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Education Summit Findings and Recommendations April 8-9, 2005 New Orleans, Louisiana.

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1 Education Summit Findings and Recommendations April 8-9, 2005 New Orleans, Louisiana

2 Executive Summary Education Summit – Forecasting the Future More than 30 Subject Matter Experts gathered in New Orleans, LA April 8-9, 2005 to study the current state of O&P education and to make recommendations for future direction. The conference was conducted as a collaborative effort of the National Commission on Orthotic and Prosthetic Education (NCOPE) and the American Academy of Orthotists and Prosthetists (The Academy). This meeting was underwritten by an Academy grant provided by the U.S. Department of Education. More than 30 Subject Matter Experts gathered in New Orleans, LA April 8-9, 2005 to study the current state of O&P education and to make recommendations for future direction. The conference was conducted as a collaborative effort of the National Commission on Orthotic and Prosthetic Education (NCOPE) and the American Academy of Orthotists and Prosthetists (The Academy). This meeting was underwritten by an Academy grant provided by the U.S. Department of Education. It had been nearly 14 years since the last critical assessment of O&P education. Numerous changes within the O&P profession have necessitated advancements to the quality and consistency of O&P clinical education and training. The target population was future practitioners to meet the changing demands of O&P care through appropriate, quality entry level education. The panel of experts, from the ranks of educators, researchers and practitioners, were gathered to clarify the issues involved in moving the professional education of orthotists and prosthetists from the current certificate and baccalaureate level to the masters degree level. It had been nearly 14 years since the last critical assessment of O&P education. Numerous changes within the O&P profession have necessitated advancements to the quality and consistency of O&P clinical education and training. The target population was future practitioners to meet the changing demands of O&P care through appropriate, quality entry level education. The panel of experts, from the ranks of educators, researchers and practitioners, were gathered to clarify the issues involved in moving the professional education of orthotists and prosthetists from the current certificate and baccalaureate level to the masters degree level.

3 Executive Summary Education Summit – Forecasting the Future (Continued) Consensus was reached regarding the current challenges facing the profession and the recommended objectives necessary to meet those challenges. A Masters-level education was deemed necessary for the delivery of quality patient care due to the dynamic base of knowledge and emerging processes and technologies. It was also evident that the state of O&P education should be re-evaluated on a three-year cycle. Consensus was reached regarding the current challenges facing the profession and the recommended objectives necessary to meet those challenges. A Masters-level education was deemed necessary for the delivery of quality patient care due to the dynamic base of knowledge and emerging processes and technologies. It was also evident that the state of O&P education should be re-evaluated on a three-year cycle. From the O&P Education Summit findings a report of short- and long-term recommendations will be generated by NCOPE, the Academy and other key stakeholders. NCOPE will assess and create standards to help guide the O&P institutions to the successful development of a masters-level education. Advancing the profession through increased education will ultimately be most beneficial to the O&P consumer and his or her quality of life. From the O&P Education Summit findings a report of short- and long-term recommendations will be generated by NCOPE, the Academy and other key stakeholders. NCOPE will assess and create standards to help guide the O&P institutions to the successful development of a masters-level education. Advancing the profession through increased education will ultimately be most beneficial to the O&P consumer and his or her quality of life.

4 Table of Contents Executive Summary (Slides 2-3) Table of Contents (Slides 4-5) Objectives and Resources for the Education Summit (slide 6) Assumptions for the Education Summit (slide 7) Question #1: Is the O&P body of knowledge relevant for the future practitioner or does it need to be redefined as we move into the future? (slides 8-13) Question #2: Are the current core competencies relevant or do they need re-evaluation or updating and expansion? (slides 14-24) Question #3: Educationally, where does the profession want to be in 10 to 15 years? (slides 25-31) Question #4: Why should the profession move towards a masters degree as an entry-level education in the next decade? (Slides 32- 40)

5 Table of Contents (Continued) Question #5: If the profession transitions to a masters degree through the next decade, how will it affect the following key issues (9 parts to this question)? (Slides 41-50) Question #6: Will the current programs be able to justify this transition to their university administrations? (Slides 51-57) Question #7: How can O&Ps move towards a Masters level program be utilized to attract underrepresented populations and practitioners to underserved areas? (Slide 58) Implementation: Stakeholders and Resources (Slides 59-60) Next Steps (Slides 61-63) Post-Seminar Reporting Mechanics Dissemination Leveraging Opportunities A Look at the Future – 5-10 Years Out (Slides 64-69) Appendix I: Redefining O&P (Slides 70-72)

