It goes without saying that the prosthetics and orthotics profession is light years beyond the “Hanger limb” that James Edward Hanger whittled for himself from a barrel after becoming one of the first amputees in the Civil War.
Today, innovative new designs are offering dramatic benefits to people who require artificial limbs and to those who use orthotic devices. Bionic knees are controlled by microprocessors. Braces are equipped with Bluetooth devices that send electronic signals to nerves. Prosthetic hands are covered in materials that can move and flex and that look like human skin. As the 2006 Workforce Demand Study of the American Academy of Orthotists and Prosthetists (the Academy) pointed out, “Devices that interface with the human nervous system are among the drivers in technological innovations that are revolutionizing both prosthetic and orthotic care.”
Meeting Challenges
To meet the challenges of such revolutionary advances, the University of Hartford, Connecticut, and the Newington Certificate Program in Orthotics and Prosthetics (NCP), Connecticut, are joining resources to introduce a master of science in prosthetics and orthotics (MSPO) in the university’s department of physical therapy within its college of Education, Nursing, and Health Professions (ENHP). The Connecticut Board of Governors for Higher Education recently provided final approvals, and the program will be taught on the university’s main campus and at NCP headquarters at Hanger Orthotics and Prosthetics, Newington.
Recognizing the increased scope and the speed at which the O&P field is advancing, the National Commission on Orthotic/Prosthetic Education (NCOPE) mandated in 2004 that current educational programs be elevated from post-baccalaureate certificate programs to the master’s degree level by 2012 and that all new programs be offered at the master’s level starting in 2010.
“We are ahead of the game,” said Robert S. Lin, CPO, FAAOP, chief orthotist and prosthetist at Connecticut Children’s Medical Center and a member of the ENHP faculty. “With [ENHP Dean] Dr. Dorothy Zeiser, who is a strong advocate of the program, leaving this spring, we moved things along so the foundation would be set when the new dean comes on board. Primarily because the core competencies and the body of knowledge have expanded so much with technology and research, the only way to package the program is in a master’s curriculum. Students will have to do evidence-based research. You can’t do that at the baccalaureate level.”
Two Master’s Paths
The first complete cohort is expected to enter the program in 2012. The program will offer two paths to obtaining the master’s degree. In the 4-plus-2 program, students who have earned their bachelor’s degree in health science can apply to the two-year master’s program. The 3-plus-2 program will allow sophomores to extend their studies to five years to obtain their master’s in O&P. Both paths include a post-graduate, two-year residency requirement as a prerequisite for the board exams.
“In 2011, we will be accepting the first cohort of sophomores in the 3-plus-2 program,” Lin said.
A West Hartford, Connecticut, native, Lin was director of orthotics and prosthetics at what was then the Newington Children’s Hospital when he started NCP in affiliation with the University of Connecticut (UConn) in 1993.
“It was a manpower issue,” Lin said. “There is and was at the time a shortage of qualified practitioners in O&P. During the last recession—the one in the 1990s—we couldn’t attract practitioners” because of the high cost of living in Connecticut. To address the difficult recruiting environment, Lin said, “We started our own school. Sixteen years later, we draw from Connecticut as well as from across the country and internationally. We’ve had students from Korea and Taiwan and Canada. We started with six people from Connecticut. We now have 59 students from around the world.”
Distance Learning
The NCP also founded an O&P distance-learning program, which now constitutes more than half of NCP’s enrollment. Currently, NCP has 21 “seated” students; the rest are distance learners who are taught through a web-based system and supplemental DVDs.
“The University program will most likely have the distance-learning component, including online exams and chat rooms via Blackboard,” Lin said. Blackboard is an online educational tool that allows students and faculty to communicate and share work.
NCP’s affiliation with UConn ended in 2006. “That was a long and fruitful affiliation,” Lin said. “When UConn’s allied health school closed, I started to research other options. I had a long relationship with the University of Hartford’s engineering school. I approached [Dean] Lou Manzione, who was very enthusiastic, but when we looked at the curriculum for biomed, we didn’t find much crossover. When we looked at physical therapy, we found ENHP was a good fit.” There are still plans to interface with the UConn’s College of Engineering, Technology, and Architecture (CETA) on an ongoing basis.
Catherine Certo, MS, ScD, chair of the physical therapy department, said that CETA will eventually be involved in the new program, with, for example, biomechanical engineering students working on prosthetic and orthotic designs.
Workforce Demand Is High
The supply of practitioners in orthotics and prosthetics continues to be a concern within the industry. The employment rate is currently 100 percent for graduates of O&P educational programs in the United States, according to the Academy. Its Workforce Demand Study predicts that if practitioners continue to enter the field at the current rate, a number of factors—including aging baby boomers, the obesity epidemic, and the escalating rate of diabetes—could cause the demand for practitioners to overwhelm the supply.
O&P professional organizations expect patients using orthoses and prostheses to reach nearly 9.7 million by 2020. In 2008, the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) reported 5,538 practitioners were board certified. The O&P academy is campaigning to increase the number of qualified graduates entering the profession.
