Handbook for Site Visitors

Committee on Accreditation of Recreational Therapy Education Handbook for Site Visitors CARTE Website: http://www.caahep.org/committees-on-accreditation/default.aspx?id=carte Questions: contact CARTE at cartecoa@gmail.com 2011 Committee for the Accreditation of Recreational Therapy Education CARTE Site Reviewers Handbook Page 1

Preface Serving as a Site Visit Team member requires a substantial commitment on the part of qualified educators and practitioners in recreational therapy. The responsibilities require your time and commitment. All Site Visit Team members are expected to fulfill their duties objectively and fairly and to operate at the highest level of professional ethical conduct. By volunteering to serve in this capacity, you have made a serious commitment and the CARTE Board of Directors wishes to thank you sincerely for your efforts. You are part of a movement committed to the highest quality education in recreational therapy. CARTE Site Reviewers Handbook Page 2

Table of Contents Introduction... 4 CARTE Mission, Vision, and Core Values... 4 CARTE Mission... 4 CARTE Vision... 4 CARTE Core Values... 5 Application and Requirements for Selection of Site Visit Team Members... 5 Roles and Responsibilities of the Site Visit Team Members... 6 Travel, Honoraria, Dress Code During Site Visits, and Other Requirements... 7 Travel Arrangements... 7 Travel Expenses... 7 Honoraria... 7 Dress Code for Site Visits... 7 Goals of CARTE Accreditation Program Review... 7 Recreational Therapy Education Standards and Guidelines... 8 Recreational Therapy Content Competencies :... 8 Support Content Competencies... 9 Clinical Education Experiences... 9 Organizational Structure of Colleges and Universities... 9 Site Visit Team Review and Evaluation Procedure... 10 Review of the Programs Self-Study Report... 10 Site Visit of the Program... 13 Determining Compliance with CAAHEP Standards and Guidelines for the Accreditation of Education Programs in Recreational Therapy... 14 CARTE Outcome Measures and Thresholds... 15 The Final Report... 15 Determining Competency Compliance... 15 Program Response... 16 Annual Reporting for Accredited Programs... 17 Peer Evaluation of Site Visit Team Members... 17 Appendix A: Additional CARTE Resources... 18 Appendix B: CARTE Site Visitor Confidentiality Agreement... 19 Appendix C: Typical Site Visit Schedule... 20 Appendix D: CARTE Site Visit Standards and Guidelines Rating and Final Evaluation Report... 22 Appendix E. CARTE Site Visit Survey Questions... 45 Appendix F: Site Visitor Peer Evaluation Form... 48 CARTE Site Reviewers Handbook Page 3

Introduction In April 2010, recreational therapy was approved as an allied health profession by CAAHEP, CARTE was accepted as the Committee on Accreditation (CoA) for recreational therapy, and ATRA was accepted as a sponsor for CARTE. In August 2010, the CAAHEP Board of Directors approved the Standards and Guidelines for the Accreditation of Educational Programs in Recreational Therapy. The CAAHEP Standards and Guidelines for the Accreditation of Educational Programs in Recreational Therapy, like the ATRA Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice are designed around competencies necessary for safe and effective practice as a recreational therapist in health care and human service agencies. The standards and guidelines, forms and site visitation process in the Procedures for Accreditation of Recreational Therapy Education are the culmination of over two years of dedicated effort to initiate a formal accreditation process of education for recreational therapy practice. CARTE relies on Site Visit Team members to evaluate self-study reports of those educational programs who apply for recreational therapy accreditation. Evaluators are selected on the basis of their knowledge, education, geographic proximity to the applicant program, and ability to be impartial in reviewing the program under consideration. This Handbook is intended to be a guide to Site Visit Team members in the commission of their duties as evaluators of recreational therapy education programs. CARTE Mission, Vision, and Core Values CARTE Mission The mission of CARTE is to promote the highest levels of professional competence of recreational therapists through: the development and promotion of professional preparation standards; the encouragement of excellence in educational program development; and the accreditation of recreational therapy professional preparation programs. CARTE Vision The vision of CARTE is to provide effective leadership in the accreditation of recreational therapy and therapeutic recreation education which results in a standard of excellence in safe and effective recreational therapy practice. As a Committee on Accreditation of the Commission on Accreditation of Allied Health Education Programs, CARTE is committed to the development of standards and procedures to effectively prepare students for safe and effective practice in the diversity of settings and populations served by recreational therapists. CARTE is committed to: 1. Promoting self-evaluation, and continuing development and improvement of professional preparation programs in recreational therapy and therapeutic recreation that remain relevant and responsive to the needs of patients and consumers and the changing nature of safe and effective recreational therapy practice as a component of healthcare service delivery; and 2. Facilitating the preparation of recreation therapy professionals for the provision of services that: promote optimal health and functioning of the patient and consumer, value human dignity, and offer opportunities for independence and community involvement. CARTE Site Reviewers Handbook Page 4