6 Objectives and Resources for the Education Summit Objective: To clarify the issues involved in moving the professional education of orthotists and prosthetists from the current certificate and baccalaureate level to the masters degree level. Objective: To clarify the issues involved in moving the professional education of orthotists and prosthetists from the current certificate and baccalaureate level to the masters degree level. Resources: The NCOPE Website (www.ncope.org) contains a secure section dedicated to the Education Summit. It contains a complete list of definitions, body of knowledge materials, and seminal reports and white papers relating to the O&P profession. Resources: The NCOPE Website (www.ncope.org) contains a secure section dedicated to the Education Summit. It contains a complete list of definitions, body of knowledge materials, and seminal reports and white papers relating to the O&P profession.www.ncope.org

7 Assumptions for the Education Summit 1. The profession, as a whole, takes the responsibility of expanding/advancing the level of basic education, for entry into the professional ranks, to the masters degree. It is expected that this move will benefit the profession and the clients who receive services; 2. The current O&P education programs have the ability to and desire to transition to a masters curriculum; 3. The body of knowledge and scope of practice upon which professional practice is based has changed and expanded in the last fifteen years; 4. The core competencies that support professional practice are in need of up dating; 5. The masters degree, as the entry level requirement has the possibilities of attracting more students; keeping the profession on a level playing field with its fellow allied health professions; and increase the numbers of qualified practitioners, academicians and researchers; 6. The residency program will need to be revamped if it is to become a formal part of the overall masters degree program.

8 Question #1: Is the O&P body of knowledge relevant for future practitioner or does it need to be redefined as we move into the future? a.Has the body of knowledge changed in the past ten years? If yes, how? b.Has clinical practice changed in the last ten years? If yes, has the body of knowledge kept pace with this change? c.Will a growing body of knowledge expand our scope of practice and move us to consider a new educational model based on a masters degree? d.Given increasing globalization, do we need to be consistent with other countries? e.Does ISPOs Category I standard identify competencies and materials that should be parts of O&Ps body of knowledge?

9 1a. Has the body of knowledge changed in the past ten years? If so, how? 1.The revised definition for the Body of Knowledge (BoK) is: The basis for O and P practice, research and education. The BoK defines our practice, research and education activities 2.Yes, the Body of Knowledge has changed in the areas of: Technology, Technology, reimbursement, reimbursement, techniques, techniques, practice settings, practice settings, documentation (medical/legal), documentation (medical/legal), patient demographics, patient demographics, access to literature, access to literature, research (change in the culture related to research ie. education and residency), research (change in the culture related to research ie. education and residency), evolution of education to a clinical model from a technical model. evolution of education to a clinical model from a technical model.

10 1b. Has clinical practice changed in the past ten years? If yes, has the body of knowledge kept pace with this change? 1. Yes, in the areas of: technology, technology, clinical procedures and new patient management techniques, clinical procedures and new patient management techniques, professionalism (facility accreditation, interprofessional relations), and government regulation, and reimbursement professionalism (facility accreditation, interprofessional relations), and government regulation, and reimbursement 2. No, body of knowledge will always be and should always be ahead of the clinical practice in order to drive change and knowledge. The key is recognition of the changes and this demands a mechanism of ongoing evaluation of the body of knowledge (integration of the changes into education and practice).

11 1c. Will a growing body of knowledge expand our scope of practice and move us to consider a new educational model based on a masters degree? YES. Masters level students will bring forth: an expansion of scope of practice with improved research an expansion of scope of practice with improved research increased analytical and technical research skills increased analytical and technical research skills improved methods (note to this group, what was meant by improved methods – please clarify), practices and publishing. improved methods (note to this group, what was meant by improved methods – please clarify), practices and publishing.

12 1d. Given increasing globalization, do we need to be consistent with other countries? 1. Core consistency would be useful for collaboration between educational programs across the globe 2. This could facilitate practicing in other countries, which has not been fostered by other health professions 3. The European Community has agreed that ISPO Category I is the minimum standard for practitioner education, and will be phased in over time in all EU countries 4. Current schools in low income countries are working actively toward Category I entry level education 5. These developments will increase pressure on the USA to conform to this de facto international standard in the future 6. US standards may exceed the Category I requirements but should still be consistent with those guidelines overall 7. This could increase the credibility of the US practitioner in the rest of the world by demonstrating a consistent standard and not a crazy quilt of entry options

13 1e. Does ISPOs Category I standard identifycompetencies and materials that should be parts of O&Ps body of knowledge? 1. Yes, they seem to parallel the current NCOPE standards. 2. They could be formally incorporated into our structured residency requirements, which would enhance the consistency of preparation of students and increase credibility in the eyes of the world and among allied health peers. 3. Formal ISPO recognition will be increasingly important in the future. 4. ISPO encourages education in both O&P but recognizes education in only one discipline (see question 5a.). 5. The Category I practitioner incorporates research into patient care and participates in clinical research

