MS Degree Research Faces Challenges
October 2005 Issue
The new masters programs in O&P create both an opportunity and a challenge. The opportunity lies in the requirement that students in the programs must undertake and complete a research thesis in order to graduate. At last, there is an opportunity for conducting research on O&P!
However, before we jump to the conclusion that the masters programs automatically will enable the profession to move to higher levels of knowledge and competence, we should examine some challenges, which lie in the research requirement:
- Is there a mechanism in place to define the research problems of greatest relevance to clinical practice?
- What research methods and tools are most appropriate?
- Will students be prepared adequately through classroom experiences to apply these methods and tools?
Defining What's Needed
With respect to the first question, there currently is no mechanism within the profession to develop statements of research needs. The Department of Veterans Affairs (VA) attempts to define needs, but the VA is a closed shop. One has to be a VA employee to direct VA-funded research, and administrative decision-makers, not necessarily clinicians, set priorities. Other federal agencies such as the Department of Education and the National Institutes of Health (NIH) have competitive funding programs, but do not themselves generate statements of O&P research needs. Reviewers of proposals submitted to these entities who have clinical experience in O&P are rare. Students in the new masters programs (as well as researchers seeking federal grants, who might be faculty in the programs) could benefit from the development of a set of good research problem statements.
Appropriate Methods, Tools
The second issue, concerning appropriate research methods and tools, has been largely overlooked. O&P research faces unique problems that have yet to be fully appreciated by those who have or plan to undertake studies. Major barriers to the development of conclusive studies that utilize the types of traditional experimental methods that medicine labels as "gold standards" are 1) it is difficult in O&P to recruit a sufficient number of subjects to facilitate general conclusions, and 2) it is difficult to control for a myriad of confounding variables such as age, pathology, and type of components. The variability inherent in human movement and physiologic response seems to become magnified when examining O&P outcomes. Statistical tools such as bootstrapping and small-group and single-subject methods have been developed recently that might help to address these problems. What is found eventually to be appropriate and feasible for O&P clinical research may look very different from traditional experimental methods that require very large sample sizes. There is a critical need to identify research methods appropriate to the constraints of the O&P environment.
Both the first and second issues impact the third issue, curriculum design. To conduct research that has value in the clinic, students need to be provided both the proper research tools and a sense of research needs in specific areas. A masters program should not simply replace a bachelors program, but should surpass it in many ways, most notably in research competencies. To accomplish this, it may be necessary to upgrade curriculum requirements for quantitative skills, among others. For the graduates of the programs, the enhanced analytic skills will form the basis for the development of improved pattern recognition skills, which will evolve during clinical experience subsequent to graduation.
The graduate from an ideal masters program should be at least as competent to understand and direct O&P research as the physical therapists, physicians, and engineers who have been the lead authors on a large number of O&P research articles published during the last 20 years. If the profession can attain this level of expertise via masters-level programs, its long-term survival may no longer be questioned. I have identified some major challenges that must be overcome to reach this new plateau, but the rewards will be worth the effort.
Edward S. Neumann, PhD, PE, CP, is professor of civil and environmental engineering at the University of Nevada, Las Vegas; director of the Center for Disability and Applied Biomechanics; and adjunct professor of biomedical engineering as well as kinesiology. He has developed and taught courses in orthopedic biomechanics, human motion analysis, prosthetic systems engineering, assistive technology, and ergonomics.