starting a cheerleading program for special needs in my
hometown, and I cannot wait! This cheerleading program for individuals with special
needs will allow for so many opportunities that most people in this population do not have
access to in my hometown. They will have the opportunity to learn basic cheerleading and
tumbling skills, engage in social interactions, have a peer mentorship experience, and
potentially increase their quality of life!
—Megan Kraft
Doctoral Occupational Therapy Student
Class of 2020
School of Occupational Therapy
University of Indianapolis
Table 4-3. Potential Questions for Traditional Fieldwork Sites

Are you familiar with the DCE?
Have you had any previous DCE students?
Where do you see a fit for a DCE student?
What types of clients do you serve?
What types of services do you offer?
What programming do you currently have at the site, and do you have program
development needs?
Are you doing research, and if so, do you have student involvement?
What new initiatives has your organization identified?
Communication and Site Exploration Process for the Doctoral

Capstone Experience
As we have noted, the academic fieldwork coordinator takes the lead on the fieldwork site
procurement and development in most programs; however, this is not always the case for the
capstone. For the DCE, the student may take the lead, working in collaboration with the
capstone coordinator to identify a site that is a good match. Figure 4-1 gives the reader a
visual of the site communication process for the DCE.
Initiating Communication With Proposed Sites

As students begin the development phase for their DCEs, first the students need to spend
time brainstorming potential sites based on their proposed idea or focus area of interest. One
way to do this is for the doctoral capstone coordinator (or occupational therapy faculty) to
invite site personnel to the class when the OTD students begin the development phase of
their capstones. This provides an excellent way to exchange ideas. It is a time for the sites to
discuss their needs and ideas and for the student to get inspired about ideas for potential sites
that might welcome them and their project purpose. Jirikowic et al. (2015) recommends
having community and clinic sites present proposals on potential projects they would like to
have master’s level capstone students complete. The faculty members determine which
proposals will move forward to the students, and the students rank their choices for capstone
experiences and projects based on the proposals the site has outlined. This model could also
be used for DCEs.
Throughout this process, it is important for the student to reflect back on the mindset of
embracing ambiguity in human-centered design. Identifying a site is a process, and there is
not a cookie-cutter or perfected method for securing the site that matches the student’s
doctoral capstone project purpose. Not all sites will be a good match for students and their
idea, and not all sites will agree to take a capstone student. This can be frustrating to students
because things may not “fall into place” as they would like. Students are driving the process
and need to make decisions relative to site identification based on their project purpose and
persevere until a site is mutually agreed on. The process of identifying and securing a DCE
site has many ambiguities, and if the student can embrace this, it will be a more positive
experience.
Although it can be done several ways, a determination needs to be made as to the process
for securing capstone experience placements. Who will make the initial contact? Will the
student be the one to reach out to the site, or will the doctoral capstone coordinator reach out
first? A well-established policy is required if students are to understand their role in site
procurement. Because this is a self-directed experience, it is important for students to take the
lead in initiating site contacts when possible.
TEACHING TIP 3: Developing a policy for the initial communication with a potential
site mentor is an important first step, and it is recommended that a policy be developed
so that all parties understand responsibility. One recommendation may be to have this
policy in the DCE and project section of the OTD program’s student handbook. A simple
statement could be as follows:
Sample Policy: Capstone students must FIRST identify whether the site they are
interested in for their capstone is currently a fieldwork site for the program. If the site IS
a current fieldwork site, the capstone coordinator will contact the site FIRST to establish
the initial interest in taking a capstone student. If the site IS NOT a current fieldwork
site, the capstone student may reach out to the potential site FIRST to describe the
capstone experience and project, but the capstone coordinator must be notified that
this conversation is taking place.
Figure 4-1. DCE flow of site communication.
Communication via email is often one of the first modes of communication to potential
sites. Establishing email templates for the capstone student and doctoral capstone
coordinator will be helpful in ensuring professionalism with the capstone student and
reducing time for the capstone coordinator. Appendix 4-A at the end of the chapter provides
examples for email communications for both the capstone student and doctoral capstone
coordinator.
Communication with sites will be much more fluid than that for fieldwork Level I and
Level II because students may be reaching out to make initial contact. Table 4-4 illustrates the
differences in the type of communications between fieldwork sites and DCE sites.
Meetings With Sites

