Last year I wrote a series of articles regarding the history and state of education in the O&P profession while I was director of prosthetics at Northwestern University Feinberg School of Medicine. A lot has changed for me in the past year and I am now working at Hines VA Hospital as the supervisor of the orthotics and prosthetics clinic. I still teach graduate level classes in teacher leadership for Concordia University and I am still contemplating working on my PhD in education. When I was leaving, I was asked to provide some advice to help the faculty with a smooth transition and my response was simple and one that was given to me by my former mentors at Northwestern University Prosthetics-Orthotics Center (NUPOC). I’ll provide that later in the article.

Recently I went to dinner with Mark Edwards, CP, and Gunter Gehl, CP(E), and we had a wonderful time along with our spouses walking down memory lane and discussing the state of education in the profession.

Gunter Gehl taught at Northwestern University from 1966 to 1992. Mark Edwards taught at NUPOC from 1985 to 2008 and I taught there from 1992 to 2011. We represent three of the four directors of prosthetics at NUPOC. The only director missing here is Blair Hanger. Collectively the three of us account for 46 of the 53 years of education at NUPOC.

 

Tom P. Karolewski

Driving home from dinner, I reflected on the success of the programs at 
NUPOC and why they were successful. It might be a good time to provide a new generation of educators and residency directors a look back on O&P’s education success and the opportunity to influence so many lives over the years.

These are the areas I believe are important to any education program: the student, the teacher, the curriculum, and the school environment.

Prepare for the future

While working as a new faculty member I was taught to always make the student my number one priority. This statement was valid throughout the years and should be the focus of any future educator. It starts with the student because they are the raw material by which we are to build a future for the profession.

If you think about all the students that have been educated in O&P, you realize we tried to make the student feel special. A great book that educators could benefit from is Generations at Work by Ron Zemke. This book details different generations from baby boomers to Generation Y, and their work ethics, values, range of knowledge and lifestyle, as well as each group’s expectations regarding the workplace. Knowing these diverse characteristics may give future educators insight about their students’ experiences and help direct their instruction and ability to answer students’ questions.

Other areas of concern that I believe will challenge future educators are ESL students (English as a Second Language), students with learning disabilities and multiculturalism. Are future educators prepared for these challenges in the classroom? Work experience in the orthotics and prosthetics profession cannot be the only prerequisite as an educator in our field any longer. The future educator has to be trained to recognize all of these challenges in the classroom and be prepared to effectively handle them.

 

Gunter Gehl, Thomas P. Karolewski and Mark Edwards (left to right) enjoy a meal and discussion of O&P education trends.

Images: Thomas P. Karolewski

Motivation to learn

The future educator has to determine what motivates students to learn. Extrinsic motivation is most usually in the form of grades but that tends to be a reward system for temporary gratification. We always believed that intrinsic motivation allowed the student to find a deeper understanding and required less reliance on a reward system. It’s best if students know that you are not teaching to the test, but are there to prepare them for life working with patients or clients. Williams and Williams wrote, “Intrinsic motivational factors found to be at work with most students include involvement (the desire to be involved), curiosity (find out more about their interests), challenge (figuring out the complexity of a topic), and social interaction (creating social bonds).”

Another factor that influences students’ motivation to learn is Maslow’s hierarchy of needs. Abraham Maslow was a psychologist and in 1954 released his book, Motivation and Personality. In it he describes the various levels of needs: physiological, safety, love, esteem and self-actualization. In order for someone to be motivated they need to satisfy these levels and anything less will inhibit motivation and, in turn, learning.

Life-altering events can also affect a student’s motivation for learning. Planning a wedding or the death of a loved one can become the primary focus in the student’s life for a time, and significantly lessen motivation on many levels. Imagine in our own lives what our motivation was like after a life-altering event and you get the idea. Learning cannot take place when we are not motivated.

Another factor that can also curtail learning is the student’s ability to find placement after school. This problem seemed to increase in the last 10 years. We have heard so many stories of students uprooting families to find a job, or just as the student is ready to graduate, their employer tells them they do not have the money to keep them on as a resident. This uncertainty about their future job prospects can influence students’ performance in the classroom.

As an educator, I am always mindful of a student’s pain and the difficulties and obstacles to learning he or she might face.

Some new programs will be including the residency in the curriculum before graduation — imagine a student’s relief knowing they do not have to worry about finding a residency after graduation. The facility owner does not have the burden of having to pay the resident so it is less likely that the facility will release the student before graduation. And the school benefits by gaining more control and guidance of residency training. I predict this model will support a student’s motivation to learn.

Art of teaching

The never-ending argument that I’ve studied over the years is whether teaching is an art or science. Although research supports both sides, I still believe teaching is more art than science. Dewey, Friere, and Eisner are just a few of many authors that have written extensively on the subject.

Eisner writes about the four senses of the art of teaching:

“First it is an art that teaching can be performed with such skill and grace that, for the student as well as the teacher, the experience can be justifiably characterized as aesthetic. Second, teaching is an art that teachers, like painters, composers, actresses, and dancers, make judgments based largely on qualities that unfold during the course of action. Third, teaching is an art that the teacher’s activity is not dominated by prescriptions or routines but is influenced by qualities and contingencies that are unpredicted, and fourth, teaching is an art in that the ends it achieves are often created in process.”

The ability to connect to the students on a personal level is very important. Not everyone has the natural ability to be a teacher and that is why a must read by any young educator is The Courage to Teach by Parker Palmer. Teachers should inspire their students to protect the future of the profession, and having a connection to the student is an important factor to success.

As Ward writes, “The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires.”

Motivation to teach

One of the most important aspects of teaching is the motivation level of the teacher. Are you passionate about teaching and do you truly care about the student? Think back on all the teachers you’ve had and I can guarantee the favorite teachers in your life are the ones who seemed to really care about what they were doing.

I know many successful faculty that have the uncanny ability to remember remote details about students and address them personally — details like remembering family members or school memories of the student. I was not as good at this, but I did remember obscure facts from the applications over the years. It may seem insignificant to you but to the student, remembering their name or asking about family members tells them you care.

It did not stop there either, as we tried to make the model patients that worked with the students feel like they were part of the family. We always took time to speak to each one, and make them feel welcome in the program.

This leads me to another point: faculty that have the ability to know each student’s limitations in school and how to challenge them to be better.

  

Regarding the model patients, we knew the challenges each patient offered and knew how to match the patient to the student based on ability level and personality. We tried to foster success in the school setting so the student felt more competent as they progressed into the residency. If someone had no experience coming into school it made no sense to assign them to a patient who was a difficult fit and then watch them fail as a result.

In order to understand your students, you have to get to know them on a personal level as well as a professional level. This will help establish trust and a good learning environment. Our job as faculty is to foster learning and when the student experiences success the motivation to learn increases.

Another element of a successful teacher is knowledge in the subject matter. Students are comforted and confident when faculty are highly skilled and know the subject matter. They will respect a teacher more if they believe the teacher has valuable experience, coupled with the motivation to teach. Students tend to be more engaged with learning when the instructor has a good command of the subject matter. In my case, the students enjoyed my troubleshooting techniques during lab sessions that would help them conserve time or save their project from disaster. They started to joke and called them, “Tom’s Tech Tips.” The point is, the students respond when you have mastered the content and they know it.

In the next part of the series I will continue with our dinner discussion and present our thoughts on curriculum design and the overall institution environment.