Exploring core concepts and principles underpinning prosthetic and orthotic practice - a qualitative study involving...

Concept-based curricula are increasingly being adopted in medical and allied health education, supporting students to organise their knowledge and transfer their learning to unfamiliar situations. The approach is grounded in the professional reasoning and practice underlying specific disciplines and requires detailed knowledge of the core concepts and principles relevant to professional practice. This study focused on the allied health discipline of prosthetics and orthotics and aimed to identify core concepts and principles applied by Swedish-certified prosthetists/orthotists during routine clinical consultations.

Ten Prosthetists/orthotists with a minimum of 10 years experience were fitted with a chest-mounted video camera which recorded them during routine client consultations. Video recordings were subsequently used in stimulated recall interviews, during which participants watched the footage and were prompted to reflect on, and articulate, thoughts, decision-making processes and feelings experienced at the time of the consultation. Interview transcripts were transcribed verbatim and analysed using inductive thematic analysis to identify core concepts and underpinning principles used by clinicians.

Eleven core concepts were identified and organised under four overarching themes: (1) clinical relationships and systems, (2) clinical evaluation, (3) biomechanics and human movement, and (4) device design, materials, and context. Each core concept was underpinned by between two and eight core principles that explained how clinical reasoning and actions were enacted in practice.

The core concepts and principles identified in this study provide an exploratory practice-informed foundation for the continued development of a comprehensive conceptual framework for the prosthetic and orthotic profession. Findings have the potential to inform concept-based curriculum design, teaching strategies, and assessment approaches, supporting the alignment of educational programs with authentic clinical practice.