This online course provides an introduction to health and medical conditions commonly encountered in O/P practice, including information about pathologies, impairments, medical and therapeutic interventions, diagnostics and collegial collaboration. It includes basic concepts in epidemiology, etiology, clinical pathology, neuropathology, pharmacology, diagnostic imaging and other technologies and interdisciplinary practice that support O/P practice. Learning activities assist students in integrating this knowledge to form the basis for clinical decision making, building interdisciplinary relationships, and O/P practice skills in various clinical settings.

This course provides an introduction to relevant chemical, physical and structural properties of materials used to design, engineer and apply O/P devices as interventions that facilitate human function. Materials covered include metal alloys, thermoplastics, thermosets, synthetic reinforcement materials, fabrics and soft foam materials. Manufacturing methods and guidelines are discussed from the perspectives of clinical practice, research and development. Occupational safety and human tissue interface concepts are introduced and later integrated into the onsite practicum and laboratory experiences.

This course integrates clinically relevant aspects of human anatomy, physiology, neuroanatomy, neurophysiology, kinesiology and biomechanics. Included are an introduction to motor learning and control principles that support human functioning; and clinical concepts in bioengineering and electrophysiology. Onsite coursework will include cadaver prosection, surface anatomy palpation, and task analysis to support assessment skills. Each section of this course will relate the didactic concepts to clinical O/P practice.

This course highlights the fundamental principles of O/P practice and the relationship of the foundational sciences to the theoretical constructs that guide O/P practice, including human function and impairment, interface mechanics, shape acquisition, suspension, modification and rectification principles, alignment guidelines, component selection, force & power analysis, device creation and functional integration. The profession's Practice Analysis is used as a framework for clinical analysis that includes evidenced based practice, problem-solving, inter-professional collaboration, and research investigations. These fundamental concepts will be integrated with synchronous, online activities to promote mastery of the practical application of this knowledge during onsite clinical practicum coursework and laboratory experiences.

This course has online and onsite segments covering:

• Exploration and evaluation of sociocultural perspectives of health and disability
• Rehabilitation science and O/P practice perspectives
• Defining professional behavior
• Relationships with other healthcare professionals, peers, industry and government entities
• Legal, healthcare and payment systems
• Implications of professional issues on O/P practice and clinical decision making, both locally and globally

This course is designed to assist the student in defining his/her roles and responsibilities, professionally and personally, by exploration of ethics and values. By the conclusion of this course, the student will demonstrate professional conduct and develop a plan for lifelong professional development.

The online and onsite segments of this course include:

• Fundamentals of personality development 
• Self-awareness as a clinical caregiver
• Personal values and ethics
• Concepts of self-care and self-health
• Psychosocial aspects of health and disability and its meaning in the lives of people with disability
• The impact of rehabilitation and O/P care on quality of life
• Principles of effective interpersonal communication

Related activities will be integrated throughout the onsite clinical practicum coursework and laboratory experiences.

This course focuses on the theories and hypotheses of contemporary and emerging technologies used in O/P practice including:

• Technologies employed in assessment / measurement & shape acquisition
• Structural assessment of materials and components
• Fabrication machinery and related safety

Discussion will explore psychosocial issues surrounding human/technology integration, the role of O/P professionals and student perspectives. The clinical application of concepts presented didactically online will be integrated into the onsite practicum coursework and laboratory experiences.

Guided and reflective professional clinical experiences illustrate the relevance of foundational educational concepts and demonstrate how they are integrated and applied in actual practice. Observations will be offered in multiple settings including:

• O/P clinical sites
• Interdisciplinary clinics
• Acute care hospitals
• Rehabilitation facilities
• Manufacturing and central fabrication settings
• Governmental entities

Structured objectives are established for each placement; review and reflection will be conducted with faculty, clinical supervisors and classmates.

The online and onsite segments of this course provide the entry-level clinician with the knowledge and skills necessary to conduct critical evaluation of published research and to identify the clinical implications for patient care. Topics covered include:

• Principles of structured literature reviews
• Research methodology
• Ethical considerations in research and human subject trials
• Clinical impact of research results
• Evidence-based clinical decision making
• Utilization of research to expand professional competencies

Students will complete a Capstone Project that may be suitable for the Directed Study project required during their Residency.

Integrating P&O Knowledge: The Capstone Project*

An integral part of the NUPOC MPO student experience is developing an understanding of clinically relevant research through the Capstone Project. The Capstone is a required, multi-faceted process that matches faculty mentors with students who work autonomously to develop a clinically relevant investigation. Through mentored interactions, students develop research skills that integrate literature review, critical analysis, and writing. The Capstone process enables students to become good consumers of research that will impact their evidence-based clinical practice of P&O.

Throughout the MPO, students take a progression of courses that teach methods of inquiry, synthesis of ideas, use of evidence, support of conclusions, and critical analysis. Guided by the MPO Capstone Project Manual (SFatone, 2014) students define a research question, write a project proposal, execute their project, and submit a final project report. Periodically students give multiple presentations on development of their project to faculty and fellow students.

Students use individualized feedback from faculty mentors to refine and improve their projects. The Capstone process helps students develop intellectual rigor, critical thinking, problem-solving, goal-setting, and timeliness. More than a graded assignment, full engagement with the Capstone process throughout the MPO program can cultivate students’ research skills, evidence-based reasoning and critical thinking that will augment their professional clinical careers in P&O.

