Case Studies and Testimonials of OETT Support : Wednesday, 13 December 2017

Case Studies and Testimonials of OETT Support

1. Lucy Best, Orthotist

Expert Witness Intermediate Report Writing Course (1 day)
25th February 2014

I was approached by a solicitor and asked if I would write an expert witness report for one of their clients who had a drop foot and leg length discrepancy following a surgical procedure. I had never done one before and after talking to 2 colleagues who regularly write expert witness reports, I realised there was much more to it than just writing an assessment report. I bought some books on writing medico-legal reports and scanned the internet for information. I read that the large majority of medical expert reports in civil claims is inadequate and fails to serve its proper purpose. I didn’t want my report to fall into this camp. I hence enrolled on the report writing course.

The course was arranged by the Expert Witness Institute and taught by Lynden Alexander who is a communication skills consultant, specialising in forensic communication and has trained over 5000 expert witnesses. The course content was very full with lots of examples of good and bad reports. We were given templates for our area of expertise (the other participants were from all sorts of professions, not only medical). We learnt how the particular use of words is vital in legal cases e.g.” in my opinion…” is good, “I think…” is bad; we learnt which declaration and statement of truth needs to be included in the report and where to find up to date protocols from the Civil Justice Council. Very important is that the expert witness has a Duty to the Court and not to the instructing solicitor.

Having started with no clue on legal matters, the course gave me confidence and information on writing medico-legal reports. I have now completed 1 expert witness report and 2 advisory reports (which are less detailed than the expert witness reports) and have had good feedback from the instructing solicitors.

Many thanks to the OETT for providing the funding to allow me to learn this skill.


2. Kim Gadsdon, Prosthetist/Orthotist

Neuro-orthotics Study Day - 9 November 2013
With an audience consisting mainly of physiotherapists with facilitators from both orthotics (Paul Charlton & Duncan Marchbanks) and neurophysiotherapy (Richard Sealey) this was a great opportunity for a day's learning, debate and discussion; theoretical and practical in the arena of Neuro-orthotics.

The ever important refresher on "biomechanics and gait in the states of recovery following neurological insult" was enthusiastically presented to focus us on the topic of the day with mention of difference specialists techniques. This was followed by principles of interventions with input from all.

A quick overview of SWIFT casting - more on its way for those that will be attending the Stroke Conference - highlighting its economic benefits and quick turnaround sounded promising in this presentation.

Paul Charlton's self designed Hemi' test was included in the "Practical assessment and outcome measures" presentation, along with suggestions and examples of a clinical assessment record for MDT documentation.

"Therapeutic clinical reasoning for orthotic management in neurorehabilitation" provoked debate on protocols for resting splints and the value of any muscle recruitment versus none.

The importance of communicating closely with other professions as an MDT approach was highlighted as resulting in a more rounded input giving better results, this included examples and suggestions for documentation.

The final part of the day included two patients divided between the attendees and the opportunity for questions and discussions. All in all a very worthwhile day at a reasonable cost.


3. Pamela McGeachan, Junior Orthotist, Nottingham University Hospitals

I first applied for OETT funding when my free paper abstract was accepted to be presented at the ISPO 14th World Congress in Hyderbad, India.

Having just graduated, the support OETT offered me to participate in the Congress was exceptional and eased the financial aspect of attending such a worthwhile event.

For me, attending and presenting at the Congress was an achievement which has given me a whole new sense of enthusiasm towards my profession. There was a whole range of topics, information and new innovations and I definitely feel I came home more enlightened.

Knowing that OETT support exists, I feel encouraged in furthering my knowledge base and skills.

Thank you OETT.

4. Paul Charlton - Senior Orthotist, Peacocks Medical Group, Newcastle-Upon-Tyne

Hyderabad India - 4-7th February 2013

The benefits of this fantastic opportunity fell into three categories, academic presentations, exhibition and networking. The congress was well attended by a delegation from around the world providing the opportunity to share and understand the orthotic challenges and solutions of different cultures, this has considerable relevance to our work in the UK as our multi-cultural society expects us to take into consideration he needs and expectations of those different cultures.

