Reflections &Projections - CONGRESS PROCEEDINGS 14-15 OCTOBER 2021 PART ONE: VIRTUAL EDUCATION #AOPA21
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AUSTRALIAN ORTHOTIC PROSTHETIC ASSOCIATION
Reflections &Projections
CONGRESS
PROCEEDINGS
14-15 OCTOBER 2021
PART ONE: VIRTUAL EDUCATION #AOPA21
Acknowledgements
The AOPA National Congress is proudly supported by industry partners and stakeholders, in particular our
Premium Partners; Ottobock and OPC Health. We thank the following partners for assisting us in the delivery of
exciting Keynote and Free Paper Sessions.
PREMIUM PARTNERS
DAY 1 PARTNER DAY 2 PARTNER
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Suite 1.01 Century Corporate 26-32 Clayton Road
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02 8818 2800
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– PROFESSOR HYLTON MENZ AND OUR PRACTICE
Ottobock Orthotic Prosthetic Solutions
Suite 1.01 Century Corporate Unit 2, 46 Hasler Road
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Baulkham Hills NSW 2153 Barry Smith, Andrew Vearing
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DAY 2 KEYNOTE PRESENTATION CLINICAL APPLICATIONS
– PROFESSOR DEIRDRE DESMOND Össur Australia
OPC Health 26 Ross Street
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2 AOPA | National Congress, 14-15th October, 2021
With thanks
CONGRESS COMMITTEE
AOPA would like to thank the congress convening prosthetic focused. She has been actively involved with
committee for their effort and flexibility in convening ISPO Australia and AOPA and is currently completing her
this year’s event. The committee has worked hard to Master of Health Administration.
adapt to the changing congress format to successfully
deliver this Part One event and will follow up with the Amy-Beth Seeley – Senior
delivery of Part Two in March 2022. Orthotist, Nova Orthotics
Amy-Beth is a Senior Orthotist
Tim Muling (Congress at Nova Orthotics, specialising
Convener) – Acting Head of in paediatric disability care. She
Department, Children’s Hospital has spent time working across
Westmead Australia and the UK before
Tim graduated from La Trobe settling in Newcastle.
University in 2009. He has Amy-Beth is passionate about
worked as an Orthotist in finding orthotic prescriptions to
Queensland, London and support her client’s individual goals and best suit their
Sydney where he is currently family dynamics. Outside of her clinical work, Amy-Beth
the Acting Head of Department is passionate about sustainability and works to advocate
at the Children’s Hospital Westmead. Tim specialises for sustainable reforms on both a community and
in adult and paediatric neuromuscular management national level.
and has an interest in advocacy, leadership and service
development. Tim has held a number of consultative
Nishani Bandaranayake –
roles including chair of the NSW Health O&P advisory
Orthotist/Prosthetist, Ballarat
committee, Covid-19 Allied Health Response Lead and
Health Services
Convener of the 2020 and 2021 AOPA Congress.
Nishani is a Latrobe University
Jess Fox – Lecturer Prosthetics graduate and commenced her
and Orthotics, La Trobe University career working as an orthotist at
the Sydney Children’s Hospital.
Jess Fox graduated from La She have recently begun a new
Trobe in 2008. She has worked role as an orthotist/prosthetist
clinically in Singapore, the UK, at Ballarat Health Services. She really enjoys working
Queensland and Melbourne, in the public health sector and is excited to continue
refining her skills as a Prosthetist. progressing her career in prosthetics and orthotics.
In 2019 she joined the Prosthetics
and Orthotics teaching team at
Joshua DeStefanis – Prosthetist/
La Trobe University where she
Orthotist, Royal Melbourne
loved developing the skills of future O&P clinicians.
Hospital
Meleita Finnigan – Senior Josh graduated from the Clinical
Prosthetist/Orthotist, The Royal Masters of Prosthetics and
Children’s Hospital, Melbourne Orthotics program in 2015 and
started work at OPST North in
Meleita graduated from the Launceston at the beginning
University of Melbourne in 2009 of 2016. After a brief stint in
with a Bachelor of Biomedical Tasmania Josh came back to the
Science (Honours) before mainland to work with the team at The Royal Melbourne
completing her Orthotics & Hospital. Josh has continued working at the RMH in
Prosthetics degree in 2012. Upon the prosthetics department servicing the acute, rehab
graduating she worked at Ballarat inpatient/outpatient, and community amputee patients.
Health Services. Since early 2017, she has been focusing Josh loves the variety of work the job has to offer,
on her paediatric skills at the Royal Children’s Hospital especially the focus on amputee rehabilitation.
seeing a large case mix but is now predominantly
National Congress, 14-15th October, 2021 | AOPA 3
With thanks
SESSION CHAIRS
We would like to thank our session chairs for their Tim Muling – Acting Head of
contribution to our event and supporting the delivery Department, Children’s Hospital
of each session. Westmead
Tim graduated from La Trobe
Dr Sarah Anderson – AOPA University in 2009. He has worked
Board Chair; Manager Research as an Orthotist in Queensland,
Analytics and Insights, Ahpra London and Sydney where
Dr Anderson has over 15 years he is currently the Acting
of tertiary teaching and research Head of Department at the
experience and is the Manager of Children’s Hospital Westmead.
Research Analytics and Insights at Tim specialises in adult and paediatric neuromuscular
the Australian Health Practitioner management and has an interest in advocacy, leadership
Regulation Agency (Ahpra). Sarah and service development. Tim has held a number of
has completed a Bachelor of consultative roles including chair of the NSW Health
Prosthetics and Orthotics, a Master of Public Health and O&P advisory committee, Covid-19 Allied Health
a Doctor of Philosophy. Sarah has played an active role Response Lead and Convener of the 2020 and 2021
in the Australian Prosthetic Orthotic Association over the AOPA Congress.
last 10 years and is the current Board Chair.
