For the orthotics and prosthetics field, there is an issue that goes beyond processes and systems—and that's education. Related to fabrication, that means technician education, a subject Brad Mattear of O&P1 is passionate about. Mattear is on the Board of Directors for some of the National Commission on Orthotic and Prosthetic Education (NCOPE)-approved technician schools and has presented on the subject at meetings of the American Orthotic & Prosthetic Association (AOPA), the American Academy of Orthotists and Prosthetists (the Academy), and PrimeFare. "The education being taught to the technicians is still the education of 20-30 years ago," Mattear says. "We haven't kept up with the practitioners coming out of the schools now who know about all the latest and greatest technology-but how to fabricate these devices is not being taught to the technicians."
Mattear feels that practitioners graduating from the schools accredited by NCOPE in cooperation with the Commission on Accreditation of Allied Health Education Programs (CAAHEP) are lacking the hand skills taught in the past, thus further driving the need for technicians who are skilled in fabricating the latest technologies. "The new practitioners are now heavily educated didactically and are expected to learn hand skills in their residency," he points out. However, some residency sites may do 50/50 in-house/central fabrication, so residents are not getting well-rounded hand skills, Mattear notes. "And if the residency site specializes, for instance, in myoelectrics, you may have a practitioner coming out who knows practically everything about programming microprocessors but doesn't know how to make a socket."
Adding to the mix is that many manufacturers offer no technician training in fabricating their new products, Mattear says. "They are marketing to the practitioner, not the technician." Some of the online resources available to technicians are severely outdated-over 20 years old, he adds.
"In O&P we talk about licensure, the constant struggle for reimbursement, patient care issues, and the latest technology, and these are all very important, but we can't forget that somebody has to make those devices," Mattear says. "If technician education hasn't kept up, we are still behind the eight-ball."
However, there are schools that are doing much better than in the past regarding training and education relevant to today's needs, he notes.
Mattear sees a brighter light in the recently completed Technician Practice Analysis Survey conducted by the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC), which can provide the data to help bring technician education and registration standards in line with today's—and tomorrow's—needs in O&P.
Miki Fairley is a contributing editor for The O&P EDGE and a freelance writer based in southwest Colorado. She can be contacted via e-mail at