Contents
- Acknowledgements
- Practice Analysis Task Force
- Introduction
- Task Force Selection
- Survey Return Rate
- Results Related to Professional Background, Work Setting and Demographic Information
- Results Related to Domains, Tasks and Knowledge and Skill Statements
- Domain Ratings
- Task Ratings
- Knowledge and Skills Statements
- Results Related to Practice Areas and Devices
- Highlights
©2024 by the American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc. All rights reserved.
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Practice Analysis of Certified Pedorthists
January 2017
Task Ratings
All survey respondents rated the tasks on two rating scales:
- Frequency: How frequently did you independently (without supervision) perform the task during the past year? 1=Never/rarely, 2=Occasionally, 3=Frequently, 4=Very frequently
- Criticality: How critical is the task to optimizing outcomes for patients, caregivers and healthcare providers? 1=Not, 2=Minimally, 3=Moderately, 4=Highly
Table 17 displays the mean of the Frequency and Criticality ratings for the task statements.
Thirty seven of the 59 tasks achieved mean frequency ratings of at least 3.0 on a 4-point scale, indicating they were performed frequently to very frequently. The two highest rated tasks both had mean frequency ratings of 3.7 and were:
- Select the appropriate footwear and/or pedorthic device(s) and materials consistent with the patient’s condition to maximize the effectiveness of pedorthic treatment
- Operate the pedorthic practice in accordance with sound business principles and governmental requirements
Thirteen tasks had mean frequency ratings of 2.5 to 2.9, indicating they were performed at least occasionally to frequently. Five tasks had mean frequency ratings of 2.0 to 2.5 and only four tasks had mean frequency ratings below 2.0, meaning they are performed on average never/rarely to occasionally. Three of these four lowest-rated tasks were in the Promotion of Competency and Enhancement of Professional Practice domain.
In general, tasks were rated quite highly on the criticality scale, with 56 of 59 tasks achieving a mean criticality rating of at least 3.0 on a 4-point scale, indicating they are at least moderately critical to optimizing outcomes. Of these, 43 achieved criticality ratings of 3.5 or higher, indicating they are moderately to highly critical. The four highest-rated tasks on the criticality scale all had mean ratings of 3.8 and included:
- Assess the patient’s feet for deformities and pedal disorders by performing a biomechanical evaluation; and assessing range of motion, alignment, muscle functioning/strength and gait to assist in the development of the pedorthic treatment plan
- Evaluate the assessment findings to formulate a pedorthic treatment plan
- Select the appropriate footwear and/or pedorthic device(s) and materials consistent with the patient’s condition to maximize the effectiveness of pedorthic treatment
- Operate the pedorthic practice in accordance with sound business principles governmental requirements
Only three tasks had mean criticality ratings below 3.0. All three of these had mean ratings of 2.8 and were in the Promotion of Competency and Enhancement of Professional Practice domain.
Table 17
| Mean Frequency | Mean Criticality | |
|---|---|---|
| Domain 1 – Patient Assessment | ||
| Evaluate the assessment findings to formulate a pedorthic treatment plan. | 3.6 | 3.8 |
| Formulate treatment goals and expected pedorthic outcomes to prevent injury, reduce pain, increase comfort, provide stability, reduce risk of deformity, prevent disability and promote healing to enhance function and independence. | 3.6 | 3.7 |
| Develop an appropriate pedorthic treatment plan using assessment data, including the prescription and reimbursement status, to provide optimal patient care, including education and follow-up. | 3.4 | 3.6 |
| Identify design, materials and components to support treatment plan. | 3.5 | 3.7 |
| Consult with physician/referral source/appropriately licensed healthcare provider to modify, if necessary, the original prescription and/or treatment plan. | 2.6 | 3.4 |
| Communicate to patient and/or caregiver about the recommended treatment plan and any optional plans, including disclosure of potential risks/benefits in pedorthic care. | 3.4 | 3.6 |
| Document treatment plan using established record-keeping techniques. | 3.4 | 3.6 |