Sessions: Opening Day 2; Keynote Dr Deirdre Desmond;
Sessions: Congress Opening Day 1; Keynote Dr Hylton Congress Closing Day 2
Menz; Congress Closing Day 2
Sally Cavenett – Director OPSA,
Paul Sprague SALHN, SA Health
Paul is a Certified Orthotist/ Sally Cavenett is the Director
Prosthetist based in Victoria, of Orthotics Prosthetics South
having returned from Perth in Australia (OPSA) based at SALHN
2016 where he spent the first 8 in Adelaide since 2001, holding a
years of his career. He established state-wide advisory role for O&P
Interface Orthotics in Perth in services with SA Health. Sally
2014, and still maintains links has extensive senior clinical and
with the company as Director. management experience within
Paul has been working in clinical the O&P field holding various public and private sector
and management roles at NeuroMuscular Orthotics roles throughout Australia since 1992. Her qualifications
in Clayton for the last 5 years. He has held positions and interests are both clinical and research oriented.
on AOPA’s National Council and subsequent Board of
Directors since 2010, including the position of Chair from Sessions: Prosthetic Research and Clinical Applications;
2017 to March 2021. User Experience in O&P
Sessions: Advancing Orthotics Through Research;
Natasha Korbut – Advocacy and
Developing our Practitioners and our Practice
Policy Officer, AOPA
Tim Burke Natasha graduated in 2011
Prior to recently transiting to with a Bachelor in Orthotics
a Lecturer role at La Trobe and Prosthetics from Latrobe
University – Tim has worked University. She then spent several
for an extended period in the years working both publicly and
Victorian public health care privately in paediatric orthotics.
system at both Alfred Health and In 2018 she graduated with her
Austin Health. His clinical areas Master’s in Public Health from
of interest and expertise include Melbourne University. She has been working as AOPA’s
orthotic trauma management and advocacy and policy officer for the past two years.
diabetic foot disease management. Session: Rapid Case Studies - Prosthetics
Sessions: Innovation in O&P Education; Rapid Case
Studies - Orthotics
4 AOPA | National Congress, 14-15th October, 2021
Welcome to Part One of the 2021 AOPA National
Congress
On behalf of the Australian Orthotic Prosthetic Following the success of the
Association (AOPA), it is my pleasure to welcome you introduction of rapid case
to part one of the 11th AOPA Congress; “Reflections studies in 2020, the rapid case
and Projections”. For many the unprecedented study series will return, giving
disruptions of 2020 have continued with intermittent delegates tangible insights and
lockdowns and borders closures throwing up some solutions into real world clinical
incredible challenges. problems.
As expected our Australian O&P community has rallied Whilst we are very excited to
and it is with great pride and commitment that AOPA catch up with all our favourite
has been able to once again adapt and deliver its 11th exhibitors and sponsors in
annual congress through challenging circumstances. person early next year, the AOPA Congress – including
Whilst we may have to wait a few more months for our the virtual component – would not be possible without
long anticipated face to face celebration, the virtual their support. In particular we are thankful for the
component (i.e., Part One) promises to be one of the ongoing support from premium partners Ottobock and
most exciting and diverse programs to date. OPC Health.
The aim of the virtual program is to provide an Finally, a sincere thank you to staff in the AOPA office,
opportunity for delegates to come together and embrace members of the AOPA Board and convening committee.
learning from a variety of general and specialist topics no These teams have worked tirelessly to adapt and
matter where in the country they are located. The success ensure that the 2021 two-part Congress is a successful,
of our first virtual congress in 2020 proves that we can enjoyable and exciting event which meets everyone’s
learn, network and share our expertise as well as build our needs. We hope you take away some new ideas and
connections more broadly online. Part One will deliver thoughts for the future, inspired by reflections and
all the education requirements and set the scene for the projections from experts as well as practical learnings
for the much anticipated face-to-face exhibition, practical from real life case studies and delegate discussions.
workshops and panel discussion series in early 2022.
I look forward to celebrating the 11th AOPA Congress with
Each day will open with a renowned keynote address you – both virtually in October 2021 and face-to-face in
from Professor Hylton Menz and Professor Deirdie early 2022!
Desmond, two experts in their fields. The sessions will
cover a range of specialist topics including research, Tim Muling
education, service delivery and clinical application. Convener, AOPA Congress 2021
Welcome from the AOPA Chair
On behalf of the AOPA Board and Staff Team I am refined to focus on education and Part Two addressing
pleased to welcome delegates to the AOPA 2021 the exhibition and networking aspects that we all love.
National Congress – Part One. The profession, our
It seems timely that our congress theme is “Reflections
O&P community and AOPA have continued to face
and Projections” as we have much to look forward to in
challenges in 2021 associated with the COVID-19
2022. I look forward to meeting with many of you at our
pandemic, that has again touched our much loved
in-person event in March 2022 as we make the much
annual event.
anticipated return to typical congress format, welcome
I would like to thank the Board for the swift and our exhibitors to the exhibition hall and share a coffee
strategic management of the national congress, with colleagues and friends.
originally scheduled as an in-person event at the Crown March 2022 will represent more than 2 years without
Convention Centre. It is a testament to the hard work of an in person event, and the AOPA Board, staff and
the Congress Committee, capably lead by Tim Muling volunteer team are as excited as you are! In the
and supported by the staff team, that the event has been meantime, please enjoy our Part 1 Virtual Education
reimagined quickly and strategically. over two exciting days and show your support for our
presenters, chairs and event partners.
We are pleased to still be able to meet all of our your
O&P education and networking needs across the two Dr Sarah Anderson
parts of the 2021 National Congress – with Part One Chair, AOPA Board
National Congress, 14-15th October, 2021 | AOPA 5
Reflections &Projections
INVITED PRESENTATION THURSDAY
14TH OCTOBER
Professor Keynote
Hylton Menz
School of Allied Health,
Human Services
& Sport, La Trobe #AOPA21
University, Melbourne
Preventing falls from the ground up: the role of orthoses
and footwear
Biography Professor Menz’s current research focuses on the
epidemiology and management of foot disorders in
Professor Hylton Menz, PhD, DSc, FAHMS, is a podiatrist older people, with a particular emphasis on non-surgical
who graduated with first class Honours and the University treatments for osteoarthritis. He is currently co-chair
Medal from La Trobe University in 1993, and completed of the Australian Foot and Ankle Research Network,
his PhD in physiology at the University of New South co-chair of the Outcome Measures in Rheumatology
Wales in 2002. He has received continual National Health (OMERACT) Foot and Ankle Working Group, and serves
and Medical Research Council of Australia fellowship on the steering committee of the International Foot and
funding since 2003. Ankle Osteoarthritis Consortium.
Professor Menz’s broad research disciplines are human Invited presentation summary
movement, rehabilitation and rheumatology, with a
Preventing falls from the ground up: the role of orthoses
particular focus on musculoskeletal foot problems in
and footwear, will provide an overview of the problem of
older people. His research extends from laboratory-
falls, discuss foot and footwear risk factors for falling, and
based biomechanical studies through to analysis of
present the results of recent randomised controlled trials
epidemiological datasets and the conduct of clinical
that have been conducted to evaluate the effectiveness
trials. Professor Menz has published over 300 papers in
of foot-specific interventions to prevent falls in older
podiatry, gerontology, rheumatology and biomechanics
people. In particular, the role of foot orthoses and
journals.
ankle-foot orthoses will be highlighted.
