Seeing and Doing
April 2009 Issue
When the spring 2009 semester began at the college of prosthetics and orthotics at St. Petersburg College (SPC), my stress level was quite low. Granted, the assigned 15 chapters of not-so-light reading was a bit shocking, but the fact that we were starting the "fun stuff" (lab work) made those 15 chapters bearable. To my surprise, however, the hands-on aspect of the program, which we started one week into the semester, was much more difficult than I had anticipated.
I thought the work I had done as a technician at a prosthetic central fabricator in Orlando, Florida, would give me an advantage in my lab courses. Unfortunately, thought and reality don't always mesh. Though my technician work exposed me to a great deal of invaluable information, I found that I still had so much to learn.
During the second week of the semester, my transtibial prosthetics class was broken up into groups, and we started seeing patients. My class had 23 students and eight patients, so most groups-like mine-had three students and one patient. In the fall, the practitioner I had been shadowing at my clinical rotation site instructed me in how to gather relevant information from the patient, which made taking our patient's history much easier. The experience also made it easier to "engage" the patient, which, according to my professor, Scott Sanford, MS, CO, is the first important communication skill for taking a patient's history. To make the most efficient use of our time, we would also be casting our patients during their visit. Having grown up around prosthetics, I have witnessed firsthand the establishment and growth of good practitioner-patient relationships. With this in mind, I was excited to begin and meet my patient for the semester.
Though we were constantly supervised, it felt as if we had been let loose to a certain extent. Instead of being onlookers, we had the opportunity to be care providers. Granted, the prosthesis we would be creating wasn't going to be used full-time, but creating it definitely helped us get into the all-important "practitioner" mindset.
Creating a cast, however, presented more of a challenge than I had anticipated. I've seen countless patients cast for a prosthesis, but seeing and doing this are two very different things. The other two students in my group both received their bachelor's degrees in art before entering this program, so their expectations for how the cast should look were very high. I also hadn't expected the three-part casting method to present me with as many problems as it did. While applying the first stage-an anterior panel- to the residual limb, I failed to maintain appropriate pressure, which caused a loose anterior fit. Luckily, this was the only major complication that arose. Though the problem was minor, it felt major at the time, and it made me appreciate a good cast that much more. I've seen practitioners completely recast a patient because they were unhappy with the result of a particular cast, and now I understand why-the modification process! (And we have plaster, no vermiculite.)
The patient my group was paired with had lost a leg as a child because of an explosion that had also substantially damaged the contralateral leg. The injury caused both the residual and contralateral limbs to be quite sensitive and irregular in shape. While this made it more difficult to create the perfect socket for this patient, the fact that our sockets fit fairly well was a major confidence booster.
The deeper I get into my education, the more I realize I need to learn. As Socrates said, "True knowledge exists in knowing that you know nothing." There is such an immense amount of knowledge related to orthotics and prosthetics, and so much of it baffles me-but in a good way. It creates a thirst for knowledge that is exciting. And isn't that what school should do- create a thirst for knowledge?
Michael Carroll is a junior at St. Petersburg College (SPC), Florida. He will be sharing his experiences with The O&P EDGE as he completes his bachelor's degree in orthotics and prosthetics. He can be reached at