Assessing O&P Competency with the ABC Exams

[caption id="" align="alignnone" width="250"] Candidates take the CPM test in St. Petersburg, Florida, in January. Photographs courtesy of ABC.[/caption] Three years after its founding in 1951, what was then called the American Board for Certification of the Orthotic and Prosthetic Appliance Industry (ABC), now the American Board for Certification in Orthotics, Prosthetics and Pedorthics, conducted its first exam to certify practitioners in O&P, the genesis of todays exam. At the time, millions of veterans had returned from World War II, fueling a demand for advanced technologies in O&P devices and professionals who could fabricate and provide those devices. "Following World War II, veterans were dissatisfied with the lack of technology in their devices and demanded improvement," according to an article in inMotion magazine (November/ December 2007). "The U.S. government brokered a deal with military companies to invest in improving prosthetic function rather than weapons. This agreement paved the way to the development and production of modern prostheses." ABC's founders saw a need emerging for increased professionalization among O&P health professionals, who were then commonly referred to by the general term of fitters, and determined that those meeting its standards would earn the credential of certified orthotists and certified prosthetists. That first exam, held in New York, New York, certified 51 individuals and marked the arrival of a U.S. O&P credentialing body. ABC would not only raise the bar for improved education and patient care, but would help practitioners stay current with the latest advances. Since then, ABC has credentialed thousands of O&P professionals, with about 225 new O&P practitioners certified annually. The three-part ABC exam, which tests a practitioners didactic knowledge and practical clinical expertise, is central to the organizations mission "to establish and promote the highest standards of organizational and clinical performance in the delivery of orthotic, prosthetic, and pedorthic services." The practitioner exams "cover the whole area of practice," says William Neu, CPO, president of the Ohio State Board of Orthotics, Prosthetics, & Pedorthics, the state's licensure authority. To become an ABC-certified practitioner, candidates are required to pass all three parts of the exam for each discipline in which they are attempting to become certified. Two of the three parts are computer-based tests in which the responses are electronically recorded and instantly scored. The third is the Clinical Patient Management (CPM) practical exam in which an ABC examiner—a certified practitioner with many years of experience—judges a candidate's responses to clinical situations. Practitioners must receive specific training in order to qualify as an ABC examiner. Descriptions of the three exam sections follow: Written Examination The three-hour, multiple-choice, computer-based written exam consists of 165 questions. It measures a candidate's general knowledge of basic principles of patient and practice management. The knowledge assessed includes anatomy, kinesiology, diagnoses, componentry, materials, and practice management. Written Simulation Examination This exam, which is also allocated a three-hour time slot, assesses a candidate's problem-solving skills through an interactive format. The simulations imitate situations that an orthotist or prosthetist might encounter in daily clinical practice. The written simulations include seven problems. For orthotics, the problems might include scenarios involving scoliosis/kyphosis, spinal cord injuries, fractures, treatment of stroke, upper-limb management, hip and knee pathologies, the cervical spine, and neuromuscular disease. For prosthetics, the simulations might focus on management of individuals with transtibial and transfemoral amputations, upper-limb amputations, partial foot amputations, and immediate postoperative fitting procedures. Administering the Exams ABC's practitioner exams are updated annually by respective committees of orthotic and prosthetic practitioners, and a standard percentage of questions are replaced with each update. The computer-based tests are offered at 250 testing centers around the country six times per year. The CPM exam is offered three times annually, currently at two locations. Tony Ward, CPO, an ABC senior CPM exam auditor, helps to ensure that when a candidate sits for the CPM exam "everything is recorded clearly and consistently" He also notes that "all of the answers are standardized, which allows for an objective assessment of each candidate's knowledge and skill. "This is a very extensive exam to administer," he says, adding that as many as 100 candidates take the CPM exam during each sitting. The following examples represent sample questions from the multiple-choice and written simulation exams. Orthotic exam The trim lines of a ground reaction ankle foot orthosis should be anterior to the malleoli to serve as a: Dorsiflexion assist Plantarflexion assist Dorsiflexion stop Plantarflexion stop Prosthetic Exam At a local clinic, the practitioner sees a 40-year-old male with a right transradial amputation. Also present are a social worker, an occupational therapist, a physician, and a nurse. The practitioner is asked to make a recommendation. Section A: Based on the information available, which of the following questions should the practitioner ask? Choose only the response(s) relevant at this time. What type of insurance coverage do you have? What was the cause of your amputation? What are your hobbies? What are your vocational tasks? Would you like a prosthesis exactly like the arm you lost? When was your amputation? Do you know what type of terminal device you want? Clinical Patient Management Examination The CPM portion of the exam tests candidates in real-life clinical situations. This hands-on, five-hour exam assesses the practical skills experts consider to be necessary in the competent performance of O&P. The candidate must demonstrate his or her practical ability in a clinical environment with mock patients—individuals who serve as patient models and are instructed about how to conduct themselves so that all exam candidates have a consistent experience. Skills evaluated include patient assessment, prescription criteria, measurement techniques, fitting, alignment, and appropriate treatment of patients. "During the ABC CPM exam, practitioners are judged on both their interaction with patients and professional abilities" explains Neu. Practitioners and candidates alike say the CPM portion is a distinguishing feature of the ABC exam process. It challenges candidates to think on their feet and formulate a treatment plan based on evaluating a "real" patient. DeAnna Chapman, MSPO, CPO, LPO, FAAOP, a volunteer ABC examiner, says the CPM allows a candidate to be thoroughly assessed on his or her skills. It "looks at a candidate's ability to assess and treat a patient on multiple levels" she says. "The ABC CPM exam is much more real world and real time" says Stephen Fletcher, CPO, LPO, ABC's director of clinical resources. "Others allow videotaping [of] the clinical portion…" Fletcher believes the difference between an in-person demonstration and a videotape of clinical ability is in making clinical judgments. A candidate who submits a videotape of his or her clinical interactions "may be able to demonstrate the ability to perform a specific task, but what the CPM does is assess a person's ability to make clinical decisions" he says. In the CPM test, ABC-credentialed volunteer examiners observe and record the performance of candidates facing a clinical situation. Candidates are unaware beforehand of the situation they will face or what sort of needs the patient model will have. The exam measures a candidate's ability to interact with the patient model and demonstrate the following: Patient assessment. Treatment plan formulation. Biomechanical rationale. Device design. Measurement techniques. Fit and assessment. Patient interaction. For example, after the initial orientation at the orthotic CPM exam, the subsequent 90-minute section asks the candidate to identify several gait deviations and their pathomechanical causes; recommend a lower-limb orthosis; and perform a scoliosis task. In the next three-hour, hands-on segment, the candidate assesses many additional lower limb orthotic pathologies and spinal orthotic situations The three-part certification exam is the final hurdle for candidates to become ABC credentialed after attaining a master's degree and successfully completing a clinical residency. ABC "has done an excellent job of ensuring that the CPM exam is a true picture of the profession today," says Carol Hentges, CO, ABC's orthotic exam committee chair. Eric Rosenberg, MBA, is a lecturer at Johns Hopkins University, Baltimore, Maryland, and has nearly 30 years of experience in news media and public relations. He is also a principal at EMR Content + Communications, Arlington, Virginia. He can be reached at EMRcontent@gmail.com. Editor's note: The exam process of the Board of Certification/Accreditation will be profiled in a future issue of The O&P EDGE .

