This course disseminates a 14 week doctoral experience capstone at an outpatient hands clinic in Des Moines, IA. Experience was created by a third year student in an entry level occupational therapy doctorate program at Drake University. This experience details a needs assessment, literature review, three learning objectives satisfying ACOTE standards, as well as experiential site information and additional topics of focus throughout the 14 week experience. The focus of this course is occupation based practice in the hand therapy setting, a setting commonly thought to emphasize therapeutic exercises over occupation based therapeutic activities. Recently, literature has determined a need and applicability of occupation based practice to facilitate function and independence in a variety of orthopedic upper extremity conditions commonly seen by a hand therapist.Through this course, literature will be reviewed and summarized regarding evidence based and occupation based practice specifically applied within the hand therapy setting. Objectives and areas of focus include: utilize and analyze evidence for occupation-based practice, display professionalism, ethical behavior, and advocacy skills to influence positive change with clients, communities, and the profession, increase clinical skills via orthotic fabrication, and conservative management for thumb CMCosteoarthritis. By the end of the course, students will be able to verbalize the importance of occupation-based practice, identify three barriers for implementation of occupation based practice in clinical hand therapy settings, verbalize patient reasoning for seeking treatment and/or surgery for thumb CMC osteoarthritis, and identify two strategies for conservative thumb CMC osteoarthritis.