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Tabula Rasa? Not Anymore!
By Kristin Carnahan If you have talked to anyone from the master of science
in prosthetics and orthotics program at the Georgia Institute of
Technology (Georgia Tech), you may have heard it mentioned
that one weakness in our training is in the area of technical
skills. I personally came into the program with zero, nada,
absolutely no technical fabrication experience whatsoever. Not only
had I not performed any work in an O&P lab, I also had not seen
much of it. Okay, so there, I admit it. This lack of experience
became glaringly obvious to me, and surely to my instructors, and
probably even to my patient models (who are so kind nonetheless)
last year during my first attempts at fabrication. In fact, my
first orthotic fabrication assignment, a custom-molded UCBL foot
orthotic, and my first prosthetics project, a transtibial patella
tendon-bearing (PTB) socket, were absolutely awful. They didn't fit
well and didn't even look pretty to make up for the poor fit. I
remember being discouraged with myself as I struggled to learn to
get along with plaster and to develop a comfortable confidence with
the grinding machines.
 It was not uncommon for me to stop, put down the
plaster spatula, and walk outside for a breath of fresh air and to
convince myself to go back and try again. My confidence had not
been shaken so much in quite a while, and though I never thought of
giving up, I had my doubts about how quickly I would be able to
learn and adapt.
Fast-forward to my third semester in the program, and I have
already seen improvements in my fabrication skills that I did not
think were possible. I couldn't believe that when I made my first
transfemoral socket just a few months ago, what I produced not only
looked like an appropriate socket, but it actually fit the patient
well! Okay, I thought, beginner's luck. But then I realized that
while the great fit may have been a stroke of luck, the evolution
of my fabrication outcomes were a result of the time and training
that has been invested in me over the last year. The amount of time
spent in fabrication at school could be considered lacking, but a
steep learning curve and excellent instruction have allowed for
great strides in improving my individual techniques and skills. Not
to mention, more than 400 hours so far spent in clinical rotations
at P&O clinics, which has been invaluable in providing hands-on
experience and the opportunity to watch and learn from technicians
and practitioners alike. I have lost count of the number of times
someone has taken a few minutes to show me a specific skill or
technique, and each time it has made a huge difference in the final
product. For those of you out there in practice who are tasked with
taking students under your wing for rotations or residencies, don't
underestimate the little things when you find yourself instructing
someone in the lab. Something that may seem obvious to you can be a
new and valuable tool for a student or resident who is just
learning the ropes in the fabrication lab.
The learning curve has not been all bad. The art of fabrication
has been an obstacle but also a source of excitement for me. I
don't always enjoy the feeling of tackling things that I don't know
how to do, but I love the feeling of finishing a product and
realizing that my blood, sweat, and sometimes tears literally went
into its fabrication. I am almost 30 years old, and I still have
the urge to call my parents and tell them what I did in school when
I finish a project. Maybe I shouldn't admit that, but I think it
says a lot about how great our profession is. What an exciting
career, that what we do and what we create on a daily basis can not
only bring us a sense of accomplishment, but it can also help
people to walk or function in some way better than they did
before.
Do I think I know everything now that I can make a respectable
looking socket or AFO? Absolutely not. I do, however, feel like I
will make it after all, that plaster is not my evil adversary, and
that I will be able to enter my residency with some level of
fabrication confidence. I have no doubt that in order to serve my
future patients well, I will have to keep learning continuously,
and I am looking forward to that challenge.
Kristin Carnahan is a graduate student in the MSPO Program
at the School of Applied Physiology at the Georgia Institute of
Technology in Atlanta, Georgia. She will be sharing her experiences
through articles in The O&P EDGE throughout her
two-year program. 
Table Of Contents - January 2008
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