Once a determination is made as to who will make the initial contact with the site,
individual meetings with sites may be an appropriate next step. This can take place over the
phone, in person, or in an introductory email. This is important especially if; the OTD
program is new in the state, or if the program is transitioning from the master of
occupational therapy degree to an OTD degree, or if the transition has already occurred. The
sites that OTD programs already have established relationships need to be provided
education on the DCE and project process.
TEXT BOX 4-4

The DCE and project was a new concept for us, and we had never taken a capstone
student, so we were not sure how it was all going to work. We had some initial meetings
with the capstone coordinator at the school and were educated on the process, which was
helpful and allowed us to spend time formulating ideas for potential projects. After these
initial educational meetings, we were able to come into a doctoral capstone planning
course and discussed needs we had in our hospital system with the students. Students who
were interested interviewed and discussed goals and objectives before being accepted at
our site as a capstone student. These interviews proved to be very beneficial to ensure we
felt students would be successful with their project plan and that students felt comfortable
in the setting. We feel the interview sets the student up for success and will continue this
process as we move forward.
—Angela K. Palicki, OTR
Manager
Outpatient Rehabilitation Services
Eskenazi Health
—Hannah Porterfield, MOT, OTR, CSRS

Center Coordinator of Clinical Education
Rehabilitation Services
Eskenazi Health
—Theresa Rexroat, MS, OTR, NTMTC

Occupational Therapy—NICU
Eskenazi Health
Table 4-4. Site Communication: Fieldwork Versus Doctoral

Capstone Experience
DOCTORAL CAPSTONE EXPERIENCE
FIELDWORK SITES
SITES
Initial contact communication: either student or
doctoral capstone coordinator depending on:
The relationship the site has with the school
(often the doctoral capstone coordinator will

Initial contact communication: reach out to a site that is already a fieldwork
directed by the academic site)
fieldwork coordinator The relationship the site has with the student
The relationship the site has with the doctoral
capstone coordinator
The type of site
The policy established by the program
Site procurement: academic Site procurement: student or doctoral capstone
fieldwork coordinator coordinator
Verification of student at site and
Verification of student at site and contract
contract procurement: academic
procurement: doctoral capstone coordinator
fieldwork coordinator
It is important for these sites to understand the differences in expectations, supervision

(mentorship), and outcomes between the Level I or Level II fieldwork student and the
doctoral capstone student. Identifying sites can be done through the following:
Current sites that have established contracts with the school, including both medical
sites (e.g., hospitals, outpatient centers) and community sites
Sites with which the student has connections that are new to the academic
institution (both traditional and role-emerging sites)
Community sites that have reached out to the academic institution in the past for
collaboration
The purpose of the initial site meeting should be to first explain the DCE to the site and
have students clearly articulate their DCE project purpose and goals. This will help the site
determine whether they are able to meet students’ needs. During this meeting, the student
and/or capstone coordinator needs to determine whether the site/mentor will be a good fit
and vice versa and then begin establishing potential goals and objectives. A second purpose is
to determine whether the site can provide an experience that aligns with the occupational
therapy program’s curriculum design (ACOTE, 2018). Who needs to attend the meeting
depends on the site. If the student meets with a site first, the capstone coordinator will also
need to meet with the site to determine whether it will be able to meet the planned capstone
design and to be consistent with the program’s curriculum design. The process of establishing
the initial site meeting is different for each site, and there is no one right or wrong way to
proceed with the initial meeting. Here is how one capstone student explains initiating
communication with her site:
TEXT BOX 4-5

During the planning stages, I emailed the site I was interested in and provided them with a
description of the DCE. I asked if I could meet in person to discuss any ideas they had, along
with ideas I had developed. After, I met with the management team to discuss the
requirements of the DCE. During that meeting, the topic for my DCE was solidified in that I
would be working alongside the outcomes committee to improve the evaluation process.
During this planning stage, the outcomes committee also did some planning before the
start of my DCE. As a team, they identified assessments they thought would add value to
their evaluations and helped complete the needs assessment for the site.
—Sarah Humbird, OTD, OTR
Class of 2018
School of Occupational Therapy
University of Indianapolis
Outcome of Site Meeting