He has won several awards for his research, including the
Young Tall Poppy Award by the Australian Institute for
Policy and Science, the La Trobe University Excellence
in Research Award, first prize in the British Medical
Association Book Awards for his textbook Foot Problems
in Older People: Assessment and Management, and a
Fulbright Senior Scholarship to Harvard University.
In 2016, he was awarded a Doctor of Science from the
University of New South Wales, and in 2020 he became
the first podiatrist to be inducted into the Australian
Academy of Health and Medical Sciences.
Proudly supported by Ottobock
6 AOPA | National Congress, 14-15th October, 2021Reflections &Projections
Professor
Deirdre Desmond INVITED PRESENTATION FRIDAY
15TH OCTOBER
Department of Keynote
Psychology, Maynooth
University, Ireland;
Co-director Assisting
Living and Learning
(ALL) Institute and Dublin #AOPA21
Psychoprosthetics Group
Engaging Ideas? Reflections and projections on people
and assistive technologies
Biography In her current research, she is particularly interested in
exploring issues at the interface between people and
Deirdre Desmond is a professor in the Department assistive technologies more broadly, taking a person-
of Psychology and co-director of the Assisting Living centred approach to technology integration across
and Learning (ALL) Institute, at Maynooth University the lifespan. Engaging collaboratively with academic
in Ireland. The ALL institute’s research mission focuses colleagues, including a talented group of doctoral and
on the development and integration of appropriate post-doctoral researchers, Professor Desmond works
technologies, person-centred systems and evidence- on a range of interdisciplinary projects exploring a
based policies, which empower users, and those variety of experiences, issues and challenges in assistive
supporting them, to address living and learning technology use and integration.
challenges.
Current research projects for which Professor Desmond
Professor Desmond also co-leads the Science is the Principal Investigator include a Health Research
Foundation Ireland Centre for Research Training in Board (Ireland) funded study in partnership with Spina
Advanced Communication Networks for Sustainable Bifida Hydrocephalus Ireland researching experiences
Societies (ADVANCE), a doctoral training centre aimed of health care transitions and health care needs among
at addressing the technical and societal challenges of people with Spina Bifida and/or Hydrocephalus and a
connectivity between large numbers of People and study on the impacts of Age Friendly Ireland’s ‘Healthy
Things. Age Friendly Homes’ programme.
Professor Desmond’s research is grounded in health Invited presentation summary
and rehabilitation psychology, with particular focus
This presentation considers psychosocial issues in
on psychosocial adjustment to long-term illness and
the field of prosthetics and orthotics; the changing
acquired physical impairment. This interest stems from
involvement and engagement of patients/clients/
her undergraduate and PhD studies in Psychology at
consumers as central workers in healthcare; and key
Trinity College Dublin and led to her role as codirector of
emerging challenges and opportunities.
the Dublin Psychoprosthetics Group, a multidisciplinary
team applying psychology in the rehabilitation of people
with amputations and advancing understanding of
the impact of psychological factors in amputation and
prosthesis use.
Proudly supported by OPC Health
National Congress, 14-15th October, 2021 | AOPA 7Adolescent idiopathic Reflections &Projections
scoliosis: Outcomes of primary
lumbar/thoracolumbar curves FREE PAPER SESSION: THURSDAY
14TH OCTOBER
treated with Rigo-Cheneau Advancing Orthotics
style TLSO‘s Through Research
Felicity Williams1 & Wayne Borgelt1 #AOPA21
1
Orthotics Department, Sydney Children’s Hospital
Introduction Males had an initial Cobb of 34.00 (+/-4.3) and an in-
Bracing has been clearly established as an efficient brace Cobb of 14.10 (+/-8.0) with an average in-brace
treatment in adolescent idiopathic scoliosis (AIS) with correction of 59%.
regards to surgical prevention (Weinstein et al., 2013). 14 patients had completed treatment, and post
Landauer et al., (2003) also showed in compliant patients treatment radiographs were available for 10. For this
with an in-brace correction >40%, permanent reduction group, the average pre-brace Cobb was 29.30, in-brace
can be achieved in thoracic curves. However, no such Cobb 10.50 and Cobb at the end of treatment 27.60.
study exists for lumbar curves.
In patients with a self-reported wear time >16hrs per
Lumbar curves have historically been more difficult to day, the Cobb at initial presentation was 30.50 and
brace with Clin et al., (2010) showing less than 2% of completion of treatment 23.50.
simulated Boston brace designs were able to achieve
Two male patients were non-compliant and ceased
sufficient correction to control a primary lumbar curve.
bracing before skeletal maturity. Both progressed to
The service at SCH Randwick have observed good surgical levels.
in-brace correction and results with the use of Rigo-
Cheneau bracing. This is an audit of our results in single Discussion
lumbar/thoracolumbar curves. Excellent in-brace correction was achieved in lumbar
curves with Rigo-Chenau style bracing. Compliance with
Method bracing remains a significant prognostic factor. This is a
A retrospective audit of patients with AIS treated with a limited cohort, with medium term results for follow-up.
Cheneau style TLSO provided at SCH was performed.
A lumbar or thoracolumbar curve was defined as those Conclusion
meeting the criterion for an E-type brace as defined by Excellent in-brace correction of lumbar curves can be
Rigo et al., (2010). Patients with non-idiopathic cause for achieved with Rigo-Cheneau style bracing. With good
their scoliosis or those treated with alternate braces were compliance it is not unreasonable to expect curves to
excluded. be at least maintained, if not decreased at the end of
Radiographic outcomes included the coronal angular treatment.
Cobb, measured at multiple intervals to assess treatment
efficacy.
Results
26 patients were identified: 20 females and 6 males. The
average initial Cobb angle was 28.30 (+/-6.0). Average
initial in-brace Cobb was 6.00 (+/-11.6). Average in-brace
correction was 83%.
Females had an average initial Cobb of 26.60 (+/-5.1)
and an in-brace Cobb of 3.60 (+/-11.4) with an average References
in-brace correction of 90%. Clin, J., Aubin, C-E., Sangole, A., Labelle, H. & Parent, S. (2010). Correlation Between
Immediate In-Brace Correction and Biomechanical Effectiveness of Brace Treatment in
Adolescent Idiopathic Scoliosis.mSpine, 35(18), 1706–1713.
Landauer, F., Wimmer, C. & Behensky, H. (2003). Estimating the final outcome of brace
treatment for idiopathic thoracic scoliosis at 6-month follow-up.mPediatric Rehabilitation,
6(3-4), 201–207.
Rigo M, Jelačić M. (2017). Brace technology thematic series: the 3D Rigo Chêneau-type
brace. Scoliosis Spinal Disord. 16(12), 10.
