O&P Tech Education Programs Adapt During Pandemic Restrictions

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By Maria St. Louis-Sanchez

As a former advocate for the disabled, Marie Gaudet was enthralled by the O&P devices that many of her clients used. The more she learned about them, the more she realized that she wanted a career as an O&P technician so she could help people by building those devices.

When she figured out what she wanted to do, she threw herself into the profession by enrolling in the Orthotic & Prosthetic Technologies program at Oklahoma State University Institute of Technology (OSUIT). She arranged four classes per semester. If everything went as planned, she would be able to graduate on an accelerated schedule and start her new career as soon as possible.

Things, however, did not go as planned. Like most higher education institutions in the United States, OSUIT shut down its campus abruptly in mid-March in response to the COVID-19 pandemic. It was Gaudet's first semester at the school. The project she was working on could not be completed, and she was graded instead by how well she had done on it before the shutdown. Many of her classes have now shifted online.

"It's just sad to not be able to learn in the capacity we anticipated and to have everything put on hold," she says. "I feel like we are still gaining knowledge through online education, although it will never quite replace the hands-on lab experience we expected."

She, and O&P tech education students across the country, were in unchartered territory. O&P tech education programs have had to be creative and work together to figure out new ways to teach what has traditionally been a hands-on education.

An Abrupt Change

For most of the O&P tech education programs, the transition from in-person to online learning was sudden. Many institutions were told they would have an extended spring break, then were told the closure would be just a few weeks longer, then they learned the schools were closed for the rest of the semester.

Programs had to scramble to adjust based on new information coming in week by week and day by day. With no road map to show how to handle the situation, they had to figure out how to help their students finish the semester and, in some cases, graduate.

"Initially we were in shock," says Desmond Masterton, MS, CO, CPed, associate professor of orthotic prosthetic technology at Joliet Junior College (JJC). "This was quite different than anything we had ever done before. It's historic. But we had to think of how we meet our objectives and serve our students."

Deciding how to grade some students on their work wasn't that difficult.

"For the freshman class, it wasn't a total loss," Masterton says. "We have all of our quizzes and midterms online anyway. We cancelled practical exams for obvious reasons."

For other students, figuring out what to do was more of a challenge. At JJC, the seniors set to graduate had not finished their final projects when the campus closed.

"They were supposed to be finishing that semester and weren't planning on coming back," Masterton says. Instead of turning in their products for review, they had to create fabrication manuals about how they had planned to finish the fabrication of their products. This was not an ideal solution, but it was all they could do at the time, Masterton says.

"Technically speaking, it does violate the accreditation standards," he says. "So discussions have to take place between NCOPE [National Commission on Orthotic and Prosthetic Education] and CAAHEP [Commission on Accreditation and Allied Health Education Programs].

"My feeling is that our seniors that graduated, though they did not necessarily complete the fabrication of a certain project, they only missed seven weeks of the program. I feel they are more than adequately prepared to start their careers as orthotic prosthetic technicians."

Working Together for a Solution

The most important goal for everyone, the educators agree, is to ensure that students get the best possible education and learn what they need to benefit patients.

"The bottom line is that we educate the students we are putting out in the public arena," says Michael

Madden, CPO/L, FAAOP, OSUIT instructor. "We want to make sure we are giving them the best educational experience we can for the sake of the public that will be the recipient of those services."

Even though the format of O&P technician programs may have changed, that doesn't mean expectations for graduates should be lowered, says Chris Robinson, MS, MBA, CPO, ATC, FAAOP(D), clinical research director for NCOPE.

"The key thing to appreciate is that the CAAHEP education standards have not changed in any way," he says. "We haven't changed anything in terms of expectations. The change in format is something that is understood and expected by Council for Higher Education Accreditation, and NCOPE has developed resources to assist in this transition."

To help, NCOPE has collaborated with the O&P practitioner-level educators to develop a graduate preparedness form that will allow schools to identify variations in their education programs that may have occurred due to the disruption during the pandemic. Allowing the academic programs to shape expectations for their graduates enables the residency programs to better address the students' needs during residency programs. Residency is the second half of a practitioner's education and facilitating an effective hand-off from the academic programs to residency sites is a priority for NCOPE, Robinson says.

"O&P technician program faculty have identified opportunities to assess competency via technical/clinical rotations. NCOPE has worked closely with the technical educators to help develop competency assessment tools that enable technician program faculty to collaborate with preceptors ensuring readiness to enter into the workforce. Creative strategies such as this one can help offset time lost on campus," he says.

To help share ideas and work together more, faculty from all of the US O&P tech education programs have started meeting regularly via video conferencing. NCOPE has also given the educators a platform on its website for the educators to share resources with one another. The resources range from videos that demonstrate how to build certain components to the entire curriculum of some classes.

"What I saw was a real camaraderie of concern for students and concern for technical education, and that inspired us to come together," Madden says. "It's a sense that we're all in this, so why not be all in it together and why not figure out a way to use more minds and more ideas to navigate through the process."

Working together like this is something that the educators hope continues well past the pandemic.