Once the meeting takes place, it is important to determine the next steps. Will this be a
good match for the student? Does the site agree to take the student for the capstone
experience? Does the site feel it is not a good fit and they will not be able to meet the students
needs? An outcome needs to be determined. The site may say yes or no to taking the student,
or may need more information.
Common Misconceptions
Recent evidence indicates decreased awareness of the benefits of the entry level
occupational therapy degree (Molitor & Nissen, 2018), which includes the capstone. A
frequently heard misconception is that the capstone is an additional Level II fieldwork
placement. Education to sites is an important first step in placing a capstone student at a site
for the experience. Along with the sites understanding the differences, it is also important
that the doctoral student to be able to articulate the differences.
TEACHING TIP 4: Fieldwork sites need to understand that DCE students are expected
to be self-directed. Often, the prospective mentors at the site worry about how they will
fill the students time. Management of time and projects are the student’s responsibility.
The mentors need to understand the benefits of having a capstone student. For
example, the student can meet the needs of an occupational therapy department by
providing program development, which often cannot be done by the staff occupational
therapy practitioners due to productivity standards.
Benefits and Incentives of Taking a Doctoral Student

Evenson and Connor (2015) discussed improving professional development, creative
program development, and strengthening the link between academia and practice as benefits
to the site taking a capstone student. The fieldwork relationship has the potential for students
to share new knowledge gained in evidence-based curricula, in addition to new technological
ways of doing practice. A definite reciprocal learning experience occurs between the
fieldwork educator and their students. The students learn from the many years of experience
that the fieldwork educators have to offer and how organizations work. They learn the actual
“doing” of what they read on the pages of their occupational therapy textbooks. In turn, the
fieldwork educators learn new evidence and occupation-based ideas from their students
(Hanson, 2012). In addition, fieldwork educators are allowed to use fieldwork education as
professional development for state and national continuing education requirements. As
stated in the National Board for Certification in Occupational Therapy (NBCOT)
Certification Renewal Activities Chart, NBCOT accepts supervision of entry-level or
postdoctoral advanced fieldwork direct supervision for renewal certification. This reciprocal
learning process is a win-win because it enriches the whole profession. Likewise, it is
anticipated that this same enrichment will continue through the DCE and maybe to an even
greater degree as the circle of influence is broadened. The opportunity for students to work
not only with occupational therapy practitioners but with a myriad of other professionals
who are experts in their fields will allow future clinicians to practice with a deeper
understanding of their role in health care. The academic fieldwork coordinator and capstone
coordinator will frequently have discussions with fieldwork educators and site mentors about
the need for more resources, and innovations. These discussions allow for a creative exchange
of potential program development needs and solving problems through both fieldwork and
capstone students setting goals and objectives to meet site project needs. Following are
examples of how a capstone student could be beneficial to the site.
TEXT BOX 4-6

Mentoring and hosting a doctoral capstone student allowed for the opportunity to
complete research and develop programming for the implementation of a NICU (neonatal
intensive care unit) follow-up clinic within our hospital system. The value of having a high-
level student who could dedicate all of her time to the project to ensure complete
thoroughness, with appropriate and safe research, is priceless and absolutely needed in our
profession. The working rehab world expects, as it should, high productivity and best
patient care, which most days does not allow a clinic therapist to pursue goals for program
development without it taking a copious amount of time beyond scheduled working hours.
The implementation of capstone students has opened a gateway for integrating
programming and opportunities in the field that would otherwise be lost. I have a greater
understanding, and now support, of the benefit that the doctoral program has for students.
It was a great honor to have a student who accepted the lofty challenge and expectations I
had to bring a much need program to fruition.
—Terri Cupp, MOT, OTR
TEXT BOX 4-7

We found that having capstone students allowed us to develop needed programming in
three areas of our hospital system. These program development needs were on the back
burner secondary to our focus needing to be on our primary roles involving direct patient
care. The capstone students came in with knowledge of the literature and used the most
up-to-date research to create innovative programming. The three students who came to
our hospital had three unique mentoring experiences. One student worked with an OTR on
the NICU in a traditional medical setting, one worked with a medical doctor in the
transgender clinic, and the third student worked with an OTR who recently took on a new
role as a clinical manager of outpatient services. It was wonderful to see these students
grow, be self-directed, develop autonomy, and learn how to communicate, effectively and
professionally, with doctors, nursing staff, social workers, and others to achieve program
goals. The students learned from us, and we learned from the students—it was a win-win
for all.
The students at the level they came into the capstone were at the point that they seemed
like colleagues coming to work on projects that we just could not possibility get done but
were all ideas and innovations that were swirling in our heads. In other words, having
capstone students has been awesome, and we continue to work in partnership with the
school of occupational therapy—we have two more capstone students for 2019 and are
working on (finding) capstone students for 2020.”
—Angela K. Palicki, OTR
Manager
Outpatient Rehabilitation Services
Eskenazi Health
—Hannah Porterfield, MOT, OTR, CSRS