CARTE is committed to maintaining collaborative relationships between related accreditation groups, licensure and certification bodies, and professional associations to improve the practice competencies of recreational therapists. CARTE Core Values The Statement of Core Values of CARTE provides further clarification and support for CARTE Mission and Vision statements. CARTE believes in advancing the recreational therapy profession through quality and excellence in recreational therapy education that results in advanced levels of safe and effective recreational therapy practice; serving as a responsible leader in protecting the public, including patients and consumers through the promotion of safe, effective, consistent, and competent RT practice; ensuring a fair, consistent, relevant, and ethical decision-making process in recreational therapy educational practices; promoting cooperation, and collaboration in accreditation of recreational therapy and therapeutic recreation education to influence and encourage growth, and consistently increasing levels of competence in recreational therapy practice; and creating and strengthening standards that reflect the needs of the patient and consumer and society as a whole, respect the integrity of instructional approaches and strategies, and encourage educational program improvement and best practices in recreational therapy education and clinical practice. Application and Requirements for Selection of Site Visit Team Members Applications for Site Visit Team Members are accepted throughout the year by the CARTE Board of Directors. Those interested in applying should follow the following application procedures: Answer all sections below and provide a copy of your résumé or Curriculum Vitae. Completed applications can be submitted to Rob DuPont in an attached Word document to cartecoa@gmail.com. Describe your interest in becoming a Site Visitor with CARTE. Provide a summary of your qualifications to be a Site Visitor with CARTE. Include years of experience in RT/TR, experience with supervising interns, your involvement in RT/TR curriculum, and any current affiliations with RT/TR education programs. Provide information on experience you have had within the last five years as a site visitor to determine compliance with educational standards/regulations. Provide information on experience you have had with external accreditation/regulatory review such as Joint Commission, Commission on Accreditation of Rehab Facilities, Centers for Medicare and Medicaid Services, Veteran s Affairs or other health/human service organizations. Please include certifications and licenses that you currently hold. All applications will be reviewed by the Board and will require a majority vote for acceptance. Length of term is three years, with the ability to be re-elected for a second term. All CARTE Site Visitors must complete an initial training program prior to participating in their first site visit. CARTE Site Reviewers Handbook Page 5

In addition to the initial training, it is required that Site Visitors will read the CARTE Standards and Guidelines, CARTE By-laws, and CARTE Procedures Manual (all three CARTE documents are available at http://www.caahep.org/committees-on-accreditation/default.aspx?id=carte). Additionally, potential site reviewers should be familiar with the ATRA Standards for the Practice of Therapeutic Recreation, the ATRA Code of Ethics, and the NCTRC National Job Analysis Study. A signed confidentiality release form will be required of those applicants selected as Site Visitors. The CARTE Site Visitor Confidentiality Agreement appears in Appendix B. Roles and Responsibilities of the Site Visit Team Members The centerpiece of any meaningful review of academic programs is the evaluation of program strengths and weaknesses by qualified experts in the discipline. CARTE carefully selects qualified individuals who have the breadth of knowledge and expertise in recreational therapy necessary to complete the evaluation of educational programs according to the CARTE Standards and Guidelines. To that end, CARTE solicits the service of three Site Visit Team Members to conduct a comprehensive evaluation of an academic program for initial site visits. Two of the selected reviewers will be recreational therapy educators and one will be a recreational therapy practitioner. The purpose of the site visit is to clarify, verify and evaluate information submitted in the Self-Study Report and application materials and/or Annual Report and to improve the extent to which the program is in compliance with the CAAHEP Standards and Guidelines for the Accreditation of Educational Programs in Recreational Therapy. Your role as a member of the Site Visit Team is critical to the ultimate success of this endeavor. The duties and tasks expected of you include: Reviewing and Evaluating the Self-Study Report individually prior to meeting with the full team for the on-site visit. Conducting an on-site visit to the campus where you will meet with key program constituents including faculty, staff, administrators, students, and program alumni; Evaluating all program materials provided to you in the institution s self-study report prior to and during the campus visit for consistency and quality; and Producing, in consultation with other selected reviewers, a report summarizing the recreational therapy education program s compliance with CARTE Standards, the strengths and weaknesses of the program under review as well as making a recommendation to the CARTE Board of Directors on the accreditation decision for the program along with suggestions for improvement no later than 30 days following the campus visit. Determination of the quality of an academic program is a complex undertaking and must be considered not only in terms of disciplinary standards, but also in light of the institutional context and program-specific mission and goals. To assist you in your evaluation, we will provide you as much information as possible on the Standards and Guidelines, the thresholds for outcome assessment, and the program under review. See Appendix A for a list of additional resources. In this handbook, you will find the CARTE Standards and Guidelines for Recreational Therapy Education Programs, the established thresholds for program performance indicators, the CARTE Site Visit Report Form, sample questions to lead discussion with key individuals during the site visit, and CARTE Site Reviewers Handbook Page 6

