Contents
- Acknowledgements
- Practice Analysis Task Force
- Introduction
- Results Related to Professional Background, Work Setting and Demographic Information
- Results Related to Domains, Tasks and Knowledge and Skill Statements
- Domain Ratings
- Task Ratings
- Knowledge and Skills Ratings
- Results Related to Practice Areas and Devices
- Highlights
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Practice Analysis of Certified Technicians in the Disciplines of Orthotics and Prosthetics
January 2017
Task Ratings
All survey respondents rated the tasks on two rating scales:
- Frequency: How frequently did you independently (without supervision) perform the task during the past year? 1=Never/rarely, 2=Occasionally, 3=Frequently, 4=Very frequently
- Criticality: How critical is the task to optimizing outcomes for patients, caregivers and healthcare providers? 1=Never/rarely, 2=Occasionally, 3=Frequently, 4=Very frequently
Table 17 displays the mean of the Frequency and Criticality ratings for the task statements.
Four of the 34 tasks achieved a mean frequency rating of 4.8 (frequently to very frequently performed):
- Fabricate/assemble an orthosis and/or prosthesis to prepare for initial or diagnostic fitting and/or delivery
- Assess device for structural safety and ensure that manufacturers’ guidelines have been followed prior to patient fitting/delivery (e.g., torque values, patient weight limits, manufacturers’ guidelines)
- Adhere to applicable local, state and federal laws and regulations (e.g., OSHA, FDA)
- Follow patient care guidelines and procedures (e.g., ABC’s Code of Professional Responsibility, ABC Orthotic, Prosthetic and Pedorthic Scope of Practice, quality control programs, ABC Facility Accreditation Standards)
One task had a frequency of 2.3 (rarely performed):
- Develop and document long-term service plan
In general, tasks were rated highly on the 4-point criticality scale regardless of discipline, with 28 of 34 tasks achieving a mean criticality rating of at least 3.0, indicating they are moderately to highly critical to optimizing outcomes. Of these, 20 achieved criticality ratings of 3.5 or higher, indicating they are close to highly critical. The two highest-rated tasks on the criticality scale both had mean ratings of 3.9 and were:
- Evaluate orthosis and/or prosthesis for structural integrity (e.g., are the materials used in the fabrication appropriate in regards to characteristics and properties)
- Assess device for structural safety and ensure that manufacturers’ guidelines have been followed prior to patient fitting/delivery (e.g., torque values, patient weight limits, manufacturers’ guidelines)
There were six tasks with mean criticality ratings below 3.0, and only one of these had a mean rating lower than 2.5. This task was also rated lowest on the frequency scale:
- Develop and document long-term service plan
Table 17
| Mean Frequency | Mean Criticality | |
|---|---|---|
| Domain 1 – Initiation of Treatment Plan | ||
| Review physical assessment data provided by practitioner (e.g., height, weight, activity level, amputation level, diagnoses, measurements, prior orthosis/prosthesis usage) to determine technical requirements for the orthosis/prosthesis | 4.3 | 3.6 |
| Consult with practitioner(s)/clinician(s) to confirm physical assessment data obtained (e.g., patient’s condition/diagnosis, measurements, work order) | 4.1 | 3.5 |
| Participate in the education of patient and/or caregiver about the use and maintenance of the orthosis/prosthesis (e.g., donning and doffing, wearing schedules, other instructions, cleaning, lubrication) | 2.5 | 2.6 |
| Document technical treatment plan (including work order, layups, componentry, serial numbers) using established record-keeping techniques | 4.0 | 3.3 |
| Domain 2 – Biomechanics | ||
| Determine fabrication requirements/technical criteria (e.g., static alignment of orthoses or prostheses) | 4.6 | 3.7 |
| Verify function of orthosis and/or prosthesis (e.g., does it perform as required in all planes of motion) | 4.5 | 3.6 |
| Domain 3 – Implementation of the Treatment Plan | ||
| Review range of motion requirements (e.g., varus/valgus, flexion, extension) of the individual to determine patient’s orthotic/ prosthetic technical needs | 3.2 | 2.9 |