14 Question #2: Are the current core competencies (taught in O&P programs and residency) relevant or do they need re-evaluation or updating and expansion? a.Are there developing events, trends, or futures that will elevate demand for O&P and/or change the nature of our body of knowledge? b.If our core-competencies are not adequate for the upcoming decade does this demonstrate the need for a new educational model (master degree) or just re-evaluation of the current core competencies? c.Will changing the educational system to better deliver the core- competencies produce a better care-giver and researcher in the future? d.If our core-competencies are inadequate to meet the needs of the future what will we have to add in order to make them relevant to the future practice of O&P? e.How do the levels of O&P care (practitioner, technician, assistant, fitters) fit into the current scheme of core competencies and are the core- competencies specific to each level? f.Is the practitioner level of competencies an accumulation of all levels? g.How will we determine core-competencies for the future (practice analysis, Nielsen study, experts)? h.Is the ISPO Category I standard high enough? i.Would that curriculum, etc., work for our healthcare delivery system and schools?

15 2a. Are there developing events, trends, or futures that will elevate demand for O&P and/or change the nature of our body of knowledge? Yes, future events will elevate demand for O&P and change the nature of our body of knowledge if the profession makes the right decisions and choices. See the attached Core Competencies graphic on the next slide, which portrays the contributions of Entry-level (plus clinical) and Residency to the skill sets of the O&P professional and his/her body of knowledge.

16 Core Competencies CognitiveBehavioral/Affective Traditional Hand Skills (Psychomotor) Technology Skills (Cognitive) Entry Level (+ Clinical Hours) -Needs to and continues to be updated -Increase focus on patient care (not product focus) -Distinguish science vs. cliniical science -Appropriate treatment plan (health economics) -Integrated into entry level ed. (internship) -Focus on consumer needs -Enhance curriculum in area (including the rehabilitation team) There are two levels of hand skills 1. Technical (as applies to lab) and 2. Patient care i.e., physical examination -Ties together lecture/demonstration through lab. -Should be basic minimum but differentiation between programs. -We are still defined (unique) by our hand skills. -Technology wont always be an option in every case. -Constant re- evaluation and updating required. -Key to the future; will draw people to the profession. Residency (1 year per discipline – O and P) -Current standards are appropriate. -Practical application -Assessment of acquisition of skills needs updating. -Constant impact on behavioral/affective skills (patient care) -Evaluation process needs updating. -Interaction with better educated consumers requires different and higher-level skills Residency is where theory hits the road. -Expand assessment processes. -Focus on people, not just materials -Application during individual patient care -How, when, and why?

17 2b. If our core competencies are not adequate for the upcoming decade, does this demonstrate the need for a new educational model (masters degree) or just re-evaluation of the current core competencies? The masters-level degree plus residency is needed to deliver the core competencies required for the practice of O&P. See the Core Competencies graphic to demonstrate this point.

18 2c. Will changing the educational system to better deliver the core competencies produce a better care-giver and researcher in the future? Yes, the quality of care and research will improve. See the Core Competencies graphic to reinforce this point.

19 2d. If our core competencies are inadequate to meet the needs of the future what will we have to add in order to make them relevant to the future practice of O&P? The Core Competencies graphic suggests the sort of fully- developed masters-level plus residency combination needed to deliver the core competencies necessary for the future practitioner.

20 2e. How does the levels of O&P care (practitioner, technician, assistant, fitters) fit into the current scheme of core competencies and are the core competencies specific to each level? The current scheme is based on the practitioner level. We are concerned that core competencies for each level are not adequately defined and should be for fitter, technician and assistant. We agree with the possible expansion of practitioner core competencies.

21 2f. Is the practitioner level of competencies an accumulation of all levels? Yes, definitely.

22 2g. How will we determine core competencies for the future (practice analysis, Nielsen study, experts)? The following combination of techniques will be needed: Current and future practice analysis Current and future practice analysis Experts and funded studies Experts and funded studies Skill assessment studies specific to each level Skill assessment studies specific to each level Use outcomes of these studies to improve educational outcomes Use outcomes of these studies to improve educational outcomes

23 2h. Is the ISPO Category I standard high enough? The Professional Profile for Category I standard is high enough.

24 2i. Would that curriculum, etc., work for our healthcare delivery system and schools? Yes, though it will be difficult to attain this in a four-year or masters degree program without the component of the residency program which is an integral part of this and would have to be restructured.

