Last month I wrote about the wonderful evening I spent with former Northwestern University educators Mark Edwards, CP, and Gunter Gehl, CP(E), having dinner, reminiscing and discussing education. In the first part I discussed the student and the teacher; here are other topics that we discussed that night.


Here is a topic that can go in many different directions and cover much ground depending on the philosophies of the teacher or the institution. My background of writing objectives, lesson plans, and curriculum originates from my undergrad days as a physical education, special education, and adapted physical education teacher. This has served me well as I helped design courses and the curriculum moving toward the master’s program in O&P.

When it comes to designing a curriculum for a program it comes down to one question: what do you want the graduate to look like? In other words, what information do you feel is necessary for the student to have as he or she enters a residency?

Since the early 1950s — when the original apprentice standards were developed — until now, individuals have tried to design curriculum in our profession to prepare individuals for the workforce. Some curriculum experts call this “social efficiency.” When I went to school for prosthetics, my technical grade carried more weight than the written exams. We were being technically trained to prepare ourselves to fit into the O&P workplace right out of school. In more recent times we have moved away from a predominantly technical apprenticeship to a more refined clinical training. Looking at the curriculum over the years, one can see that it has evolved quite a bit.

Today, many health education programs use a form of problem-based learning modules that can enhance the clinical experience for the student. The teacher becomes the facilitator and the student must problem solve and research many issues before coming to a conclusion. This form of learning is useful in O&P education because it allows the student to create ways of solving clinical problems that correspond with their learning style.

There are many books on curriculum development that I have read over the years but Curriculum Development for Medical Education: A Six Step Approach by Kern, Thomas, Howard and Bass is simple, well written and provides good tools to help any teacher design curriculum.

Six steps

In the book, step one describes problem identification and a general needs assessment. I would bet that all of the O&P programs have done this at some time, either at the initial curriculum design or during curriculum maintenance. One tool that can help with the general needs assessment is the practice analysis report from the American Board for Certification in Orthotics, Prosthetics & Pedorthics. The report provides information on tasks that are performed in the clinical setting, which is important when designing curriculum so the schools and clinical practice can be in sync.

Step two is needs assessment of targeted learners. Once the general needs of a program are established, then an assessment of the targeted learner can be performed. Again, this can be accomplished through various surveys or the practice analysis.

Step three is having the faculty establish goals and objectives for every aspect of the curriculum to be covered. This is done at a variety of levels. Global objectives are written for the whole program; from there, objectives are established for the various sections and then again for the individual classes. This provides the framework for the program’s direction.

Step four involves educational strategies used to impart knowledge to the student. Although there are many different theories and methods, I will concentrate on a couple of ideas that I believe are successful methods in the profession.

I happen to favor some ideas about the theory of progressive education and the writings of John Dewey along with the use of problem-based learning to enhance clinical reasoning skills. In a simplified explanation, Dewey believed in learning through social experiences. Students learn when they utilize their hand skills for technical projects, interact with one another, and enjoy the school environment. This is the main reason Northwestern University designed a blended format and not a pure distance format because of the importance of the hands-on, in-person experience.





Gunter Gehl, CP(E) discusses socket fit.

Images: Thomas Karolewski


Step five involves implementing the curriculum. This part has several components: support of the curriculum, identifying and addressing the barriers of implementation, piloting the curriculum, phasing in the curriculum, and refining the curriculum over successful cycles.

Step six is evaluation and feedback. This is an extremely important means of validating curriculum design. All programs should routinely evaluate the effectiveness of the program based on feedback and modify the curriculum if necessary.

Institution environment

I read the Williams and Williams article and started thinking about how important the environment is on motivating the student. However, I interpret the importance of the the environment in a different way than the authors mentioned. This is where I believe Dewey’s theories add to the institutional environment.




Thomas P. Karolewski

Northwestern University may be the oldest operating O&P school in the profession, but all the O&P schools have a storied history or will have one someday. I run into students that attended New York University or UCLA and are extremely proud of their educational heritage, as they should be.

How the student perceives the school environment and its history or reputation makes a difference. When perspective students would call me, I tried to be engaging from the beginning so they felt welcomed; I hoped I had made a good first impression. Is the office staff friendly and do they make the student feel special during the application process or registration process? Does everyone have a positive attitude in the building? Students can tell right away.

When people walk into the institution, do they get a sense of the heritage of those who attended before them? It’s exciting to learn about the history of the various institutions and reminisce about former students who have gone on to become accomplished practitioners. Every school has their alumni or will have alumni that will do something extraordinary in or for the profession.

That leads me to devoted alumni who give back to the school in various ways and not the least of which is financial support. Alumni can donate old components to the school, offer to lecture, be part of an advisory board or mentor students as a residency director. There are many ways alumni can give back to the institution that gave them an education. In essence, the alumni become an indirect link to the institution.


Mark Edwards, CP, leads the way at NUPOC.



Well-equipped classrooms

The next aspect of environment is the classrooms. Do they enhance learning? How does their design affect learning? The lecture halls should be appropriate for basic lectures and support the audiovisual needs of the faculty. With today’s advanced technology, the classrooms should go beyond Powerpoint presentations. Now, teaching institutions are using clickers, Twitter, blogs, wikis, or even smartphones to engage the students into a lecture. These are the kind of things that make learning fun for the student.

Are the fabrication room and machine room designed for safety? Do they provide proper space for the students? Are the components up to date for teaching the latest topics? Often manufacturers can be asked to assemble resources for different modules. This could be, for example, a crate of the latest prosthetic feet or knees that students could use for a particular module, and then it is returned to the supplier. This way the school does not have to purchase the components but are using the latest designs, and the manufacturer can satisfy all the schools without having to provide the same components to every single school.

It comes down to this: where the school environment is concerned, do the students feel as if they are a priority in the building and are they engaged in becoming professionals?


In the lab, Thomas Karolewski, CP, FAAOP, demonstrates hands-on learning.




As a faculty member and a prosthetist, I have been lucky enough to have helped mold the lives of some students. I’m sure the same can be said by other teachers in the past and those currently teaching. Knowing this validates the things you do and why you do them. It is what makes our profession so special.

For more information:
Kern, Thomas, Howard and Bass. Curriculum Development for Medical Education: A Six Step Approach. Baltimore, Md.: Johns Hopkins University Press;1998.
Williams C, Williams K. Five key ingredients for improving student motivation. Research in Higher Education Journal. 2011.



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