"We feel the silver lining in all of this was that as technician educators, we made it a priority to meet regularly and offer each other resources," says Joanna Kenton, CPO/L, FAAOP, a member of the prosthetic faculty at Century College. "I wouldn't want to give that up. We are all very passionate about technician education, our students, and their success. It's important to stay connected both now and in the future for the advancement of O&P technical content."

Madden says another change that will continue past the current crisis will probably be the use of online instruction. "I think one of the main takeaways from this is that we weren't utilizing online education to the full extent that we could," he says. "We've had to become very, very creative in how we do the curriculum online."

By using online tools, he says educators can help reinforce lessons for the students and give them a head start to making the devices themselves.

"Online, they've seen it done, they've heard how it's done, now they just need to assemble it, which we all know is a whole other level."

Challenges Ahead

The educators say they are proud of what they have been able to accomplish in such a short amount of time. However, the solutions they have found might not work for all their students.

Madden acknowledged that online education is not a great fit for everyone. In fact, it might be less of fit for the students in tech programs than for others.

"A lot have admitted to me that this is not their favorite teaching environment," Madden says. "They want to be in the classroom. Technical students tend to be hands-on people. That's what draws them here. We can give them the videos and talk them through it, but they want to do it."

Laura Roughley is one of those students. She was in her first semester as OSUIT when it closed in March. She chose the program precisely because it's hands on, and she's not sure what she will do now that there has been a bigger shift online.

"I've done online classes before, and I've never done well in them," Roughley says. "It doesn't matter what video they put out there. If I'm not face-to-face with someone, it doesn't sink in. I struggled with online learning because I wasn't connecting."

She plans to wait to return at least until classes resume fully in person. That is, if she returns at all, she says.

"It's hard enough to learn online with an English or a math class," she says. "For something that requires hands-on learning, it's impossible. I'd be paying money for service to a school and not learning."

She doesn't fault her instructors for the way that things have turned out. She's not sure what else they could have done.

"They're doing the best they can," she says. "It's not their fault. It's just the circumstances being what they are. No one has the option to continue life as we knew it."

The New Normal

Even when O&P tech programs are allowed back on campus, education will look much different than before. At Spokane Falls Community College, students and educators are some of the first to adjust to the new health directives in the O&P lab setting.

The O&P technology program at the school was given special permission to open the lab in late May for five students scheduled to graduate in June. Educators had no prior experience as they worked to figure out how to give their students hands-on learning, while still following health directives to keep everyone healthy and safe, says Bernard Hewey, CPO, program director of the O&P Technology program at the college.

The new directives mean that everyone wears face shields at all times, temperatures are checked on a daily basis, students' workbenches are separated, and they have to maintain social distancing in the lab. Everything is sanitized and scrubbed down at the end of the instructional day, so they are ready to go first thing in the morning. Also, transit directions in the lab have been marked off so students can only walk in certain directions through the lab.

Hewey says it can be challenging for him to abide by all the new rules, and he helped make them, so he understands why his students also have trouble at times.

"I'll be the first to admit this. I find myself wanting to walk a different way than what is marked," Hewey says.

"I have to catch myself and go down the identified pathways to show that I am doing it and be an example for the students. We're constantly monitoring them. We're not policing them per se, but we are helping them get into the rhythm of doing that. It's new to everybody."

Because of the delays from the pandemic, the graduating seniors have to get through a quarter's worth of work in about one-third of the usual amount of time. The extended spring quarter ended on June 30, and if their coursework wasn't completed by then, students received incomplete grades and will be required to continue into the summer quarter, which begins a new academic year. This could have consequences involving financial aid and other issues.

"We're working eight hours a day, five days a week to work everyone through the abbreviated quarter," he says. "We'll work weekends if we have to."

For now, the health directives are working with the five graduating students. Come fall, however, there will be an expected 32 students in the program and the program will have to keep these same COVID-19 mitigation rules with a lot more students, Hewey says.

"We may have to stagger times, and reduce the amount of in-lab time," he says. "That really makes getting the online content even more important, so the reduced lab time is spent effectively developing psychomotor skills instead of lecture demonstrations."

He hopes to pass on the lessons he's learned as one of the first programs back in the lab to his fellow O&P tech educators.

"We'll learn a lot from this and how to mitigate the issues," he says. "We'll have conversations with other instructors so they can have a better idea of how to approach this."

It remains to be seen how long these new directives will be in place and impact the educators and the students. The important thing, Madden says, is that they keep learning from one another and working to improve the educational experience under these new conditions.

"Our world is going to be a little different on the other side of this," Madden says. "We're doing the best we can to provide the best education we can under the worst circumstances we've ever had to do it under."

Gaudet, an O&P tech student, says she knows things will be different when she gets back in the lab, but she's willing to do whatever it takes to finish her education.

"I'll wear a mask. It will be uncomfortable, but I'll do it," she says. "If everybody uses their common sense, I think we'll be okay."

She is no longer confident that she will be able to graduate early as planned. A couple of her summer classes were pushed to fall, and for the other two, she will be taking half online in the summer and half in the fall so she can work in the lab.

"I have a feeling that I probably won't be able to graduate on time," she says. "But I'm hoping for the best and trying to stay positive. I also want to be realistic and I'd rather plan for reality than not."


 Maria St. Louis-Sanchez can be contacted at msantaray@yahoo.com.