web links to key CARTE documents. In addition, you can expect to receive the following documents 30 days prior to the scheduled campus visit: An electronic copy of the program s internal self-study document and appendices. Web links for the program under review. A copy of the required documentation outlined in the CARTE Standards and Guidelines. Your visit to the program s campus will be designed to accommodate several key activities including interviews with selected university administrators, meetings with important program constituents, and private work meetings between the Site Visit Team. A typical visit schedule can be found in Appendix C. The Program will coordinate your travel and lodging needs during the site visit and will provide you with a final itinerary and schedule for your campus visit prior to your arrival. Travel, Honoraria, Dress Code During Site Visits, and Other Requirements Travel Arrangements The Program being reviewed will work with you to make travel arrangements to and from their campus. Lodging on or near campus will be arranged for you in advance of your visit. The Program will assist you in making flight arrangements. The Program faculty will provide or schedule your ground transportation during your visit. Travel Expenses The Program being reviewed will reimburse documented travel costs per their university travel policies. Typical expenses include airline fare or mileage and meals not provided by Program for the duration of the campus visit. All travel expenses must be submitted through the Program under review. Honoraria Each Site Team Member will be paid an honorarium of $200.00 per self-study visit from CARTE for his or her services. The honorarium will be submitted for payment following receipt of Site Review Team Report and recommendation for accreditation, which is due to the CARTE Chair no later than 30 days following the campus visit. Dress Code for Site Visits The dress code for site visits is business attire. Although there may be times when more casual attire is permissible (e.g., during work and planning meetings of the Site Visit Team), dress for all formally scheduled meetings with Program and University representatives is business attire. Please remember that all Site Visitors represent CARTE and as ambassadors for CARTE, it is expected that Site Visitors will exhibit the highest level of professionalism in dress and personal representations. Goals of CARTE Accreditation Program Review 1. Assure that recreational therapy education standards and guidelines are implemented and evaluated objectively and fairly. 2. Identify recreational therapy education programs that comply with and exceed standards and guidelines. CARTE Site Reviewers Handbook Page 7

3. Encourage and support recreational therapy education program self-improvement by: Documenting program compliance with standards, Highlighting strengths of programs, Identifying recommendations for program improvement, and Recommending the accreditation decision. 4. Provide a formative and summative review of programs. Recreational Therapy Education Standards and Guidelines The CAHEP Standards and Guidelines for the Accreditation of Recreational Therapy appear in the CARTE Procedures Manual, which should be employed by the Site Visit Team Members as a companion document to this handbook. These standards are the minimum standards of quality used to accredit programs that prepare students to enter the recreational therapy/therapeutic recreation profession. Standards represent minimum requirements Guidelines are not required, but assist with interpretation of the Standards Site Visit Team Members review and evaluate the educational program self-study as well as documented evidence from the site visit to determine if the program meets minimum requirements and to what extent. The five areas of the Standards described in the CARTE Procedures Manual. For each area of the Standards, specific minimum requirements are delineated. The Standards are grouped by: I. Sponsorship II. III. IV. Program Goals Resources Student and Graduate Evaluation/Assessment V. Fair Practices In addition to these areas, Appendix B of the Procedures Manual delineates the Curriculum Competency Requirements that must be met. Standards are presented in regular typeface and they represent minimum requirements. Throughout this section of the Procedures Manual and Standards, Guidelines are presented in italics and they represent descriptions, examples or recommendations that elaborate the Standards. Guidelines are not required but are used to assist in interpreting standards. Curriculum Content Requirements include recreational therapy content competencies, support content competencies, and clinical education experiences. Recreational Therapy Content Competencies cover: 1.1 Foundations of Professional Practice 1.2 Individualized Patient/Client Assessment 1.3 Planning Treatment/Programs 1.4 Implementing Treatment/Programs 1.5 Modalities CARTE Site Reviewers Handbook Page 8

1.6 Evaluating Treatment/Programs 1.7 Managing Recreational Therapy Practice Support Content Competencies include: Anatomy, Physiology, and Analysis of Movement/Biomechanics Human Growth and Development Psychological, Cognitive or Educational Psychology, and Abnormal Psychology Disabling Conditions The Guideline for additional support content states:should include: motor skill learning, counseling, group dynamics and leadership, first aid and safety, pharmacology, health care organization and delivery, legal aspects of health care, recreation and leisure services. Clinical Education Experiences include: Clinical education experiences must include provision for clinical experiences, including clinical education/practicum and clinical internship/field placement, under the direct supervision of a qualified clinical instructor in an appropriate setting. The intent of clinical education experiences is to integrate cognitive learning with the associated psychomotor skills requirements of the profession, in accordance with professional standards of practice, to develop entry-level clinical proficiency and professional behavior as a recreational therapist/therapeutic recreation specialist as defined by professional guidelines for competencies necessary for safe and effective recreational therapy practice. (CARTE Standards and Guidelines) Organizational Structure of Colleges and Universities For the uninitiated, academic governance can be fairly confusing. Site reviewers will meet with a variety of individuals at various levels of administrative status and with varying knowledge of the recreational therapy curriculum. While colleges and universities vary somewhat in their administrative structure, they typically have the following characteristics. Universities are typically divided into administrative units. These include Academic Affairs, Student Affairs, Business Affairs, and Athletics. Academic Affairs is where the various schools and departments are housed and it is the area that the site visitors will primarily be concerned. The Chief Executive Officer of the university is the President/Chancellor. The President or Chancellor answers to the Board of Trustees and is administratively responsible for the total functioning of the university including the divisions mentioned above. The President/Chancellor is accountable for the fiscal and academic integrity of the institution and insures that the university adheres to the various regulations and restrictions from the Board of Trustees, the state (if applicable), the U.S. Department of Education, and the regional university accrediting body. In larger institutions, it is unlikely, though not out of the question, that the site reviewers will meet with the President/Chancellor. In smaller institutions, it is much more likely that the site reviewers will meet with the President/Chancellor. Immediately beneath the President/Chancellor are a variety of Vice Chancellors or Vice Presidents. There is usually one for each of the administrative areas mentioned above with the exception of athletics, which is typically headed by a Director of Athletics. In addition to these Vice Chancellors there may be others, most notably a Vice Chancellor for Advancement which is the fund raising arm of CARTE Site Reviewers Handbook Page 9

