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The Move Toward Entry-Level Masters
By Bryan Malas, MHPE, CO "The debate over the entry-level educational
requirement is part of every profession's natural evolution and
represents a progression in the maturation of that
profession." --O&P Education Summit: Forecasting the
Future--Findings and Recommendations
 As we contemplate the future of O&P education
and a move toward an entry-level masters degree, we are reminded
that our profession is not alone in this endeavor and that other
professions have gone through this same process of maturation. The
need to move O&P education from entry-level baccalaureate to
entry-level masters can be attributed to a succession of meetings
or key inflection points that have influenced the evolution of
O&P education. From Ponte Vedra I in 1970 to the Phoenix
Conference in 1990, the profession has witnessed a dramatic change
in the education landscape that can be attributed largely to the
findings and recommendations of these historic conferences as
listed below:
- Recognition of standardized essentials for O&P
programs
- Four-year degree (combined O&P) as the gold standard
- ABC requirement for entry-level bachelors (1980)
- Creation of NCOPE
- Recognition by external accreditation body (Commission on
Accreditation of Allied Health Education Programs [CAAHEP])
- Establishment of O&P Residency Program
- Recognition by the American Medical Association (1992)
Benefits of Entry-Level Masters
With the Phoenix Conference findings and recommendations having
occurred more than 14 years ago, it became necessary to evaluate
the current and future direction of O&P education. In April of
2005, more than 30 content experts convened for an Education Summit
and concluded the meeting with eight specific recommendations--the
most salient being the recommendation to move towards entry-level
masters for all practitioner level programs in the US. This
particular recommendation underscored a specific need in the
following areas and included: (1) a body of knowledge that has
increased; (2) need for evidence-based practice; (3) need to
address marketplace forces; (4) meet consumer expectations; (5)
greater demand for accountability; (6) to keep pace with other
allied health professionals. While all are important, the most
compelling evidence to move towards an entry-level masters is that
the body of knowledge has increased. This is largely due to the
evolution of the practitioner's scope of practice.
In 2000 the American Board for Certification in Orthotics and
Prosthetics (ABC) published its findings from a survey of the
profession which is documented in the Practice Analysis of the
Disciplines of Orthotics and Prosthetics. The document
confirmed that the role of the O&P practitioner had changed
over time with a greater emphasis on direct patient care and a
correlative decrease in direct fabrication. Clearly, greater
patient contact requires a greater knowledge base for the
practitioner to adequately meet the needs of the patient. This
clinical paradigm shift has had a profound effect on the
educational landscape as O&P educators have had to refocus and
expand coursework in an already impacted curriculum. While
short-term strategies can help, the long-term solution is to
elevate and expand the education model to the masters level. This
will allow educational programs to better incorporate this expanded
body of knowledge into the curriculum without compromising existing
elements of theoretical and technical training.
Growing Need for EBM, Research
In addition to an expanded body of knowledge, we also see a
growing need in our profession for evidence-based medicine,
research, and practitioners that are overall better consumers of
research. These needs initially must be addressed at the primary
education level where programs are given the latitude to
effectively expand the current curriculum even further by
incorporating evidence-based medicine and research into the
education scheme. Translated, this has the ability to optimize
clinical care, improve reimbursement, and increase government
recognition.
This shift towards masters-level training also is more in line
with the philosophical position of the US Department of Education,
Council for Higher Education Accreditation (CHEA), and Council of
Graduate Schools (CGS) as they would advocate that one set of
entry-level standards be identified with one degree level rather
then one set of standards for multiple degrees, such as our current
model (i.e. baccalaureate, post-baccalaureate, masters).
As NCOPE considers this paradigm shift and the future of
education, the profession should be reminded that a move towards
entry-level masters will help to expand the skills and knowledge
base of our practitioners and ultimately lead to a stronger O&P
profession and better patient care. Bryan Malas is Chair, National Commission on Orthotic and Prosthetic Education (NCOPE) 
Table Of Contents - March 2006
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