MPO 2015 Capstone Projects included mechanical testing of devices, device design, business plans and literature reviews. Approximately 38% of MPO 2015 Capstone Projects involved some form of research with human subjects in the form of experimental case studies/series, survey based research, education research with students, and retrospective data analysis.

Examples of mentored Capstone Projects during MPO 2015 include:

• “Knowledge Translation and Technology Transfer of Dilatancy-Based Orthosis Impression and Fabrication System”
•  ”Quantification of Stiffness in Corrugated Thermoplastic Ankle-Foot Orthoses”
• “Relationship between Preoperative Expectations and Long-Term Postoperative Outcomes in Persons with Planned Lower Limb Amputation”
•  ”Low-Cost Solution to Make Pediatric Transtibial Prostheses Water Resistant”
• “Comparison of Gait Characteristics of Unilateral Transfemoral Amputees during Early Stages of Rehabilitation using Mauch SNS, C-Leg, or Power Knee”
• “Development of a Statistical Model to Predict Retrospective Lower Limb Amputee Fallers and Non-Fallers Based on Information from Clinically-Relevant Outcome Measures”
•  “Review and Evaluation of Prosthetic Sock Management Educational Materials for Persons with Transtibial Amputation”
• “Accuracy and Reliability of Conventional Measurement Tools for Performing Length, Medial-Lateral, and Circumferential Measurements for Spinal Orthoses”
• “Development of a Low Cost Transtibial Task Trainer”
• “The Benefits to Orthotic & Prosthetic Practitioners of Using Good Patient-Practitioner Communication”
• “The Potential Application of Targeted Muscle Reinnervation to Cerebral Palsy”

This onsite laboratory course integrates concepts of human movement, physiology, pathology and function with principles of measurement to begin identification of abnormal findings and formulation of potential O/P solutions for a wide range of biomechanical deficits. Content includes:

• Provider/client engagement
• Evidence driven assessment, tests and measures
• Assessment techniques
• Communication skills
• Impact of assessment on prescription formulation, resource utilization, and clinical documentation

These hands-on, core courses provide a series of supervised clinical experiences and learning exercises that integrate concepts from earlier coursework into clinical practice.  Students apply this knowledge by creating and fitting trial prostheses and orthoses for educational models who have neuromuscular impairments including limb deficiencies.  Each module focuses on one specific body segment: head & trunk, upper limb and lower limb. Initial projects introduce basic skills; subsequent experiences involve progressive more complex challenges and technologies.

Students will demonstrate mastery by discussing and applying relevant foundational knowledge to formulate and implement an intervention to enhance an individual’s independence and quality of life.  Essential skills include:

• Clinical reasoning & judgment
• Assessment techniques
• Shape acquisition
• Basic fabrication skills
• Patient/client education
• Follow up assessment
• Practice management skills

Affective and psychomotor skills will be rigorously assessed during these onsite laboratory courses to confirm that the graduate will be ready to begin the mandatory structured Residency prior to national Board examinations.

The Special Topics course provides an opportunity for concentrated learning about an area of special interest within the practice domain of prosthetics & orthotics. Structured didactic and interactive sessions empower students to investigate areas of personal interest and to collaborate with other students interested in the chosen area of focus. Mentors will be identified to facilitate understanding of more advanced concepts. Potential topics include all domains of the profession’s Practice Analysis such as emerging knowledge or technologies, specialty areas (i.e. pediatrics) or business/public policy issues.

Special Topics and the NUPOC Legacy Project

The Special Topics section is a professional development opportunity for students to apply the research process covered in the MPO courses that support the Capstone Project and Special Topics. Students work with a faculty mentor to define, investigate and synthesize information about an area of special interest in P&O.

Students integrate research methodology with competencies such as critical reasoning, oral communication and technical skills. Students learn and then teach an expertise that is related to anatomy, assessment, biomechanical concepts, technical or clinical skills, materials science or another area within P&O-related knowledge. They work individually or in groups to produce an 8 to15-minutes long tutorial presentation using a template and citations in the APA style format. The final Special Topics presentations are concentrated tutorials that demonstrate embedded graphics and video using Camtasia®, Microsoft PowerPoint, EndNote, TracerCAD and other software.

Students present their final tutorial to their faculty preceptor and classmates through MediaSite. Some tutorials are disseminated publicly as the “NUPOC Legacy Project” on the NUPOC website and YouTube. The NUPOC Legacy Project delivers a reservoir of tutorials that are freely accessible by NUPOC alumni, P&O practitioners and others who are interested in P&O.

Examples of faculty mentored Special Topics during NUPOC MPO 2015 include:

• Assessment Concepts:  Cranial Nerve; Foot/Ankle; Knee; Hip; Spine
• Technical Skills:  Fundamentals of Plaster Work; Impression Correction for Ankle Alignment; Installation of Tamarack Joints; Fabrication of a Bent Knee Prosthesis
• Clinical Skills:  Harnessing the Transradial Patient; Assessing Efficiency in a Body-Powered Upper Limb Prosthesis; Cobb Angle Measurement for Patients with Adolescent Idiopathic Scoliosis (AIS)
• Other Topics:  Adaptive Sports; ISPO Program Accreditation

This course provides the second-year master’s student with an overview of business issues such as reimbursement and financial/legal documentation, cost accounting, personnel, management, quality assurance, and facility accreditation. Concepts of professional practice within the context of multiple stakeholders are explored.  Participants will develop a basic understanding of the contemporary government/legal, industry and business environment and best practices that support the effective application of clinical skills in different O/P settings.