Weinstein, S.L., Dolan, L.A., Wright, J.G., and Dobbs, M.B. (2013). Effects of Bracing in
Adolescents with Idiopathic Scoliosis.New England Journal of Medicine, 369, 1512-21.
8 AOPA | National Congress, 14-15th October, 2021The opinions and experiences Reflections &Projections
of adolescents with Pectus
Carinatum who use a chest FREE PAPER SESSION: THURSDAY
14TH OCTOBER
compression brace: Advancing Orthotics
A Q methodological study Through Research
Kate Chauhan1 , Linda Milnes2,
Emma Sidebotham3 & Yu Fu2
1
Steeper Group, 2University of Leeds, #AOPA21
3
Leeds Teaching Hospitals
Introduction Results
Pectus carinatum (PC) is the second most common Three factors were identified by the Q sort data: Factor
chest wall deformity. Previous research used quantitative 1: Confident and responsible (70%), Factor 2: Anxious
methods to identify a negative impact from the condition and isolated (20%), Factor 3: Supported and open (10%).
on health-related quality of life, body image and self- Themes identified within the qualitative data indicated a
esteem. negative psychosocial impact from the change in body
image, self-esteem, self-imposed isolation and behaviour
Correction of the deformity aims to improve the negative
change in all of the participants. Anxiety and depression
impact of the condition. NHS England’s withdrawal of
were reported by factor 2. These findings were reversed
funding for surgical treatment fails to consider these
as correction occurred.
psychological factors and the benefits of treatment.
This study aims to identify the opinions and experiences Half the participants did not seek information regarding
of adolescents regarding living with the condition, the treatment due to mistrust of the internet, the other
their treatment journey and using a chest compression half used the internet to try and identify information but
orthosis. found that there was little information available. Half of
the participants referral process to specialist services
Method took 2 years from initial GP contact, despite this there
was little interest in their treatment pathway.
A sequential explanatory mixed methods approach
was utilised with equal weighting to the quantitative Conclusion
and qualitative findings. Q methodology was utilised to
identify the subjective opinions of adolescents with PC. PC had a negative impact on the lived experience of all
the adolescents studied, and should not be considered
33 statements describing diverse opinions know as the purely a cosmetic condition. There is not a clear pathway
concourse were sorted by level of agreement by 10 to non-surgical treatment which increases the risk of
purposively sampled participants aged between 11 and harm due to changes in behaviour and anxiety.
19, known as the P-set. This sort was then used as the
Clinical practice should offer access to psychological
structure for semi structured interviews.
support to our patient group to reduce negative
psychological impact.
National Congress, 14-15th October, 2021 | AOPA 9Use of psychological theory Reflections &Projections
to predict adherence to use of
AFOs in people with stroke FREE PAPER SESSION: THURSDAY
14TH OCTOBER
Advancing Orthotics
Dr Christine McMonagle1 , Dr Mark Elliott2,
Robbie Rooney3, Dr Susan Rasmussen2 Through Research
1
National Centre for Prosthetics and Orthotics,
University of Strathclyde, 2School of Psychological
Sciences and Health, University of Strathclyde, #AOPA21
3
NHS Lanarkshire, United Kingdom
Introduction Results
Poor adherence to ankle-foot orthoses (AFOs) is an Adherence to use of AFOs as recommended was 63%.
inefficient use of scarce resource, and may lead to The TPB accounted for 57% variance in intentions and
poorer health outcomes. Use of a theoretical model 42% variance in use of AFOs as recommended.
of behaviour to understand adherence to AFOs is
important because interventions based on theory are A number of beliefs associated with intention and AFO
more likely to be successful in changing behaviour. use were also identified which might be targeted in a
future intervention to increase adherence to AFOs.
This investigation aimed to examine the utility of a
psychological model, the Theory of Planned Behaviour Conclusion
(TPB) (Ajzen, 1991), to predict intention and adherence to The significant amount of variance found suggests the
AFO use in people with stroke.. TPB is a useful model for understanding adherence to
AFOs. This study provides a preliminary strategy for the
Method development of an intervention designed to increase
Forty-nine participants who had been prescribed an adherence to use of AFOs in people with stroke.
AFO following stroke in NHS Lanarkshire, Scotland,
completed a postal questionnaire, which measured
key constructs from the TPB, with behaviour measured
prospectively. Regression analyses were conducted
to identify predictors of intention to use an AFO as
recommended and actual use of the AFO.
References
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human
Decision Processes, 50(2), 179-211.
Acknowledgements
Chest, Heart and Stroke Scotland, NRS Stroke Research Network and Orthotics
Education and Training Trust (OETT) supported this work.
10 AOPA | National Congress, 14-15th October, 2021Impairment of gait Reflections &Projections
adaptability in older adults
with diabetes FREE PAPER SESSION: THURSDAY
14TH OCTOBER
Advancing Orthotics
Through Research
Dr Suzanne Martin1, Dr Simon Taylor1, Dr Rajna
Ogrin2 & Prof Rezaul Begg1
1
Institute for Health and Sport, Victoria University, #AOPA21
2
Bolton Clark Research Institute
Introduction Increased stance and double support times did not
Aging and diabetes interfere with sensory motor system increase the accuracy of foot displacement adjustments,
performance. Such impairments lead to impaired as older adults with diabetes showed the greatest errors
gait adaptability, which is a deterioration in the foot of step length and minimum toe clearance adjustments
placement adjustments in the sagittal plane during compare with other groups.
perturbed walking. This can lead to falls in unfamiliar Discussion
environments. It was hypothesised that diabetes
impaired perturbed gait. The results supported that spatiotemporal gait
parameters in older participants with diabetes were
Method not affected in unchallenged baseline condition when
Forty-three subjects (16 young, 16 healthy older and participants walked for a short time on an unobstructed
16 older adults with diabetes) completed tests during smooth surface. However, gait adaptability impaired and
perturbed and unperturbed walking. the accuracy of foot displacement adaptation reduced in
older adults with diabetes. This project was the first study
A three-dimensional motion capture system and to investigate overground gait adaptability. However, it
force platforms were used to quantify spatiotemporal had some limitations: The effects of diabetic neuropathy
parameters of gait. Participants walked in baseline and on gait adaptability were not investigated, the choice of
then completed overground gait adaptability tests (40 parameters for investigation was limited to the sagittal
trials) with four random conditions: step shortening, step plane, and finally, the method of sampling might limit the
lengthening, obstacle avoiding, and walking through. generalisation of the findings.