the university and a Vice Chancellor for Human Resources responsible for all personnel processes. The Vice Chancellor that the site visitors will be most concerned with is the Vice Chancellor for Academic Affairs also called the Provost. At some institutions, the Provost carries the title of Executive Vice Chancellor to indicate that he or she is in charge of the entire university in the Chancellor s absence. While the Provost will have been briefed about the recreational therapy curriculum, site visitors will want to determine the degree to which the Provost is familiar with the program and attempt to ascertain the level of administrative support for the curriculum as well as any pending changes. Answering to the Provost will be the Dean of the school or college in which the recreational therapy curriculum is housed. The Dean has many responsibilities delegated from the Chancellor and the Provost and is responsible for the efficient and effective administration of his/her college or school. Typically, the Dean allocates financial resources to the various departments within the college or school and provides other academic and administrative support. It is important for the site visitors to determine whether the department housing the recreational therapy curriculum is treated as fairly as the various other departments within the college or school. The department housing the recreational therapy curriculum may be located in any one of a variety of colleges including College of Education, College of Health, College of Arts and Sciences, or College of Health, Physical Education and Recreation. There are many existing configurations including ones not mentioned here. While in a very few cases, recreational therapy may be its own department it is far more likely that it will be one curriculum or program within a larger departmental structure. Ideally, recreational therapy will be a major unto itself but it is not uncommon to see recreational therapy as an option within a major such as recreation and leisure studies, or parks and recreation. The Chairperson is the head of the department and reports directly to the Dean. The chairperson, like the Dean, has authority delegated to him/her to effectively and efficiently manage the department and its various programs. As with the Dean, site reviewers want to determine that the recreational therapy major is treated as equally as the other programs within the department. The recreational therapy major should have a person responsible as a Curriculum Coordinator sometimes referred to as a Program Director. The Curriculum Coordinator is responsible for insuring an excellent learning experience and meeting accreditation standards but typically has little authority over personnel with that falling to the Chairperson. The role of the Curriculum Coordinator and the relationship with the Chairperson and other majors/programs within the department should be of major concern for site reviewers. Of course, the remaining ingredients in the governance mix are the program faculty, the students, clinical educators, and advisory boards. The Standards and Guidelines provide clear direction on what to look for when meeting with those constituents. Site Visit Team Review and Evaluation Procedure There are three basic phases to the review and evaluation of the educational program within the CARTE accreditation process: 1 Review of the Program s Self-Study Report 2 Site Visit Review of the Program 3 The Final Report Review of the Programs Self-Study Report Approximately 30 days prior to the scheduled site visit, Site Visit Team Members will receive the Program s Self-Study Report. It is important that this document be carefully reviewed and studied by each individual Site Visit Team Member prior to coming together for the site visit of the program. Each individual member should complete an analysis of the program s compliance with the CAAHEP CARTE Site Reviewers Handbook Page 10

Standards and Guidelines for the Accreditation of Recreational Therapy Education Programs. Each individual should complete the CARTE Site Visit STANDARDS AND GUIDELINES RATING AND FINAL REPORT FORM. (see Appendix D). Prior to the site visit, the assigned team members (evaluators) should independently review the submitted materials and develop a list of questions or items needing clarification. Each team member should discuss these items with the other members of the site visit team in order to develop a comprehensive list of questions to pursue with representatives of the college or university seeking CAAHEP-CARTE accreditation during the site visit. The Site Visit Report Form provides a useful means to compare information from the college or university with CAAHEP Accreditation Requirements. Since those seeking CAAHEP accreditation are required to submit complete and accurate data and information in the Self-Study Report to successfully evaluate compliance of the degree program with CAAHEP Standards and Guidelines for the Accreditation of Educational Programs in Recreational Therapy and the CARTE accreditation procedures, the evaluators should have an accurate profile of the program prior to arrival. Should additional information be needed, however, the chair of the site visit team may choose to contact the program degree director (applicant for accreditation) prior to the site visit to ask for clarification or additional information or data needed to effectively evaluate compliance. The Self-Study Report is intended to provide evidence of the program s compliance with CAAHEP Standards and Guidelines and the curriculum content competencies in both recreational therapy and support content. The suggested content to be included in the Self-Study Report is as follows: Program Overview Compliance with CARTE Standards and Guidelines Information on Faculty Clinical Education and Experiences Competencies and Learning Outcomes Appendices CARTE has developed several forms for documenting key aspects of the program. Below is a table describing each form used by a program to document compliance, a brief description and the section of the report wherein documents should be presented. Form Number Title Description Report Section 1 CARTE Request This form is completed online and provides basic Separate for Accreditation Services information on the sponsoring institution s Chief Administrative Officer (CAO), Dean (or comparable administrator), Department Chair and/or Program Director 2 Program Overview Seven sections of information providing an overview of the Program, including: Program Overview Questions Historical Overview Program Goals and Objectives, Methods to Assure Continued Appropriateness of Program Goals and Objectives How Program Goals and Objectives are Used in Program Planning and Implementation Special Considerations Which Impact the Program Characteristics Mission of the Sponsoring Institution CARTE Site Reviewers Handbook Page 11

