The concept of a terminal doctoral degree in O&P has been discussed for several years. In May 2015 the National Commission on Orthotic and Prosthetic Education (NCOPE) sponsored an educational summit meeting that discussed the future direction of education, including the concept of a doctoral program, not as an entry-level requirement, but as a professional pathway option. The discussion has frequently centered on the themes of professional roles, demand, and economic justification. Gerry and I designed a needs assessment survey as a pilot survey for the profession to assess each participant’s views and opinions regarding education and the doctoral pathway.
The six-question survey hosted on a third-party web hosting service was designed on a mixed-methods phenomenology derived using five-point Likert measures and a comment section. The two demographic questions assessed years of experience and undergraduate background compared to three opinion questions regarding the need for a doctorate in O&P followed by a comment section. The Likert-style questions were carefully designed to follow the dimensional format of curriculum, organizational climate, and instructional resources. There were 319 respondents over a 15-day period (May 29-June 12, 2018) with 100 percent completion rate and an average completion time of six minutes. There were 147 subsequent open-ended comments provided.
The average years of experience were bimodal, with 24 percent of respondents having six to ten years of experience followed by 23 percent with 26 years or more. Most of the respondents, 26.3 percent, had an allied health background closely followed by those with a science background of 25.7 percent. Other backgrounds included business, sociology, and psychology. The ability to write orders was listed as the highest justification for an O&P doctorate as well as its use in completing coursework in healthcare, quantitative analysis, and geriatrics and aging.
The open-ended questions elicited responses that required qualitative coding procedures to produce a variety of emergent categories along with subcategories for analysis. Categories and subcategories included cost concerns, current education issues, and salary expectations. Most comments related to billing for O&P services, development of research pathways, and economic support/need for an advanced degree. Of the 319 respondents, 45.4 percent strongly agreed or agreed there is need for an O&P doctorate and 45.6 percent strongly agreed or agreed that they would be interested in earning one. No statistically significant correlation relationships were found between years of experience or background and the need or interest in an O&P doctorate.
The results of the comment section produced 15 favorable, 31 neutral, and 86 unfavorable responses. The favorable responses concerned themselves with the desired ability to self-prescribe, enhance academic courses and research, and to match the education level of others in allied health. Unfavorable comments primarily asked if a doctorate level could be supported economically in terms of student loans required, salary expectations, and if it would ultimately produce better patient care. One surprise in the open-ended section were the comments regarding the current state of education. Sixteen percent of the responses voiced concern about the quality of the master’s degree programs and how this should be addressed before moving forward. Further, more detailed surveys should be designed to drill deeper into the question of preparedness going into a residency.
Although there is strong interest in an O&P doctoral program, there seems to be collective concern whether a program could be supported.
Thomas Karolewski, CP/L, FAAOP, is the O&P supervisor at Hines VA Hospital, Illinois. He can be reached at legmakerpro@mac.com. Gerald Stark, PhD, CPO/L, FAAOP (D), is a senior clinical specialist at Ottobock.
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