Step length targets were 40% of the baseline step length
longer or shorter than the mean baseline step length. Conclusion
The obstacle presented a 5cm height across the walkway. In conclusion, the study used novel tools to investigate
Analysis of variance (ANOVA) was used to test the main whether age and diabetes impaired gait adaptability
effects of group and condition at a significance level of in older adults with diabetes, which can lead to falls.
0.05. The presented gait adaptability tests can be used to
investigate the effects of lower limb prostheses on gait
Results
adaptability and falling in challenging environment.
Gait data of 16 young adults, 14 healthy older adult and
13 older adults with diabetes were included for data
analyses. Groups were not significantly different in gait
spatiotemporal parameters (step length, stance time,
swing time, double support time, step velocity) when
they walked normally at their preferred speed. However,
they were different in gait spatiotemporal parameters
when they tried to meet goal-tasks in adaptability tests
significantly. In older adults with diabetes, stance and
double support times significantly increased when they
adapted the trajectory of their feet to step length targets
and the obstacle height.
National Congress, 14-15th October, 2021 | AOPA 11Long term strength of 3D Reflections &Projections
printed passive dynamic
element ankle foot orthoses FREE PAPER SESSION: THURSDAY
14TH OCTOBER
Advancing Orthotics
Through Research
Hugo Marchant1 #AOPA21
1
AbilityMade
Introduction The plantar flexion
Literature indicates 3D printing passive dynamic element bending forces started
ankle foot orthoses (PDE AFO) can achieve: at 95.93 N before
exponentially dropping
• Dimensional accuracy of 0.39±0.23 mm (Schrank & over the first 300,000
Stanhope, 2011) cycles to a constant value
• Bending force predictability of 0.2±0.14 Nm/deg of 78.22 N. No significant
(Schrank et al., 2013) marks or orthosis damage
• Production times ofRisk factors associated with Reflections &Projections
halo specific complications:
A retrospective cohort study FREE PAPER SESSION: THURSDAY
14TH OCTOBER
of 444 patients Advancing Orthotics
Karly Wheeler1, Gavin Burchall1, Susan Liew2, Patrick Through Research
Chan3, Catherine Martin4, Anne E Holland5,6
1
Orthotic and Prosthetic Department, The
Alfred, 2Orthopaedic Department, The Alfred,
3
Neurosurgical Department, The Alfred, 4Department
of Epidemiology and Preventative Medicine, Monash
University, 5Department of Allergy, Immunology
and Respiratory Medicine, Monash University, #AOPA21
6
Physiotherapy Department, The Alfred
Introduction Multivariate analysis demonstrated patients discharged
The Halo Thoracic Orthosis (Halo) is commonly employed directly home were at less risk of any pin complication
to treat fractures of the cervical spine, however, numerous than those admitted for inpatient rehabilitation (adjusted
complications have been reported including minor sub hazard ratio (aSHR) 0.59, 95% CI: 0.37-0.95).
pin complications (loosening and infection), major pin Multiple pin complications tended to be more common
complications (dislodgement and pin penetration), loss in patients taking more than 2 days to mobilise (aSHR
of reduction and pressure injury (Garfin et al., 1986). 1.96, 0.92-4.17) and less common in males (aSHR 0.49,
Risk factors for Halo specific complications are unknown 0.22-1.08). Major pin complication tended to be more
(Middendorp et al., 2009). The purpose of this study was to common in patients aged >65 years (aSHR 1.75, 95% CI:
identify risk factors leading to Halo specific complications. 0.93-3.28). Minor pin complications were associated with
pendulous abdomen (aSHR 2.20, 1.22-3.99). Thoracic
Method
kyphosis was a risk factor for pressure injury (aSHR 7.59,
Retrospective study investigating Halo specific 1.64-35.26). No predictors of Halo failure were identified.
complications. Predictors of mortality were age (aSHR 1.10, 1.05-1.15)
Subjects: All adults fitted with a Halo at The Alfred over a and ISS ≥12 (aSHR 1.08, 1.05-1.12).
six-year period.
Discussion
Apparatus: A database was updated prospectively
Avoidance of some risk factors such as discharge
throughout the patient’s treatment.
to inpatient rehabilitation may not be possible.
Procedure: Complications investigated were pin Consideration of weekly reviews for patients known to be
complication of any type; major pin complication; minor at greater risk is recommended, potentially diagnosing
pin complication; multiple pin complications; Halo complications earlier and avoiding more serious
failure; pressure injury; and, mortality. Independent consequences.
variables included demographic, injury-related and
Body phenotype also impacted patients’ risk of
treatment-related factors. The treating orthotist
developing a Halo related complication. This finding is
diagnosed and recorded complications at inpatient and
limited by the subjective nature of this factor.
outpatient review appointments.
Data Analysis: Univariate and multivariate competing risk Conclusion
survival analysis was used to determine risk factors for Patients discharged directly home were less likely to
complications. develop Halo-specific complications. Body phenotypes
such as thoracic kyphosis and pendulous abdomen may
Results increase risk of Halo-specific complication.
There were 444 patients included, of which 119 (26.8%)
experienced a pin complication, with 9% experiencing
multiple pin complications.
References
Garfin S.R., Botte, M.J., Waters. R.L. and Nickel V.L. (1986). Complications in the Use of
the Halo Fixation Device. Journal of Bone Joint Surgery, 68(3), 320-325.
Middendorp, J.J., Sloof, W.B.M., Nellestein, R, & Oner, F.C. (2009). Incidence of and
Risk Factors for Complications Associated with Halo-Vest Immobilization: A Prospective,
descriptive Cohort Study of 239 Patients. Journal of Bone Joint Surgery, 91(1), 71-79.
National Congress, 14-15th October, 2021 | AOPA 13Prosthetic pressure...the Reflections &Projections
pressures prosthetists are
put under and the potential FREE PAPER SESSION: THURSDAY
14TH OCTOBER
effect it has on their mental Developing our
health Practitioners and our Practice
Cameron Ward1 #AOPA21
1
Innovo Prosthetics
Introduction Results
There is evidence showing that secondary trauma is The literature confirmed the author’s theory that
quite common in therapists dealing with patients who secondary trauma is a large problem in therapists.
have suffered a traumatic event. Prosthetists see many amputees that have suffered
severe trauma that resulted in their amputation. It is clear
The aim of this presentation is to highlight the secondary
that a large amount of exposure to this puts prosthetists
trauma to which prosthetists are subjected and the
at serious risk of secondary trauma and PTSD. Both the
potentially dangerous effects this may have on their
individual and their place of work need to understand
mental health. This presentation looks at different ways
these risks and take steps to minimise them.
organisations’ can try and help minimise these effects
upon its staff. The “Wellbeing Program” that has been Potential solutions are suggested including the approach
implemented at Innovo Prosthetics will be used as an of Innovo Prosthetics and the recent implementation of
example. The author hopes to help prosthetists stay their new “Wellness Program”.