25 Question #3: Educationally, where does the profession want to be in ten to 15 years? a.Should we transition to a higher-level degree? b.If we move to a higher-level degree can we link this with our residency program? c.How do governmental issues, such as licensure and competitive bidding affect the restructuring of education? d.In light of the recent development of external pressures on O&P (NRM, PT effects to eliminate us, competitive bidding, licensure, impacts of technology), is it imperative that we move to the higher level to maintain our place in the health care world? e.What role could technology play in basic education and training, continuing education, refreshment of skills, collaboration in practice, and sharing of best practices? f.How and would reimbursement be affected?

26 3a. Should we transition to a higher-level degree? YES! (…as long as the body of knowledge drives this) -This is much more likely to succeed with a combined O&P curriculum Further discussion is required to decide whether masters level is the only pathway for entry level at some point in the future (This point is discussed later in the findings).

27 3b. If we move to a higher-level degree can we link this with our residency program? Residency could be an integral part of the masters program. Residency must be structured - Proper sequencing - Periodic assessment - Outcomes of residency should be measured (in-training exam?) - Better academic support and mentoring of residency sites (residents and directors) as well as sharing of best practices - Encourage affiliation with academic teaching hospitals/ universities

28 3c. How do governmental issues, such as licensure and competitive bidding, affect the restructuring of education? - Government issues impact the education process, but they should not drive the process. - We need to think through the impact of education on governmental issues - how will the changes of future entry- level education impact governmental issues, i.e, licensure, competitive bidding - Licensure sets the legal bare minimums. Some programs will aspire to higher standards of achievement. This will entire choice and variety into the programs available to students.

29 3d. In light of the recent development of external pressures on O&P (NRM, PT efforts to compete with us, competitive bidding, licensure, impacts of technology), is it imperative that we move to the higher level to maintain our place in the healthcare world? 1. Yes and enhance and change our place in the healthcare world. 2. Licensure and degree are highly recognized publicly. 3. Residency is the key factor for future and what is unique about O&P (i.e., tie to licensure as requirement) 4. Yes, it is important to move ahead to masters 5. In future – minimum masters with door open to move even higher 6. Define O&P – for O&P in the future - ok to be self-serving 7. Vision needs to step up and how we are perceived by others (currently today – we simply are seen as suppliers – need to move to the next level, being known as provider)

30 3e. What role would technology play in basic education and training, continuing education, refreshment of skills, collaboration in practice, and sharing of best practices? 1.Yes, it has impacted O&P and will continue to do so. 2.Distance education and collaborative learning require technology. 3.The issue of having enough people to teach appropriate areas is vexing. Distance education can assist by sharing access to key experts. (Most people join a practice profession to be clinicians, not educators) 4.O&P should embrace technology 5.This will change the delivery of care model (practice issue). 6.Patient management is still the centerpiece of care (practice issue).

31 3f. How and would reimbursement be affected? 1. Issue of supplier (L-codes) vs. service (CPT-codes) – a status change (greater level of responsibilities for the practitioner). 2. Current system of reimbursement may not last – is already experiencing changes. 3. Expanded scope of practice will require a new reimbursement system. 4. O&P has a role in helping change the landscape of reimbursement (hard to present however, a unified voice is needed). 5. Transition/blur now and into future with custom made and off-the-shelf devices. 6. The level of industry payment (salary) of technicians is a concern.

32 Question #4: Why should the profession move towards a masters degree as an entry-level education in the next decade? a.What evidence supports this transition? b.Will this transition produce more teachers, researchers and better clinicians? c.Will this transition help us compete with external pressures such as PT infringement, government relations, and lack of reimbursement? d.How does a masters-level degree impact our clinical training program? e.Are there any negatives associated with this type of transition? f.Is there an international system of accreditation for education? g.Is there an international system for certification? Do they mix the concepts of certification/criteria with education?

33 4a. What evidence (factors) supports this transition? 1.The market (supported within the profession by Davis and Edwards studies) 2.Expanded body of knowledge/technical advances 3.Need for evidence-based medicine (research) 4.Current curricula are poised for an upgrade to Masters, with addition of research skills, advanced science, patient management, other related courses 5.Direction of other health professions 6.External pressures Perception of lack of education (related to NRM) Perception of lack of education (related to NRM) Consumer expectations, demands and accountability Consumer expectations, demands and accountability

34 4b. Will this transition produce more teachers, researchers, and better clinicians? 1. Increased applications from those that might have applied to Masters PT/OT programs. Also, attract applicants that may not have considered the profession in the past. 2. Yes, better trained clinicians will ultimately increase teaching and research capacity. 3. We may not produce more clinicians, but they will be deliver a higher quality service. 4. It may be ideal to have requirements that facilitate both practice and academic masters.

35 4c. Will this transition help us to compete with external pressures such as PT infringement, government relations and lack of reimbursement? 1. We may retain and expand our scope of practice. 2. We will become a more credible member of the health care team. 3. Evidence-based outcomes are necessary to improve government relations and enhance reimbursement.

