A Call to Expand and Improve the Advanced Science Content of O&P Curricula

The capabilities of any technical profession are highly dependent on the quality of the science underlying it. The successes and accomplishments of the profession often can be traced back directly to the underlying science, which guides thought processes at deeper levels of understanding and fosters the development of cause-and-effect insights that are essential for problem-solving within the discipline. The role of science within a profession is comparable to the role of the navigational aids used when embarking on a journey - these aids warn of obstacles and dangers, enable one to select and evaluate alternative paths to the destination, and then help prevent one from straying off the chosen path when the journey is undertaken.

Academic Program Structure

The curricula of all engineering academic programs and many healthcare programs contain courses at three levels. During the first year or two, students develop basic knowledge in the areas of science and mathematics. In the healthcare fields, basic courses may include college algebra and trigonometry, chemistry, biology, anatomy, physiology, and psychology. The content of these courses is usually broad, and students in disciplines other than engineering or healthcare may enroll in them since they contain the basic scientific knowledge needed in a number of diverse occupations.

Advanced science courses are taken during the second and third years of engineering and health care programs. The content of the advanced science courses is based on the concepts taught in the earlier courses, but the applications are focused more narrowly on the range of common analytic problems unique to the discipline, and additional concepts are introduced.

In the healthcare fields, the courses may include upper-level courses in psychology, nutrition, physiology, pharmacology, microbiology, and courses that introduce clinical assessment concepts. The knowledge base developed in these advanced science courses is essential to practice within the discipline, and these courses often mark the point of divergence between the curricula of different engineering and healthcare disciplines. When advances occur in the state of the art, they usually entail the application of principles and concepts at this level. Therefore, the ability of an individual to advance the discipline is often dependent on their understanding of the principles and concepts introduced in the advanced science courses.

Professional practice courses comprise the third and highest level. They reinforce and apply the concepts learned in the advanced science courses within the context of open-ended design problems typical of those encountered in the discipline.

In the healthcare fields, the courses involve patient-practitioner interactions and the development and implementation of intervention strategies for pathology-specific health problems. It is the successful completion of the courses at the third level that marks the transition from being merely a student to becoming a practitioner in a profession, having the ability to apply the concepts and analytic methods developed at the advanced science level to solve real-world engineering or healthcare problems of economic, political, legal, and social significance.

O&P Curricula

Current NCOPE curriculum guidelines are quite specific and thorough with respect to the third level of course work. Section II.B.2.d identifies the prosthetic and orthotic techniques and systems in which students "must successfully demonstrate knowledge," and Section II.C, "Entry-Level Competencies for the Orthotist and Prosthetist," expands on this requirement by listing 27 educational goals that relate to patient-practitioner interactions and intervention strategies. NCOPE guidelines also are very specific with respect to the first level of knowledge. They stipulate that pre-requisite course work must be completed in a number of relevant basic science and mathematics courses. They further recommend that a minimum of three semester hours be taken in each.

However, with respect to knowledge at the second level, advanced science, NCOPE guidelines state only that students "must receive formal instruction" in a number of areas including biomechanics, gait analysis/pathomechanics, kinesiology, pathology, materials science, radiography, and research methods. Although the guidelines state that "this subject matter should constitute the academic 'core' of the curriculum," the criteria would be stronger if credit hours were specified and there was a statement requiring that course work taken at the third level must build upon and utilize the conceptual foundation provided by advanced science "core" courses at the second level. I propose an alternative organization of topics and an expansion of the content.

More high-quality, discipline-specific advanced science educational materials appropriate for the second level need to be developed and included in the curricula. Materials should be based on applied scientific knowledge that relates directly to clinical practice in O&P and should prepare the O&P student for clinical practice experiences at the third level.

One of the underlying reasons for the dearth of educational material may be that the profession as a whole has not had the resources needed to comprehensively identify relevant underlying scientific concepts and principles which influence outcomes in the clinic-to seek at a more fundamental level the reasons why some solutions work and others do not-and prepare appropriate educational materials. The issues of what to present and how many credit hours are needed to cover the material are still waiting to be fully addressed. Only the O&P profession can answer these questions; no other discipline faces the same set of assessment, prescription, and implementation problems. However, O&P research already undertaken by related disciplines which rest on a strong scientific foundation, including medicine, biomedical and rehabilitation engineering, physical and occupational therapy, and kinesiology, may provide a useful framework and relevant source material.

Proposed Categories for O&P Advanced Science

As a starting point for broadly identifying the relevant content, I propose that the question be asked, "What factors limit the capabilities of an individual who uses a prosthesis or an orthosis?" A preliminary list of the principal limiting factors would include the broad categories of tissue biomechanics, gait biomechanics, physiologic factors, psychophysical factors, motor control factors, material strength factors, and economic factors. Depending on the characteristics of the patient, the components, and the funding source, one or more of these factors will influence the prescription, dictate the maximum performance that can be achieved, and create the follow-up concerns. Thus, these seven categories could form organizing themes for the content of advanced science knowledge. The scientific literature published by both the O&P profession (Journal of Prosthetics and Orthotics and Prosthetics and Orthotics International) and the related disciplines mentioned previously contains a reasonably large number of research-oriented articles related to these topics. Taken collectively, these articles identify the principles, concepts, and theories most relevant to the science that underlies prosthetics and orthotics.

In the next issue, Dr. Neumann discusses these seven proposed categories of advanced science-tissue biomechanics, gait biomechanics, physiologic factors, psychophysical factors, motor control factors, material strength factors, and economic factors-and makes recommendations and conclusions relevant to O&P course work.

A Call to Expand and Improve the Advanced Science Content of O&P Curricula

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A Call to Expand and Improve the Advanced Science Content of O&P Curricula

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OIG Report Fuels Competitive Bidding

Apex Expands Pedorthic Team to 17 CPeds

Apex Expands Pedorthic Team to 17 CPeds

RECENT NEWS

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O&P JOBS

Open Bionics hiring for CPO’s!

ABC Certified Prosthetist/Orthotist/ Resident – Memphis TN/Southaven MS

Part Time Certified Prosthetist

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