Use of and confidence in administering outcome measures among clinical prosthetists

Abstract

Background Outcome measures can be used in prosthetic practices to evaluate interventions, inform decision making, monitor progress, document outcomes, and justify services. Strategies to enhance prosthetists' ability to use outcome measures are needed to facilitate their adoption in routine practice. Objective To assess prosthetists' use of outcome measures and evaluate the effects of training on their confidence administering performance-based measures. Design Cross-sectional and single group pretest-posttest survey Methods Seventy-nine certified prosthetists (mean of 16.0 years of clinical experience) were surveyed about their experiences with 20 standardized outcome measures. Prosthetists were formally trained by the investigators to administer the Timed Up and Go and Amputee Mobility Predictor. Prosthetists’ confidence in administering the Timed Up and Go and Amputee Mobility Predictor was measured before and after training. Results The majority (62%) of prosthetists were classified as non-routine outcome measure users. Confidence administering the TUG and AMP prior to training was low-to-moderate across the study sample. Training significantly (p<0.0001) improved prosthetists' confidence administering both instruments. Conclusion Prosthetists in this study reported limited use of and confidence with standardized outcome measures. Interactive training resulted in a statistically significant increase of prosthetists' confidence in administering the TUG and AMP and may facilitate use of outcome measures in clinical practice.

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals

“…Since occupational therapy can be considered a core team member for outpatient mental health (26), we chose to include this article. The second study directed the intervention at prosthetists (27). Since the outcome measures used were focused on functional mobility and for the purposes of measuring changes in functional mobility due to prosthetist treatment, we determined that this study was relevant to rehabilitation.…”

“…Two of the studies were in an outpatient pediatric setting (28,34). Seven of the studies targeted physiotherapists only (1,28,29,31,(33)(34)(35) , one study occurred with community mental health professions (unspecified but occupational therapy assumed) (25), one study each targeted occupational therapists only (30) and prosthetists only (27), and one study involved physiotherapists, occupational therapists and speech-language pathologists (32). While nine studies reported various provider characteristics such as age, gender, years of experience, work location, and caseload levels, one study reported only the professional discipline of the providers (33), and one study reported only 'mental health providers' without specifying any further provider characteristics (25).…”

“…Only one of the studies had strong ratings for any of the six components that made up the overall quality rating (31). Of the nine studies that were rated as weak, one was weak in all categories (30) and the other eight were weak in either four or five of the six categories (1,25,(27)(28)(29)(32)(33)(34). One of the studies that had on overall rating of moderate (31) used an experimental design with randomization but was limited by a small sample size, i.e.…”

“…Of the remaining seven that did not provide full information on the dose of the intervention, four (28,30,34,35) provided some but not all information (ie. the length of time of the workshop but not how many reminders were provided) (35), and three studies reported no details on the dose of the intervention (1,25,27). Only one of the studies did not measure use rates, measuring confidence in using measures (27).…”

“…the length of time of the workshop but not how many reminders were provided) (35), and three studies reported no details on the dose of the intervention (1,25,27). Only one of the studies did not measure use rates, measuring confidence in using measures (27). Of the other ten studies that measured use rates, three also measured attitudes towards measures (1,29,35) and two also measured knowledge of measures (28,34).…”