A conceptual framework for orthotic and prosthetic education

Abstract

Background: Variables that influence orthotic and prosthetic patient outcomes beyond direct care are poorly conceptualized for orthotic and prosthetic students. Restructuring educational curricula around important clinical reasoning variables (i.e. factors that may influence outcomes) could improve teaching, learning, and clinical practice. Objectives: To propose an orthotic and prosthetic education framework to enhance the development of orthotic and prosthetic students’ clinical reasoning skills. Study Design: Scoping review. Methods: We conducted a scoping review, identified variables of orthotic and prosthetic usability, and performed a qualitative thematic analysis through the lens of orthotic and prosthetic clinical educators to develop a conceptual framework for orthotic and prosthetic education. Results: Sorting of variables identified from the literature resulted in three thematic areas: (1) the state of functioning, disability, and health (International Classification of Functioning, Disability and Health); (2) orthotic and prosthetic technical properties, procedures, and appropriateness; and (3) professional service as part of orthotic and prosthetic interventions. The proposed orthotic and prosthetic education framework includes these three areas situated within the context of patient-centered care. Conclusions: A conceptual framework was developed from variables identified in peer-reviewed literature. This orthotic and prosthetic education framework provides a structure to explore orthotic and prosthetic clinical reasoning and advance our teaching and assessment of students’ clinical reasoning skills. Clinical Relevance The proposed orthotic and prosthetic (O&P) education framework is intended to promote conversation about variables (e.g. health condition, procedures, services, and O&P principles) that influence O&P clinical practice outcomes and further advance our teaching and assessment of students’ clinical reasoning skills.

Entrustment trends in orthotic and prosthetic residencies

“…14,15 For developmental competencies, clinical skills such as ‘patient evaluation skills’ and ‘interpersonal skills,’ as opposed to ‘technical skills,’ predicted resident progress toward independence, reflecting the profession’s focus on patient care. 16 Spaulding et al’s 17 conceptual framework for O&P education supports our findings that, despite historical precedence, technical skills are only a portion of skills required to provide patient-centered care. In this context, results of our study suggest that it is important for residents not only to exhibit technical skills, but also to possess strong evaluation and interpersonal skills when making clinical decisions.…”

Fostering integration among students with different backgrounds using an orthotic community service program

“…Clinical reasoning skills could facilitate the categorization of gathered information in a mentally logic manner. 25 One of the advantages of this service journey was the integration of different levels of competence (teachers, alumni, and students) that could promote the students' critical thinking and clinical reasoning skills.…”

“…35 Students and teachers of the service team may also take advantage of using the conceptual P&O framework to enhance the P&O students' clinical reasoning skills to see whether the intervention induces the preplanned outcome or not. 25 Given the fact that the global engagement is the focus of interest in many institutions, the service team humbly proposes the implementation of community service either in pedagogies or through cocurricular arrangements in P&O programs.…”

Education in prosthetic and orthotic training

“…49 To develop students' clinical reasoning skills in a systematic way, students could use frameworks to map and compare variables that affect desired technical and functional outcomes. 50,51 Once students identify a pathway to make clinical decisions about a case, they can explore how various contexts might alter the outcomes and, thus, the clinical decision. Finally, to further develop critical inquiry, educators could use prosthetic threshold concepts (i.e.…”