Entrustment trends in orthotic and prosthetic residencies
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.