Going Into the World to Do Good: Integrating O&P Education With Humanitarianism

[caption id="attachment_245708" align="aligncenter" width="300"] Photograph courtesy of Dreaming and Working Together.[/caption] A characteristic shown by many O&P professionals is humanitarianism. A humanitarian as defined by Oxford Learner’s Dictionary is “a person who tries to help people who are suffering and improve the conditions that they are living in.” The O&P profession lends the opportunity for interventions that can improve quality of life through the collaboration of patients and health professionals. Functionality that can be achieved through the support of well-designed orthoses or prostheses can be life altering for users and those in their proximity. Striving for universal access to these life-improving interventions must be a pillar of our profession. We are presented with patients daily whose immediate or future quality of life we can impact with our actions, but the complexities and demands in this scope of practice can sometimes distract from initial humanitarian motivations. Nonetheless, many practitioners, residents, students, and technicians seek opportunities to share their acquired knowledge and experience with whom they may not traditionally interact. In preparation for this article, it is encouraging to see the number of opportunities to provide support and direct action to others domestically and abroad. It is my hope that the following two vignettes may provide encouragement, inspiration, or motivation for those in O&P to contribute to the betterment of humanity in whichever approach is most feasible. To the unique focus of this Academy Spotlight, a 2020 article by Ewers et al. identified and explored the development of the educational landscape within O&P over the past 50 years. Past and current trends, as well as future considerations outlined within their text, should be considered when integrating education both internal and external to the traditional settings of academe and the clinic. 1 The admirable development of training programs provided to various in-country health professionals—spearheaded by the more commonly visualized direct patient care providers—is a valued evolution of O&P humanitarian efforts. This article highlights the elements of educational novelty and implementation, as these are the primary lenses through which I have become most familiar and witnessed success. Education With a Focus Abroad: Dreaming and Working Together “Great things are done by a series of small things brought together.” —Vincent Van Gogh [caption id="attachment_245706" align="alignright" width="300"] Photograph courtesy DWT.[/caption] Dreaming and Working Together (DWT) was initiated by Hernando Garcia, a Peruvian medical records employee at Hartford Hospital in Connecticut. In 2005, he petitioned physicians to assemble a multidisciplinary team for on-site patient care at Daniel Alcides Carrión National Hospital in Lima, Peru. Garcia, using funds he acquired through aluminum can recycling, was the first official donor. Through the support of the Peruvian team and collaboration among physicians; physical, occupational, and speech therapists; and prosthetists, the DWT organization has been involved in direct patient interactions for greater than 600 individuals across 15 trips. A long-standing and significant element for DWT is introducing techniques to Peruvian colleagues in the operating room as well as the rehabilitation and prosthetic fabrication specialties. In prosthetics specifically, challenges with shipping traditional fabrication materials and limited on-site tooling have led to innovative solutions in socket fabrication. The hosting arm of DWT made it a priority for willing and qualified Peruvian healthcare peers to have the opportunity to engage with visiting US-based team members on the myriad tasks required for high-volume, time-limited patient encounters. In-country support is not to be understated. The sustainability of any of the DWT endeavors would not have been possible without an equally dedicated host country contingent led by Mary Querevalu, MD. A common response when a successful nongovernmental organization is asked, “What is one of the keys to your organization’s success?” is “A reliable in-country partner is critical.” [caption id="attachment_245707" align="alignright" width="213"] Photograph courtesy DWT.[/caption] In 2019, DWT was awarded a multi-year vocational training team grant from the Rotary International organization, “Developing a sustainable amputee care program for the underserved and underinsured population in Peru.” The unifying deliverable of the US (District #5160) and Peruvian (District #4465) Rotarian support was specifically to train Peruvian personnel in methods and best practices to be used in rehabilitation of people with lower-limb amputations. This Rotary-funded collaboration between Hartford Hospital, Hanger Clinic, and the University of Hartford focused on two areas related to education: the preliminary investigation into the viability of telemedicine (prior to the COVID-19 pandemic) focusing on limb assessment and dynamic alignment of the prosthesis; and formal didactic and practical coursework for interested healthcare workers. The rehabilitation formal curriculum comprised physical therapy best practices in relation to obtaining patient history, performing physical examination, and the practical experience of gait training. The prosthetic elements focused on componentry identification and troubleshooting socket pressures primarily for the lower-limb patient population. The content from both curricula was augmented from master of science in prosthetics and orthotics training materials and continuing education training seminars for physical therapists. The content domains were selected by informal polling of the Carrión Hospital orthopedic and neurological department staff and various Prosthetic and Orthotic Impact Assessments performed by the United States Agency for International Development (USAID) and the International Society for Prosthetics and Orthotics. 