healthy so they can continue to help the amputee
population. Discussion
The research conducted for this presentation has
Method
highlighted a very real issue facing the prosthetics
A literature review was conducted on the phenomenon industry worldwide. Prosthetists very likely take on
of secondary trauma and PTSD in therapists treating much of their patient’s trauma which can have serious
patients who have suffered trauma. long term mental health repercussions. This needs to
Subjects: The author’s personal experience and that be discussed openly. The issue is further compounded
of past and present colleagues were used as example by the lack of psychological teaching for prosthetists
subjects. They were all male and their ages were throughout their training.
between 40 and 65. Innovo Prosthetics hopes that by talking about its
Procedure: Observational analysis was made on the program, other facilities across Australia will take note
work environment of prosthetists that seem to have and consider best practices and how it relates to their
suffered from forms of secondary trauma. Potential employees as well as their amputee clients.
solutions to minimise the likelihood of such secondary
trauma were considered and put forward as potential
Conclusion
solutions. This paper aims to highlight the secondary trauma to
which prosthetists are subjected and the potentially
dangerous effects this may have on their mental health.
Discussion involves potential solutions that may work
within prosthetic practices, including one devised by
Innovo Prosthetics. The aims are to open the discussion
around this difficult subject and ensure an improvement
in the well-being of individual prosthetists and the
industry as a whole. Having mentally healthy prosthetists
will ensure they continue their important work servicing
and supporting the amputee community which is
something Innovo Prosthetics is passionate about.
Proudly brought to you by Orthotic Prosthetic Solutions
14 AOPA | National Congress, 14-15th October, 2021Learning through shared Reflections &Projections
experience – proposal of
group mentoring in O&P FREE PAPER SESSION: THURSDAY
14TH OCTOBER
Developing our
Practitioners and our Practice
Andrea de Rauch1 #AOPA21
1
St Vincent’s Hospital
Introduction making this transition potentially more difficult than
Clinical supervision promotes professional learning and that of other larger allied health professionals, thereby
support, being vital for clinical development (Saxby et increasing the need for external mentoring to achieve
al., 2014). Group supervision occurs in some allied and developmental goals.
mental health professions with individuals of a similar Online group mentoring has the potential to offer new
grade and is led by senior staff who are not the direct graduates support as they develop within the profession,
report, providing supervisees with a relaxed space to regardless of the size or geographical location of their
problem-solve and raise concerns for the purpose of employing facility. This addresses the uneven geographic
the group learning from shared experience (White & dispersion of the O&P profession across Australia, as well
Winstanley, 2010). Group supervision participants report as the potential ratio of mentor to mentee (approx. 1:5),
higher levels of satisfaction and effectiveness than those ensuring the sustainability of the initiative within the O&P
experiencing one-to-one supervision (Martin et al., 2014). profession (Ridgewell et al., 2021).
Mentoring is a process where an experienced individual The purpose of this paper is to propose a new way
offers their knowledge and life experience to a mentee for knowledge-sharing and mentoring within the O&P
(Wilding et al., 2003). Mentorship programs are offered profession, initially focusing on new graduates with the
by some allied health associations as part of their potential to be advanced to the wider O&P community.
continued professional development program (Coppin &
Fisher, 2016).
Building on these foundations, group mentoring
combines these two concepts by supporting a mentee
to connect to a mentor (external to their workplace) and
References
their peers (Emelo, 2011). This creates a rich learning Carvin, B. (2011). The hows and whys of group mentoring. Industrial and Commercial
environment to address topics of clinical, educational Training, 43(1), 49-52.
and professional resilience (Coppin & Fisher, 2016). Peers Coppin, R. & Fisher, G. (2016) Professional association group mentoring for allied health
report significant learning through shared experiences, professionals. Qualitative Research in Organizations and Management: An International
Journal, 11(1), 2-21.
where they are provided multiple viewpoints facilitating
Emelo, R. (2011). Group mentoring: rapid multiplication of learning. Industrial And
problem-solving through a collaborative approach Commercial Training, 43(3), 136-145.
(Carvin, 2011). Martin, P., Copley, J. & Tyack, Z. (2014). Twelve tips for effective clinical supervision based
on a narrative literature review and expert opinion. Medical Teacher, 36, 201-207.
New orthotic and prosthetic (O&P) graduates are faced
Moran, A. et al., (2014). Supervision, support and mentoring interventions for health
with several challenges in their first year: initiated by practitioners in rural and remote contexts: an integrative review and thematic synthesis
high competition for employment, possible interstate of the literature to identify mechanisms for successful outcomes. Human Resources for
relocation, transitioning from academic to clinician and Health, 12(10).
the natural expectations of starting a new career, all of Ridgewell, E., Clarke, L., Anderson, S. & Dillon, M., 2021. The changing demographics of
the orthotist/prosthetist workforce in Australia: 2007, 2012 and 2019. Human Resource for
which can impact on job satisfaction and retention in the Health, 19(34).
industry (Solowiej et al., 2010). The size of O&P facilities Saxby, C., Wilson, J. & Newcombe, P. (2014). Can clinical supervision sustain our
means that group supervision with peers of similar level workforce in the current healthcare landscape? Findings from a Queensland study of
and/or supervision by a non-direct superior is unlikely, allied health professionals. Australian Health Review, 39(4), 476-482.
Solowiej, k., Upton, P. & Upton, D. (2010). ‘Supporting the transition from student to
practitioner: a scheme to support the development of newly qualified practitioners...
including commentary by Stagnitti K’. International Journal of Therapy & Rehabilitation,
17(9), 494-504.
White, E. & Winstanley, J. (2010). A RCT of clinical supervision: selected findings from
a novel Australian attempt to establish the evidence base for causal relationships with
quality of care and patient outcomes, as an informed contribution to mental health
nursing practive development. Journal of Research in Nursing, 15(2), 151-167.
Wilding, C., Marais-Strydom, E. & Teo, N. (2003). MentorLink: Empowering occupational
Proudly brought to you by Orthotic Prosthetic Solutions therapists through mentoring. Australian Occupational Therapy Journal, 259-261.
National Congress, 14-15th October, 2021 | AOPA 15Have you assessed your Reflections &Projections
digital health readiness?