36 4d. How does a masters-level degree impact our clinical training program? (Basic assumption: includes P & O education and residency) 1. Standardization of minimum entry-level requirements 2. Combined P & O education 3. Offers choice: variety in educational models at the masters level 4. Opportunity for specialization 5. Brings increased research-based activity to profession at practitioner level and educational level 6. Increase clinical skills education

37 4d. How does a masters-level degree impact our clinical training program? (Continued) 7. Clinical experiences: integrated with program, at end of educational program, and/or mixture of the two models 8. Opportunity to create coordination between education program and residency sites with NCOPE oversight 9. Enhancement of skills 10. Opportunity for specialization 11. Research

38 4e. Are there any negatives associated with this type of transition? Difficulty of implementation: funding, coordination of residency if it is the responsibility of the school, increased length of education, faculty development for advanced degrees Unclear identity of standards to the public Pressure from existing practitioners who do not have that level of training Manpower issues with increasing length of curriculum

39 4f. Is there an international system of accreditation for education? ISPO is an international recognition of the process to be a Category I & II practitioner, currently Accreditation of the process began in 2004 Accreditation of the process began in 2004 Reviewed voluntarily on a 5-year term Reviewed voluntarily on a 5-year term

40 4g. Is there an international system for certification? Do they mix the concepts of certification/criteria with education? There is no international system. No reciprocity at this time.

41 Question #5: If the profession transitions to a masters degree through the next decade: a.Should O&P be combined into one discipline for masters-level training – thereby expanding the body of knowledge and producing clinicians who can practice both? b.Should O&P expand each discipline for masters-level training and grow each, thereby producing highly trained specialists for each? c.How should it be designed – technical/professional, research or combination of the two? d.How will this affect the residency program since we recognize that clinical training is necessary, and is it possible to make the residency part of the masters degree? e.Has any other healthcare profession transitioned to a masters degree and are there models that we can evaluate? f.Will the masters-level design require a combining of orthotic and prosthetics? g.Will this affect the manpower shortage? h.What faculty would be available to teach at this level? i.Does the transitioning of the practitioner program to an entry level masters degree affect the education of our technicians, assistants or fitters? j.Will this program be attractive to potential students?

42 5a. Should O&P be combined into one discipline for masters-level training – thereby expanding the body of knowledge and producing clinicians who can practice both? YES, Practitioner needs O and P to be both integrated at the masters level. Core education of both then specialization Core education of both then specialization Business Business Teaching Teaching Research Research Clinical Clinical Permit various structures to achieve a masters Permit various structures to achieve a masters Should develop outcomes measurements Should develop outcomes measurements Foster specialization Foster specialization

43 5b. Should O&P expand each discipline for masters-level training and grow each, thereby producing highly trained specialists for each? No, best if the masters student is trained in both. Specialization is encouraged after core education.

44 5c. How should it be designed – technical/professional, research or combination of the two? Clinical P&O core + specialization TechnicalBusinessTeachingResearch Advanced Clinical

45 5d. How will this affect the residency program since we recognize that clinical training is necessary, and is it possible to make the residency part of the masters degree? With specialization, academic residencies are even more important. It is possible to integrate the residency program into a masters degree. Investigate advantages and disadvantages of different models.

46 5e. Has any other healthcare profession transitioned to a masters degree and are there models that we can evaluate? Nurse Practitioners Physicians Assistant (PA) Physical Therapy (has actually gone beyond masters to DPT) Occupational Therapy (OT)

47 5f. Are we sure there is a manpower shortage? 1. The Nielsen study suggested a manpower shortage, but it looked at the ABC credential only. A more comprehensive study is needed covering both ABC and BOC credentiled practitioners. 2. Government issues like licensure and competitive bidding will also affect the manpower shortage. 3. Will there be other career pathways available other than the masters degree? (O&P has always embraced the career ladder concept for fitter, technician, assistant, who could conceivably move up the ladder and become practitioners. In reality, relatively few professionals have actually followed such routes.) 4. Another key question: What are the career pathway options for practitioner-level O&P professionals – practicing O&P, business owner, working for suppliers/vendors, government/professional societies? 5. PR/Marketing will affect the attraction of people to the profession. A masters degree requirement may attract even more people, including people who are would not have considered.

48 5g. What faculty would be available to teach at this level? 1. The current faculty would be availablehowever, the university will likely require that the faculty have the equivalent or higher degree than the program is offering. (Reference PORSTI report) 2. Adjunct faculty would be utilized, distance learning is an option. 3. Attraction of clinicians to be full-time faculty is an issue. Faculty-practice plans could be utilized.