2-4 The experience and timeliness of these actions were significant as the COVID-19 pandemic limited any in-country intervention from the US team for the next three years. The familiarization with virtual methods for patient assessment and upgrades to the physical space infrastructure allowed the DWT team members to maintain a clinical presence with their Peruvian peers. Throughout the time in which DWT was not on-site, the Carrión team remained proactive in advancing prosthetic services to their patients. In 2022, Carrión hosted another cohort of physical medicine and rehabilitation residents with their international resident from Cuba for training and care of patients with lower-limb amputations. Physical space has since been allocated for expansion into traditional fabrication and adjustment methodologies, which will allow for use of advanced componentry and materials for task-specific interventions. In 2023, the DWT team will be revisiting to assist in the final stages of the formal training and lab set up, and provide support to the home team during eight days of high-volume prosthetic evaluation, fabrication, delivery, and training. This is an incredibly exciting time in which an organization has ostensibly succeeded in their founding purpose and will transition into an updated model of assisting their Peruvian colleagues to continue serving their patients. DWT’s achievements shine a light on how the international community can share resources, passion for profession, and the humanitarian spirit to improve individuals’ quality of life through in-country education and partnership. Education for the Next Generation With Experiences Abroad: LimbKind Foundation “Go into the world and do well. But more importantly, go into the world and do good.” —Minor Myers Jur It has been greater than a decade since the terminal degree for O&P clinical training has elevated to the master’s level in the United States. This expansion of the training requirement now provides educational institutions the opportunity to expand the scope and depth of experiences available to graduate-level students. This extra bandwidth has provided a novel opportunity for students to participate with the LimbKind Foundation as part of their formal training. [caption id="attachment_245710" align="alignright" width="300"] Photograph courtesy Matilde Sima.[/caption] Piloting in 2023, students from the University of Hartford will be engaging with approximately 50 pediatric patients at AIC-CURE International Hospital in Nairobi, Kenya. The LimbKind Foundation was founded by Robert Shulman, CP, in 2019 and has an impressive list of experiences in the few years of being formalized. Notably, trips to Haiti, Kenya, Ethiopia, and the Philippines have been completed, as well as the creation of a New York-based center for patient care. The LimbKind Foundation has prioritized the involvement of prosthetic students in a model designed to be the capstone of months of preparation for both the organization and the participating students. The LimbKind experience and similar experiential learning capstone activities will be supported by in-semester coursework such as local and regional presentations promoting the O&P profession as a mechanism for diversity and inclusion, conversations with key personnel of various nonprofit and government officials about the value of humanitarian work, and individual preparedness to work in unique environments. Providing logistical support, clinical mentorship, and directed feedback and assessment of in-country performance is one of the educational benefits LimbKind has offered to second-year graduate students. At the AIC-CURE International Hospital, two graduate students will be provided their own case load (triaged by senior members of the LimbKind team) with which they will be expected to independently complete the process of patient/clinician experience, albeit on a compressed timeline. Multiple patient encounters through delivery and alignment will be the primary responsibility of these students with the supervision of a dedicated LimbKind team member. This pilot-experience location was selected for its similarity to clinics and labs the students are familiar with and will allow for standard fabrication practices to be completed. Students will receive feedback from various team members, technicians, peer mentors, clinicians, and patients and their family members as part of this comprehensive practice. Upon their return, the students will disseminate the details through various platforms to promote further opportunities for student engagement and outlining the learning experiences through their perspective. [caption id="attachment_245709" align="aligncenter" width="300"] Photograph courtesy Matilde Sima.[/caption] The next generation—at 25-34 years old—is entering the professional phase of their O&P career as evidenced by the age category becoming the largest representation of orthotic respondents in the ABC Practice Analysis 2022. It is in the best interest of the O&P community to provide avenues for our colleagues to participate in a wide range of O&P experiences. The diverse humanitarian opportunities, domestic and abroad, that our profession offers is an engaging segment to cultivate a long-term career pathway. It is the level of professional training that elevates our peers to “do well,” and organizations such as LimbKind providing access for our peers to “go into the world and do good.” Duffy Felmlee, MSPO, CPO, FAAOP, is an associate professor for the Prosthetics and Orthotics Program within the College of ENHP at the University of Hartford and maintains a practice as a clinical and educational consultant for Hanger Clinic. He is a member of the American Academy of Orthotists and Prosthetists (the Academy) board of directors, co-chair of the Academy Fabrication Sciences Society, a member of the Outcome Research Committee, Online Education Committee, and the O&PiQ Advisory Board. Academy Society Spotlight is a presentation of clinical content by the Societies of the Academy in partnership with The O&P EDGE . References Spaulding, S. E., S. Kheng, S. Kapp, and C. Harte. 2020. Education in prosthetic and orthotic training: Looking back 50 years and moving forward . Prosthetics and Orthotics International 44(6):416-26. Sexton, S., C. Rosie Jovane, D.cRosario, and M. Castaneda. 2015. Prosthetics & Orthotics Impact Assessment Latin American: Mexico, Guatemala and Colombia. https://www.ispoint.org/resources/reports Sexton, S., H. Shangali, and B. Munissi. 2012. Prosthetics & Orthotics Impact Assessment the Impact of Training Personnel to the Minimum Standards ISPO Category I & II: Tanzania Training Centre for Orthopaedic Technologists . https://www.ispoint.org/resources/reports Cochrane, H., R. Demetria, A. Singh, and R. Ghosh. 2015. Prosthetics & Orthotics Impact Assessment India and Bangladesh . https://www.ispoint.org/resources/reports

