Analysis of Residency Experience in Transfemoral Prosthetics

Abstract

Abstract Introduction As part of the requirements for certification in orthotics and prosthetics, a clinical residency must be completed. Currently, there has been minimal analysis of residency data that could demonstrate a presence or lack of consistency between each resident’s experiences. Analysis of data and the standardization of the residency experience may offer a pathway toward consistency in entry-level practice. Transfemoral prosthetic competency is one of the most difficult to achieve. Objective The objective of this study was to quantify the experience of residents with respect to transfemoral patient care. Study Design This study is a retrospective data analysis. Methods Data were collected from National Commission on Orthotics and Prosthetics Education (NCOPE) Tracker for residents who completed an integrated residency from the years 2018–2021. Patient appointment date, appointment type, patient age (years), gender (male/female), diagnosis (ICD-10 code with descriptor), device type, and resident engagement level (observer, assistant, independent) were analyzed to determine trends and variation. Results Residents saw a median of 112 (interquartile range [IQR] = 61) transfemoral patient encounters with a median of 17.8% (IQR = 17.2) logged as independent encounters. Results were similar across three cohorts of residents. Conclusions This study provides a baseline for developing transfemoral prosthetic competency during an integrated, combined O&P residency. Just under one tenth of cases logged involved transfemoral care. The majority of those cases were logged at the level of assistance, and the timing of transfemoral competency attainment did not affect subsequent case volume or resident engagement level. Comparison with the ABC Practice Analysis indicated potential differences in appointment types experienced during residency as compared with clinical practice. Further analysis is required to evaluate other residency models and other factors, which affect the attainment of clinical competence and development of skill in transfemoral prosthetic care. Clinical Relevance Documentation and comparison of the residency experience may offer a pathway toward developing consistency in residency training and continuation into entry-level practice.