Academic programme:
This offered a considerable array from which to choose with a broad programme of free papers and keynote speakers of international acclaim. This served to both increase my clinical knowledge but also learned of new research to support and reinforce my current practice. I also took the opportunity to debate and explore options and theories with several of the speakers. there were several key topics through programme; Osteo arthritis of the knee and the use of AFOs in hemi/diplegia

Exhibition:
This was very interesting having the usual global exhibitors along with some of the more local companies. I took the opportunity to explore new devices and componentry with some new designs on stance contract KAFOs and some interesting developments on 3d scanning and manufacturing options.

Networking:
It was fantastic to be able to renew acquaintances with people from all over the world. Many share similar challenges to those in the UK in the politics and challenges of delivery healthcare via large organisations. I believe I have secured over sea speakers for BAPO and ISPO who will share research and stimulate the UK orthotic world in the coming year.

I would like to take the opportunity to thank OETT and Peacocks Medical Group for the opportunity of attending this fantastic and stimulating event.

5. Rhia Kakaiya - ISPO World Congress 2013

I attended the ISPO World Congress 2013 conference in Hyderabad, India to present a literature review on the orthotic management of deformational plagiocephaly. As a recent graduate from the University of Strathclyde, this was the first World Congress conference that I attended and to have this opportunity to present at it was fantastic. I am very grateful to OETT who agreed to fund a considerable amount towards the experience, alongside the company I work for.

The review was carried out as part of my undergraduate degree and I was whole-heartedly supported by my two supervisors. I presented my paper in a paediatric free paper session and was the only presentation regarding head shape deformities in these sessions. My presentation was very well received and as expected it generated some discussion regarding the controversial treatment protocols for head shape deformities in infants. It was interesting to be able to hear about the treatment methods on an international scale, as I was able to further discuss my findings with other Orthotists who practice cranial remoulding as part of their clinics. Although I do not practice cranial remoulding in my clinics at the moment, I feel that I have knowledge to discuss the topic with clinicians who do because of the in depth research I carried out for my literature review.

The controversy regarding deformational plagiocephaly comes from the belief that it is a purely cosmetic condition. This means that in the UK families must fund their own treatment which can be fairly costly. My literature aimed to look at the efficacy of the methods of shape capture of the infant's skull, as well as finding out the best and most effective mode of treatment remould the skull.

By attending the conference I have been able to further my learning by taking part in instructional courses, for example on OA knee bracing as well as symposiums of which the most interesting and appealing to myself were the presentations regarding new advances in design of orthopaedic footwear and the treatment of the diabetic foot. The two large exhibition halls were a great opportunity to meet fellow clinicians and find out about new products which are available.

Since return from the conference I feel my skills as a clinician have grown and I have the confidence to present another exciting project the opportunity next arises.

6. OETT Keynote Speaker BAPO Conference & Exhibition 2013

Our OETT keynote speaker for BAPO 2013 was Professor William Jeffcoate who presented on "Diabetes - the ticking bomb" to a standing room only audience of predominately Orthotists as well as other AHP's, Prosthetists, technicians and therapist colleagues Professor Jeffcoate, a consultant endocrinologist whose passion is the creation of evidence to underpin clinical practice, presented on the management of the Charcot foot; this has been the major interest and subject of four major foot ulcer trials. The trials were undertaken by his specialised service for the management of the foot in diabetes that has produced over 80 peer reviewed publications. Presently he is chair/co-chair of systematic review working parties for the international Working Group on the Diabetic Foot on infection and on treatment to improve healing. In 2010-12 he has been lead of the working party to develop an audit tool for foot care in routine clinical practice.

His presentation was a resounding success with a balance of education and entertainment from one of the UK's most eminent speakers on Diabetes that encompassed OETT principles to advance orthotic education.

7. Stephanie Conover - Allard Boston Course June 2013

As a current user of the Boston brace system I was excited to attend this course as on occasion I felt out of my depth. I had previously been trained 6+ years ago then had little exposure to patients. Though I understood the principals of the system, the gap between training and practice lead me to forgetting some of the intricacies.