Center Coordinator of Clinical Education
Rehabilitation Services
Eskenazi Health
—Theresa Rexroat MS, OTR, NTMTC

Occupational Therapy—NICU
Eskenazi Health
TEXT BOX 4-8

Having OTD capstone students at the Cancer Support Community has been invaluable.
Not only are students able to meet one on one with survivors, they are able to develop
broad educational programs. For instance, survivors and caregivers learned methods to
manage their cancer-related fatigue in one program. Students were able to follow up with
survivors as they progressed through the educational programs. This is a resource most of
our survivor population would never be able to afford, or even know existed, if it were not
for our capstone students. One capstone student wrote for a grant to fund a part-time
occupational therapist at our community site, and it was awarded, allowing for
sustainability of the programs.
—Lora Hayes, LMFT, RPT
Executive Vice President

Cancer Support Community Central Indiana
Description of Goals and Objectives and How They Relate to the

Capstone
It is important that the student is able to articulate the purpose and goals of the proposed
capstone experience and project and relate how achieving these goals will facilitate advanced
knowledge. The overall purpose of the capstone is the overarching needs statement. Why is
the capstone project important, and how is it supported by the evidence from current
research? How is the project going to improve the lives of others and influence occupational
performance? The overall outcome is what the capstone student strives to achieve. The
capstone student will be answering these questions through the literature review and needs
assessment that are required to be completed before the start of the capstone experience
(ACOTE, 2018). Refer back to Chapter 3 for specifics on determining the purpose of the
capstone experience and project. The goals that are developed are specific to what the student
wants to accomplish, and the objectives are a step-by-step plan of how the student plans to
meet those goals. Development of goals and objectives for the DCE is very different from that
for fieldwork.
Guiding the student through the goals and objectives process is initially facilitated by the
capstone coordinator and the faculty mentor. The site mentor will become involved as the
capstone process moves into the planning stage, and it all starts with the initial idea. What
does the site mentor or the student want to accomplish as part of the capstone experience? Is
it a product, an experience, something learned, or a service? Is the doctoral capstone project
realistic? Can it be completed within the time frame and with the resources available?
Knowing some of this information will help facilitate the process of writing initial goals and
objectives. Goals could be broad ideas to explore and then operationalize into a measurable
objective within a stated time frame. The objectives are measurable steppingstones to reach
that overarching goal. These small achievements can keep the process on track to ensure that
the doctoral capstone project comes to fruition or may be reevaluated during the course of
the experience. Chapter 6 goes into further detail on development of individualized student
goals for the capstone.
Importance of Exploring State Licensure Implications

When direct individual client care is a part of the DCE and aligned with the student’s
goals and objectives, it is necessary for the doctoral capstone coordinator and the capstone
student to investigate the impact of regulatory bodies. For instance, state licensure boards or
third-party payers may dictate supervision requirements, and it is the ethical responsibility of
the student and the site to comply with these. As mentioned previously, the site mentor or
individual completing on-site supervision of the capstone student may or may not be an
occupational therapy practitioner; however, is required that such individuals be experts in
their field relative to the capstone focus.