49 5h. Does the transitioning of the practitioner program to an entry level masters degree affect the education of our technicians, assistants, or fitters? No. However, if the assistants and fitter levels are redefined (and/or combined) the education of this new level would also need to be redefined.

50 5i. Will this program be attractive to potential students (new students, international students, current practitioners)? 1. Yes. Current post-baccalaureate programs have many of the elements of a masters level program. 2. Marketing/PR and recruitment will be the key, (i.e. NCOPE residency requirement of an O&P awareness presentation, AAOP O&P awareness program). 3. Accessibility of programs for practitioners who want to complete the masters degree will be important (on-line, condensed programs – i.e. transition degree?). 4. Masters may be less confusing to potential students than the mix of currently available baccalaureate and post- baccalaureate certificate programs. 5. Value to the consumer may also be raised.

51 Question #6: Will the current programs be able to justify this transition to their university administrations? a.Will current bachelors/certificate programs be able to move towards masters-level training if mandated by NCOPE? b.How long will it take? c.Is it of benefit to the university? d.What are the obstacles in the university system preventing this? e.Will this increase student enrollment? f.Can O&P get crossover students from PT/OT?

52 6a. Will current bachelors/certificate programs be able to move towards masters-level training if mandated by NCOPE? 1. YES, given new standards and adequate time to implement. 2. Baccalaureate vs certificate implementation? 3. Possible hurdles: financial, curriculum additions, research, same students ?, more faculty, time to get through the UCC (councils, hoops), sequencing, number of credit hours? increased student fees, residency interface 4. May be opportunity to create pre-admission curriculum. 5. Course work and hours now being taught, can lead to a masters in some universities. 6. Post-bac entry eliminates many challenges dealing with undergrads. 7. Clinical practice, science-based courses and research

53 6b. How long will it take? Active action on the major vectors of change - this transition needs to be accomplished by the end of 10 years 1. Current institutions with masters level will have a prototype within the next 2 -3 years. 2. Transition will include the need for advanced degrees for faculty, and acquisition of new faculty 3. Time will be needed to develop paperwork to transition to Masters. 4. Move to O/P combination could reduce redundancy of core courses and therefore total hours for Masters in O&P. 5. The challenge will include how to refine/reinvent 60-92 hours into an integrated O&P Masters. Specialization in O or P will only be possible on top of an integrated O&P base. 6. Will the length of the residency be shortened for O&P to honor the overlap in patient care (integrated within the program?).

54 6c. Is it of benefit to the university? 1. We assumed that all present programs want to be retained by their administrations. 2. Yes, but needs to be concerned about glut of Masters in higher education. Majority of masters offerings are clinical or professional. 3. Added value/marketability for the University to include Masters. 4. May allow for cross-over of people from other professional lives. 5. The resources available for individual graduate student loans are higher than those availabe for individual undergraduates.

55 6d. What are the obstacles in the university system preventing this? 1. External & Internal buy-in 2. Structured and clear set of courses foundation 3. Demonstrate the academic rigor necessary for a masters level program? 4. Provide unique course work 5. Identify & secure qualified instructors 6. Identify potential students and access to them 7. Fiscal 8. Adequate Facilities 9. Politics

56 6e. Will this increase student enrollment (applicants)? 1. Yes, on par with other Allied Health & other graduate programs 2. Maybe, if not limited by current facilities and staff 3. No, if the resource demands are too great

57 f. Can O&P get crossover students from PT/OT? 1. Yes, it is happening now and many other fields as well. 2. Some may chose to have multiple degrees to have a broader scope of practice.

58 Question #7: How can O&Ps move towards a Masters level program be utilized to attract underrepresented populations and practitioners to underserved areas? - Awareness/outreach programs need to be conducted in historically underrepresented areas - Academy working with NCOPE residents and O&P practitioners to conduct outreach programs - Leverage the publicity of the masters level movement - Scholarships and internships can be critical - Entry-level masters program may interfere with career ladder i.e., gap between tech/assistant and practitioner and how important is the concept of career ladder for the future of O&P? This is a question that keeps being raised.

59 Implementation: Stakeholders and Resources Stakeholders (impacted by implementation) Stakeholders (impacted by implementation) Educational InstitutionsEducational Institutions Six Plus One Developing Six Plus One Developing Two with Masters Two with Masters Other non-O&P educational institutions (allied health offerings) Other non-O&P educational institutions (allied health offerings) Applicant Pool/StudentsApplicant Pool/Students Residency SitesResidency Sites Practitioners (all credentials)Practitioners (all credentials) Sister OrganizationsSister Organizations NCOPE, ABC, CAAHEP, AAOP, AOPA, NAAOP, NAPOE NCOPE, ABC, CAAHEP, AAOP, AOPA, NAAOP, NAPOE VA (especially related to research; implementing residency grants)VA (especially related to research; implementing residency grants) Patient CommunityPatient Community ACA, MDA, PVA, UCP, Disabled Veterans, etc. ACA, MDA, PVA, UCP, Disabled Veterans, etc.

