The Move Toward Entry-Level Masters

"The debate over the entry-level educational requirement is part of every profession's natural evolution and represents a progression in the maturation of that profession." --O&P Education Summit: Forecasting the Future--Findings and Recommendations As we contemplate the future of O&P education and a move toward an entry-level masters degree, we are reminded that our profession is not alone in this endeavor and that other professions have gone through this same process of maturation. The need to move O&P education from entry-level baccalaureate to entry-level masters can be attributed to a succession of meetings or key inflection points that have influenced the evolution of O&P education. From Ponte Vedra I in 1970 to the Phoenix Conference in 1990, the profession has witnessed a dramatic change in the education landscape that can be attributed largely to the findings and recommendations of these historic conferences as listed below: Recognition of standardized essentials for O&P programs Four-year degree (combined O&P) as the gold standard ABC requirement for entry-level bachelors (1980) Creation of NCOPE Recognition by external accreditation body (Commission on Accreditation of Allied Health Education Programs [CAAHEP]) Establishment of O&P Residency Program Recognition by the American Medical Association (1992) Benefits of Entry-Level Masters With the Phoenix Conference findings and recommendations having occurred more than 14 years ago, it became necessary to evaluate the current and future direction of O&P education. In April of 2005, more than 30 content experts convened for an Education Summit and concluded the meeting with eight specific recommendations--the most salient being the recommendation to move towards entry-level masters for all practitioner level programs in the US. This particular recommendation underscored a specific need in the following areas and included: (1) a body of knowledge that has increased; (2) need for evidence-based practice; (3) need to address marketplace forces; (4) meet consumer expectations; (5) greater demand for accountability; (6) to keep pace with other allied health professionals. While all are important, the most compelling evidence to move towards an entry-level masters is that the body of knowledge has increased. This is largely due to the evolution of the practitioner's scope of practice. In 2000 the American Board for Certification in Orthotics and Prosthetics (ABC) published its findings from a survey of the profession which is documented in the Practice Analysis of the Disciplines of Orthotics and Prosthetics . The document confirmed that the role of the O&P practitioner had changed over time with a greater emphasis on direct patient care and a correlative decrease in direct fabrication. Clearly, greater patient contact requires a greater knowledge base for the practitioner to adequately meet the needs of the patient. This clinical paradigm shift has had a profound effect on the educational landscape as O&P educators have had to refocus and expand coursework in an already impacted curriculum. While short-term strategies can help, the long-term solution is to elevate and expand the education model to the masters level. This will allow educational programs to better incorporate this expanded body of knowledge into the curriculum without compromising existing elements of theoretical and technical training. Growing Need for EBM, Research In addition to an expanded body of knowledge, we also see a growing need in our profession for evidence-based medicine, research, and practitioners that are overall better consumers of research. These needs initially must be addressed at the primary education level where programs are given the latitude to effectively expand the current curriculum even further by incorporating evidence-based medicine and research into the education scheme. Translated, this has the ability to optimize clinical care, improve reimbursement, and increase government recognition. This shift towards masters-level training also is more in line with the philosophical position of the US Department of Education, Council for Higher Education Accreditation (CHEA), and Council of Graduate Schools (CGS) as they would advocate that one set of entry-level standards be identified with one degree level rather then one set of standards for multiple degrees, such as our current model (i.e. baccalaureate, post-baccalaureate, masters). As NCOPE considers this paradigm shift and the future of education, the profession should be reminded that a move towards entry-level masters will help to expand the skills and knowledge base of our practitioners and ultimately lead to a stronger O&P profession and better patient care. Bryan Malas is Chair, National Commission on Orthotic and Prosthetic Education (NCOPE)

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