If the site mentor is an occupational therapist, then there should be a discussion of the
impact of occupational therapy licensure within the state in which the DCE is taking place.
What language is used in the regulations and requirements for the occupational therapy
practitioner or assistant? Does the state practice act include language specific to the student,
fieldwork, or other language that suggests a supervisory process? If so, those requirements
will influence the DCE with regard to selection of the site mentor, supervision guidelines, and
implementation of the DCE objectives.
For instance, if the objectives of the DCE is to further the student’s skills in an area of
practice that is beyond entry level occupational therapy clinical practice, the site mentor will
likely be an occupational therapy practitioner. If the state practice act for that occupational
therapy site mentor states that there must be a certain level of student supervision by an
occupational therapist, then those guidelines need to be followed and documented in the
DCE memorandum of understanding. Some state practice acts and guidelines do not address
students. For instance, in Indiana, “an individual who is practicing occupational therapy as
part of a supervised course of study in an educational program” is exempt from the licensing
requirement (IC 25-23.5-0.52). The onus, however, is on the supervising occupational
therapy practitioner and how he or she is regulated by the state practice guidelines. Students
will be using the processes of occupational therapy evaluation, programming planning,
intervention, and discontinuation with input from occupational therapy faculty mentors as
well as the site mentors.
CHAPTER SUMMARY
This chapter has provided recommendations to inspire best practices and work systems
that occur between the academic fieldwork coordinator and doctoral capstone coordinator
and preparing the capstone student. It is clear that education and communication are
essential key steps to the capstone site development. Assisting the capstone student and
prospective sites to understand the differences between fieldwork and the capstone
experience is a critical first step in site development. Once education is initiated, the process
of procuring sites will evolve. As this relationship builds, the student will begin to work with
the site to develop goals and objectives. Relationship development among the program,
student, and site is essential to build a solid foundation for the DCE and project.
Learning Activities
1. Locate and review your occupational therapy program outcomes. These program
outcomes have been established to measure student learning in your program and
are based on the curricular design of the program. As you review your program
outcomes, think about how your capstone purpose will link to program outcomes.
Which program outcomes do you feel will relate to your capstone purpose? Write
one potential capstone outcome you wish to achieve based on one of your program
outcomes.
2. Determine the state in which you will complete your DCE and locate and review the
occupational therapy licensure laws in that state. What items in the occupational
therapy licensure law pertain to your doctoral capstone, and what is important to
know or understand?
3. How do you define an expert? How will you determine that your site mentor is an
expert?
4. Think about a time you had to deal with ambiguity and the results of experiencing
this. Now determine how you will deal with the ambiguity of working through the
process of locating a site for your capstone.
REFERENCES
Accreditation Council for Occupational Therapy Education. (2018). Standards and interpretive guide. Retrieved from
https://www.aota.org/~/media/Corporate/Files/EducationCareers/Accredit/StandardsReview/2018-ACOTE-Standards-
Interpretive-Guide.pdf
American Occupational Therapy Association. (2009). Fieldwork education: value purpose. American Journal of Occupational
Therapy, 63(6), 821-822. doi:10.5014/ajot.63.6.821
American Occupational Therapy Association. (2017). AOTA Fieldwork Data Form. Retrieved from
https://www.aota.org/Education-Careers/Fieldwork/Supervisor.aspx
DeIuliis, E. D. (2017). Professionalism and fieldwork education. In E. DeIuliis (Ed.), Professionalism across occupational
therapy (pp. 201-222). Thorofare, NJ: SLACK Incorporated.
Dickerson, A. E. (2006). Role competencies for a fieldwork educator. American Journal of Occupational Therapy, 60, 650-
651. doi:10.5014/ajot.60.6.650.
Evenson, M. E., & Connor L.T. (2015). Perspectives on the doctoral experiential component. OT Practice, 20, 17-19.
Hanson, D. (2012, November 12). Benefits for fieldwork educators in working with students. OT Practice, 18.
Hanson, D., & DeIuliis, E. (2015). The collaborative model to fieldwork education: A blueprint for group supervision of
students. Occupational Therapy in Health Care: Occupational Educational Practices, 29, 223-239.
Jirikowic, T., Pitonyak, J.S., Rollinger, B., Fogelberg, D., Mros, T.M. & Powell, J.M. (2015). Capstone projects as scholarship
of application in entry-level occupational therapy education. Occupational Therapy in Healthcare, 29(2), 214-222.
https://doi.org/10.3109/07380577.2015.1017788
Molitor, W. L., & Nissen, R. (2018). Clinician, educator and student perceptions of entry-level academic degree requirements
in occupational therapy education. Journal of Occupational Therapy Education, 2, 1-23.
National Board for Certification in Occupational Therapy (NBCOT®). (2017, September 6). NBCOT® Certification Renewal
Activities Chart. Retrieved from https://www.nbcot.org/-/media/NBCOT/PDFs/Renewal_Activity_Chart.ashx?la=en
Stutz-Tanenbaum, P., Greene, D., Hanson, D. J., & Koski, J. (2017). Professional reward in the academic fieldwork
coordinator role. American Journal of Occupational Therapy, 17, 2-7. doi:10.5014/ajot/2017/022046
Appendix 4-A
EXAMPLES OF EMAIL COMMUNICATIONS
Student Contacting a Potential New Site
Hello,
My name is XXXX and I am an occupational therapy doctoral (OTD) student in the School of
Occupational Therapy at the XXXX. As an OTD student, I am required to complete a
Doctoral Capstone Experience (DCE) and project prior to graduation. This is a 14-week (40
hr/week) placement at a site working with a site mentor, who does not have to be an OT. My
DCE will start in XXXX. At the point I start my DCE, I will have completed all Fieldwork
requirements and coursework.
The DCE will allow me to gain advanced knowledge. It is an in-depth experience that will
focus on one or more of the following: clinical practice skills, research skills, administration,
leadership, program and policy development, advocacy, education or theory development.
My area of focus is XXXX (program and policy development). I would like to partner with
XXXX in order to develop an evidence-based healthy living program for seniors residing in
your community.
I have enclosed my resume detailing my academic achievements and experience level. I hope
to have an opportunity to speak with you further about my doctoral capstone. I look forward
to hearing back from you soon. Thank you for your time.
Sincerely,
XXXX
Occupational Therapy Doctorate Student
Doctoral Capstone Coordinator Sending Mail to a Fieldwork
Coordinator at a Current Fieldwork Site
Hello XXXX,
I have an occupational therapy doctoral (OTD) student, XXXX, who is very interested in
completing her Doctoral Capstone Experience (DCE) with XXXX Health Network in the area
of Home Health. I thought it might be best to first give you a brief description of the DCE
here at XXXX since the Capstone is new to our profession. Our OTD students are required to
complete a DCE and Project prior to graduation. This is a 14-week (40 hr/week) placement at
a site working with a site mentor who does not have to be an OT depending on the site and
project. The DCEs for our students start in XXXX. At the point the student starts the DCE
they have completed all Fieldwork requirements and coursework.
The DCE is different than a Level I or Level II experience. It is an in-depth experience that
allows the student to gain advanced knowledge. The student will focus on one or more of the
following focus areas outlined by ACOTE: clinical practice skills, research skills,
administration, leadership, program and policy development, advocacy, education or theory
development. This is a very student self-directed learning experience. Students collaborate
with a site mentor prior to the start of the experience to ensure goals and objectives for the
experience and project are appropriate and meaningful to both the student and the site.
XXXX is interested in completing her DCE in the area of Home Health. She is interested in
gaining advanced clinical skills in the area of home health and home modifications. She
would like to work also on program development especially in the area of your home
modification programming if there is a need.
I wanted to contact you to get your thoughts on the possibility of taking an OTD student for
her DCE and project. I am attaching a brief description of the experience/roles and
responsibilities and the mid-term and final evaluations.
Thanks so much and I hope to hear from you soon!
XXXX

