Survey: Upper limb specialists report more confidence, take greater risks than novices

LEIPZIG, Germany — Experts and specialists in upper limb prosthetics tend to take greater technologic and financial risks and are more confident in their practice than less experienced prosthetists, according to a speaker, here.

Gerald Stark

According to his 2013 survey of upper limb practitioners, Gerald Stark, MSEM, CPO/L, FAAOP, senior upper limb specialist with Ottobock Healthcare, said that 71.8% of respondents described themselves as novice-intermediates, whereas 26.2% described themselves as experts or specialists in upper extremity fitting.

“The larger group is much more fragmented, and the smaller group is much more cohesive, and driving most of the innovation,” Stark said at the OT World Congress, here.

Survey results showed that experts and specialists are much more aggressive in pursuing relationships and professional linkages outside of their localized group or practice, he said.

Overall, 60% of all practitioners said they worked at privately owned clinics, whereas 40% worked at an institution, corporation or manufacturing environment. Practitioners in private clinics are more isolated in their view, Stark said.

“When we look at novices and intermediates, 66% are, paradoxically, in private companies, and experts and specialists are actually higher in corporate-owned situations. So the ones who need to have the external linkages are in an environment where they are probably not going to find them,” he said.

Novices and intermediates expressed more aversion to risk, Stark said. A lack of clinical confidence may be because they see few upper limb patients, while 62% said they lack personal confidence or knowledge with upper limb fitting.

“This lack of personal confidence can also be transmitted to the patient, so as prosthetists, we can actually become part of the issue,” Stark said.

Whereas novices and intermediates found componentry knowledge and fitting adjustment to be the most challenging areas of concern, experts and specialists were more concerned with socket design and patient training and variation.

“The expert and specialist seem to be more worried about the overall health and welfare of the patient, whereas the novice and intermediate practitioners focus only on that component,” he said.

To bridge the gap in technical dissonance, novices and intermediate practitioners should make and stay in contacts with experts, seek referrals when necessary and increase their technical knowledge with targeted learning.

“Education should provide patient exposure, technical advice and increase communication,” Stark said. — by Carey Cowles

For more information:

Stark G. Upper limb prosthetic competency and characteristics among self-assessed novices-intermediates and experts-specialists. Presented at: OT World Congress; May 12-16, 2014; Leipzig, Germany.

Disclosure: Stark is employed by Ottobock Healthcare. 

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