3 Institutional Program Information 4 CARTE Standards and Guidelines Response Form 5 CARTE Academic Program Self- Assessment Summary 6 Recreational Therapy Knowledge and Skills Compliance Matrix 7 Standardized Course Syllabus Form 8 Faculty Biographical Summary 9 Student Evaluation Mission of the Program Program data, including: Length of the program Total credits for completion Maximum class size Actual current enrollment Number of students admitted each year Type of degree awarded Number of RT/TR faculty (full and part-time) Number of internship sites Year Program enrolled the first class Provides the Program the opportunity for verification of compliance with CARTE Standards and Guidelines. This verification should be supported by information or data which should appear in an appendices. For each standard area, the program documents how the standard is met and the exact location of supporting documentation within the appendices. This summary form lists the program s courses related to the curriculum content competencies in recreational therapy and support. For each competency content area, the program lists the exact course title, number and credits. Documents the exact course covering each knowledge and skill listed for recreational therapy content and support content competencies. This is a very detailed delineation of the location for coverage of each competency standard. This is the cover sheet used for each course syllabus submitted with the Self-Study Report. The form includes course name, number, prerequisites, description, student learning objectives, academic hours, instructor, semester taught, required text, student requirements, topic outline/ schedule, course evaluation, and emergency preparedness instructions. Presents faculty biographical data in a standardized format including education/training, professional experience, certification/licensure, courses taught over the past two years, and scholarship/presentations for the past five years. Survey of information from current students. The program must submit a blank copy of the actual survey used along with an accurate analysis of survey data. Survey results must include the number sampled, the response rate to the survey, and a summary of overall ratings on a scale from 1 to 5 with five being the highest, positive rating. 10 Graduate Survey Survey of information from graduates of the program covering at least the most recent past three years. The program must submit a blank copy of the actual survey used along with an accurate analysis of survey data. Survey Program Overview Compliance with CARTE Standards, Guidelines Compliance with CARTE Standards, Guidelines Compliance with CARTE Standards, Guidelines Appendices Information on Faculty Appendices Appendices CARTE Site Reviewers Handbook Page 12

11 Faculty Assessment Form 12 Employer Survey results must include the number sampled, the response rate to the survey, and a summary of overall ratings on a scale from 1 to 5 with five being the highest, positive rating. This survey allows individual faculty members to evaluate program resources. The survey should be completed by program faculty, clinical instructors, and advisory committee members. Survey of information from employers of graduates of the program covering at least the most recent past three years. The program must submit a blank copy of the actual survey used along with an accurate analysis of survey data. Survey results must include the number sampled, the response rate to the survey, and a summary of overall ratings on a scale from 1 to 5 with five being the highest, positive rating. Appendices Appendices The Clinical Education section of the Self-Study Report provides information about clinical experiences including clinical education/practicum and clinical internships/field placements to include the process for orientation and interactions with clinical supervisors of the clinical education/practicum and clinical internships/field placements as well as information about verification of qualifications, credentials and experience of clinical supervisors. In addition, summary data of clinical performance, assessed at the completion of internships/field placements, must be submitted for all students completing internships for the reporting year, using the Clinical Performance Appraisal Summary and Reference form. This form can be found in the ATRA Standards for the Practice of Therapeutic Recreation & Self-Assessment Guide (ATRA, 2000, pp. 85-86). The Competencies and Learning Outcomes section of the report includes documentation of summary evaluation data of student self-assessment of competencies and specific learning outcomes using the Competency Self-Assessment Detail Form found in the ATRA Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice (ATRA, 2008, pp. 31-54). The program should document the system for collecting student self-assessment of competencies and learning outcomes, including pre- and post-testing points of capture. A minimum sample size of 85% or more of those students completing internships in the reporting year is required for the assessment of competencies summary data. Data from other sources documenting student learning outcomes include such data as the NCTRC Score Report for the Program, program retention and graduation data, etc. The Program should seek maximum participation of all enrolled in the program and report all relevant data in this area. If data is available for multiple years, this should be included. Finally, the Self-Study report should include an appendices section which provides data and report on surveys of current students, graduates, faculty, and employers as well as other information such as: Student Handbook, Internship Manual, Technical Standards, Admission Process and Application, Annual Assessment Reports (for independent degree programs), and other policies and procedures as delineated in the CARTE Standards and Guidelines. Site Visit of the Program Upon arriving on campus for the site visit, the Site Visit Team will meet. Under the direction of the Chair of the Site Visit Team, individual team members will compile their individual review results of the program and prepare a list of additional questions they have regarding the program s compliance with standards as well as any additional documents they wish to review. CARTE Site Reviewers Handbook Page 13