FREE PAPER SESSION: THURSDAY
14TH OCTOBER
Developing our
Practitioners and our Practice
Jackie O’Connor1 #AOPA21
1
Allied Health Specialist Consultants
Introduction Further administrative efficiencies are being sought by
Digital innovation is driving the opportunity to change the development of the Service Registration Assistant
many aspects of the way orthotists/prosthetists (O&P) and improvements within clinical information systems.
work and subsequently the options, timeliness and It is predicted 35-40% of Australian clinical services
quality of outcomes that can be delivered to clients. are using digital technology within their workflow to
Research commissioned by Allied Health Professions produce O&P devices. Possible benefits are related to
Australia (AHPA) (Survey matters, 2021) indicates that occupational health and safety, repeatability, decreased
generally allied health practices have infrastructure space requirements, time efficiencies, improved design
in place to support digital health adoption but that and manufacturing options, accuracy and collaboration.
awareness of options and actual adoption are low due
to a variety of barriers. The readiness of O&P practices Discussion
specifically is difficult to understand as the profession is A significant challenge for clinics appears to be how to
not represented within the survey. This presentation aims determine which technology option/s to implement,
to increase awareness of O&P relevant digital innovation when, and for which clients. The answer likely differs for
and provide options for improving your ability to use each clinic and the process of consideration needs to
them when the time is right. be continuous. Utilising key resources such as the AHPA
Method digital health collation, measuring & evaluating your
work and a growth mind-set may improve your digital
A variety of work which includes digital aspects that can readiness.
influence O&P practice was considered. The solutions
becoming available were grouped into practice Conclusion
areas and the amount of use and possible benefits to
A large and varied amount of digital innovation relevant
practitioners, clinics and clients were considered.
to O&P practice is currently occurring. To be ready to
Results implement and able to benefit from digital innovations,
O&P clinics will need to remain informed and open to
Improved communication, both of health information change.
and direct with clients is a focus area for both
government and the private sector. Specific topics
include secure messaging, My Health Record and
Telehealth. Solutions aim to provide benefits such as
improved:
• privacy and security of information
• access to health professionals
• information accuracy
• ability for clients and families to communicate
information between professionals.
References
Survey matters. (May, 2021). Digital health Adoption and Readiness in the Allied Health
Proudly brought to you by Orthotic Prosthetic Solutions Sector: Final Research Report. Allied Health Professions Australia.
16 AOPA | National Congress, 14-15th October, 2021COVID 19 risk mitigation Reflections &Projections
strategy – impact on orthotic
and prosthetic staff FREE PAPER SESSION: THURSDAY
14TH OCTOBER
Developing our
Practitioners and our Practice
Michelle Oliver1
1
Ballarat Health Services, Credit to Emily McNamara #AOPA21
(formerly of Ballarat Health Services)
Introduction Scheduling split shifts enabled staff to see clients,
The year 2020 saw Victoria go into lockdown during an access equipment, machinery, materials, and stock of
outbreak of the COVID-19 virus. The O&P department of componentry and orthoses. The satellite workshop
Ballarat Health Services (BHS) used strategies to reduce enabled the completion of some technical tasks. Its
staff exposure to the virus, and introduced novel work success was limited due to unexpected sick leave. Safety
structures to ensure ongoing provision of O&P services. concerns also limited tasks allowable when only one staff
member was present.
Method
Discussion
Subjects: 11 O&P staff were involved in the workforce
changes. Physiotherapy, Podiatry and Nursing staff were It was important that staff were able to feel safe at work,
invited to provide feedback on the adapted O&P service as they were under unprecedented pressure, both at
structure. work, and in dealing with COVID-19 in their personal
lives.
Intervention: Staff were consulted during the decision-
making regarding workforce strategies, and provided The introduced workforce structure changes were
feedback at conclusion. effective, and our team feels confident they could
implement similar strategies in the future. These findings
Three strategies were implemented: may be useful to other O&P facilities.
1. Splitting the team: 2 groups contained clinicians and
This exercise helped create good cleaning habits, and
technicians. A solo clinician serviced the acute wards.
staff learnt the benefits of having dedicated blocks of
2. Scheduling split shifts: Two 5-hour shifts on site (0730- administration time.
1230 or 1300-1800). Remainder of shift was completed
at home/satellite workshop. The solo clinician worked The use of telehealth is an assessment option which
normal shifts. could be explored in more depth for our service.
3. Make-shift satellite workshop: Installed a router, dust Methods, and frequency of communication, and the
extractor, chemical storage, vacuum table, lamination induction of new staff, could have been improved.
equipment, and hand tools.
Conclusion
Results
This strategy had an impact on O&P staff and our
Staff felt safe to attend work. internal allied health stakeholders. While face-to-
Splitting the team enabled risk mitigation in the event face communication is preferred, we were able to
of a team member becoming exposed to COVID-19, the demonstrate alternative communication strategies that
remaining team was still able to provide the O&P service, were effective. It was a great demonstration of teamwork,
while the other team was isolating. and highlighted the adaptability and resilience of our
team.
Proudly brought to you by Orthotic Prosthetic Solutions
National Congress, 14-15th October, 2021 | AOPA 17Exploring perceptions of and Reflections &Projections
barriers to utilising outcome
measures in orthotics and FREE PAPER SESSION: THURSDAY
14TH OCTOBER
prosthetics related care: a Developing our
preliminary report Practitioners and our Practice
Eloise James1
1
Queensland Health Orthotics and Prosthetics
Cadetship; Princess Alexandra Hospital; University #AOPA21
of the Sunshine Coast
Introduction Results
Outcome measures (OMs) are used to assist healthcare Thirteen staff completed the first survey. Over half
providers in assessing and measuring changes (56.8%) of the responses regarding frequency of O&P
in a patient following treatment or intervention, specific OMs were “never”. Most frequently used OMs
providing justification to funding bodies, and aiding were manual muscle testing, range of motion testing,
communication between healthcare providers (Gaunaurd and numeric pain scales.
et al., 2015; Robinson & Fatone, 2013). Despite orthotic
and prosthetic (O&P) guidelines advocating for the use Eleven staff responded to the second survey. Forty-
of OMs (Hall et al., 2020; Gaunaurd et al., 2015), much of five percent of participants indicated that measuring
the literature report barriers to using OMs among O&P a patient’s progress is the main reason for using OMs,
clinicians. and time constraints as the main reason for disuse. An
open-ended question identified greater training, and
The purpose of this report is to investigate the Princess availability of resources and protocols to be the most
Alexandra (PA) Hospital clinician’s use of, confidence in, requested methods for overcoming barriers of OM
and barriers to administering OMs in O&P and related disuse.
disciplines. The report investigates the frequency of O&P
specific OM use, perceived benefits and barriers to use Discussion
of OMs, and recommendations to improve their use. This report indicates low use of O&P specific OMs within
Method the PA hospital. Those performed are often by other
areas of allied health (i.e. physiotherapists). The barriers
Subjects: O&P, podiatry and physiotherapy Queensland recorded in this report align with the literature (Hall et al.,
Health staff employed at the PA hospital. 2020; Gaunaurd et al., 2015).
