Practice Analysis of ABC Certified Assistants in the Disciplines of Orthotics and Prosthetics

May 2025

Executive Summary

The specific objectives of the study were to:

conduct a practice analysis of the disciplines of orthotic and prosthetic assistants by updating and validating the domains of practice, the specific tasks performed, the associated knowledge and skills required to perform each task and the practice areas and devices used
develop profiles of practice of certified prosthetic and/or orthotic assistants, including time spent in each domain and the criticality of domains
quantify time spent and tasks performed with regard to various orthotic and prosthetic devices
explore expected trends in the profession for the next three years
develop defensible test specifications for orthotic and prosthetic assistants in connection with the multiple-choice certification exam administered to candidates for the credentials

Independent Review of Content Outline

Prior to the first meeting, the past content outline developed from the 2012 practice analysis study was distributed to each panelist for independent review. The feedback of the independent review guided discussion during the meetings and informed the determination of test specifications.

Instructional materials were distributed to each panelist to aid the practice analysis study, which included the meeting agenda, information regarding the practice analysis process, and guidelines for developing a content outline. The materials distributed to panelists can be referenced in Appendix A and the results of the independent review are presented in Appendix B of the final report document.

Review of Target Audience and Eligibility

After reviewing the purpose of the meeting and clarifying roles and responsibilities, the panel discussed the mission of the program, relevant characteristics of potential certificants, the changes in the industry during the past five years, as well as the anticipated changes in the next five years.

Domain and Task Development

After the panel established a clear understanding of the program’s target audience, the meeting shifted to developing a new content outline for COAs and CPAs. In small and large groups, the panel reviewed the 2012 practice analysis content outline, identifying the key domains—the major groupings of responsibilities and tasks that constitute significant areas of the role—and the specific tasks or activities performed within each domain.

Discussions focused on ensuring the identified responsibilities and tasks accurately reflected the diverse settings in which COAs and CPAs operate. Panelists received guidance on developing and evaluating domains and task statements (see Appendix A). As the panel refined the content outline, they evaluated the relevance and currency of each domain and task, making revisions as needed to ensure comprehensive coverage. Throughout the meetings, some tasks were reworded, removed, or reassigned to more appropriate domains.

Through an iterative process of development, review, and revision, the panel finalized a comprehensive list of four domains and 30 tasks for the COA exam, and four domains and 32 tasks for the CPA exam. The domains for each exam include:

Assessment
Implementation of the Treatment Plan
Continuation of the Treatment Plan
Practice Management

Knowledge and Skill Statements

After finalizing the domains and tasks, the panel received guidance on developing knowledge statements. Working in both small and large groups, they identified industry-specific knowledge and skill areas required for the competent performance of each task. As part of this process, the panel participated in a linkage activity to ensure that each knowledge and skill statement was essential to at least one task within a domain. Some statements were linked to multiple tasks or domains, while one was removed (i.e., loss control) for not being critical across most practice settings.

In addition, the panel rated when each knowledge or skill area should be acquired for successful performance— either prior to certification or after. Most statements were determined to be necessary before certification, while those identified as acquired after certification were still considered essential, though typically required at a more foundational level. For both the COA and CPA exams, this process resulted in a final set of 44 knowledge statements and 21 skill statements. A complete list of the knowledge and skills, along with their associated linkages, can be found in Appendix C of the final report document.

Conclusion

The 2025 Practice Analysis for the Certified Orthotic Assistant (COA) and Certified Prosthetic Assistant (CPA) examinations provides a comprehensive evaluation of the competencies required for entry-level practice as a COA and CPA. Through the collaboration of experienced subject matter experts and adherence to industry standards, this study has ensured the relevance of the updated exam blueprints.

Key outcomes of this analysis include:

The identification of four core domains and 30–32 critical tasks for each certification track.
The alignment of 44 knowledge statements and 21 skill statements with these tasks, confirming their essential role in competent practice.
Detailed weighting of each domain to reflect current professional practice, ensuring the examination accurately assesses the most critical and frequently performed responsibilities.
Insights into the evolving nature of practice areas, device usage, and fabrication methods.

Once the test specifications are finalized, the existing item bank will be reclassified to align with the updated content areas. Any gaps—where content does not adequately meet the test specifications—will be addressed through the development of new items. When new test forms are created, items will be selected to ensure full alignment with the test specifications.

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