Tabula Rasa? Not Anymore!

Home > Articles > Tabula Rasa? Not Anymore!
By Kristin Carnahan

If you have talked to anyone from the master of science in prosthetics and orthotics program at the Georgia Institute of Technology (Georgia Tech), you may have heard it mentioned that one weakness in our training is in the area of technical skills. I personally came into the program with zero, nada, absolutely no technical fabrication experience whatsoever. Not only had I not performed any work in an O&P lab, I also had not seen much of it. Okay, so there, I admit it. This lack of experience became glaringly obvious to me, and surely to my instructors, and probably even to my patient models (who are so kind nonetheless) last year during my first attempts at fabrication. In fact, my first orthotic fabrication assignment, a custom-molded UCBL foot orthotic, and my first prosthetics project, a transtibial patella tendon-bearing (PTB) socket, were absolutely awful. They didn't fit well and didn't even look pretty to make up for the poor fit. I remember being discouraged with myself as I struggled to learn to get along with plaster and to develop a comfortable confidence with the grinding machines.

It was not uncommon for me to stop, put down the plaster spatula, and walk outside for a breath of fresh air and to convince myself to go back and try again. My confidence had not been shaken so much in quite a while, and though I never thought of giving up, I had my doubts about how quickly I would be able to learn and adapt.

Fast-forward to my third semester in the program, and I have already seen improvements in my fabrication skills that I did not think were possible. I couldn't believe that when I made my first transfemoral socket just a few months ago, what I produced not only looked like an appropriate socket, but it actually fit the patient well! Okay, I thought, beginner's luck. But then I realized that while the great fit may have been a stroke of luck, the evolution of my fabrication outcomes were a result of the time and training that has been invested in me over the last year. The amount of time spent in fabrication at school could be considered lacking, but a steep learning curve and excellent instruction have allowed for great strides in improving my individual techniques and skills. Not to mention, more than 400 hours so far spent in clinical rotations at P&O clinics, which has been invaluable in providing hands-on experience and the opportunity to watch and learn from technicians and practitioners alike. I have lost count of the number of times someone has taken a few minutes to show me a specific skill or technique, and each time it has made a huge difference in the final product. For those of you out there in practice who are tasked with taking students under your wing for rotations or residencies, don't underestimate the little things when you find yourself instructing someone in the lab. Something that may seem obvious to you can be a new and valuable tool for a student or resident who is just learning the ropes in the fabrication lab.

The learning curve has not been all bad. The art of fabrication has been an obstacle but also a source of excitement for me. I don't always enjoy the feeling of tackling things that I don't know how to do, but I love the feeling of finishing a product and realizing that my blood, sweat, and sometimes tears literally went into its fabrication. I am almost 30 years old, and I still have the urge to call my parents and tell them what I did in school when I finish a project. Maybe I shouldn't admit that, but I think it says a lot about how great our profession is. What an exciting career, that what we do and what we create on a daily basis can not only bring us a sense of accomplishment, but it can also help people to walk or function in some way better than they did before.

Do I think I know everything now that I can make a respectable looking socket or AFO? Absolutely not. I do, however, feel like I will make it after all, that plaster is not my evil adversary, and that I will be able to enter my residency with some level of fabrication confidence. I have no doubt that in order to serve my future patients well, I will have to keep learning continuously, and I am looking forward to that challenge.

Kristin Carnahan is a graduate student in the MSPO Program at the School of Applied Physiology at the Georgia Institute of Technology in Atlanta, Georgia. She will be sharing her experiences through articles in The O&P EDGE throughout her two-year program.