Residency in O&P has garnered much discussion since its inception in 1993. Topics ranging from resident selection to the ideal learning environment serve as the backdrop for this educational paradigm that is now mandatory in our profession. Residency is the next logical step in the progression of O&P educational training. Where classroom training ends, residency picks up and training continues in the clinic arena. While much discussion lies in how residents are shaped, little discussion has taken place about how residency has shaped practices—in this case, how residency has shaped our orthotic/prosthetic practice at Children's Memorial Hospital, Chicago, Illinois.
Practices that have a residency program know that such an endeavor takes effort, and yet many would agree that residency has proven to be fruitful and has in fact shaped our practices in a positive way.
While the resident benefits from learning in a clinical environment, the consensus in our department is that residency makes us better practitioners as well. The resident will ask a question and we, as practitioners, must be able to answer. The questions posed by the resident force the practitioner to really think about and be able to articulate the task at hand. Whether billing questions or clinical questions, we find that each year we are fielding higher-level questions. Responding to these questions seems to provoke one of two things to happen. Either our response reinforces our current line of thinking, or it causes us to stop, think, and perhaps re-investigate our current practice.
While we see the results of resident questions, we also see that residency has improved our practitioners' ability to mentor and to mentor effectively. Practitioners tend to provide more timely and appropriate feedback with new hires as well. We have also seen an improvement when communicating with families, patients, and the healthcare team in general.
Another example of how residency has shaped our practice has to do with the fresh ideas that residents bring to the table regarding evidence-based practice and research. With residency and the required directed study, we have begun to see a steady stream of research being conducted in and through our department. The required directed study has allowed our practice an avenue to pursue research while being fiscally responsible to our department budget. With the resident taking the lead on the research and the practitioner facilitating and providing direction, the practitioner is able to maintain a nice balance between patient volume and the ability to pursue research. This is beneficial to the resident and practitioner alike.
Overall, we find that residency has shaped our department for the better. We have seen more thoughtful approaches to clinical care, improved communication, and an avenue to pursue research. Mentoring a resident prevents us from becoming stagnant and presses us into a continuous re-evaluation of our practice and clinical outcomes. We know that whenever we are doing something, there is always someone over our shoulder asking the important question, "Why?"
Bryan Malas, MHPE, CO, is the director of the Orthotics/Prosthetics Department and the Moira Tobin Wickes Orthotics Program at Children's Memorial Hospital, Chicago, Illinois. He is an adjunct faculty member in the Department of Physical Medicine and Rehabilitation at Northwestern University Feinberg School of Medicine, Chicago, Illinois, and is the current education committee chair for the International Society for Prosthetics and Orthotics (ISPO).