Although the course was pitched in a manner that an absolute beginner could follow and learn there was plenty of information for those of us who were there for refreshers. The course was modern and relevant. A physio told us how she is doing a Pilates class for scoli patients. Her clients are varied ages and all feel there are benefits they feel comfortable in the class as they all suffer the same deformity. She tailors the routine after assessing individually so each client benefits the greatest. Thinking about our patients out of brace and post bracing is something we should be doing. In fact a girl just about to wean out of her brace asked me for advice on any exercise she could do so I was able to direct her to Pilates. She was thrilled at receiving something other than just a brace from me that will help her.

The second day was practical after the day of theory on the first day. Two patients attended and we all had a module which we were to map and trim after reading the x-rays and measuring the patients. Getting hands on on a course like this is essential and all tools and equipment were provided. Speakers were experienced and forthcoming with their knowledge.

Overall I cam away with a greater understanding of how to treat my patients and a new confidence which was instantly helpful with my next weeks clinic where I saw three new cases.

8. Ian Berryman - HNC

I have found the HNC course enlightening and useful in my work, in particular the units covering communication methods, data storage and dissemination. I have learnt the importance of and how to apply stakeholder analysis. This has enabled me to fully understand the differing requirements of each stakeholder involved in my area of work. The organisational behaviour unit has helped me understand the concept of leadership, the relevance of organisational culture and how to apply managerial and motivational theory. I have also learnt approaches to business strategy and how create and implement strategy. The unit titled PPD explored learning approaches and strategies to promote and encourage life long learning, which I have applied, not only to myself but also to some of my staff to help them meet their HCPC commitments, as well as considering their personal goals. The assignments throughout the course have helped me explore both my own organisation and the industry I work in, giving me a better understanding, ability and confidence in my current role.

9. Jonathan Tebbut, MSc

I wish to offer my sincere thanks to BAPO and OETT for the funding and support I received to help me throughout several years of studying at MSc level. I have recently successfully completed my MSc in Clinical Biomechanics at Staffordshire University. Again, thank you for the continued help and support I have received. Without this help and support I would not have achieved so much.




10. Andrew Dodds, Clinical Lead Orthotist, Nuffield Orthopaedic Centre, Oxford

I have recently completed an MSc in Applied Biomechanics from the University of Strathclyde. This would not have been possible without the generosity of the OETT in funding all of the course fees. I applied well in advance of the start of the course and my application outlined the content of the course and how this would benefit my clinical practice and ultimately my patients. I also outlined how I would be able to put this new knowledge into practice and share it with other orthotists, I was awarded 67% funding.

Postgraduate study can be a daunting prospect, by choosing an area of interest where I thought there was a gap in knowledge made this an enjoyable and rewarding experience. I was pleasantly surprised by the number and willingness of people to help me along the way. I am very grateful that the OETT are available as a source of funding for such courses that can be very rewarding. If you feel that there is a better way of making orthoses, delivering your service or gaining new knowledge then I would strongly encourage you to give it a go, it might take time and hard work but I can assure you will be very rewarding.

11. OETT Technician Training Day BAPO Conference & Exhibition 2013

The 2013 OETT sponsored BAPO Conference parallel Technician training programme was exceedingly well supported and a resounding success.
Contributions were received from eminent presenters e.g. Dr Stephen Hutchins, Andy Dewsbury and Marsh Gibson as well as some new contributors namely; Blake Jackson, Rob Bradbury Mark Corrigan and Lee Willan.

Presentations covered future technician training, new materials and manufacturing techniques as well as updates of more established orthoses for the newer generation present. All this was shared in an open and generous dialogue which enabled all attendees to learn, contribute and greatly enjoy this event.


12. Nick Gallogly (Orthotist - Royal Berkshire Foundation Trust, Reading)

I am currently undertaking a Masters in Clinical Biomechanics at Staffordshire University. The decision to undertake this was not an easy one both from a financial and time point of view.

I put forward my application for funding help to the OETT board and received the full allocation. Working a full time job within the NHS and studying for an MSc is no easy task but the personal and professional rewards out-weight the long nights and weekends sat in front of the computer.

As I trawl through all the research in my travels, one element becomes very apparent, the lack of Orthotists doing research and adding to our practice. I do believe that this is a trend that will change, it has to if we, as Orthotists are going to be seen as influential members in the management of conditions and not facilitators in order for the other professionals to get what they want.