60 Implementation: Stakeholders and Resources (Continued) Resources Resources FundingFunding Grants, Scholarships, Loans and Assistantships Grants, Scholarships, Loans and Assistantships Existing precedents (PT/OT examples)Existing precedents (PT/OT examples) Faculty/FacilitiesFaculty/Facilities Shared visionShared vision Industry supportIndustry support suppliers/practitioners/manufacturers endowments suppliers/practitioners/manufacturers endowments College Fund – est. to fund PhD programsCollege Fund – est. to fund PhD programs

61 Next Steps – Post-Summit Reporting Mechanics Clean up PowerPoints Clean up PowerPoints Loaded to www.ncope.org; www.oandp.org Loaded to www.ncope.org; www.oandp.orgwww.ncope.orgwww.oandp.orgwww.ncope.orgwww.oandp.org Feedback from Summit participants Feedback from Summit participants Consensus report finalized Consensus report finalized Initial report to U.S. Department of Education, Academy/NCOPE websites, CAAHEP/NCOPE- accredited schools, NAPOE with executive summary of consensus/recommendations Initial report to U.S. Department of Education, Academy/NCOPE websites, CAAHEP/NCOPE- accredited schools, NAPOE with executive summary of consensus/recommendations NCOPE to approve/adopt and build implementation foundation NCOPE to approve/adopt and build implementation foundation Work with ABC to include in criteria for certification Work with ABC to include in criteria for certification

62 Next Steps - Dissemination O&P Almanac, Academy Today, O&P Business News, oandp.com, In Motion, POI O&P Almanac, Academy Today, O&P Business News, oandp.com, In Motion, POI Press release to stakeholders Press release to stakeholders Release information to other association allied health professions (?) Release information to other association allied health professions (?) O&P schools can use as evidence to secure institution support O&P schools can use as evidence to secure institution support *Handled collaboratively by NCOPE & Academy

63 Next Steps – Leverage Opportunities Leadership (Many participated in conference; others can be contacted by phone/mail) Directors are committed Directors are committed Fear factor Fear factor Those that are there can help lead others Those that are there can help lead others Is there a middle road between science-based and professional masters? – must be clear to the student Is there a middle road between science-based and professional masters? – must be clear to the student Community colleges cannot offer masters programs – try to establish ties to another school that can Community colleges cannot offer masters programs – try to establish ties to another school that can Evaluate assistant/technician level training/education Evaluate assistant/technician level training/education Its whats best for the patient in the long run…not just for the profession Its whats best for the patient in the long run…not just for the profession

64 A Look at the Future (5-10 years out) The PractitionerThe Practitioner Focus on new processes/techniques Focus on new processes/techniques Osseointegration; regeneration?Osseointegration; regeneration? Robotics/bionics Robotics/bionics Evidence-based practice Evidence-based practice Paperless office/documentation Paperless office/documentation Virtual gait analysis and training/evaluation Virtual gait analysis and training/evaluation Outcomes-based research Outcomes-based research Standards of careStandards of care Changes in patient issues (decrease in spina bifida, treatments for diabetes) Changes in patient issues (decrease in spina bifida, treatments for diabetes) Self-learners to easily adapt Self-learners to easily adapt Prevention experts – supporting patient wellness Prevention experts – supporting patient wellness Tighter relations with the rehab team Tighter relations with the rehab team Enhancing the able body (performance-enhancing O&P devices) Enhancing the able body (performance-enhancing O&P devices)

65 A Look at the Future (5-10 years out) The Academic Programs The Academic Programs Engineers/manufacturers collaborative testing of acceptable new devices ($$ for schools?)Engineers/manufacturers collaborative testing of acceptable new devices ($$ for schools?) Faculty transition/turmoil – shift of programs and elevation of current teaching facultyFaculty transition/turmoil – shift of programs and elevation of current teaching faculty Increase in total number of facultyIncrease in total number of faculty Delivery of education – accessibility/virtual classrooms/simulationsDelivery of education – accessibility/virtual classrooms/simulations Changes in the way you teach – mentoring of studentsChanges in the way you teach – mentoring of students Change in learning process – more clinically drivenChange in learning process – more clinically driven Video student assessment to improve techniquesVideo student assessment to improve techniques Interfaces with the Gen Y group – technology saavy, but too big for their britches, question authority (differs across cultures/diversities)Interfaces with the Gen Y group – technology saavy, but too big for their britches, question authority (differs across cultures/diversities)

