An Exploration of Global Prosthetist/Orthotist Education, Projected Workforce Need, and Information Access Among Faculty

Abstract

People around the world experience disability due to unaccommodated physical impairments. Prosthetic and orthotic devices serve to accommodate many physical disabilities, thereby restoring mobility, function and participation in society. Successful prosthetic and orthotic service provision relies upon a well-trained and accessible workforce of prosthetists/orthotists. Education of prosthetic and orthotic professionals requires a thorough understanding of the current personnel need and state of prosthetist/orthotist education. To date, the global need for and education of prosthetists/orthotists is largely undocumented. The studies in this dissertation address three aims (1) estimate region specific prosthetist personnel need to serve the population of people with amputation based on estimates of global amputation prevalence due to trauma and diabetes, (2) examine the prosthetic and orthotic education, curriculum and teaching methods described in prosthetic and orthotic literature and (3) explore how prosthetic and orthotic faculty in Ghana and the U.S. access information. Global Burden of Disease (GBD) amputation estimates were used in a secondary data analysis to provide descriptive interpretation for prosthetic and orthotic service provision and calculate estimates of prosthetist need globally. A systematic review of current prosthetic and orthotic education research was used to aggregate the body of literature and identify areas for development. Lastly, a social network analysis was conducted to explore information access and exchange among faculty at two prosthetic and orthotic professional preparation programs. Together this body of work explores the global prosthetic and orthotic workforce at three different levels. The first chapter provides global amputation prevalence estimates to contribute to the current knowledge of prosthetist need and service provision planning. GBD estimates of amputation incidence could build upon this work, provide evidence of amputation rates and change over time to better guide and assess prevention efforts. Additionally, GBD estimates of etiologies that could benefit from orthoses could be used to estimate global orthotic need. The second chapter synthesizes current evidence in prosthetic and orthotic education and in doing so, highlights a recent shift in the field and identifies key strategies to build upon recent efforts. The paucity of prosthetic and orthotic education research points to a strong need for a professional shift toward evidence-based education which could include increased support for education researchers, international collaborations and a culture shift toward peer-reviewed publication in prosthetic and orthotic education. Lastly, an exploratory application of social network analysis provides an example of how unique research methodologies can be applied in prosthetic and orthotic education to enrich the body of knowledge. This exploration of information access and exchange in the U.S. and Ghana identifies areas for intervention including a need for increased peer-reviewed journal access in Ghana and improved faculty collaboration in the U.S. Additionally, the social network analysis can be replicated among students at these same institutions and among faculty and students at other institutions to provide a more thorough understanding of information exchange in prosthetic and orthotic education. Together, the three studies of this dissertation provide insight into global need for prosthetist personnel, prosthetic and orthotic education practices and information access and exchange among prosthetic and orthotic faculty.