I hear in the back of my head people saying to me “what are you studying for, I still see Orthotists that can’t do footwear correctly”. The simple truth is that if we don’t, we will, if we are not already, be left behind.

So I encourage you all to pick up a new piece of research today, analyse it, and use it as a method to prove or disprove treatments. Look at others ways for you to expand your knowledge base and moved up the clinical ladder. One thing you can be sure of is that the OETT will be there, ready and waiting for your application to help in any way they can.

My aim is to add to my profession, for a fellow professional to read my research (the title changes from week to week) and use or not use it in their treatment regimes. At the very least it should spark conversation and discussions.

I would not be doing this MSc if I didn’t have the backing from the OETT, the costs are too great. I cannot thank the Board enough for their help


13. Jim Ashworth-Beaumont - OETT helps make dreams come true !

Since graduation in 2000 I had retained my focus and primary interest on nurturing team approaches in community and acute teams, as the gold standard to providing rehabilitation from neurological injury. I have been privileged to work alongside expert Orthotist, AHP and medical colleagues at the Royal National Orthopaedic Hospital NHS Trust where we aim to provide the highest standards of integrated rehabilitative care for spinal cord injury survivors who encompass the widest possible spectrum of abilities and goals.
I had long pondered the fundamental factors underlying motor learning - the lasting (or plastic) changes in behaviour and underlying neurophysiology which underpin therapy – the lasting skills improvements and adaptive short-term variations which allow us to meet goals in a dynamic environment. In the spring of 2007 I sent a proposal to OETT, setting out the aims and objectives which would be satisfied by undertaking an MSc in Neurorehabilitation at Brunel University. This course is aimed at specialist AHPs and medical professionals who seek a deeper understanding of the field and are considering embarking on neurorehab-focused research or evidence-based service delivery as part of their future career.

My NHS Trust supported me superbly in both spirit and study leave, but OETT was most generous in supporting me through this 2 year part-time taught course with 2/3 of the course funding. So I graduated in 2009, having met my personal learning objectives and having been exposed to a mind-boggling range of quantitative and qualitative themes along the way! My dissertation focused on the effect of non-invasive brain stimulation twinned with voluntary activity and FES on brain plasticity (cortical stimulation having the potential as a novel class of orthotic device to boost brain performance and skills learning), which earned me a Distinction.
I’m now embarked on a full-time PhD in Health Studies looking at brain plasticity and motor learning, and the effect of brain stimulation to enhance rehabilitation from tetraplegia following spinal cord injury. Though I was lucky to have been awarded a PhD Research Scholarship from Brunel, and continue working part-time at the RNOH, without the continuing help from OETT in the form of a 50% grant for travel expenses I simply would not be able to continue my career journey.


14. Paul Charlton - Senior Orthotist, Peacocks Medical Group, Newcastle-Upon-Tyne

The two challenges to learning and professional development of an individual are time and resources. I have been most fortunate in that the time offered by my employer has been complimented by financial support from OETT.

This has developed my orthotic knowledge and understanding by allowing me to attend short courses in several areas including functional foot orthoses and diabetes.

My special interest in adult neurology has been enhanced by learning the associated skill of application of functional electrical stimulation at the approved course at Salisbury. My breadth of knowledge and understanding was further broadened by attending a physiotherapy “Bobath” course on posture and balance.

My interest in gait anomalies and links with ORLAU and our local gait laboratory in Newcastle where enhanced by completing the Strathclyde University Postgraduate certificate in clinical gait analysis.

More recently I have been involved in both my London orthotic interest group and the ISPO consensus conference on orthotic management of stroke. Both of these involvements made me aware of the importance of supporting our work with good quality research and evidence. To this end I was fortunate to be funded to extend my Post Graduate certificate to a Master of Science degree. This both gave me an understanding of research quality and how to perform it well and to carry out a piece of in depth research.

My research embodied my learning of clinical gait analysis and stroke as I investigated the effect of rigid AFOs on knee alignment and muscle recruitment in the early recovery of stroke. This was considered to large a project for a MSc and consequently I co-opted a fellow student to carry out the muscle recruitment study. We hope to publish our findings in a peer reviewed journal later in 2006.

