Incorporating a residency program into your O&P practice requires a financial commitment from the owner and a professional commitment from the practitioner. Residents vary from those just out of school to experienced practitioners working towards extending their expertise into additional disciplines.
“School teaches you so much, but hands on experience is more important than anything in this field,” Jack Lawall, CO, vice president of Harry J. Lawall & Son, a full service O&P facility, told O&P Business News. “The residents today are opened-minded and more computer savvy but they do not come out of school ready to treat patients by themselves. They need a mentor.”
Residency directors are required to perform quarterly reviews and maintain written evaluations as part of the performance record for each resident, according to the National Commission of Orthotic and Prosthetic Education (NCOPE) . The residency director must submit the final evaluation of the resident’s performance and completion of the program to NCOPE. Residency programs are required to complete a minimum of 1 year for each discipline, according to NCOPE.
“Some companies do shy away from residency programs because it is a large commitment of time but when you look at the need of field and the projected shortage of practitioners, in order for our field to thrive, it is a commitment we have to make,” Carrie Melton, CPO, LPO, clinical director of prosthetics at OrPro Prosthetics & Orthotics, said.
NCOPE’s 22-page Standards of Excellence for the O&P Residency Program, outlines the general policies and responsibilities of the facility and resident. The O&P facility’s responsibilities include:
- Creating an environment wherein both residency staff and residency improve their knowledge and skills;
- Incorporating residents into professional O&P staff programs, education and patient care; and
- Recording and maintaining evaluation forms on each resident’s performance.
Melton and Lawall’s standards for the resident exceed NCOPE’s requirements. Melton has the resident establish specific objectives and has monthly evaluations to review the resident’s goals, strengths and areas of improvement. Lawall’s company sends their residents to Shriners Hospital to work in pediatrics or DuPont Hospital focusing on sclerosis.
Most residents join the residency program as a paid employee with the hopes of turning their residency into a long-term position with the company. Whether a recent graduate or an experienced practitioner, every resident begins the same way, according to Melton.
“In our practice, the resident begins with our practitioner and they are just observing,” Melton said. “For me, as the supervising practitioner, I have to be committed to spend the time with them and be willing to explain everything that I am doing. They are learning through observation.”
The observation time offers the resident the opportunity to ask questions and discuss the case with the supervising practitioner. One of the key components of having a good working relationship with a resident is always having an open channel of communication, according to Melton. It is important the resident understands that although they may not know an answer or are uncomfortable with a situation, it is all part of the learning process.
“Maybe they are a little intimidated to say ‘I don’t know’ or ‘I’m not comfortable with that,’” Melton explained. “One thing I try to establish is that I have been doing this for 29 years and there is still a lot that I do not know. It is a constant learning process for everyone.”
As the resident progresses, the roles begin to reverse.
“I still go in the room, but I let the resident complete the patient history, talk to the patient and then after we step out of the room, the resident makes a recommendation as to how we should proceed,” Melton explained. “So you are giving them a chance to start making decisions and applying their skills with direct supervision.”
Despite the added workload associated with residency programs, Lawall encouraged O&P companies to participate. The infusion of youth among the office often revitalizes his entire staff.
“For our company, we want to have at least one or two residents in the pipeline,” Lawall said. “We want the rising stars. We can train them our way and it is nice to have young blood in there. It is rejuvenating.”
Melton thinks more residency programs will improve the future of the entire O&P field.
“It is important not to think just in immediate terms, but in terms of the needs of our field,” Melton explained. “A little more work today could potentially mean more to our field in 5 to 10 years.” — by Anthony Calabro
For more information:
National Commission on Orthotic and Prosthetic Education. Standards of excellence for the orthotic/prosthetic residency program. Available at: www.ncope.org/assets/pdfs/standards_accred.pdf Accessed Aug. 30, 2010.