The primary purpose of the site visit is to confirm data presented in the self-study report and to acquire additional documentation and evidence which may support compliance with the standards. The team will meet with key players at the university/college, including (but not limited to) the President or Chancellor, the dean, department head, program faculty, students, and alumni. It will assist the team in collecting data if they have a series of questions established in advance for each personwith whom they anticipate meeting. Appendix E provides suggested questions to be used during site visit meetings. Time is allowed in the site visit schedule for the Team to prepare the draft report based on both the self-study document and site visit data. Prior to ending the site visit, the Team will meet with university/college and program personnel to present preliminary findings. Determining Compliance with CAAHEP Standards and Guidelines for the Accreditation of Education Programs in Recreational Therapy The basis for CARTE competency requirements for safe and effective recreational therapy practice is the ATRA Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice (2008). Understanding that the ATRA Guidelines use a life-long learning approach to developing competencies for optimal safe and effective recreational therapy practice during a career, CARTE adapted the ATRA Guidelines for use in CAAHEP accreditation so the majority of quality programs could meet accreditation requirements. In doing so, CARTE is recognizing that accreditation requirements as well as the competencies necessary for safe and effective practice are not static, but dynamic and evolving. To reasonably adapt the breadth and scope of competencies identified in the ATRA Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice (2008) to what is reasonable and possible within most recreational therapy/therapeutic recreation baccalaureate degree programs, CARTE has limited and narrowed the competency requirement focus to the recreational therapy content areas and knowledge and skill competency statements for recreational therapy courses that are primarily didactic in nature. The ATRA Guidelines requirements for ability will not be included in the compliance scoring at this time but CARTE is requesting that agencies collect data on student abilities at the conclusion of the clinical internship or field placement in order to better define the base-line abilities for entry-level practice across settings. The ATRA Guidelines contact time listed for each content area is a guideline or recommendation used to interpret whether or how the standards are met. CARTE will determine compliance with knowledge and skills but will continue to collect ability competencies data as an aspect of continuing development. Assessment of compliance will focus on compliance with the recreational therapy content areas as defined in Standards and Guidelines. With this adaptation of competency assessment based upon the ATRA Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice (2008), it is expected that any curriculum concerned with preparing students for safe and effective recreational therapy practice should be able to meet the competency requirements. In addition, CARTE has reasonably adapted the broad and diverse set of support content requirements identified in the ATRA Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice (2008), to those deemed most important to understanding health and human functioning as a foundation for recreational therapy practice. This adaptation affords institutions a more realistic breadth and scope of support content for baccalaureate level entry into the profession. CARTE requirements identify support content necessary to establish the foundation of understanding of health and human functioning upon which to build competencies for safe and effective recreational therapy practice. Support Competencies are considered fundamental competencies essential to understanding physical, cognitive, social and emotional functioning of patients/consumers. Agencies should refer to the CAAHEP Standards and Guidelines for the Accreditation of Educational Programs in Recreational Therapy for specific curriculum requirements. CARTE Site Reviewers Handbook Page 14

CARTE Outcome Measures and Thresholds CARTE has adopted outcome measures and performance thresholds that must be achieved by the academic program seeking accreditation in order for CARTE to recommend CAAHEP accreditation. The outcome measures are consistent with outcome measures selected by other CAAHEP CoA s and the threshold levels are also consistent with those established by other CoA s. It is the intent of CARTE, as a new CoA, to select outcome measures and threshold levels that are both consistent with other CAAHEP CoA s and achievable by the majority of quality educational programs preparing students for recreational therapy practice. Some outcome measures selected may not be currently used by the academic programs in recreational therapy so no threshold has been established at this time. A statement of Data should be collected to establish an appropriate threshold. is used to direct the academic program to begin collecting this data so CARTE can later establish an appropriate threshold, based upon an analysis of the data collected nationally. Over time it is the intent of CARTE to raise thresholds as performance levels and compliance by academic programs increase. Following are the CARTE outcome measures and thresholds; 1. Student retention rates from the past three years are 65%. 2. Credentialing Exam Success with 65% at one standard deviation above or below the national passing rate 3. Graduate Satisfaction with average rating of 3.0 on a 5-point scale. 4. Clinical Supervisor Performance Evaluation: 70% of interns obtain rating > 3.0 (achieves expectations) 5. Clinical Intern Competency Self-Assessment: 70% of interns rating > 3.0 (average perceived competence) Applicants for accreditation are also requested to collect data on the following outcome measures so that a threshold can be established at a later date: 1. Graduate survey return rate 2. Positive placement, defined as the graduate is employed full or part-time in recreational therapy or in a related field and/or continuing his/her education; and /or serving in the military. 3. Employer survey return rate 4. Employer Satisfaction Survey Outcome measures and performance thresholds will be reviewed by the Site Visit Team and the CARTE designated reviewer of Self-Study Report of the academic program seeking accreditation.performance compared to the threshold will be reported on the Site Visit Summary Report and used by CARTE in determining whether to recommend an academic program for CAAHEP accreditation. The Final Report The final report must be completed and submitted to the CARTE Board within 30 days. The CARTE Board will work with the Team to refine the final report and the recommendation for accreditation. The final report, including CARTE Board review must be completed within six weeks of the site visit for delivery and response from the Program. Determining Competency Compliance Assessment of competency development and achievement is considered a programmatic summative measure of the outcomes assessment of the academic program. The Site Visit Team and the CARTE Site Reviewers Handbook Page 15