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CHAPTER 4

Capstone Site Development and Communication

Julie A. Bednarski, OTD, MHS, OTR Rebecca Barton,

Human-Centered Design Mindsets for the Doctoral Students

Capstone Student Reflective Questions

Education to Faculty and Administration

Student Education and Preparation

Professional (practice-ready) behaviors and the importance of professional communications

Establishing and Developing New Sites

Table 4-1. Role Comparison Between Academic Fieldwork and

to the FW site identification

FIELDWORK SITE EXPLORATION

academic program through exploration of the occupational therapy profession as a possible

TEXT BOX 4-1

FIELDWORK GOALS AND OBJECTIVES

DOCTORAL CAPSTONE SITE COMMUNICATION

TEACHING TIP 2: In my role as the capstone coordinator at the University of Indianapolis, I

TEXT BOX 4-2

Table 4-2. Questions for Potential Community and/or Role-

TEXT BOX 4-3

Table 4-3. Potential Questions for Traditional Fieldwork Sites

Communication and Site Exploration Process for the Doctoral

Initiating Communication With Proposed Sites

Meetings With Sites

TEXT BOX 4-4

—Hannah Porterfield, MOT, OTR, CSRS

—Theresa Rexroat, MS, OTR, NTMTC

Table 4-4. Site Communication: Fieldwork Versus Doctoral

(often the doctoral capstone coordinator will

It is important for these sites to understand the differences in expectations, supervision

TEXT BOX 4-5

Outcome of Site Meeting

Benefits and Incentives of Taking a Doctoral Student

TEXT BOX 4-6

TEXT BOX 4-7

—Hannah Porterfield, MOT, OTR, CSRS

—Theresa Rexroat MS, OTR, NTMTC

TEXT BOX 4-8

Executive Vice President

Description of Goals and Objectives and How They Relate to the

Importance of Exploring State Licensure Implications

their field relative to the capstone focus.

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