Education And More Education
A. Bennett Wilson, Jr.
In 1945 a research program in limb prosthetics was initiated by the National Research Council at the request of The Surgeon General of the Army. The NRC was not interested in simply filing reports on the results of research, but was concerned rather in seeing that positive research findings were used to benefit patients, and, therefore, experiments were undertaken to determine the most effective means for transferring information from the research laboratories to the clinicians who could apply it.
The positive results of the suction socket for above-knee amputees, an American invention originally conceived by Parmalee in 1863, but used by the Germans in the 1930s and refined by the Biomechanics Laboratory, University of California, Berkeley, in 1946-48, afforded the first opportunity for an experiment in transferring information to the field.
With the cooperation of the Orthopedic Appliance and Limb Manufacturers Association, the NRC and the Prosthetic and Sensory Aids Service of the Veterans Administration conducted approximately 40 "suction socket schools" in more than a dozen locations throughout the United States during the 1948-1951 period.
The success of these traveling instructional teams suggested a more permanent approach to the problem. Thus, in 1952 when a body of knowledge concerning the management of the upper-limb amputee had been accumulated, funds supplied by the Veterans Administration were used to set up an experimental education program at the University of California at Los Angeles, where a good deal of pioneering research had taken place.
Because prosthetists had to be taught the technique of plastic lamination, it was necessary for that group to spend six weeks at UCLA. Four weeks later therapists arrived for instruction and during the final week surgeons and physicians joined the group to complete the clinic management team. The success of this program during 1953-54 led to the introduction of material on above-knee prosthetics which had been developed by the University of California at Berkeley. Programs of prosthetics education were also initiated at New York University and Northwestern University. The Office of Vocational Rehabilitation, Department of Health, Education, and Welfare, assumed fiscal responsibility of the education program about 1958. These early programs consisted solely of courses to provide continuing education. More recently programs of basic education for prosthetists and orthotists have also been provided.
The American Orthotic and Prosthetic Association, the American Academy of Orthopaedic Surgeons, and others, have long recognized the need and have made use of these DHEW-sponsored programs. Despite the fact that it can be shown that the Prosthetics and Orthotics Education Program has paid off handsomely, DHEW in compliance with the directives of the U.S. Office of Management of the Budget has given notice that the support for education will be withdrawn completely after the current fiscal year. In fact the programs at UCLA, NYU, and NU have been kept alive during the past year and will be able to continue during the present one only because the Veterans Administration was able to supply the supplementary funds needed.
The future for federal support of education in the allied health field is thus quite uncertain. Without question, formal educational programs for future and practicing prosthetists and orthotists are needed, and some subsidization, like that required for most other undergraduate and graduate programs, will be required. If you agree, letters should be sent to your U.S. Congressman and Senators so that they will be aware of the need for and the usefulness of the federally sponsored programs.
As for continuing education, it is gratifying that the American Academy of Orthotists and Prosthetists is conducting short-term courses to keep practitioners up to date. In coordination with the formal education program, the American Academy of Orthopaedic Surgeons and others, the American Academy of Orthotists and Prosthetists has tremendous possibilities for becoming a very effective component in continuing education programs for orthopaedic clinic teams.
The Veterans Administration has asked the National Research Council to study the past and present education programs, especially with respect to the needs of VA, and to make recommendations for future programs. This of course will be done with respect to the entire country. Any comments and suggestions will be welcomed by the Task Force now being organized to carry out the study. They should be forwarded to: Executive Director, Committee on Prosthetics Research and Development, National Research Council, 2101 Constitution Ave., N.W., Washington, D.C. 20418.