Apparatus: Two surveys distributed via email or
hardcopy. Conclusion
Despite PA hospital clinicians advocating for their
Procedure: A literature review was conducted regarding
importance, this report recorded low use of O&P specific
health clinician’s use of, confidence in, and barriers to
OMs. A recommendation for greater access to staff
administering outcome measures in O&P or related
training and protocols may improve frequency of OM
disciplines. Two brief surveys were constructed based on
use.
the findings.
The first survey identified specific OMs relating to O&P
intervention and examined frequency of their use. The
second survey investigated the clinician’s perspective
of, confidence in, and perceived barriers to performing
outcome measures.
Data Analysis: Results were tabulated and trends
identified by the researcher.
References
Gaunaurd, I., Spaulding, S.E., Amtmann, D., Salem, R., Gailey, R., Morgan, S.J. and
Hafner, B.J. (2015). Use of and confidence in administering outcome measures among
clinical prosthetists: Results from a national survey and mixed-methods training program.
Prosthetics and Orthotics International, 39(4), 314-321.
Hall, N., Parker, D. & Williams, A. (2020). An exploratory qualitative study of health
professional perspectives on clinical outcomes in UK orthotic practice. Journal of Foot
and Ankle Research, 13(1), 1-11.
Robinson, C. & Fatone, S. (2013). You’ve heard about outcome measures, so how do you
use them? Integrating clinically relevant outcome measures in orthotic management of
Proudly brought to you by Orthotic Prosthetic Solutions stroke. Prosthetics and Orthotics International, 37(1), 30-42.
18 AOPA | National Congress, 14-15th October, 2021Exploring the use of clinical Reflections &Projections
simulations and OSCEs in
the development of higher FREE PAPER SESSION: THURSDAY
14TH OCTOBER
order learning skills Innovation in O&P
Education
Brian Delaney1 #AOPA21
1
University of the Sunshine Coast
Introduction During simulation-based training at USC, the feedback
Assessment has been described as “the engine that is provided in various forms to ensure the learning
drives student learning” and is more than simply a outcomes are met and the learning cycle is closed with
measurement of achieving learning outcomes (Brown & students reflecting on their performance and learning
Race, 2012). As orthotic and prosthetic (O&P) education objectives.
evolves, and the focus on accreditation standards While OSCEs are time consuming and resource
moves with more emphasis on the client-centered skills demanding, the evidence highlights enhancement of
required to assess, prescribe, design, fit and maintain quality education and better prepared students for
the O&P intervention, students are increasingly required clinical placements (Fidment, 2012; Hagemann et al.,
to demonstrate ongoing competence in these areas 2014; Mitchell et al., 2009).
(Spaulding et al., 2020). For students to demonstrate
competence in clinical skills, the assessment design The aim of this presentation will be to explore the role
needs to resemble real life clinical practices. Assessment clinical simulations and OSCEs play in the development
designs such as clinical simulations and Objective of higher order learning skills of students at USC.
Structured Clinical Exams (OSCEs) have demonstrated
capacity to improve learning outcomes within other
healthcare education institutions (Motola et al., 2013).
They continue to play an increasing role in curriculum
design at University of the Sunshine Coast (USC)
to promote assessment as not only a measure of
competence, but an avenue for active learning. References
Barry Issenberg, S., Mcgaghie, WC., Petrusa, ER., Lee Gordon, D., & Scalese, RJ. (2005).
The success of O&P prescription has been linked to Features and uses of high-fidelity medical simulations that lead to effective learning: A
the clinical reasoning of a clinician, and their ability to BEME systematic review. Medical Teacher, 27(1), 10–28.
understand a client’s problems and goals and develop Brown, S., & Race, P. (2012). Using effective assessment to promote learning, in Hunt, L.
and Chalmers, D. (eds.). Acer Press, pp. 74–91.
an appropriate treatment plan (Modi et al., 2015). These
Byrne, E., & Smyth, S. (2008). Lecturers’ experiences and perspectives of using an
complex interactions that occur between the clinician objective structured clinical examination. Nurse Education in Practice, 8(4), 283–289.
and the client require multifaceted critical reasoning Durning, SJ., Artino, AR., Schuwirth, L., & Van der Vleuten, C. (2013). Clarifying
skills and personal reflection on the outcomes (Durning assumptions to enhance our understanding and assessment of clinical reasoning.
et al., 2013). In order for students to build these complex Academic medicine: journal of the Association of American Medical Colleges, 88(4),
442–448.
skills, the application of clinical simulations and OSCEs
Fidment, S. (2012). The objective structured clinical exam (OSCE): A qualitative study
are regarded as useful methods for assessing high-level exploring the healthcare student’s experience. Student Engagement and Experience
relevant skills within authentic contexts, and for allowing Journal 1(1).
students an opportunity to demonstrate ongoing Hagemann, E., Williams, CK., McKee, P., Stefanovich, A., & Carnahan, H. (2014). Using
competence of these skills (Fidment, 2012; Nulty et al., model hands for learning orthotic fabrication. The American Journal of Occupational
Therapy, 68(1), 86–94.
2011).
Mitchell, ML., Henderson, A., Groves, M., Dalton, M., & Nulty, D. (2009). The objective
structured clinical examination (OSCE): optimising its value in the undergraduate nursing
Although OSCEs have the potential to increase feelings curriculum. Nurse Education Today, 29(4), 398–404.
of anxiety, students have reported the assessment Modi, JN., Anshu Gupta, P., & Singh, T. (2015). Teaching and assessing clinical reasoning
to be beneficial and feeling better prepared for the skills. Indian Pediatrics, 52(9), 787–794.
subsequent clinical placements (Byrne & Smyth, 2007; Motola, I., Devine, LA., Chung, HS., Sullivan, JE., & Issenberg, SB. (2013), Simulation in
Fidment, 2012). Feedback is integral to this process healthcare education: a best evidence practical guide. AMEE Guide No. 82. Medical
Teacher 35(10) pp. 1511-1530.
and has been found to be the most important part of
Nulty, D., Mitchell, M., Jeffrey, C., Henderson, A., & Groves, M. (2011). Best Practice
simulation-based training in healthcare education (Barry Guidelines for use of OSCEs: Maximising value for student learning. Nurse Education
Issenberg et al., 2005). Today, 31(2), 145–151.
Spaulding, SE., Kheng, S., Kapp, S., & Harte, C. (2020). Education in prosthetic and
orthotic training: Looking back 50 years and moving forward. Prosthetics and Orthotics
International, 44(6), 416–426.
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