Entrustment trends in orthotic and prosthetic residencies.

Abstract

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