CARTE assigned reviewers will review academic program requirements for Content Areas and the Knowledge and Skill competencies that are required as student learning in required courses of the curriculum in comparison to the CARTE Standards and Guidelines, Appendix B, pages 34-44. Standards are the minimum requirements to which a program seeking accreditation and an accredited program is held accountable. Guidelines are descriptions, examples, or recommendations that elaborate on the Standards. Guidelines are not required, but assist with interpretation of the Standards. For example, Guidelines provide the suggested semester contact hours for a Content Area (a Standard) as an indication of the reasonable depth of coverage expected for the Content Area and the Knowledge and Skill competencies to be developed for the Content Area. The Guideline may be applied to one or more required courses in the curriculum to assess whether the academic program reasonably meets the Standard requirements of the Content Area and the Knowledge and Skills competencies to be developed. Likewise, Knowledge and Skill competency statements may be introduced in one course that addresses a Content Area (Standard) and be continued in other courses or Content Areas to assure adequate depth of coverage and opportunity for a reasonable proficiency in the competencies to be developed. Ultimately, the Site Visit Team and reviewers will determine whether the academic program provides documentation that adequately demonstrates that required Content Areas and Knowledge and Skill competency statements are appropriately taught and developed in the academic program. Each Content Area and Knowledge and Skill statement is rated in the Standards and Guidelines Rating and Verification sections of the Site Visit Summary Report as either Met (M) Partially Met (PM) or Not Met (NM) and a citation or recommendation for correction of all ratings of Partially Met and Not Met shall be made in the Recommendations for Program Improvement section of the Site Visit Summary Comments. The basis for recommending accreditation to CAAHEP is made using the following decision criteria that indicate the minimal level of compliance with the Content Areas and Competencies To receive a CARTE recommendation for CAAHEP accreditation, the academic program must have courses that significantly comply or match 71% or 5 of 7 (rounded to the whole number) of recreational therapy Content Areas. To receive a CARTE recommendation for CAAHEP accreditation, the academic program must demonstrate evidence of substantial compliance, or teaching and developing 90% or 77 of the 85 (rounded to the whole number) required recreational therapy knowledge and skill competencies. To receive a CARTE recommendation for CAAHEP accreditation, the academic program must have courses that significantly comply or match 71% or 5 of 7 (rounded to the whole number) of Support Content Areas. To receive a CARTE recommendation for CAAHEP accreditation, the academic program must demonstrate evidence of substantial compliance or teaching and developing 90% or 26 of the 29 (rounded to the whole number) Support Content knowledge and skill competencies. Program Response The program will have the opportunity to comment in writing and to correct factual errors on the on-site review report, and the CARTE forwards a status of public recognition recommendation to the CAAHEP Board of Directors. CARTE Site Reviewers Handbook Page 16

Annual Reporting for Accredited Programs Once a program is accredited by CAAHEP-CARTE, an annual report must be filed. The Annual Report is designed to provide an on-going mechanism for quality assurance of curriculum accredited by CAAHEP-CARTE. Each section of the report is relatively self-explanatory and should provide information on general administrative facets of the program, as well as resource, and outcome measures. This report will collect information on General and Administrative Information and Academic Program Information. This form may be downloaded from the CARTE website at: http://www.caahep.org/committees-on-accreditation/default.aspx?id=carte. Peer Evaluation of Site Visit Team Members The Committee on Accreditation for Recreational Therapy Education (CARTE) continuously strives to improve its accreditation process and increase the quality of its Site Visitors. An integral step in the quality assurance process is obtaining valid feedback from its Site Visitors. At the conclusion of each Site Visit to an academic institution, all Site Visit Team Members will be asked to complete a Peer Evaluation. The Peer Evaluation form appears in Appendix F. CARTE Site Reviewers Handbook Page 17

