Developing the Science of Prosthetic and Orthotic Practice
Dudley Childress, PhD recently revised an editorial that he first presented 10 years ago at the Federally-sponsored Conference on Prosthetic Orthotic Research for the 21st Century. The updated commentary was republished in the most recent issue of the Journal of Prosthetics and Orthotics and can be found online at http://members.oandp.org. This is an excellent summary of the historical development of the field of P&O.
I believe Dr. Childress is an astute observer of our profession, and find his comments very insightful. In brief summary, he notes that P&O practice is currently almost exclusively based on knowledge that has been derived empirically from practical experience and experiment. This is reflected in our respect for the opinions of the senior practitioner and in our skepticism toward academic theories that are not grounded in clinical experience. Many rehabilitation fields are in a similar stage of development; most notably, surgery is an example of highly empirical field.
Dr. Childress postulates that we will gradually develop a scientific basis for many of our fundamental practices, as part of the normal development of our immature profession. Science will not replace clinical acumen or experience, but will help us make more objectively defensible decisions. It will also help us identify effective new concepts and components more quickly, and accelerate the acceptance of genuine advances into daily practice.
To use Dr. Childress' example, just as alchemy spawned the science of chemistry, today's clinical practices can evolve into tomorrow's scientific evidence-based patient care. That is the work for today's new practitioner, who I believe will gradually change the way we practice and inject a substantial scientific foundation that will provide a sturdy basis for the future of the profession.
