Entrustment trends in orthotic and prosthetic residencies

Prosthet Orthot Int. 2020 Apr;44(2):73-80. doi: 10.1177/0309364620909236. Epub 2020 Mar 5.


Background: Orthotic and prosthetic residency preceptors have little guidance transitioning residents between observing and performing patient care. Understanding current entrustment trends and factors can help guide resident progression during residency.

Objectives: To identify entrustment trends and factors within an orthotics and prosthetics residency affecting a supervisor's decision to entrust residents with independent patient care.

Study design: Cross-sectional study.

Methods: In this cross-sectional study, 831 National Commission of Orthotic and Prosthetic Education preceptors were invited to complete a 26-question, online questionnaire that examined possible entrustment factors.

Results: A total of 77 preceptors completed the questionnaire. The top-reported behavioral qualities impacting entrustment were recognition of limitations and willingness to ask for help (n = 45) and competence (n = 37). Preceptors ranked evaluation (n = 27) as the professional skill which most affected entrustability; technical skill least affected entrustability (n = 4). Preceptors of 12-month residencies entrust residents to indirect supervision when they have completed approximately 75% (i.e. 9 months) of the program. Preceptors of 18-month residencies reported that they entrust their residents by the time they reach 50% (i.e. 9 months) of their training. A small number of preceptors (n = 19) never allow a resident to independently perform practice management.

Conclusion: Residency supervisors value interpersonal and evaluation skills when making entrustment decisions. Residency mentors can use these findings to inform their entrustment decisions and support a resident's progression toward independent practice.

Clinical relevance: This study presents information which can inform clinical preceptors and residents on what factors contribute to the decision to progress a resident from observation to independent patient care. These findings may influence clinical education standards which aim to promote both resident training and patient access to quality care.

Keywords: Education; orthotics; prosthetics; teaching.

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Clinical Competence*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Internship and Residency*
  • Male
  • Middle Aged
  • Orthotic Devices*
  • Prostheses and Implants*
  • Surveys and Questionnaires
  • Trust