Appendix A: Additional CARTE Resources The following documents are available on the CAAHEP-CARTE Website at http://www.caahep.org/committees-on-accreditation/default.aspx?id=carte: CARTE Standards and Guidelines CARTE Bylaws CARTE Policies and Procedures Manual CARTE Self-Study Report Forms Request for Accreditation (go to http://www.caahep.org/accreditation-services- Application/default.aspx) Form 2 Program Overview Form 3 Institutional Program Information Form 4 CARTE Standards and Guidelines Response Form 5 Academic Program Self-Assessment Summary Form 6 Compliance Matrix of Knowledge and Skills for RT and Support Competencies Form 7 Standardized Course Syllabus Form Form 8 Faculty Biographical Sketch Form 9 Sample Student Evaluation of Program Survey Form 10 Sample Graduate Survey Form 11 Sample Faculty Assessment Survey Form 12 Sample Employer Survey CARTE Site Reviewers Handbook Page 18

Appendix B: CARTE Site Visitor Confidentiality Agreement I,, participate in the accrediting process of the Committee on Accreditation of Recreational Therapy Education ( CARTE ) a Committee on Accreditation ("CoA") of the Commission for the Accreditation of Allied Health Education Programs ( CAAHEP ), as a site visitor. In order to carry out my duties and responsibilities as a site visitor, I understand that, while a site visitor at a program ("Program"), I may come in contact with certain student/faculty/institution information that is confidential in nature, including information that can be used to identify those parties ("confidential information"). I hereby attest that I shall hold as strictly confidential all information related to accreditation or reaccreditation activities, or other matters to which I have access as a member, consultant, site visitor, or agent of the Committee on Accreditation of Recreational Therapy Education (CARTE). I attest that I shall not disclose to any person, now nor at any time in the future, either directly or indirectly, any information, not otherwise public, regarding sponsoring institutions, key personnel, students, related information, or Committee activities to which I have access, except as necessary to fulfill my CARTE responsibilities, without the prior written consent of the Chair of the CARTE. I agree to handle all sponsoring institution or program documents and information not otherwise public, in such a way that they will not be inadvertently revealed to any other person. Also, I shall not maintain in my files any permanent record that contains confidential information after I have completed my duties to the institution, the program, or the CARTE, and will dispose of all such records securely. I acknowledge that any breach of confidentiality is a serious matter and may result in action which may include my removal from the CARTE or legal action against me or the CARTE. Finally, I agree to immediately notify the Chair of CARTE and the Program of any use or disclosure of confidential not permitted by this Confidentiality Agreement of which I become aware. The terms of this confidentiality statement are effective immediately and will apply to all work performed by me in carrying out my responsibilities for the CARTE. Signed this day of 201_. Signature Printed Name CARTE Site Reviewers Handbook Page 19

Appendix C: Typical Site Visit Schedule EVENING BEFORE: Members of the Evaluation Team arrive at designated hotel. The team members meet to get acquainted, to discuss their perspectives of the program on the basis of the information provided in the Annual Reports, and/or other miscellaneous documentation, to review the schedule prepared by the program director and to identify those areas that need their most thorough attention. FIRST DAY Activity 1: Meeting with Academic Program Director & Chairperson -- The on-site evaluator(s) should meet with the Program Director and Chairperson to review the schedule of activities planned by the program director for the site visit, making adjustments as necessary. (30-45 minutes) Activity 2: General Group Session -- The evaluator(s) meet with the program director, members of the administrative staff, and faculty members: To allow the evaluation team to explain the CAAHEP accreditation process and the role of CARTE; To discuss the functions of the on-site evaluation team; To review the types of accreditation status available to the program; and To affirm the purposes of the on-site evaluation. Similarly, the on-site evaluation team will have an opportunity to make individual observations of the program's guiding philosophies, operating procedures, curriculum content and sequence, student evaluation procedures, program enrollment, student attrition, and success of graduates, from those most directly informed in these matters. (60 minutes) Activity 3: Review of Program Documentation and Facilities -- The on-site evaluation team should be provided with the opportunity to review relevant documentation available (to include, but not limited to, student records, complete course syllabi, program documentation, etc.) and to observe the facilities and supplies, as appropriate. (90 minutes to 2 hours) Activity 4: Meeting with Representatives of the Program's Advisory Committee -- The team should assess the extent to which the program and the advisors understand the functions of the committee and the subjects addressed by it. (Faculty members should not be present during these interviews ) (60 minutes) Activity 5: Interviews with Members of the Faculty -- The evaluator(s) identify the frequency with which the faculty jointly assess curriculum content, the clarity to which they have described the learning objectives of the various components of the didactic and supervised practice components of the curriculum, the means and frequency for which they assess each student's progress through the various units of a course or supervised practice assignment, and the manner in which students are informed of their successes and their need for improvement. This activity may include interviews with program faculty, general education faculty, and librarian. (20-30 minutes per faculty member) Activity 6: Interviews with Students in the Didactic Phase and/or the Clinical/Practical Phase of the Program -- The evaluator(s) obtain students' assessments of the curriculum, faculty, frequency and means by which faculty assess their progress, and related subjects. Evaluator(s) also obtain students' responses to the program and their understanding, knowledge, and perception of their roles after graduation. (Faculty should not be present during these interviews) (30 minutes) CARTE Site Reviewers Handbook Page 20