I am delighted to have this opportunity to thank the OETT for the support in my career development and would encourage all orthotists and their employers to take advantage of this superb support and opportunities offered.



15.

Whilst I was the BAPO short course co-ordinator, I made contact with the Trustees to look for ways of integrating the aims of the Association and OETT to develop postgraduate training of orthotists. I was invited to become a Trustee in 2001 and with the other Trustees have looked for new ways to progress professional development now advertised on this website. I encourage any orthotists with an interest in formal postgraduate study to apply for help from the OETT and to realise your educational ambitions.

My tips for making a successful application are to be well organised and particularly:

1) Apply well in advance of when you want to start, and to demonstrate initiative and enthusiasm in your application.
2) Provide as much information about what you wish to do as you can, include any relevant course promotional material and website addresses.
3) Make a coherent case for why this educational opportunity will help you to further your career in orthotics.
4) Think through and detail clearly all the costs involved.
5) Think of alternative sources of funding, such as your employer, and mention in your application what contribution they are willing to provide.
6) If you need more than the 50% of funding that the OETT usually provides then make a persuasive case.

Remember: the Trustees want to help you but they are duty-bound to only authorise funding for appropriate cases; therefore make your application as clear as possible and you will have more chance of success.


16. Chris Morris - Principal Orthotist, Nuffield Orthopaedic Centre NHS Trust, Oxford

I have benefited considerably from the OETT throughout my career as an orthotist. Firstly the Trust helped to establish the diploma course from which I graduated from in 1988. Since then my postgraduate training and development has also been supported by the Trust.
The costs of attending BAPO and other short courses over the years have been generously reimbursed retrospectively for tuition fees, travel and where necessary accommodation. When I wished to study part time for a Masters degree I made an application to the OETT several months in advance. My application was approved and the funding enabled me to achieve an MSc in Evidence-based Health Care in 2000.

Having decided to study for a DPhil, I was in the process of applying to the OETT again when I was awarded a scholarship as part of a studentship from the University of Oxford. Although I was not in need of help for tuition fees in Oxford the Trust has enabled me to participate in health research methodology courses at the London School of Hygiene and Tropical Medicine and at McMaster University in Canada.

17. Jonathan Tebbutt (Orthotist, Trulife)

I have spent the last few years undertaking an Msc in Clinical Gait Analysis at the University of Stafford. With the help of OETT funding, it has eased the financial worry and helped me concentrate on the studies in hand. Whilst working in a challenging and demanding role within a busy Orthotic team here in South Wales.
So far I have completed several modules in sports biomechanics, origins and principles of injury, tissue stress, musculoskeletal diagnosis and applied diagnostic imaging to name a few. This has helped me grow in my clinical and professional practice and helped me think outside the box when presented with complex patients. Deepening my understanding of certain mechanisms of injury has made problem solving easier within clinic. It has also helped me grow in confidence as a clinician and to question practices and theories in a healthy and inquisitive way to establish whether evidence is sound or not.
I will now endeavour to complete the final dissertation year of my Msc, although not an easy undertaking, it has been extremely worthwhile expanding my clinical understanding and development.

18. Sarah Wilson (Prosthetist/ Orthotist - Addenbrookes Hospital Cambridge)

I am currently involved in the diabetic foot clinic where I work and see many diabetic patients in my prosthetic clinics. I wanted to further develop my knowledge in this area so that I could improve the service I provide. I decided to undertake a MSc Diabetes as a distance learning course. My Company allow me study leave to attend the week blocks and the OETT contribute to the funding of my modules. I have now completed the first of my three years and already I have broadened my knowledge of diabetes. Studying with people involved in various aspects of diabetes care from all over the world allows me to gain from their experience but also pass on information about our profession. I have found myself reflecting on my own practice and been able to get involved in the development of the clinic using the information I have gained. I am also able to pass on my knowledge to the students and colleagues in my department by presenting some of my papers written throughout the year. I look forward to next year when I will be looking into management of the diabetic clinics and preparing to do my own research.


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