Sustaining health professional education programs: a thematic analysis for the orthotic and prosthetic profession

Sustaining health professional education (HPE) programs to meet workforce needs is an ongoing challenge. Evolving healthcare practices, societal influences, and emerging technologies create new challenges for HPE programs. Therefore, this study aimed to 1) identify and describe factors that affect orthotic-prosthetics (O&P) HPE sustainability within the United States and 2) recommend factors to monitor for sustainability and prioritize for sustainment efforts.

An online survey was developed using an adapted grounded theoretical approach and administered to a purposive sample to capture insights from O&P professionals across the United States. Open-ended responses were analyzed using line-by-line analysis. The original research question and data-generated themes were continually revisited during analyses to elucidate clear connections between the "strengths" and "challenges" of sustaining O&P HPE programs. Next, data were sorted into two a priori-identified groups based on the participant's primary occupational setting: "academic" and "practice." Finally, the authors used an inductive approach to identify themes that revealed strengths and challenges. Themes were then categorized by their relationship to O&P HPE or the O&P profession.

Fifty participants completed the survey - twenty-four from O&P practice and twenty-six from education settings. Strengths included Outcomes, Curriculum Content, Program Model, Delivery Methods and Student Attributes. Challenges included the Costs to Implement Programs, Setting, Academic Personnel, External/ Internal Support, Accreditation, Cost for Students, Awareness of the Profession, Value of Education/ Certification, Workforce, Credentialing Model, Resistance to Change, and Business and Policy Issues of the Profession. Strengths and challenges were separated into two categories: education-related and profession-related. Participants from both academic and practice settings reported more challenges to sustainability than strengths in both categories. Overall, the most frequently noted strength was educational outcomes while the most frequently noted challenge was the cost to implement programs - both in the education-related area. Within the profession-related category, the most frequently noted challenge expressed by respondents from academic and practice settings was awareness of the profession.

Sustainability is an ongoing process. Accreditation and credentialing organizations could use the factors identified in this paper as determinants to track sustainability and focus sustainment efforts.