| Confirm that patient or responsible parties are informed of their financial responsibilities pertaining to the proposed treatment plan (for example, insurance verification/authorization, deductibles, copays). | 3.2 | 3.5 |
| Domain 2 – Formulation of the Treatment Plan | ||
| Evaluate the assessment findings to formulate a pedorthic treatment plan. | 3.6 | 3.8 |
| Formulate treatment goals and expected pedorthic outcomes to prevent injury, reduce pain, increase comfort, provide stability, reduce risk of deformity, prevent disability and promote healing to enhance function and independence. | 3.6 | 3.7 |
| Develop an appropriate pedorthic treatment plan using assessment data, including the prescription and reimbursement status, to provide optimal patient care, including education and follow-up. | 3.4 | 3.6 |
| Consult with physician/referral source/appropriately licensed healthcare provider to modify, if necessary, the original prescription and/or treatment plan. | 2.6 | 3.4 |
| Communicate to patient and/or caregiver about the recommended treatment plan and any optional plans, including disclosure of potential risks/benefits in pedorthic care. | 3.4 | 3.6 |
| Document treatment plan using established record-keeping techniques. | 3.4 | 3.6 |
| Confirm that patient or responsible parties are informed of their financial responsibilities pertaining to the proposed treatment plan (for example, insurance verification/authorization, deductibles, copays). | 3.2 | 3.5 |
| Domain 3 – Implementation of the Treatment Plan | ||
| Inform patient and/or caregiver of the pedorthic treatment plan potential risks, goals and time involved in the procedure. | 3.5 | 3.6 |
| Select the appropriate footwear and/or pedorthic device(s) and materials consistent with the patient’s condition to maximize the effectiveness of pedorthic treatment. | 3.7 | 3.8 |
| Refer to manufacturer’s specifications and other technical resources regarding components/materials. | 2.7 | 3.1 |
| Measure/fit shoes using assessment data to maximize the effectiveness of pedorthic treatment. | 3.6 | 3.7 |
| Measure/fit prescription and non-prescription lower extremity compression garments and diabetic socks/hosiery using assessment data to maximize the effectiveness of pedorthic treatment. | 2.4 | 3.1 |
| For custom-molded foot orthoses and/or partial foot prostheses, obtain a negative foot impression using appropriate casting or computer-assisted technology to facilitate fabrication of the device. | 3.4 | 3.7 |
| For custom shoes, obtain a negative model of the patient’s foot using appropriate casting or computer-assisted technology to facilitate fabrication. | 2.4 | 3.5 |
| Document specifications/instructions for fabrication of device. | 3.3 | 3.6 |
| Prepare and modify patient model/image for fabrication. | 2.8 | 3.5 |
| Fabricate foot orthoses using assessment data to implement the pedorthic treatment plan | 2.6 | 3.4 |
| Fabricate partial foot prostheses using assessment data to implement the pedorthic treatment plan. | 3.4 | 3.6 |
| Fabricate custom-molded shoes using assessment data to implement the pedorthic treatment plan. | 3.4 | 3.6 |
| Assess device prior to patient fitting/delivery for structural safety and ensure that manufacturers’ guidelines have been followed. | 3.2 | 3.5 |
| Ensure that design was followed and materials and components are provided as specified in the treatment plan. | 3.5 | 3.6 |
| Conduct trial fittings of a pedorthic device(s), making adjustments as needed, to ensure proper fit and function of device(s). | 3.7 | 3.8 |
| Provide the patient and/or caregiver with oral and written instructions on the proper use and care of pedorthic device(s). | 2.7 | 3.1 |
| Document treatment using established record-keeping techniques to verify implementation of treatment plan. | 3.6 | 3.7 |
| Refer patient and/or caregiver to other appropriate healthcare providers as needed. | 2.4 | 3.1 |
| Domain 4 – Follow-up to the Treatment Plan | ||
| Obtain feedback from patient and/or caregiver to evaluate outcome (for example, proper usage and function, wear schedule/tolerance, ability to don and doff, comfort, perceived benefits, perceived detriments, overall patient satisfaction). | 3.3 | 3.6 |
| Assess and document patient’s function, outcomes of pedorthic device(s) and achievement of treatment goals. | 3.3 | 3.6 |
| Assess patient’s skin condition (for example, integrity, sensation, color, temperature and volume) and document any changes. | 3.2 | 3.6 |