Assessing O&P Competency with the ABC Exams

Össur VP Sets Marathon World Record for Transtibial Amputees

IT’S HERE: The Preview Issue of Amplitude Magazine!

IT’S HERE: The Preview Issue of Amplitude Magazine!

RECENT NEWS

Get unlimited access!

O&P JOBS

CPO

We’re Looking for ABC CPs/CPOs to Join Our Team

Certified Prosthetist Orthotist

Are you sure want to unlock this post?

Are you sure want to cancel subscription?

The most important industry news and events delivered directly to your inbox every week.

Welcome Back!

Retrieve your password

Are you sure want to unlock this post?

Are you sure want to cancel subscription?

Assessing O&P Competency with the ABC Exams

Support authors and subscribe to content

Subscribe

Related posts:

Össur VP Sets Marathon World Record for Transtibial Amputees

IT’S HERE: The Preview Issue of Amplitude Magazine!

IT’S HERE: The Preview Issue of Amplitude Magazine!

RECENT NEWS

Get unlimited access!

O&P JOBS

CPO

We’re Looking for ABC CPs/CPOs to Join Our Team

Certified Prosthetist Orthotist

Login to your account

Reset Password

Signup to your Account

Are you sure want to unlock this post?

Are you sure want to cancel subscription?

Account Activation

The most important industry news and events delivered directly to your inbox every week.

Welcome Back!

Retrieve your password

Login to your account

Reset Password

Signup to your Account

Are you sure want to unlock this post?

Are you sure want to cancel subscription?

Account Activation