Going Into the World to Do Good: Integrating O&P Education With Humanitarianism

How to Improve Gait Analysis via Telehealth

Remark Code CO-261

Remark Code CO-261

O&P JOBS

We’re Currently Seeking Certified Prosthetist/Orthotists (CPOs) for Opportunities Throughout Several States

Certified Prosthetist Orthotist or Board Eligible Prosthetist Orthotist

Certified Prosthetist / Prosthetist-Orthotist (CP/CPO) Gates Prosthetics + Mobility Clinic — Mountain Home, AR

Get unlimited access!

EDGE DIRECT

Welcome Back!

Retrieve your password

Not enough quota to unlock this post

Going Into the World to Do Good: Integrating O&P Education With Humanitarianism

Support authors and subscribe to content.

Subscribe

Related posts:

How to Improve Gait Analysis via Telehealth

Remark Code CO-261

Remark Code CO-261

O&P JOBS

We’re Currently Seeking Certified Prosthetist/Orthotists (CPOs) for Opportunities Throughout Several States

Certified Prosthetist Orthotist or Board Eligible Prosthetist Orthotist

Certified Prosthetist / Prosthetist-Orthotist (CP/CPO) Gates Prosthetics + Mobility Clinic — Mountain Home, AR

Get unlimited access!

EDGE DIRECT

Welcome Back!

Retrieve your password

Not enough quota to unlock this post