66 A Look at the Future (5-10 years out) The Residency Programs The Residency Programs School-based programs?School-based programs? Distance caseworkDistance casework Summative examSummative exam More structure and monitoring (residency review board)More structure and monitoring (residency review board) More stringent standards (weed out the weak) – outcomes-based?More stringent standards (weed out the weak) – outcomes-based? Closer matching process with schools and residency sitesCloser matching process with schools and residency sites Elevate student expectationsElevate student expectations NCOPE-accredited teaching residenciesNCOPE-accredited teaching residencies Alternative sources of funding for residentsAlternative sources of funding for residents

67 A Look at the Future (5-10 years out) O&P Manufacturers/Suppliers O&P Manufacturers/Suppliers Practitioners may lead the R&D of manufacturersPractitioners may lead the R&D of manufacturers Reimbursements will be a hurdle Reimbursements will be a hurdle Manufacturers will have practitioners on staffManufacturers will have practitioners on staff Practitioners demanding support dataPractitioners demanding support data Increased support to the schoolsIncreased support to the schools

68 A Look at the Future (5-10 years out) Relations with the O&P organizations Relations with the O&P organizations Unification of ABC/BOCUnification of ABC/BOC More agile relative to pursuing and leveraging licensureMore agile relative to pursuing and leveraging licensure Academy taking lead for the O&P professional more close collaboration with ABC/NCOPEAcademy taking lead for the O&P professional more close collaboration with ABC/NCOPE NCOPE driving educationNCOPE driving education

69 A Look at the Future (5-10 years out) Professional Development/Continuing Education Professional Development/Continuing Education Specialized online education coursesSpecialized online education courses Referring within the profession – recognizing our own strengths and weaknessesReferring within the profession – recognizing our own strengths and weaknesses

70 Appendix I: Redefining O&P Orthotics and prosthetics is a profession that is redefining itself. Orthotics and prosthetics is a profession that is redefining itself. Traditionally, the mission of orthotics and prosthetics has been to prepare and dispense orthoses and prostheses. In the performance of these roles, orthotists/prosthetists have had close interactions with customers, so much so that for a number of years orthotists/prosthetists have been ranked in the national polls as one of the nations most trusted group of professionals. Traditionally, the mission of orthotics and prosthetics has been to prepare and dispense orthoses and prostheses. In the performance of these roles, orthotists/prosthetists have had close interactions with customers, so much so that for a number of years orthotists/prosthetists have been ranked in the national polls as one of the nations most trusted group of professionals. Nonetheless, orthotics/prosthetics, much more so than most other health-related professions, has been based upon a product-oriented ethos, and, as late as the 1950s, national law regulated the type of interactions orthotists/prosthetists could have with their customers. Nonetheless, orthotics/prosthetics, much more so than most other health-related professions, has been based upon a product-oriented ethos, and, as late as the 1950s, national law regulated the type of interactions orthotists/prosthetists could have with their customers.

71 Redefining O&P (Continued) Over the last decade or two, a new mission has been emerging for the profession of orthotics/prosthetics care. Over the last decade or two, a new mission has been emerging for the profession of orthotics/prosthetics care. In this patient-centered ethos, the orthotist/prosthetist takes responsibility for patient outcomes related to orthotic/prosthetic patient management. The orthotist/prosthetist social object is no longer a product but a patient. This new mission intensifies the fiduciary responsibilities that a professional has for the people he or she serves. Orthotists and prosthetists still must be firmly grounded in anatomy, physiology, biomechanics, but increasingly important are their abilities to think critically, solve problems, communicate, and resolve ethical dilemmas. In this patient-centered ethos, the orthotist/prosthetist takes responsibility for patient outcomes related to orthotic/prosthetic patient management. The orthotist/prosthetist social object is no longer a product but a patient. This new mission intensifies the fiduciary responsibilities that a professional has for the people he or she serves. Orthotists and prosthetists still must be firmly grounded in anatomy, physiology, biomechanics, but increasingly important are their abilities to think critically, solve problems, communicate, and resolve ethical dilemmas.

72 Redefining O&P (Continued) This new mission of O&P practice necessitates a corresponding new mission for O&P education: to prepare practitioners to provide orthotic and prosthetic care. This new mission of O&P practice necessitates a corresponding new mission for O&P education: to prepare practitioners to provide orthotic and prosthetic care. The challenge of O&P education today is to design, implement and assess curricula that integrate the general and professional abilities that will enable practitioners to be responsible for O&P outcomes and the well-being of patients. The challenge of O&P education today is to design, implement and assess curricula that integrate the general and professional abilities that will enable practitioners to be responsible for O&P outcomes and the well-being of patients.


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