Extremity Trauma and Amputation Center of Excellence, Research Support Division, Defense Health Agency, Falls Church, VA 22042, USA.
Extremity Trauma and Amputation Center of Excellence, Research Support Division, Defense Health Agency, San Antonio, TX 78205, USA.
Mil Med. 2024 Jan 23;189(1-2):e176-e181. doi: 10.1093/milmed/usad231.
Over the past 20 years, military medicine made great strides in the medical management of traumatically injured patients. Significant advancements were made in the treatment and rehabilitation after limb loss. These advancements can be attributed to the large number of complex patients presenting to military treatment facilities and the demand for medical professionals to provide care to patients with complex injuries and multiple traumatic amputations. The concern now is to maintain the skills needed to be prepared for the next conflict. To meet this demand, the Extremity Trauma and Amputation Center of Excellence (EACE) initiated the documentation of knowledge, skills, and abilities (KSAs) to ensure that the skill sets needed to treat this unique population are not lost. The EACE developed KSAs to sustain advanced clinical practice for physical therapists, occupational therapists, and prosthetists and is in the process of developing KSAs for orthotists and physical medicine physicians. The learning objectives [terminal and enabling learning objectives (TLOs and ELOs)] derived from each set of KSAs will drive curricula development for enduring education, residencies, and fellowships. This article describes the KSAs and learning objectives for advanced physical therapist competencies in amputation care.
Clinical subject matter experts (SMEs) convened from the Department of Defense (DoD) Advanced Rehabilitation Centers (ARCs) to draft the initial KSAs. All experts had specific expertise in treating individuals with highly complex lower and upper limb amputation. In a quasi-Delphi methodology, the initial draft KSAs underwent five cycles of review and comment by an additional 15 DoD, Veterans Affairs, and civilian institution experts from clinical practice, education, and research. The consensus KSAs were then transcribed into learning objectives with collaboration between clinical subject matter experts and doctoral-level educators.
The final program document has 21 instructional modules with 30 TLOs and 157 ELOs.
The KSAs and the learning objectives describe the skills expected of an advanced practice physical therapist treating patients with traumatic limb loss. Weaknesses of this document include the focus on traumatic amputation and military specific needs. However, many of the central advanced practices are universal to all physical therapists working in amputation. Thus, this document should serve as a starting point and can evolve to include dysvascular, oncology, and other etiologies. To our knowledge, this is the first paper to describe the KSAs for the advanced practice physical therapist working with traumatic limb loss population. This work will form the framework for physical therapist advanced practice training programs.
在过去的 20 年里，军队医学在创伤患者的医疗管理方面取得了重大进展。在截肢后的治疗和康复方面取得了重大进展。这些进展可以归因于大量复杂的患者到军队医疗机构就诊，以及医疗专业人员为治疗复杂损伤和多发性创伤性截肢的患者提供护理的需求。现在的问题是保持为下一次冲突做好准备所需的技能。为了满足这一需求，卓越肢体创伤和截肢中心 (EACE) 启动了知识、技能和能力 (KSA) 的记录工作，以确保不会失去治疗这一独特人群所需的技能。EACE 制定了 KSA，以维持物理治疗师、职业治疗师和假肢矫形师的高级临床实践，并正在为矫形师和物理医学医师制定 KSA。从每套 KSA 中得出的学习目标[终端和使能学习目标 (TLO 和 ELO)]将推动持久教育、住院医师和研究员的课程开发。本文介绍了高级物理治疗师截肢护理能力的 KSA 和学习目标。
来自国防部 (DoD) 高级康复中心 (ARC) 的临床主题专家 (SME) 召集起来起草最初的 KSA。所有专家都在治疗下肢和上肢高度复杂截肢的个体方面具有特定的专业知识。在准德尔菲方法中，最初的 KSA 草案经过五轮由来自临床实践、教育和研究的另外 15 名国防部、退伍军人事务部和民用机构专家的审查和评论。然后，临床主题专家与博士级教育者合作，将共识 KSA 转录为学习目标。
最终的项目文件有 21 个教学模块，30 个 TLO 和 157 个 ELO。
KSA 和学习目标描述了治疗创伤性肢体丧失患者的高级实践物理治疗师所期望的技能。本文件的不足之处包括对创伤性截肢和军队特定需求的关注。然而，许多中心高级实践对所有从事截肢工作的物理治疗师都是通用的。因此，本文件应作为起点，并可发展为包括血管疾病、肿瘤学和其他病因。据我们所知，这是第一篇描述创伤性肢体丧失患者工作的高级实践物理治疗师的 KSA 的论文。这项工作将为物理治疗师的高级实践培训计划奠定框架。