| Participate in procedure to obtain patient model (e.g., identify anatomical landmarks, measure patient, take impression, delineate, scan) | 2.4 | 2.7 |
| Review assessment of fit of orthosis and/or prosthesis with regard to anatomical relationships to orthosis and/or prosthesis (e.g., trimlines, musculoskeletal anatomy, static/dynamic alignment) to make needed changes to initial treatment goals | 2.8 | 2.9 |
| Domain 4 – Materials, Componentry and Design | ||
| Evaluate orthosis and/or prosthesis for structural integrity (e.g., are the materials used in the fabrication appropriate in regards to characteristics and properties) | 4.7 | 3.9 |
| Adhere to manufacturer’s conditions of use and/or specifications (e.g., identification of the need for repairs or replacement, warranties) | 4.6 | 3.7 |
| Consult with manufacturing professionals, as required (e.g., regarding componentry, design limitations, new materials) | 3.5 | 3.2 |
| Align orthosis and/or prosthesis for accuracy in sagittal, transverse and coronal planes in order to provide maximum function prior to initial fitting | 4.4 | 3.6 |
| Participate in the assessment to determine an orthotic/prosthetic treatment plan (e.g., orthosis/prosthesis design such as solid ankle versus posterior leaf spring [PLS], patella tendon bearing [PTB] versus total surface bearing) | 2.7 | 2.6 |
| Identify materials and components to support treatment plan | 4.3 | 3.5 |
| Determine orthosis/prosthesis design requirements (e.g., structural requirements, device specific functional requirements) | 3.9 | 3.3 |
| Verify that materials, design and components are provided as specified in the treatment plan | 4.6 | 3.7 |
| Select materials/techniques necessary to create a positive patient mold (e.g., fiberglass, plaster, scan) | 3.4 | 3.0 |
| Domain 5 – Fabrication | ||
| Consult with practitioners regarding fabrication requirements | 4.4 | 3.7 |
| Modify patient model/image for fabrication | 3.6 | 3.1 |
| Fabricate/assemble an orthosis and/or prosthesis to prepare for initial or diagnostic fitting and/or delivery | 4.8 | 3.8 |
| Complete fabrication process after optimal fit and function of orthosis and/or prosthesis is achieved (e.g., convert test socket to definitive orthosis and/or prosthesis) | 4.7 | 3.8 |
| Assess device for structural safety and ensure that manufacturers’ guidelines have been followed prior to patient fitting/delivery (e.g., torque values, patient weight limits, manufacturers’ guidelines) | 4.8 | 3.9 |
| Verify and document final fabrication process (e.g., lamination materials, plastic thickness) using established record-keeping techniques | 4.3 | 3.5 |
| Domain 6 – Follow-Up | ||
| Modify/adjust orthosis and/or prosthesis, as necessary, to maintain optimal function | 3.7 | 3.3 |
| Repair orthosis and/or prosthesis, as necessary | 4.1 | 3.6 |
| Document modifications/adjustments/repairs | 3.7 | 3.3 |
| Develop and document long-term service plan | 2.3 | 2.4 |
| Domain 7 – Facility Management | ||
| Maintain a safe and professional environment (e.g., ABC Facility Accreditation Standards) | 4.6 | 3.7 |
| Perform scheduled machines and equipment maintenance and calibration | 3.9 | 3.6 |
| Document service of machines and equipment (e.g., maintenance logs) | 3.4 | 3.2 |
| Domain 8 – Professional Responsibility | ||
| Adhere to applicable local, state and federal laws and regulations (e.g., OSHA, FDA) | 4.8 | 3.8 |
| Follow patient care guidelines and procedures (e.g., ABC Code of Professional Responsibility, ABC Orthotic, Prosthetic and Pedorthic Scope of Practice, quality control programs, ABC Facility Accreditation Standards) | 4.8 | 3.8 |
| Participate in continuing professional development and/or provide such education to other healthcare provide | 4.0 | 3.5 |
Frequency: 1=Never/rarely, 2=Occasionally, 3=Frequently, 4=Very frequently Criticality: 1=Not, 2=Minimally, 3=Moderately, 4=Highly
In summary, the overall pattern of the Frequency and Criticality ratings on these task statements indicates that the practice analysis delineation included critical tasks performed by technicians in both disciplines. The pattern of Frequency and Criticality ratings validates the use of these tasks in initiatives related to item writing and examination development.