| Assess fit of pedorthic device(s) with regard to anatomical relationships (for example, trimlines, strategic contact, static/ dynamic assessment) to determine need for changes relative to initial treatment goals. | 3.4 | 3.7 |
| Make or supervise modifications to pedorthic device(s) (for example, relieve pressure, change alignment and/or components) and inform patient and/or caregiver of modifications. | 3.3 | 3.8 |
| Evaluate results of modifications and assess modified device(s) for structural integrity. | 3.3 | 3.7 |
| Reassess patient’s and/or caregiver’s knowledge of goals and objectives to ensure proper use of pedorthic device(s) relative to modifications. | 3.2 | 3.5 |
| Document all findings and pedorthic interventions and communicate, as necessary, with physicians, referral sources and other healthcare providers to ensure patient status is updated. | 3.2 | 3.6 |
| Develop a long-term follow-up plan. | 2.9 | 3.4 |
| Domain 5 – Practice Management | ||
| Comply with standard precaution procedures, occupational safety and health rules and disability accommodation guidelines to protect patients and employees. | 3.5 | 3.7 |
| Plan, implement, evaluate, document policies and procedures in compliance with all applicable federal and state laws and regulations and professional and ethical guidelines (for example, CMS, HIPPA, FDA, ADA, OSHA, ABC Code of Professional Responsibility). | 3.2 | 3.6 |
| Develop, document and implement personnel policies and procedures (for example, benefits, training, staff recognition, regular performance evaluations). | 2.7 | 3.2 |
| Maintain adequate inventory, equipment and supplies to provide pedorthic services in a professional and timely manner. | 3.4 | 3.6 |
| Develop, document and implement a quality assurance plan in order to identify and address deficiencies in current operations and improve overall pedorthic care by reviewing outcomes and addressing complaints from patients, payment sources and/or referral. | 2.8 | 3.3 |
| Develop, document and implement procedures for patient care that comply with current medical and legal requirements. | 3.1 | 3.5 |
| Develop and implement procedures for comprehensive documentation of patient care. | 3.1 | 3.5 |
| Operate the pedorthic practice in accordance with sound business principles and governmental requirements. | 3.7 | 3.8 |
| Domain 6 – Promotion of Competency and Enhancement of Professional Practice | ||
| Participate in continuing education. | ||
| Provide education for pedorthic practitioners and other health care providers (for example, podiatrists, physical therapists and orthopedists). | 3.6 | 3.8 |
| Participate in education of pedorthic interns, students and trainees. | 3.6 | 3.7 |
| Conduct and participate in evidence-based practice, clinical trials, outcome studies, product development and research. | 2.4 | 3.1 |
| Participate in/with consumer organizations and nongovernmental organizations to promote competency, enhancement and awareness of the pedorthic profession. | 3.4 | 3.7 |
| Promote a collaborative working relationship with other health care providers to enhance their understanding of the pedorthic scope of practice. | 2.4 | 3.5 |
| Document specifications/instructions for fabrication of device. | 3.3 | 3.6 |
| Participate in the development, implementation and monitoring of public policy regarding pedorthics (for example, provide testimony/ information to legislative/regulatory bodies, serve on professional committees and regulatory agencies). | 2.8 | 3.5 |
Frequency: 1=Never/rarely, 2=Occasionally, 3=Frequently, 4=Very frequently
Criticality: 1=Not, 2=Minimally, 3=Moderately, 4=Highly
In summary, the overall pattern of the Frequency and Criticality ratings on these task statements indicates that the practice analysis delineation included critical tasks performed by pedorthists. The pattern of Frequency and Criticality ratings validates the use of these tasks in initiatives related to item writing and examination development.
Tasks in the Promotion of Competency and Enhancement of Professional Practice were reviewed using slightly different criteria. The tasks in this domain are generally performed only after certification is awarded and the pedorthist is in practice. Therefore, while the tasks in this domain are included as part of the overall profile of pedorthic practice, all of the tasks and the domain itself was excluded from the entry-to-practice test blueprint.
